- Email: [email protected]
094 ASSESSMENT OF DYNAMIC GAIT ANALYSIS BETWEEN AMNESTIC AND NON-AMNESTIC MILD COGNITIVE IMPAIRMENT
S28
Posters / Parkinsonism and Related Disorders 16S1 (2010) S11–S86
function were associated with gait measures independent of executive function and processing speed. 094 ASSESSMENT OF DYNAMIC GAIT ANALYSIS BETWEEN AMNESTIC AND NON-AMNESTIC MILD COGNITIVE IMPAIRMENT E. McDade1 , K. Bieniek2 , B. Boeve1 , R. Roberts3 , Y. Geda4 , D. Knopman1 , T. Christianson5 , R.C. Petersen1 . Mayo Clinic Study of Aging. 1 Neurology, Mayo Clinic, Rochester, MN, 2 Iowa State University, Ames, IA, 3 Epidemiology, Mayo Clinic College of Medicine, Rochester, MN, 4 Psychiatry, Mayo Clinic College of Medicine, Rochester, MI, 5 Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA Background & aim: Mild Cognitive Impairment (MCI) represents a state of increased risk for the development of dementia. To distinguish amnestic MCI (aMCI) from non-amnestic MCI (naMCI) and thus provide clues to the underlying pathology, new markers are needed. We sought to identify the possible utility of spatiotemporal gait patterns between these two groups. Methods: Cross-sectional analysis of participants in the Mayo Clinic Study of Aging diagnosed with aMCI or naMCI who underwent automated gait analysis with GAITRite® system. Subjects with Parkinson’s disease, stroke or other neurological and medical causes of gait impairment were excluded. 2 sample t-test and chi-square analysis were performed for descriptive statistics of baseline clinical and demographic parameters and multivariate logistical regression was employed for comparison of gait variables. One model adjusted for age, gender and education and a second included total UPDRS scores as a covariate. Results: There were 120 aMCI and 30 naMCI subjects who were similar in age, gender and MMSE. Z scores for memory (−1.5 vs −0.05, p < 0.0001) and attention (−0.37 vs −1.21, p < 0.0001) domains were significantly different between groups as well as modified UPDRS score (5 vs 2, p = 0.002). There were no statistically significant differences in any of the measured gait parameters. Both MCI groups differed significantly from cognitively normal controls. Conclusion: Although dynamic gait assessment may differentiate cognitively normal elderly persons from those with MCI, it was not useful in differentiating aMCI from naMCI. This may, however, highlight the contribution of non-executive cognitive domains in gait changes in MCI and degenerative dementias. 095 WALKING PILOT STUDY IN ADULTS WITH CHROMOSOME 18Q DELETIONS A. Newstead1 , G. Walden2 , R. Trevino3 , J. Cody4 , D. Hale4 . 1 Physical Therapy, UTHSCSA, 2 PM & R, South Texas Veterans Administration Hospital, 3 PM & R, 4 Pediatrics, UTHSCSA, San Antonio, TX, USA Young adults with 18q deletions (18q−) have different cognitive and walking characteristics in comparison with young adults without a chromosome abnormality. The main aims were: 1. To explore and quantify the locomotor characteristics of young adults with 18q− compared with age- and gender-matched young adults without a chromosome abnormality. 2. To quantify the factors of young adults with 18q− that may contribute to locomotion e.g. balance and sensation. Background: Reduced brain myelination and lack of growth hormone lead to developmental and cognitive differences (delays) in young adults with 18q− (Cody JD, et al. 2005; 2007). No information about locomotion is found in the literature, although many people with chromosomal abnormalities have walking differences. Methods: Young adults with 18q− (N = 4) and healthy young adults (N = 4) were tested during one session. A quantitative balance and gait analyses were performed using the VICON system. Results: Mean age (18q− = 22.0 y; YA = 22.7 y), height (1.7 vs. 1.7 m), and weight (64.2 vs. 67.4 kg), and BMI (22.5 vs. 24.5 kg/m2 ) were
comparable between groups (YA vs 18q−). Decreases were found for 18q− in single limb stance balance (30.0 vs. 7.9 s), Berg (56 vs. 52.8) and for great toe vibration sense (15 vs. 7.9 s). Mean walking velocity was slower (1.15 vs. 1.09 m/s) and cadence faster (106 vs. 111 steps/min); stride was longer for the young adults with 18q− (1.2 m vs. 1.3 m). The head–arms–trunk displayed excessive mediallateral lurch and less excursion at the hip and knee; greater ankle dorsiflexion and lesser plantarflexion moment at terminal stance were found. 096 GAIT PERFORMANCE AND COGNITIVE FUNCTION IN PARKINSON’S DISEASE J. Nocera1,2 , S. Amano3 , S. Vallabhajosula3 , H. Fernandez4 , C. Hass3 . 