Supplemental Digital Content is Available in the Text. Background and Purpose: Gait and turning impairments are common in people with Parkinson disease (PwPD). Tactile cues delivered in open- or closed-loop modalities may improve gait and turning in PwPD, but underlying mechanisms are unclear. Attention stemming from the prefrontal cortex (PFC) may play a role in cue response, but PFC contributions to specific cue modalities are unclear. Examining how open- and closed-loop cueing influences PFC activity during walking and turning in PwPD may elucidate mechanisms involved in cue response, which could advance development of effective therapeutics. We examined PFC activity during walking and turning in response to open- and closed-loop cueing in PwPD, and explored relationships between PFC activity and behavioral measures. Methods: A mobile functional near-infrared spectroscopy device measured PFC activity during walking and turning in 25 PwPD (n = 13 freezers, n = 12 nonfreezers). Participants performed 180° and 360° turns while walking, and a 2-minute walk under single- and dual-task (AX-CPT) conditions with and without an open- (metronome-like vibration) or closed-loop (biofeedback vibration) tactile cue. Results: PFC activity did not change when walking or turning in PwPD; freezing status or task demands did not influence PFC activity. With both open- and closed-loop cueing dual-task cost of gait significantly improved, whereas turning slowed. Discussion and Conclusions: Our preliminary results indicate that both open- and closed-loop cueing can improve gait without additional burden to the PFC beyond usual walking. However, turning while walking slowed with cueing with no PFC activity change. Further investigations are necessary to establish these findings in a larger cohort. Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, the Video, available at: http://links.lww.com/JNPT/A280).

中文翻译：

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帕金森病行走和转弯时前额皮质激活与开环和闭环触觉提示

补充数字内容在文本中可用。背景和目的：步态和转动障碍在帕金森病 (PwPD) 患者中很常见。以开环或闭环方式传递的触觉提示可能会改善 PwPD 的步态和转弯，但潜在的机制尚不清楚。来自前额叶皮层 (PFC) 的注意力可能在提示反应中发挥作用，但 PFC 对特定提示方式的贡献尚不清楚。检查开环和闭环提示如何影响 PwPD 在行走和转动过程中的 PFC 活动可能会阐明提示反应所涉及的机制，这可能会促进有效疗法的发展。我们检查了步行和转弯过程中 PFC 活动以响应 PwPD 中的开环和闭环提示，并探讨了 PFC 活动与行为测量之间的关系。方法：移动功能近红外光谱设备测量了步行和转动 25 PwPD（n = 13 个冰柜，n = 12 个非冰柜）期间的 PFC 活动。参与者在行走时进行 180° 和 360° 转弯，并在单任务和双任务 (AX-CPT) 条件下步行 2 分钟，有和没有开环（类节拍器振动）或闭环（生物反馈振动）触觉提示。结果：在 PwPD 中行走或转弯时 PFC 活动没有变化；冻结状态或任务要求不影响 PFC 活动。在开环和闭环提示的情况下，双任务步态成本显着提高，而转弯速度减慢。讨论和结论：我们的初步结果表明，开环和闭环提示都可以改善步态，而不会给 PFC 带来超出通常步行的额外负担。然而，在没有 PFC 活动变化的情况下，走路时转身减慢了提示。需要进一步调查以在更大的队列中确定这些发现。视频摘要可从作者那里获得更多见解（见补充数字内容 1，视频，可在：http://links.lww.com/JNPT/A280）。