The effect of morphometric brain changes on gait-cognitive impairment of patients with Parkinson’s disease
Bibliographic record
Abstract
Introduction With the progression of Parkinson`s Disease (PD), patients suffer from impairments of gait and cognition [1,2]. More severe cognitive impairment is often accompanied by worse gait performance [3]. It is widely believed that ongoing neurodegeneration underlies both disorders. While several studies published their findings regarding brain morphology changes correlating either with cognitive or gait parameters [4], it stays open if there are volumetric differences in brain-regions related to gait between patients with and without cognitive impairment . Research question Is there a relationship between dual-task gait results and brain atrophy in PD patients and is it depending on the existence of cognitive impairment? Methods We included 79 drug-naive PD patients (59.5±12 years) and 54 healthy controls (HC) (60.5 ±9.0 years). All subjects underwent the MoCA test and a single-task (ST) and dual-task (DT) gait assessment. In DT the subjects had to count down from 100 by sevens. The DT cost was calculated for velocity, stride length and cadence, as follows: [(DT − ST)/ST × 100]. Additionally, brain MRI including a T1-weighted images with 1mm3 isotropic resolution was done on a 3 T scanner Based on gait and MoCA results, the subjects in both groups were further divided into cognitively unimpaired subjects, with MoCA ≥24 and first PCA component of DT cost >-0.178 (PD 44, 58.63±12.2 years; HC 43, 61.05±9.3 years), and cognitively impaired subjects with MoCA <24 and first PCA component of DT cost of ≤ -0.178 (PD 35, 60.65±12.3 years; HC 11, 58.55±7.5 years). A voxel-based-morphometry analysis using a multiple regression model with the covariates DT-cost, total intracranial volume, age and sex was performed using the CAT12 software. Results For cognitively unimpaired PD patients, a cluster in the primary motor cortex positively correlated with the stride-length DT cost (pFWEcorr=0.027). This correlation was not detectable for either the cognitively impaired PD group or both HC subgroups. No significant correlations were found for velocity DT-cost and cadence DT-cost. Fig. 1: Results of VBM, positive correlation of DT-cost for stride length for cognitive unimpaired PD patients (significant peak at -21,-12,78) Download: Download high-res image (120KB) Download: Download full-size image Discussion By filtering the group of PD patients into a cognitively impaired and cognitively unimpaired group, we were able to detect a correlation between the precentral gyrus volume and stride-length DT cost in patients without cognitive impairment. This indicates that the poorer DT performance in these patients is mainly driven by degeneration of motor brain regions. This correlation is not detectable in the whole PD dataset, pointing to the fact that more extensive brain atrophy involving different brain regions, might be responsible for worse results in DT in cognitively impaired subjects. In conclusion, the impact of cognitive impairment on gait analysis in PD patients should be considered an important influencing factor. Supported by the Czech Ministry of Health (Grant No. NU20-04-00327)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".