1 Department of Aging and Geriatric Research, University of Florida, 2 Brain Rehabilitation Research Center, Malcom Randall VAMC, 3 Department of Applied Physiology & Kinesiology, 4 Department of Neurology, University of Florida, Gainesville, FL, USA Background and Aims: Recently studies have demonstrated that cognitive impairment may be closely linked to specific subsets of motor symptoms within the clinical spectrum of Parkinson’s disease (PD). Particularly, impaired motor symptoms not influenced by dopaminergic stimulation, including gait, have been associated with accelerated cognitive decline. To date, however, studies examining this relationship have relied on subjective measures of gait dysfunction provided by the Unified Parkinson’s Disease Rating Scale (UPDRS). Unfortunately, the UPDRS gait scores are too simplistic and fail to capture the essence of motor function. Therefore, to further understand the relationship between motor function on cognitive status, gait must be objectively quantified beyond the 0–4 ratings provided by the UPDRS. Methods: Twenty-three patients with idiopathic PD (Age: 63 ±6; Modified Hoehn & Yahr stage of 2 to 3) participated in this study. Gait performance was measured by a motion capture system while participants walked at a self-selected pace. Cognitive function was evaluated using 4 standard neuropsychological tests (Digit Span Backward, Color-word Interference Test, Letter and Semantic Fluency). Results: No significant associations were observed between gait performance (gait velocity, step length) and any of the four cognitive measures. Conclusions: Our findings suggests that the subjectivity of the UPDRS in describing both cognitive and motor features of PD may lend itself to overestimation of symptomology based on the presence of one or more symptoms. Future research utilizing more specific and objective measurement tools are required to understand pathophysiological mechanism/s between motor and cognitive impairment in PD. 097 IS APATHY ASSOCIATED WITH POSTURAL CONTROL IN PARKINSON’S DISEASE? J. Nocera1,2 , S. Vallabhajosula3 , L. Zahodne4 , C. Sozda4 , D. Bowers4 , H. Fernandez5 , C. Hass3 . 1 Department of Aging and Geriatric Research, Univeristy of Florida, 2 Brain Rehabilitation Research Center, Malcom Randall VAMC, 3 Department of Applied Physiology & Kinesiology, 4 College of Public Health and Health Professions, University of Florida, 5 Department of Neurology, University of Florida, Gainesville, FL, USA Background and aim: Apathy, a disorder of motivation, is one of the most common neuropsychological disturbances in Parkinson’s disease (PD). Previously, apathy has been associated with nonmotor symptoms including depression, global cognitive and executive dysfunction, and certain autonomic symptoms. However, the relationship between apathy and motor features of PD is less well known. Methods: Seventeen patients with idiopathic PD (Mean age: 67±8 years) and apathy (Apathy Scale [AS]; 19.3±4.6) participated in this
Posters / Parkinsonism and Related Disorders 16S1 (2010) S11–S86
function were associated with gait measures independent of executive function and processing speed. 094 ASSESSMENT OF DYNAMIC GAIT ANALYSIS BETWEEN AMNESTIC AND NON-AMNESTIC MILD COGNITIVE IMPAIRMENT E. McDade1 , K. Bieniek2 , B. Boeve1 , R. Roberts3 , Y. Geda4 , D. Knopman1 , T. Christianson5 , R.C. Petersen1 . Mayo Clinic Study of Aging. 1 Neurology, Mayo Clinic, Rochester, MN, 2 Iowa State University, Ames, IA, 3 Epidemiology, Mayo Clinic College of Medicine, Rochester, MN, 4 Psychiatry, Mayo Clinic College of Medicine, Rochester, MI, 5 Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA Background & aim: Mild Cognitive Impairment (MCI) represents a state of increased risk for the development of dementia. To distinguish amnestic MCI (aMCI) from non-amnestic MCI (naMCI) and thus provide clues to the underlying pathology, new markers are needed. We sought to identify the possible utility of spatiotemporal gait patterns between these two groups. Methods: Cross-sectional analysis of participants in the Mayo Clinic Study of Aging diagnosed with aMCI or naMCI who underwent automated gait analysis with GAITRite® system. Subjects with Parkinson’s disease, stroke or other neurological and medical causes of gait impairment were excluded. 2 sample t-test and chi-square analysis were performed for descriptive statistics of baseline clinical and demographic parameters and multivariate logistical regression was employed for comparison of gait variables. One model adjusted for age, gender and education and a second included total UPDRS scores as a covariate. Results: There were 120 aMCI and 30 naMCI subjects who were similar in age, gender and MMSE. Z scores for memory (−1.5 vs −0.05, p < 0.0001) and attention (−0.37 vs −1.21, p < 0.0001) domains were significantly different between groups as well as modified UPDRS score (5 vs 2, p = 0.002). There were no statistically significant differences in any of the measured gait parameters. Both MCI groups differed significantly from cognitively normal controls. Conclusion: Although dynamic gait assessment may differentiate cognitively normal elderly persons from those with MCI, it was not useful in differentiating aMCI from naMCI. This may, however, highlight the contribution of non-executive cognitive domains in gait changes in MCI and degenerative dementias. 