Brain Activity During Complex Walking in People With Atypical Parkinsonian Syndromes
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
AgeNot listed
SponsorKarolinska Institutet
About this trial
Every-day life means being part of a complex environment and performing complex tasks that usually involve a combination of motor and cognitive skills. However, the process of aging or the sequelae of neurological diseases such as atypical Parkinson's disease (APD) compromises motor-cognitive interaction necessary for an independent lifestyle. While motor-cognitive performance has been identified as an important goal for sustained health across different clinical populations, little is known about underlying brain function leading to these difficulties and how to best target these motor-cognitive difficulties in the context of rehabilitation and exercise interventions.
The challenge of improving treatments of motor-cognitive difficulties (such as dual-tasking and navigation) is daunting, and an important step is arriving at a method that accurately portrays these impairments in an ecologically valid state. The investigators aim therefore to explore brain function during complex walking in healthy and APD by investigating the effects of age and neurological disease on motor-cognitive performance and its neural correlates during three conditions of complex walking (dual-task walking, navigation and a combination of both) using non-invasive measures of brain activity (functional near infrared spectrometry, fNIRS) and advanced gait analysis in real time in older healthy adults and people with APD.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
clinical diagnosis of PSP according to Movement Disorder Society (MDS) (2017) or
MSA according to MDS criteria (2022)
the ability to walk with or without a mobility device for ≤5 minutes continuously
Disqualifiers
cognitive difficulties affecting the ability to understand and/or follow verbal/written - instructions
severe freezing of gait
Severe hearing or visual impairments that affect participation in the assessments
Other neurological diseases
Trial population
We are studying complex walking in different populations, such as people with Multiple Sclerosis, healthy young adults, healthy elderly, and elderly with Parkinson's disease. We have during 2022 completed data collection (ClinicalTrials.gov ID: NCT05218213) of healthy young adults, healthy elderly, and elderly with Parkinson's disease. In 2024, we completed data collection in people with Multiple Sclerosis (NCT05787704). Hence, this registration concerns the atypical parkinsonism cohort.
Trial design
Design model
Cohort
Time perspective
Prospective
Treatments tested in this trial
Assessment of brain activity with fNIRS and behavioural assessments (motor, motor-cognitive and cognitive) during three complex walking conditions.
Other interventionDual-task walking with the auditory stroop task. Navigational walking - a course consisting of a distribution of 45 and 90 degrees turns to the left and right Navigational and dual-task walking (condition 1 and 2 together)
Treatment groups
30 Participants
are divided into 1 treatment groupGroup A: Atypical Parkinsonian syndromes1 intervention
Trial outcomes
Primary outcomes
1
Functional near infrared spectrometry (fNIRS)
The measurement of changes in concentration of HbO and HHb in the prefrontal cortex will be assessed using a NIRSPORT 2 (NIRx Medizintechnik, Berlin, Germany) device.
Time frame
Baseline2
Gait performance during all conditions
Gait variables such as stride time and/or velocity will be analyzed with the APDM mobility system.
Time frame
Baseline3
Dual-task performance-reaction time
Cognitive performance of the dual task will be assessed as errors in the response to the Auditory Stroop task.
Time frame
BaselineSecondary outcomes
1
Resting-state functional near infrared spectrometry (rsfNIRS)
The measurement of changes in concentration of HbO and HHb in the whole cortex will be assessed using a NIRSPORT 2 (NIRx Medizintechnik, Berlin, Germany) device during 2x 10min of rest, while seated in a comfortable chair.
Time frame
Baseline2
Cognitive function- composite score
The cognitive test battery comprised the following tests: The Color-Word Interference Test (CWIT), Verbal Fluency, Trail Making Test (TMT), Ray Auditory Verbal Learning Test (RAVLT), and Symbol Digit Modalities Test (SDMT). Cognitive function will be assessed as a composite measure of these tests together.
Time frame
Baseline3
Cognitive function - verbal fluency
Verbal function, initiation \& task-set switching with the Verbal Fluency test from D-KEFS (Delis-Kaplan Executive Function System).
Time frame
Baseline4
Cognitive function - Attention and psychomotor processing speed
Attention and psychomotor processing speed will be assessed with the Trail Making Test (TMT) from D-KEFS (Delis-Kaplan Executive Function System).
Time frame
BaselineSponsors and contacts
Click on the lead sponsor to view all of their trials.
Karolinska Institutet
Lead sponsor
Karolinska University Hospital
Collaborator
Source ClinicalTrials.gov