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Direct and indirect effects of attention and visual function on gait impairment in Parkinson's disease: influence of task and turning

Lookup NU author(s): Dr Sam Stuart, Dr Brook Galna, Dr Louise Delicato, Dr Susan Lord, Professor Lynn RochesterORCiD

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This is the authors' accepted manuscript of an article that has been published in its final definitive form by Wiley , 2017.

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Abstract

Gait impairment is a core feature of Parkinson's disease (PD) which has been linked to cognitive and visual deficits, but interactions between these features are poorly understood. Monitoring saccades allows investigation of real-time cognitive and visual processes and their impact on gait when walking. This study explored; 1) saccade frequency when walking under different attentional manipulations of turning and dual-task; and 2) direct and indirect relationships between saccades, gait impairment, vision and attention. Saccade frequency (number of fast eye-movements per-second) was measured during gait in 60 PD and 40 age-matched control participants using a mobile eye-tracker. Saccade frequency was significantly reduced in PD compared to controls during all conditions. However, saccade frequency increased with a turn and decreased under dual-task for both groups. Poorer attention directly related to saccade frequency, visual function and gait impairment in PD, but not controls. Saccade frequency did not directly relate to gait in PD, but did in controls. Instead, saccade frequency and visual function deficit indirectly impacted gait impairment in PD, which was underpinned by their relationship with attention. In conclusion, our results suggest a vital role for attention with direct and indirect influences on gait impairment in PD. Attention directly impacted saccade frequency, visual function and gait impairment in PD, with connotations for falls. It also underpinned indirect impact of visual and saccadic impairment on gait. Attention therefore represents a key therapeutic target that should be considered in future research.

Publication metadata

Author(s): Stuart S, Galna B, Delicato LS, Lord S, Rochester L

Publication type: Article

Publication status: Published

Journal: European Journal of Neuroscience

Year: 2017

Volume: 46

Issue: 1

Pages: 1703-1716

Print publication date: 01/07/2017

Online publication date: 26/04/2017

Acceptance date: 12/04/2017

Date deposited: 12/05/2017

ISSN (print): 0953-816X

ISSN (electronic): 1460-9568

Publisher: Wiley

URL: https://doi.org/10.1111/ejn.13589

DOI: 10.1111/ejn.13589

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