Cognitive and Motor Dual Task on Multi-area Brain Activation and Gait Performance in Individuals with Parkinson’s Disease

Background: In people with Parkinson’s disease (PD), gait performance deteriorating during dual task walking compared to single-task walking has been noted in previous studies. However, the effects of different types of dual task on gait performance and brain activation were still unknown. Methods: This study investigated the walking performance changes and multi-area brain activities during cognitive and motor dual task walking in people with PD. Twenty-eight participants with PD were recruited and performed single walking (SW), walking while performing a cognitive task (WCT), and walking while performing a motor task (WMT) at their self-selected speed. Gait performance including walking speed, cadence, stride length, stride time, swing cycle, temporal and spatial variability and dual task cost (DTC) were recorded. Brain activation of the prefrontal cortex (PFC), premotor cortex (PMC), and supplementary motor areas (SMA) were measured by functional near-infrared spectroscopy during walking. Results: Results showed the walking performance deteriorated upon performing a secondary task, especially the cognitive task. Also, a higher and sustained activation in PMC and SMA during WCT as compared with WMT and SW in the late phase of walking was found. Moreover, gait performance was negatively correlated with PMC and SMA activity during different walking tasks. Conclusions: Individuals with PD demonstrated gait deterioration during dual task walking, especially WCT. The SMA and PMC were further activated in people with PD when performing cognitive dual task walking. Trial registration TCTR20190118010. Registered 18 January 2019, retrospectively registered.