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Multi-limb Control in Parkinson's Disease: Implicit and Explicit Control of Attention

帕金森病的多肢控制：注意力的内隐和外显控制

基本信息

批准号：
9377125
负责人：
Tara L McIsaac
金额：
$ 38.43万
依托单位：
A.T. STILL UNIVERSITY OF HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-01 至 2021-08-31
项目状态：
已结题

项目摘要

ABSTRACT Driving and walking are important aspects of everyday life, yet car crashes and falls pose serious public health concerns. Distraction and multi-tasking while driving or walking often lead to disastrous results, indicating the importance of attention and cognition for safe mobility in the community. Parkinson disease (PD) affects over 1 million Americans at an annual cost of $25 billion, and specifically impacts attention and the ability to dual- task. Drivers with PD are at particular risk for driving cessation or crashes due to progressive difficulties in motor function and cognition that can lead to loss of independence, depression, isolation, and less participation in the community. A characteristic feature of cognitive impairment in PD is difficulty to begin or change self- initiated movement based on implicit cues. People with PD rely more heavily on external cues to overcome their slowed and small movements. For example, stepping to the beat of a metronome or stepping to lines on the floor improves walking. We will test the hypothesis that PD reduces the ability to flexibly allocate attention between arm and foot tasks based on accuracy constraints. Aim 1: Compare the effects of explicit instruction of task prioritization with implicit accuracy demands on shifts in attention during concurrent reaching and foot- pedal tracking tasks in participants with PD and age-matched healthy old adults. Aim 2: Compare the effects of explicit instruction of task prioritization with implicit accuracy demands on shifts in attention during lane-keeping (steering) and car-following (braking/accelerating) behavior during simulated driving performance in drivers with PD and in age-matched healthy old adults. Aim 3: Identify the effect of dopaminergic medication state on attention switching to explicit and implicit cues during driving-like tasks and simulated driving performance behavior in adults with PD. The long-term goal of this research is to characterize impairments in dual task abilities for driving and develop and implement intervention programs to reduce driving difficulties for people with PD.

摘要开车和走路是日常生活的重要方面，然而车祸和福尔斯会造成严重的公共健康问题性问题开车或走路时分心和多任务处理往往会导致灾难性的结果，这表明注意力和认知对社区安全流动的重要性。帕金森病（PD）影响超过 100万美国人，每年花费250亿美元，特别是影响注意力和双重能力，任务患有PD的驾驶员由于进行性困难而面临停止驾驶或撞车的特别风险。运动功能和认知，可能导致丧失独立性、抑郁、孤立和参与减少在社区PD认知障碍的一个特征是难以开始或改变自我，基于暗示的主动运动。PD患者更依赖外部线索来克服他们缓慢而微小的动作。例如，踩着节拍器的节拍或踩着地板改善了行走。我们将检验PD降低灵活分配注意力能力的假设手臂和脚的任务之间的准确性约束。目标1：比较显性教学的效果任务优先级与隐含的准确性要求在同时达到和脚的注意力转移， PD参与者和年龄匹配的健康老年人的踏板跟踪任务。目标2：比较以下因素的影响任务优先级的明确指示与隐含的准确性要求在车道保持过程中注意力的转移驾驶员在模拟驾驶性能期间的（转向）和车辆跟随（制动/加速）行为和年龄匹配的健康老年人。目的3：确定多巴胺能药物状态对在类似驾驶的任务和模拟驾驶表现中对外显和内隐线索的注意转换成年PD患者的行为本研究的长期目标是表征双重任务中的损伤提高驾驶能力，制定和实施干预计划，减少人们的驾驶困难 PD的。