Patients with Parkinsonian syndromes have different brain activity patterns in regard to balance control compared to healthy people, according to a new study by researchers from Albert Einstein College of Medicine who used a new portable measuring device developed at Drexel University.
The findings highlight the critical role of the prefrontal cortex in balance control and may eventually lead to better detection and treatment of Parkinsonian symptoms in older patients.
Parkinson’s disease is a neurological disorder that arises when brain cells that control movement die, leaving many patients in the late stages of the disease unable to walk at all. Parkinsonian syndromes, which are common in the elderly, are conditions that do not result in a Parkinson’s diagnosis but include many symptoms of the disease, such as rigidity, tremor, and walking difficulties.
Previous attempts to analyze brain activity and stability in people with Parkinsonian syndromes have been limited, because neuroimaging tools could only be used when a study participant was lying flat, rather than walking or standing. In these cases, the patient receiving the brain scan could only imagine that he or she was performing the tasks.
A portable system created by researchers in Drexel’s School of Biomedical Engineering and Health Systems has fixed this problem. It has allowed scientists, for the first time, to better understand the role of the brain’s prefrontal cortex during standing and walking.
The prefrontal cortex is an area of the brain linked to higher-level processing, such as memory, attention, problem solving, and decision-making. When a person is learning a new skill, for example, neural activity is greater in this region.
Unlike fMRI (functional magnetic resonance imaging), the new fNIR system (functional near-infrared spectroscopy) is fully portable: Participants wear a headband, allowing them to talk and move around while a computer collects data in real time.
“This initial study allowed us to measure brain activity in real-time, in a realistic setting. It shows that there are indeed differences in the prefrontal cortex of healthy and Parkinsonian syndrome patients, and those differences relate to their performance in maintaining stability while standing,” said co-author Meltem Izzetoglu, Ph.D., an assistant research professor of biomedical engineering at Drexel. “It opens up new fields of research.”
For the study, researchers compared 126 healthy adults to 117 individuals with mild Parkinson’s symptoms and 26 with more severe symptoms. While wearing a headband device, the participants were asked to stand and look straight ahead while counting for 10 seconds.
They then walked on a mat that captured their gait speed, pace and stride length. The system recorded their brain oxygen levels during the entire testing period.
The findings show that those with Parkinsonian symptoms had significantly higher prefrontal oxygenation levels to maintain stability when standing than participants with mild and no symptoms.
“In fact, brain activity in the frontal brain region was nearly twice as large,” said lead author Jeannette R. Mahoney, Ph.D., assistant professor of neurology at Einstein.
The new portable technology could aid in diagnosing Parkinsonian syndromes or developing new treatments.
“Our goal is to be able to intervene with Parkinsonian symptoms and develop novel remediation in the not-so-distant future to improve elders’ quality of life,” Mahoney said.
The findings are published in the journal Brain Research.