Does Cueing Need Attention? A Pilot Study in People with Parkinson's Disease

Carla Silva-Batista, Óscar Miranda-Domínguez, Anjanibhargavi Ragothaman, Damien A. Fair, Alessandra Mantovani, Sam Stuart, John G. Nutt, Fay B. Horak, Martina Mancini

Research output: Contribution to journalArticlepeer-review

Abstract

We previously showed that both open-loop (beat of a metronome) and closed-loop (phase-dependent tactile feedback) cueing may be similarly effective in reducing Freezing of Gait (FoG), assessed with a quantitative FoG Index, while turning in place in the laboratory in a group of people with Parkinson's disease (PD). Despite the similar changes on the FoG Index, it is not known whether both cueing responses require attentional control, which would explain FoG Index improvement. The mechanisms underlying cueing responses are poorly understood. Here, we tested the hypothesis that the salience network would predict responsiveness (i.e., FoG Index improvement) to open-loop and closed-loop cueing in people with and without FoG of PD, as salience network contributes to tasks requiring attention to external stimuli in healthy adults. Thirteen people with PD with high-quality imaging data were analyzed to characterize relationships between resting-state MRI functional connectivity and responses to cues. The interaction of the salience network and retrosplenial-temporal networks was the best predictor of responsiveness to open-loop cueing, presenting the largest effect size (d = 1.16). The interaction between the salience network and subcortical as well as cingulo-parietal and subcortical networks were the strongest predictors of responsiveness to closed-loop cueing, presenting the largest effect sizes (d = 1.06 and d = 0.84, respectively). Salience network activity was a common predictor of responsiveness to both cueing, which suggests that auditory and proprioceptive stimuli during turning may require some level of cognitive and insular activity, anchored within the salience network, which explain FoG Index improvements in people with PD.

Original languageEnglish (US)
Pages (from-to)36-51
Number of pages16
JournalNeuroscience
Volume507
DOIs
StatePublished - Dec 15 2022

Bibliographical note

Funding Information:
This research was supported by the Oregon Health & Science University Fellowship for Diversity in Research (Carla Silva-Batista), National Institute on Aging (NIA) grant 5R01 AG006457 PI (Fay B Horak), US Department of Veterans Affairs VA grant: I01 RX001075 PI (Fay B Horak), National Institutes of Health National Institute of Mental Health (NIMH) grants R01MH115357 (Damien Fair), National Institute of Health via Career Development Award K99 HD078492 0IAI PI (Martina Mancini), and 5R00 HD078492 PI (Martina Mancini). CSB, OMR, AR, DAF, AM, SS, JGN, and MM declare that they have no conflicts of interest relevant to the content of this review. FBH has a significant financial interest in APDM, a company that may have a commercial interest in the results of this research and technology. FBH also consultants with Biogen, Neuropore, Sanofi, Adamus, Abbott, and Takeda. This potential individual conflict has been reviewed and managed by Oregon Health & Science University.

Funding Information:
This research was supported by the Oregon Health & Science University Fellowship for Diversity in Research (Carla Silva-Batista), National Institute on Aging (NIA) grant 5R01 AG006457 PI (Fay B Horak), US Department of Veterans Affairs VA grant: I01 RX001075 PI (Fay B Horak), National Institutes of Health National Institute of Mental Health (NIMH) grants R01MH115357 (Damien Fair), National Institute of Health via Career Development Award K99 HD078492 0IAI PI (Martina Mancini), and 5R00 HD078492 PI (Martina Mancini).

Publisher Copyright:
© 2022 IBRO

Keywords

  • closed-loop cueing
  • cognitive activity
  • freezing of gait
  • insular activity
  • open-loop cueing
  • salience network

PubMed: MeSH publication types

  • Journal Article
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, N.I.H., Extramural

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