Evidence for Differential Effects of 2 Forms of Exercise on Prefrontal Plasticity During Walking in Parkinson’s Disease

Abstract

Background. In a randomized control trial conducted in patients with Parkinson’s disease, a treadmill training program combined with virtual reality that targeted motor and cognitive aspects of safe ambulation led to fewer falls, compared with treadmill training alone. Objective. To investigate if the 2 types of training differentially affected prefrontal activation and if this might explain differences in fall rates after the intervention. Methods. Sixty-four patients with Parkinson’s disease were randomized into the treadmill training arm (n = 34, mean age 73.1 ± 1.1 years, 64% men, disease duration 9.7 ± 1.0 years) or treadmill training with virtual reality arm (n = 30, mean age 70.1 ± 1.3 years, 71% men, disease duration 8.9 ± 1.1 years). Prefrontal activation during usual, dual-task, and obstacle negotiation walking was assessed before and after 6 weeks of training, using a functional near-infrared spectroscopy system. Results. Treadmill training with and without virtual reality reduced prefrontal activation during walking (P