Differences Between Patients With Multiple System Atrophy With Predominant Parkinsonism and Parkinson's Disease Based...

To investigate the differences in gait parameters and cortical activity during a single-task walking (STW) and cognitive dual-task walking (DTW) between multiple system atrophy with predominant parkinsonism (MSA-P) and Parkinson's disease (PD).

24 MSA-P patients, 20 PD patients, and 22 healthy controls (HCs) were enrolled. Gait parameters were collected using a portable inertial measurement unit system, and the relative change of oxyhemoglobin (ΔHbO₂) in the bilateral frontal and sensorimotor cortex was obtained by functional near-infrared spectroscopy during walking with and without cognitive tasks.

MSA-P patients had increased step length variability and higher ΔHbO₂ in the right dorsolateral prefrontal cortex (DLPFC), relative to PD patients and HCs during the DTW condition. Meanwhile, MSA-P patients exhibited higher step length variability and ΔHbO₂ in the right DLPFC during DTW compared to STW. Furthermore, mild negative correlations were found between the ΔHbO₂ in the right DLPFC and step length, while there was a mild positive correlation between ΔHbO₂ and step length variability during the DTW condition. Notably, receiver operating characteristic (ROC) curve analysis uncovered that the areas under the curve (AUCs) of the ΔHbO₂ of the right DLPFC and step length variability during DTW were 0.798 (95% confidence interval [CI]: 0.651-0.945, sensitivity = 0.650, specificity = 0.958) and 0.721 (95% CI: 0.570-0.871, sensitivity = 0.625, specificity = 0.800), respectively.

MSA-P patients demonstrate more severe gait disturbance and increased DLPFC activity compared with PD patients and HCs. Gait parameters and cortical activity could be a potential features discerning MSA-P patients and PD patients.