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

Authors

Manuel Montero-Odasso, The University of Western Ontario
Frederico Pieruccini-Faria, The University of Western Ontario
Robert Bartha, Robarts Research InstituteFollow
Sandra E. Black, University of Toronto
Elizabeth Finger, Schulich School of Medicine & Dentistry
Morris Freedman, University of Toronto
Barry Greenberg, University Health Network University of Toronto
David A. Grimes, L'Hôpital d'Ottawa
Robert A. Hegele, Schulich School of Medicine & Dentistry
Christopher Hudson, University of Waterloo
Peter W. Kleinstiver, Schulich School of Medicine & Dentistry
Anthony E. Lang, University of Toronto
Mario Masellis, University of Toronto
Paula M. McLaughlin, Schulich School of Medicine & Dentistry
Douglas P. Munoz, Queen's University, Centre for Neuroscience Studies, Kingston
Stephen Strother, University of Toronto
Richard H. Swartz, University of Toronto
Sean Symons, Sunnybrook Health Sciences Centre
Maria Carmela Tartaglia, Tanz Centre for Research in Neurodegenerative Diseases
Lorne Zinman, University of Toronto
Michael J. Strong, University of Toronto
William McIlroy, University of Toronto

Document Type

Article

Publication Date

1-1-2017

Journal

Journal of Alzheimer's Disease

Volume

59

Issue

2

First Page

707

Last Page

721

URL with Digital Object Identifier

10.3233/JAD-170149

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.