Abstract：
BACKGROUND: Walking abnormalities in people with Parkinson\'s disease (PD) are characterized by a shift in locomotor control from healthy automaticity to compensatory, executive control, mainly located in the prefrontal cortex (PFC). Although PFC activity during walking increases in people with PD, the time course of PFC activity during walking and its relationship to clinical or gait characteristics is unknown.
OBJECTIVE: To identify the time course of PFC activity during walking in people with PD. To investigate whether clinical or gait variables would explain the PFC activity changes.
METHODS: Thirty-eight people with PD tested OFF medication wore a portable, functional near-infrared spectroscopy (fNIRS) system to record relative PFC activity while walking. Wearable inertial sensors recorded spatiotemporal gait characteristics. Based on the PFC activity (fNIRS) in the late phase of the walking task (final 40 seconds), compared to the early phase (initial 40 seconds), participants were separated into 2 groups: reduced or sustained PFC activity.
RESULTS: People with PD who reduced PFC activity during walking had less impaired gait (eg, faster gait speed) than those who had a sustained increase in PFC activity (P < .05). Cognitive set-shifting ability explained 18% of the PFC activation in the group with a sustained increase in PFC activity (P = .033).
CONCLUSIONS: The time course of reduction in PFC activity corresponds to less impaired gait performance in people with PD, while a sustained increase in PFC activity is related to worse cognitive flexibility. Reduction in PFC activity while walking may indicate a less impaired, automatic control of walking.
OBJECTIVE: To identify the time course of PFC activity during walking in people with PD. To investigate whether clinical or gait variables would explain the PFC activity changes.
METHODS: Thirty-eight people with PD tested OFF medication wore a portable, functional near-infrared spectroscopy (fNIRS) system to record relative PFC activity while walking. Wearable inertial sensors recorded spatiotemporal gait characteristics. Based on the PFC activity (fNIRS) in the late phase of the walking task (final 40 seconds), compared to the early phase (initial 40 seconds), participants were separated into 2 groups: reduced or sustained PFC activity.
RESULTS: People with PD who reduced PFC activity during walking had less impaired gait (eg, faster gait speed) than those who had a sustained increase in PFC activity (P < .05). Cognitive set-shifting ability explained 18% of the PFC activation in the group with a sustained increase in PFC activity (P = .033).
CONCLUSIONS: The time course of reduction in PFC activity corresponds to less impaired gait performance in people with PD, while a sustained increase in PFC activity is related to worse cognitive flexibility. Reduction in PFC activity while walking may indicate a less impaired, automatic control of walking.
摘要：
背景：帕金森病（PD）患者的步行异常的特征是运动控制从健康的自动化转变为代偿性，执行控制,主要位于前额叶皮层（PFC）。尽管患有PD的人在步行期间的PFC活动增加，步行过程中PFC活动的时程及其与临床或步态特征的关系未知.
目的：确定PD患者步行过程中PFC活动的时间过程。研究临床或步态变量是否可以解释PFC活性变化。
方法：38名接受PD检查的患者佩戴便携式，功能近红外光谱(fNIRS)系统记录步行时的相对PFC活动。可穿戴惯性传感器记录时空步态特征。基于步行任务后期（最后40秒）的PFC活动（fNIRS），与早期阶段（最初的40秒）相比，参与者分为2组:减少或持续的PFC活性.
结果：行走时PFC活动减少的PD患者步态受损较少（例如，更快的步态速度）比那些PFC活性持续增加的人（P<.05）。认知集转移能力解释了该组中18％的PFC激活，同时PFC活性持续增加（P=.033）。
结论：PFC活性降低的时程对应于PD患者步态表现受损程度较低，而PFC活性的持续增加与认知灵活性较差有关。步行时PFC活动减少可能表明受损程度较低，自动控制行走。
目的：确定PD患者步行过程中PFC活动的时间过程。研究临床或步态变量是否可以解释PFC活性变化。
方法：38名接受PD检查的患者佩戴便携式，功能近红外光谱(fNIRS)系统记录步行时的相对PFC活动。可穿戴惯性传感器记录时空步态特征。基于步行任务后期（最后40秒）的PFC活动（fNIRS），与早期阶段（最初的40秒）相比，参与者分为2组:减少或持续的PFC活性.
结果：行走时PFC活动减少的PD患者步态受损较少（例如，更快的步态速度）比那些PFC活性持续增加的人（P<.05）。认知集转移能力解释了该组中18％的PFC激活，同时PFC活性持续增加（P=.033）。
结论：PFC活性降低的时程对应于PD患者步态表现受损程度较低，而PFC活性的持续增加与认知灵活性较差有关。步行时PFC活动减少可能表明受损程度较低，自动控制行走。
