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11th World Congress for Neurorehabilitation , LYON, FRANCE, 07-/10/2020 - 10/10/2020; Question: Non-pharmacologic treatment such as physical exercise has been proven to have beneficial effects on gait disorders in Parkinson's disease (PD). In Lyon (France), Sirroco rehabilitation program is a novel, collective, multidisciplinary program focused on intensive, high amplitude movements, and loudness of speech for patients with PD. However, the effects of physical exercise on dorsolateral prefrontal cortex (DLPFC) activity in patients with PD is still elusive. The main aim of this pilot study was to assess the effects of the Sirocco program in patients with PD on DLPFC activity on single task (ST) and dual-task (DT) walking. Methods: Fourteen PD patients (mean: 66.9 y.o ± 8.1) completed Sirocco sessions for 5 weeks. Changes in oxyhemoglobin concentration (?HbO2) in the DLPFC were measured using functional Near Infrared Spectroscopy during three walking tasks conditions: (1) ST walking, (2) DT walking while counting forward and (3) DT walking while subtracting. Participants were assessed three times: five weeks before the program (T0); few days before (T1) and one week after the program (T2). Walking performance (mean stride time and cadence) was also recorded using foot-sensors. The gain in performance was calculated by subtracting values at T0 and T1 or at T2 and at T1. Results: Significant differences were observed in ?HbO2 between the three times only for the ST walking: ?HbO2 were significantly higher at T1 than at T0 whereas ?HbO2 was lower in T2 than in T1 (p

WCNR, 11th World Congress for Neurorehabilitation, Lyon, FRANCE, 07-/10/2020 - 11/10/2020; 1.Question: Patients with Parkinson disease (PD) report difficulties walking while performing another task. Dual-task (DT) walking may therefore increase the risk of falls. To date, the effect of DT walking on brain activity is not well understood. The objective of this pilot study was to examine dorsolateral prefrontal cortex activity (DLPFC) during single-task (ST) and DT walking conditions in PD patients. 2.Methods: Thirteen patients with PD (mean age: 66 ± 7 years, 8 men, UPDRS motor score (/108): 23 ± 11, Montreal Cognitive Assessment (MoCA) score: 27 ± 2) and 13 healthy older adults (mean age: 64 ± 7 years, 8 men, MoCA score: 28 ± 3) performed three walking tasks: [1] ST walking, [2] DT walking while counting forward (+1) and [3] DT walking while subtracting (-7). Cortical activity in DLPFC, assessed by changes in oxy-haemoglobin (?HbO2) was measured using functional near infrared spectroscopy (NIRSport). Gait performance (speed, cadence and stride length) was recorded simultaneously using wearables sensors (Gait-Up sensors). 3. Results: In ST walking and DT walking while subtracting conditions, ?HbO2 was higher in patients than in controls (p < 0.05). No significant differences in ?HbO2 were found between ST and the two DT-walking conditions in patients whereas ?HbO2 was significantly higher in DT-walking conditions than in ST walking in controls. As expected, patients had reduced walking speed, cadence and stride length compared to controls, regardless of conditions (p < 0.05). Variability of their cadence increased as the walking task difficulty increased, which is not the case for controls. 4. Conclusion This pilot study suggests that dorsolateral prefrontal cortex plays a major role already during ST walking condition in patients in relatively early stages of PD. This may suggest that patients recruit additional cognitive resources, as a measure of cognitive compensation to perform the ST walking. These findings may have implications for rehabilitation of gait in patients with PD, improving automaticity in simple tasks. Another ongoing study will show the effect of an exercise-based intervention program (SIROCCO program) on DLPFC activity while walking in the same group of patients with PD.

Background: Walking becomes more and more degraded as Parkinson's Disease (PD) progresses. Previous research examined factors contributing to this deterioration. Among them, changes in brain cortical activity during walking have been less studied in this clinical population. Objectives: This study aimed to: (1) investigate changes in dorsolateral prefrontal cortex (DLPFC) activation during usual walking and dual-task walking conditions in patients with PD; (2) examine the association between cortical activity and behavioral/cognitive outcomes; and (3) explore which factors best predict increased activation of the DLPFC during usual walking. Methods: Eighteen patients with early stage PD and 18 controls performed 4 conditions: (1) standing while subtracting, (2) usual walking, (3) walking while counting forward, and (4) walking while subtracting. Cortical activity in DLPFC, assessed by changes in oxy-hemoglobin (?HbO2) and deoxy-hemoglobin (?HbR), was measured using functional near infrared spectroscopy (fNIRS). Gait performance was recorded using wearables sensors. Cognition was also assessed using neuropsychological tests, including the Trail Making Test (TMT). Results: DLPFC activity was higher in patients compared to controls during both usual walking and walking while subtracting conditions. Patients had impaired walking performance compared to controls only during walking while subtracting task. Moderate-to-strong correlations between ?HbO2 and coefficients of variation of all gait parameters were found for usual walking and during walking while counting forward conditions. Part-B of TMT predicted 21% of the variance of ?HbO2 during usual walking after adjustment for group status. Conclusions: The increased DLPFC activity in patients during usual walking suggests a potential compensation for executive deficits. Understanding changes in DLPFC activity during walking may have implications for rehabilitation of gait in patients with PD.