Mobile EEG assessment of inhibitory control during dual-task walking in Parkinson's disease

How levodopa and deep brain stimulation (DBS) modulate the cognitive processing underlying dual-task walking in Parkinson's disease remains poorly characterized, in part due to methodological challenges in capturing neural signals during walking.

To evaluate the feasibility and signal characteristics of combining mobile EEG with an inhibitory control task during walking, and to generate preliminary, group-level evidence on how levodopa and DBS may differentially modulate cognitive processing during dual-task walking in Parkinson's disease.

Ten people with Parkinson's disease completed an inhibitory control task while walking under four levodopa/DBS conditions. Behavioral measures (response accuracy, treadmill-walking speed) and event-related potentials were collected. Data from the off-levodopa/off-DBS condition were compared with data from 37 control participants, and within-subject differences across levodopa/DBS conditions were explored to assess sensitivity of behavioral and mobile EEG measures.

Compared with controls, participants with Parkinson's disease off-levodopa/off-DBS demonstrated reduced response accuracy and treadmill-walking speed. Exploratory within-subject analyses suggested that response accuracy improved primarily in the on-levodopa/on-DBS condition compared to the off-levodopa/off-DBS condition. Event-related potentials showed condition-dependent modulation, with levodopa primarily affecting early sensory-perceptual components over bilateral frontocentral regions, and DBS modulating later cognitive components over right prefrontal and right parietal regions.

This proof-of-concept study demonstrates the feasibility and sensitivity of using mobile EEG to assess inhibitory control while walking in Parkinson's disease. The observed condition-dependent behavioral and electrophysiological patterns are hypothesis-generating and provide preliminary guidance for the design of future, adequately powered studies examining combined levodopa and DBS effects on cognition-gait interactions.