the learning effects of attentional strategy on dual-task walking in patients with parkinson's disease: behavioral performance and neural plasticity

Conditions: Parkinson Disease

Summary: \[year1\] 1. to compare the effects of dual-task training with two different task priority instruction in people with parkinson's disease and healthy controls on dual-task weight shifting performances. 2. investigate the changes of brain activities and functional connectivity after dual-task training with different task priority instructions. \[year 2-3\] to investigate the learning effects of walking with internal/external focus on walking automaticity and brain plasticity in dual-task walking training for pd patients with/without freezing of gait.

postural-suprapostural task is defined as postural control takes place while another concurrent task is being performed, belonging to dual-task paradigms. effective dual-task training is important to patients with parkinson disease (pd), because they often lose balance and fall in dual-task conditions. attentional strategy includes 1) task-priority between postural and suprapostural tasks and 2) internal and external focus for the postural task, which is the critical factor for both dual-task control and motor learning. however, the appropriateness of attentional strategy has not been investigated in dual-task training in patients with pd. besides, there is lack of neural evidence of brain plasticity for previous studies about dual-task training in patients with pd. with the uses of eeg, emg and behavioral measures, the purpose of this 3-year research project is to investigate the differences in performance quality and intrinsic neural mechanisms of dual-task training in pd, by adopting task-priority strategy and internal/external strategy during weight-shifting and walking. in the first year, the investigators will characterize task-priority effect (posture-priority vs. supraposture-priority) on dual-task training, with a special focus on modulation of brain plasticity and muscle activity patterns in weight-shifting posture for patients with pd. in the second and third years, the learning effects of walking internal/external focus on walking automaticity and brain plasticity will be investigated in dual-task walking training for pd patients with/without freezing of gait. besides, the transfer effects of dual-task learning will be also investigated on medication "off" state. the present project is expected to have significant contributions not only to gain a better insight to neural correlates of dual-task training with different attentional strategies under weight-shifting and walking, but to optimize treatment strategy for pd patients with balance or dual-tasking disturbances.

Eligibility criteria:
\[year1\] inclusion criteria: 1. for people with parkinson's disease 1. modified hoehn \& yahr stage 2-3 2. without dementia and able to follow instructions 2. for healthy controls age and gender matched healthy subjects as control group exclusion criteria: 1. mmse \< 26 2. with other disease that may influence balance ability 3. with marked action and postural tremor \[year2-3\] inclusion criteria: 1. idiopathic parkinson's disease 2. modified hoehn \& yahr stage 2-3 3. without marked action or postural tremor exclusion criteria: 1. mmse \< 26 2. with other disease that may influence balance ability

Keywords: dual-task training attention parkinson's disease walking eeg