Cognitive Interference Patterns of Gait Initiation in HD

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Cognitive Interference Patterns of Gait Initiation in HD

Disturbances in gait initiation begin in the pre-manifest stages of Huntington’s disease (HD) and continue through disease progression. Gait initiation includes the anticipatory postural adjustment (APA) through the completion of the first step. The APA in gait initiation is marked by the period when the center of pressure (COP) moves backwards and laterally to the stance leg. Deficits in cued gait initiation in manifest-HD have been demonstrated by impaired APAs and first step. Specifically, decreased APA amplitudes and durations, and decreased first step durations have been evident in manifest-HD individuals when compared to healthy controls, during cued gait initiation. Cognitive tasks have the capacity to interfere with gait initiation, ultimately leading to exaggerated motor costs, as shown in healthy older and Parkinson’s disease populations. However, the presence and degree of dual-task costs of gait initiation in Huntington’s disease (HD) remains unknown. Therefore, the purpose of this study was to investigate motor-costs of gait initiation in the presence of an executive functioning task in individuals with manifest-HD. Specifically, we aimed to understand the magnitude of motor costs of APA durations and peak amplitudes, and first step duration, as a consequence of interference from an executive functioning task. We hypothesized to find a larger magnitude of motor costs across first step and APA durations and amplitudes in manifest-HD individuals as compared to healthy controls, as a result of cognitive interference. Findings from this study helps elucidate the role of cognition in gait impairments in HD.

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