Background. Although dopaminergic medication improves dual task walking in people with Parkinson disease (PD), the underlying neural mechanisms are not yet fully understood. As prefrontal cognitive resources are involved in dual task walking, evaluation of the prefrontal cortex (PFC) is required. Objective. To investigate the effect of dopaminergic medication on PFC activity and gait parameters during dual task walking in people with PD. Methods. A total of 20 individuals with PD (69.8 ± 5.9 years) and 30 healthy older people (68.0 ± 5.6 years) performed 2 walking conditions: single and dual task (walking while performing a digit vigilance task). A mobile functional near infrared spectroscopy system and an electronic sensor carpet were used to analyze PFC activation and gait parameters, respectively. Relative concentrations of oxygenated hemoglobin (HbO2) from the left and right PFC were measured. Results. People with PD in the off state did not present changes in HbO2 level in the left PFC across walking conditions. In contrast, in the on state, they presented increased HbO2 levels during dual task compared with single task. Regardless of medication state, people with PD presented increased HbO2 levels in the right PFC during dual task walking compared with single task. The control group demonstrated increased PFC activity in both hemispheres during dual task compared with single task. People with PD showed increases in both step length and velocity in the on state compared with the off state. Conclusions. PD limits the activation of the left PFC during dual task walking, and dopaminergic medication facilitates its recruitment.

中文翻译：

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左旋多巴促进帕金森病双任务行走期间的前额叶皮层激活

背景。尽管多巴胺能药物改善了帕金森病 (PD) 患者的双任务行走，但其潜在的神经机制尚未完全了解。由于双任务行走涉及前额叶认知资源，因此需要对前额叶皮层 (PFC) 进行评估。目标。研究多巴胺能药物对 PD 患者双任务行走期间 PFC 活性和步态参数的影响。方法。共有 20 名 PD 患者（69.8 ± 5.9 岁）和 30 名健康老年人（68.0 ± 5.6 岁）执行了 2 种步行条件：单任务和双任务（步行时执行数字警戒任务）。移动功能近红外光谱系统和电子传感器地毯分别用于分析 PFC 激活和步态参数。测量了来自左侧和右侧 PFC 的氧合血红蛋白 (HbO2) 的相对浓度。结果。处于关闭状态的 PD 患者在步行条件下左侧 PFC 中的 HbO2 水平没有变化。相比之下，在开启状态下，与单任务相比，他们在双任务期间呈现出更高的 HbO2 水平。无论药物状态如何，与单任务相比，PD 患者在双任务行走期间右侧 PFC 中的 HbO2 水平升高。与单任务相比，对照组在双任务过程中表现出两个半球的 PFC 活性增加。与关闭状态相比，PD 患者在开启状态下的步长和速度均有所增加。结论。PD 在双任务行走期间限制左 PFC 的激活，多巴胺能药物促进其募集。