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Role of attentional resources on gait performance in Huntington's disease
Arnaud Delval1, Pierre Krystkowiak, Marie Delliaux
1Department of Neurology and Movement Disorders, Salengro Hospital, Lille Regional University Hospital, Lille Cedex, France. a-delval@chru-lille.fr
Insights
Huntington's disease patients struggle with dual-task walking due to attentional deficits. Cognitive tasks significantly impair gait speed and stability in HD patients, unlike in healthy controls.
Area of Science:
- Neuroscience
- Human Physiology
- Clinical Neurology
Background:
- Huntington's disease (HD) is characterized by cognitive deficits, particularly in executive functions and attentional capacity.
- Impaired attentional resources in HD patients can significantly impact daily activities, including gait and mobility.
Purpose of the Study:
- To investigate the attentional demands of walking in Huntington's disease patients using a dual-task paradigm.
- To evaluate the impact of concurrent cognitive and motor tasks on gait performance in HD.
- To correlate gait disturbances with clinical symptoms in HD patients.
Main Methods:
- A dual-task paradigm was employed, involving walking under three conditions: cognitive task (counting backwards), motor task (carrying a tray), and no task.
- Gait parameters (kinematic, spatial, temporal, angular) were measured using videomotion analysis in 15 HD patients and 15 controls.
- Stride-to-stride variability was used to assess gait instability.
Main Results:
- Patients with Huntington's disease exhibited reduced gait speed, cadence, and stride length when performing a concurrent cognitive task, unlike controls.
- Performing a motor task did not significantly alter gait parameters in either HD patients or controls.
- Gait speed during the dual cognitive/walking task correlated with motor UHDRS scores, cognitive status, and executive function in HD patients.
Conclusions:
- Huntington's disease patients experience significant gait deterioration when required to divide attention between walking and a cognitive task.
- The observed gait impairment is linked to the compromised attentional resources in HD.
- These findings highlight the complex interplay between cognitive function and motor control in Huntington's disease, suggesting potential targets for therapeutic interventions.
Abstract:
Patients with Huntington's disease (HD) suffer from cognitive deficits with impaired executive functions, including limited attentional resources. We sought to use a dual-task paradigm to evaluate attentional demands and the ability of patients with HD to concentrate on two tasks simultaneously. We analyzed the interference effects of cognitive and motor tasks on walking in HD and the contribution of clinical symptoms to gait disturbances. Patients and controls were asked to perform either a motor task (carrying a tray with four glasses), a cognitive task (counting backwards), or no task at all while walking at their preferred speed. Kinematic spatial parameters, temporal parameters, and angular parameters related to gait were recorded in 15 patients and 15 controls by means of a videomotion analysis system. Gait instability was assessed using the stride-to-stride variability of the various gait parameters. For patients with HD, performing a concurrent cognitive task resulted in a lower gait speed (compared with free walking), with decreased cadence and stride length. However, this effect was not observed in controls. Performing a motor task did not change any kinematic gait parameters in either HD or control subjects. We found correlations between gait speed in the dual cognitive/walking task on one hand and the motor UHDRS score, cognitive status and executive function on the other. Patients with HD had greater difficulty walking while performing a concurrent cognitive task; the drain on attentional resources deteriorated walking performance.