095 WALKING PILOT STUDY IN ADULTS WITH CHROMOSOME 18Q DELETIONS A. Newstead1 , G. Walden2 , R. Trevino3 , J. Cody4 , D. Hale4 . 1 Physical Therapy, UTHSCSA, 2 PM & R, South Texas Veterans Administration Hospital, 3 PM & R, 4 Pediatrics, UTHSCSA, San Antonio, TX, USA Young adults with 18q deletions (18q−) have different cognitive and walking characteristics in comparison with young adults without a chromosome abnormality. The main aims were: 1. To explore and quantify the locomotor characteristics of young adults with 18q− compared with age- and gender-matched young adults without a chromosome abnormality. 2. To quantify the factors of young adults with 18q− that may contribute to locomotion e.g. balance and sensation. Background: Reduced brain myelination and lack of growth hormone lead to developmental and cognitive differences (delays) in young adults with 18q− (Cody JD, et al. 2005; 2007). No information about locomotion is found in the literature, although many people with chromosomal abnormalities have walking differences. Methods: Young adults with 18q− (N = 4) and healthy young adults (N = 4) were tested during one session. A quantitative balance and gait analyses were performed using the VICON system. Results: Mean age (18q− = 22.0 y; YA = 22.7 y), height (1.7 vs. 1.7 m), and weight (64.2 vs. 67.4 kg), and BMI (22.5 vs. 24.5 kg/m2 ) were
comparable between groups (YA vs 18q−). Decreases were found for 18q− in single limb stance balance (30.0 vs. 7.9 s), Berg (56 vs. 52.8) and for great toe vibration sense (15 vs. 7.9 s). Mean walking velocity was slower (1.15 vs. 1.09 m/s) and cadence faster (106 vs. 111 steps/min); stride was longer for the young adults with 18q− (1.2 m vs. 1.3 m). The head–arms–trunk displayed excessive mediallateral lurch and less excursion at the hip and knee; greater ankle dorsiflexion and lesser plantarflexion moment at terminal stance were found. 096 GAIT PERFORMANCE AND COGNITIVE FUNCTION IN PARKINSON’S DISEASE J. Nocera1,2 , S. Amano3 , S. Vallabhajosula3 , H. Fernandez4 , C. Hass3 . 1 Department of Aging and Geriatric Research, University of Florida, 2 Brain Rehabilitation Research Center, Malcom Randall VAMC, 3 Department of Applied Physiology & Kinesiology, 4 Department of Neurology, University of Florida, Gainesville, FL, USA Background and Aims: Recently studies have demonstrated that cognitive impairment may be closely linked to specific subsets of motor symptoms within the clinical spectrum of Parkinson’s disease (PD). Particularly, impaired motor symptoms not influenced by dopaminergic stimulation, including gait, have been associated with accelerated cognitive decline. To date, however, studies examining this relationship have relied on subjective measures of gait dysfunction provided by the Unified Parkinson’s Disease Rating Scale (UPDRS). Unfortunately, the UPDRS gait scores are too simplistic and fail to capture the essence of motor function. Therefore, to further understand the relationship between motor function on cognitive status, gait must be objectively quantified beyond the 0–4 ratings provided by the UPDRS. Methods: Twenty-three patients with idiopathic PD (Age: 63 ±6; Modified Hoehn & Yahr stage of 2 to 3) participated in this study. Gait performance was measured by a motion capture system while participants walked at a self-selected pace. Cognitive function was evaluated using 4 standard neuropsychological tests (Digit Span Backward, Color-word Interference Test, Letter and Semantic Fluency). Results: No significant associations were observed between gait performance (gait velocity, step length) and any of the four cognitive measures. Conclusions: Our findings suggests that the subjectivity of the UPDRS in describing both cognitive and motor features of PD may lend itself to overestimation of symptomology based on the presence of one or more symptoms. Future research utilizing more specific and objective measurement tools are required to understand pathophysiological mechanism/s between motor and cognitive impairment in PD. 097 IS APATHY ASSOCIATED WITH POSTURAL CONTROL IN PARKINSON’S DISEASE? J. Nocera1,2 , S. Vallabhajosula3 , L. Zahodne4 , C. Sozda4 , D. Bowers4 , H. Fernandez5 , C. Hass3 . 1 Department of Aging and Geriatric Research, Univeristy of Florida, 2 Brain Rehabilitation Research Center, Malcom Randall VAMC, 3 Department of Applied Physiology & Kinesiology, 4 College of Public Health and Health Professions, University of Florida, 5 Department of Neurology, University of Florida, Gainesville, FL, USA Background and aim: Apathy, a disorder of motivation, is one of the most common neuropsychological disturbances in Parkinson’s disease (PD). Previously, apathy has been associated with nonmotor symptoms including depression, global cognitive and executive dysfunction, and certain autonomic symptoms. However, the relationship between apathy and motor features of PD is less well known. Methods: Seventeen patients with idiopathic PD (Mean age: 67±8 years) and apathy (Apathy Scale [AS]; 19.3±4.6) participated in this