Attention and the Automatic Control of Walking in People with Parkinson's Disease

帕金森病患者的注意力和行走的自动控制

• 批准号: 7924027
• 负责人: VALERIE E KELLY
• 金额: $ 10.74万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-19 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7924027
• 关键词: Address; Affect; Age; Attention; Award; Cognition; Cognitive; Cost Measures; Development; Disease; Disease Progression; Dose; Exhibits; Functional disorder; Gait; Gender; Goals; Impairment; Individual; Instruction; K-Series Research Career Programs; Knowledge; Lead; Life; Measures; Mentors; Mentorship; Motor; Movement; Parkinson Disease; Performance; Persons; Pharmaceutical Preparations; Population; Process; Protocols documentation; Quality of life; Rehabilitation Research; Rehabilitation therapy; Relative (related person); Research; Resources; Response Latencies; Role; Scientist; Speed; Surface; Task Performances; Testing; Therapeutic Intervention; Training; Translating; Translational Research; Walking; Work; base; career; cost; environmental change; experience; fall risk; falls; improved; insight; motor deficit; motor impairment; neuromechanism; public health relevance; rehabilitation strategy; research study; response; skills

DESCRIPTION (provided by applicant): Impaired mobility in Parkinson's disease (PD) is associated with decreased independence, reduced quality of life, and increased risk for falls, leading people with PD to identify mobility limitations as one of the worst aspects of the disease. There is incomplete understanding of the factors that contribute to walking limitations in PD, which hampers the development of effective rehabilitation strategies in this population. Walking abnormalities in PD are traditionally considered a motor impairment; however, motor deficits are only one of many factors contributing to limited mobility. Research using dual task paradigms has demonstrated that the control of walking is not completely automatic, but requires some degree of attention. Walking is disrupted by the performance of concurrent cognitive or motor tasks in many populations, including PD, suggesting that attentional processes and related aspects of cognition are critical to safe and independent mobility. The effects of PD on the neural mechanisms involved in the allocation of attention and the automatic control of walking are not well understood. Therefore, the long term goals of this research are (1) to develop a better understanding of the effects of PD on attention allocation and task prioritization when walking and performing a concurrent cognitive task and (2) to translate this knowledge into improved therapeutic interventions for walking limitations in this population. The proposed experiments examine the effects of PD on attention allocation and the automatic control of walking under dual task conditions (Specific Aim 1), the effect of anti-Parkinson medications (Specific Aim 2) and disease progression (Specific Aim 3) on the interaction of attention and walking, and the ability of people with PD to modify attention allocation based on changing environmental demands or explicit instructions (Specific Aim 4). For all Aims, changes in cognitive task speed and accuracy and walking speed and stability will be used to assess dual task interference in people with PD compared to age- and gender-matched controls. The goal of this Mentored Research Scientist Career Development Award is to provide the candidate with comprehensive training in the field of rehabilitation research through a combination of didactic work, intensive mentorship, and focused research experience. This award will provide the candidate with unique knowledge and skills that will promote an independent research career in both mechanistic research related to movement dysfunction in PD and translational research aimed at improved rehabilitation strategies for functional mobility. Public Health Relevance: For people with PD, walking impairments can lead to reduced mobility and independence, poor quality of life, and increased risk of falling. A better understanding of the effects of PD on attention allocation and the automatic control of walking is critical to the development of improved rehabilitation for walking and functional mobility in this population.

描述（由申请人提供）：帕金森病 (PD) 的活动能力受损与独立性下降、生活质量下降和跌倒风险增加有关，导致帕金森病患者将活动能力限制视为该疾病最严重的方面之一。对于导致帕金森病步行受限的因素尚不完全了解，这阻碍了针对该人群制定有效的康复策略。 PD 中的步行异常传统上被认为是运动障碍；然而，运动缺陷只是导致活动受限的众多因素之一。使用双任务范式的研究表明，行走的控制并不是完全自动的，而是需要一定程度的注意力。在许多人群中，包括帕金森病在内，步行会受到并发认知或运动任务的干扰，这表明注意力过程和认知的相关方面对于安全和独立的活动至关重要。 PD 对涉及注意力分配和行走自动控制的神经机制的影响尚不清楚。因此，这项研究的长期目标是（1）更好地了解帕金森病对步行和执行并发认知任务时注意力分配和任务优先级的影响，以及（2）将这些知识转化为针对该人群步行受限的改进治疗干预措施。拟议的实验研究了在双重任务条件下帕金森病对注意力分配和步行自动控制的影响（具体目标 1）、抗帕金森药物（具体目标 2）和疾病进展（具体目标 3）对注意力和步行相互作用的影响，以及帕金森病患者根据不断变化的环境需求或明确指示调整注意力分配的能力（具体目标 4）。对于所有目标，认知任务速度和准确性以及步行速度和稳定性的变化将用于评估帕金森病患者与年龄和性别匹配的对照组相比的双重任务干扰。该导师研究科学家职业发展奖的目标是通过教学工作、密集指导和重点研究经验的结合，为候选人提供康复研究领域的全面培训。该奖项将为候选人提供独特的知识和技能，促进其在与帕金森病运动功能障碍相关的机械研究和旨在改进功能活动康复策略的转化研究方面的独立研究生涯。 公共卫生相关性：对于帕金森病患者来说，行走障碍会导致行动能力和独立性下降、生活质量差以及跌倒风险增加。更好地了解帕金森病对注意力分配和步行自动控制的影响对于改善该人群的步行康复和功能活动能力至关重要。