Motor Phenotype in Neurodegenerative Disorders: Gait and Balance Platform Study Design Protocol for the Ontario Neurodegenerative Research Initiative (ONDRI)

Manuel Montero-Odasso; Frederico Pieruccini-Faria; Robert Bartha; Sandra E Black; Elizabeth Finger; Morris Freedman; Barry Greenberg; David A Grimes; Robert A Hegele; Christopher Hudson; Peter W Kleinstiver; Anthony E Lang; Mario Masellis; Paula M McLaughlin; Douglas P Munoz; Stephen Strother; Richard H Swartz; Sean Symons; Maria Carmela Tartaglia; Lorne Zinman; Michael J Strong; ONDRI Investigators; William McIlroy

doi:10.3233/JAD-170149

Motor Phenotype in Neurodegenerative Disorders: Gait and Balance Platform Study Design Protocol for the Ontario Neurodegenerative Research Initiative (ONDRI)

J Alzheimers Dis. 2017;59(2):707-721. doi: 10.3233/JAD-170149.

Authors

Manuel Montero-Odasso^{1

2

3}, Frederico Pieruccini-Faria^{1

3}, Robert Bartha⁴, Sandra E Black^{5

6}, Elizabeth Finger⁷, Morris Freedman⁸, Barry Greenberg⁹, David A Grimes¹⁰, Robert A Hegele^{11

4}, Christopher Hudson¹², Peter W Kleinstiver¹³, Anthony E Lang¹⁴, Mario Masellis⁵, Paula M McLaughlin¹³, Douglas P Munoz¹⁵, Stephen Strother¹⁶, Richard H Swartz¹⁷, Sean Symons¹⁸, Maria Carmela Tartaglia¹⁹, Lorne Zinman⁵, Michael J Strong^{4

8}; ONDRI Investigators; William McIlroy^{6

14

20}

Affiliations

¹ Department of Medicine, Division of Geriatric Medicine, Parkwood Hospital, University of Western Ontario, London, ON, Canada.
² Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada.
³ Lawson Health Research Institute, London, ON, Canada.
⁴ Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Robarts Research Institute, University of Western Ontario, London, ON, Canada.
⁵ Department of Medicine, Division of Neurology, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada.
⁶ Canadian Partnership for Stroke Recovery Sunnybrook Site, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
⁷ Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
⁸ Department of Medicine (Neurology), Baycrest Health Sciences and University of Toronto, Toronto, ON, Canada; Rotman Research Institute, Baycrest Centre for Geriatric Care, Toronto, ON, Canada.
⁹ Toronto Dementia Research Alliance, University Health Network, Toronto, ON, Canada.
¹⁰ Department of Medicine, The Ottawa Hospital, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
¹¹ Department of Biochemistry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
¹² School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada.
¹³ Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
¹⁴ Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital and the Department of Medicine, University of Toronto, ON, Canada.
¹⁵ Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
¹⁶ Department of Medical Biophysics, Rotman Research Institute, Baycrest, University of Toronto, ON, Canada.
¹⁷ Sunnybrook Health Sciences Centre, University of Toronto, Stroke Research Program, Toronto, ON, Canada.
¹⁸ Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
¹⁹ Department of Medicine and Division of Neurology, University of Toronto, Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, ON, Canada.
²⁰ Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.

Abstract

Background: The association of cognitive and motor impairments in Alzheimer's disease and other neurodegenerative diseases is thought to be related to damage in the common brain networks shared by cognitive and cortical motor control processes. These common brain networks play a pivotal role in selecting movements and postural synergies that meet an individual's needs. Pathology in this "highest level" of motor control produces abnormalities of gait and posture referred to as highest-level gait disorders. Impairments in cognition and mobility, including falls, are present in almost all neurodegenerative diseases, suggesting common mechanisms that still need to be unraveled.

Objective: To identify motor-cognitive profiles across neurodegenerative diseases in a large cohort of patients.

Methods: Cohort study that includes up to 500 participants, followed every year for three years, across five neurodegenerative disease groups: Alzheimer's disease/mild cognitive impairment, frontotemporal degeneration, vascular cognitive impairment, amyotrophic lateral sclerosis, and Parkinson's disease. Gait and balance will be assessed using accelerometers and electronic walkways, evaluated at different levels of cognitive and sensory complexity, using the dual-task paradigm.

Results: Comparison of cognitive and motor performances across neurodegenerative groups will allow the identification of motor-cognitive phenotypes through the standardized evaluation of gait and balance characteristics.

Conclusions: As part of the Ontario Neurodegenerative Research Initiative (ONDRI), the gait and balance platform aims to identify motor-cognitive profiles across neurodegenerative diseases. Gait assessment, particularly while dual-tasking, will help dissect the cognitive and motor contribution in mobility and cognitive decline, progression to dementia syndromes, and future adverse outcomes including falls and mortality.

Keywords: Alzheimer’s disease; Parkinson’s disease; amyotrophic lateral sclerosis; balance; dementia; dual-tasking; frontotemporal dementia; gait; neurodegeneration; vascular cognitive impairment.

MeSH terms

Accidental Falls
Cohort Studies
Cross-Sectional Studies
Female
Gait Disorders, Neurologic / etiology*
Humans
Male
Motor Activity / physiology*
Neurodegenerative Diseases / classification
Neurodegenerative Diseases / complications*
Neuropsychological Tests
Ontario
Postural Balance / physiology*
Sensation Disorders / etiology*
Statistics, Nonparametric
Surveys and Questionnaires