Functional NIR Spectroscopy Reveals Altered Cortical Activation and Neural Efficiency During Obstacle Walking in Parkinson’s Disease with Mild Cognitive Impairment
Taiwanese researchers employed functional near-infrared spectroscopy (fNIRS) to investigate cortical activation patterns during prolonged obstacle walking in individuals with Parkinson’s disease (PD), comparing those with mild cognitive impairment (PD-MCI) to those without cognitive impairment (PD-nonMCI). The study, published in the Journal of Movement Disorders, combined real-time hemodynamic monitoring with detailed gait analysis to examine brain–behavior coupling during complex motor tasks.
The avoidance of obstacles while walking presents a major fall risk for individuals affected by Parkinson's disease (PD), especially those suffering from cognitive impairment. Researchers from Taiwan’s National Central University (Taoyuan), National Yang Ming Chiao Tung University (Taipei) and Mackay Memorial Hospital (Taipei, Taiwan) conducted a joint study where temporal cortical activation and gait dynamics were examined across phases of prolonged obstacle walking in PD with mild cognitive impairment (PD-MCI) and those without cognitive impairment (PD-nonMCI). Using functional near-infrared spectroscopy (fNIRS) to measure activation in the brain and continuous gait analysis, the researchers hoped that their findings could reveal how cognitive impairment affects motor behavior and alters the temporal trajectory of cortical adaptation. A paper based on this work was published in the Journal of Movement Disorders.1
While previous research has studied gait abnormalities in PD during usual walking and dual-task conditions, more challenging tasks such as obstacles walking, which demands both motor control and cognitive engagement, have received less attention.2,3 Obstacle walking requires precise motor execution and adaptive planning is necessary for obstacle walking due to the necessary responses to maneuvering changes in the environment.4
Previous fNIRS studies have shown an increase in prefrontal cortex (PFC) activation during obstacle walking in PD, which indicates a greater cognitive load as well as reduced neural efficiency.5
For this study, 19 PD-nonMCI and 15 PD-MCI participants performed obstacle walking while fNIRS measured activation in the PFC, supplementary motor area (SMA), and premotor cortex (PMC). Gait parameters (speed, cadence, stride length, stride time) and obstacle crossing metrics (crossing speed, stride length, stride time, step width) were analyzed across early (5-20 s) and late (20-40 s) phases. Generalized estimating equations examined group, phase, and interaction effects.1
The research team found that PD-MCI participants displayed poorer obstacle walking performance than those withoutPD-MCI, but no significant phase-related behavioral change was detected. While both groups showed higher PFC, SMA, and PMC activation during the early phase, reflecting greater neural engagement at task onset, SMA and PMC activation decreased at a steeper rate than those in the PD-MCI group. In PD-MCI, obstacle walking performance dissociated with early-phase PMC and late-phase PFC activation.1
“PD-MCI participants showed poorer gait and higher cortical activation,” wrote the authors of the paper,1 “indicating increased neural effort and reduced efficiency. These results highlight altered brain-gait coupling in PD-MCI and emphasize the need for interventions enhancing neural efficiency during complex walking.”
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References
- Wong, P. L.; Yang, Y. R.; Hung, C. W. et al. Cognitive Impairment Alters Cortical Adaptation and Gait Regulation During Obstacle Walking in Parkinson's Disease: Evidence from Temporal fNIRS and Gait Dynamics. J Mov Disord. 2026. DOI:
10.14802/jmd.25346 - 2.Raffegeau, T. E., Krehbiel, L. M.; Namju Kang, F. J. et al. A Meta-Analysis: Parkinson's Disease and Dual-Task Walking. Parkinsonism Relat. Disord. 2019, 62, 28–35. DOI:
10.1016/j.parkreldis.2018.12.012 - 3.Zanardi, A. P. J.; da Silva, E. S.; Costa, R. R. et al. Gait Parameters of Parkinson's Disease Compared with Healthy Controls: A Systematic Review and Meta-Analysis. Sci. Rep. 2021, 11 (1), 752.DOI:
10.1038/s41598-020-80768-2 - 4.Lu, C.; Emily Twedell, E.; Rania Elbasher, R. et al. Avoiding Virtual Obstacles during Treadmill Gait in Parkinson's Disease. Front. Aging Neurosci. 2019, 76. DOI:
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