Virginia R. de Sa

Freezing of gait (FOG) is an elusive phenomenon that debilitates a large number of Parkinson’s disease (PD) patients regardless of stage of disease, medication status, or DBS implantation. Sensory cues, especially visual feedback cues, have been shown to alleviate FOG episodes or prevent episodes from even occurring. Here, we examine cortical information flow between occipital, parietal, and motor areas during the pre-movement stage of gait in a PD-with-FOG patient that had a strong positive behavioral response to visual cues, a PD-with-FOG patient without any behavioral response to visual cues, and an age-matched healthy control, before and after training with visual feedback. Results for this case study show differences in cortical information flow between the responding PD-with-FOG patient and the other two subjects, notably, an increased information flow in the beta range. Tentatively suggesting the formation of an alternative cortical sensory-motor pathway during training with visual feedback, these results are proposed as subject for further verification employing larger cohorts of patients.

Neuroimaging studies provide evidence of cortical involvement immediately before and during gait and during gait-related behaviors such as stepping in place or motor imagery of gait. Here we attempt to perform single-trial classification of gait intent from another movement plan (point intent) or from standing in place. Subjects walked naturally from a starting position to a designated ending position, pointed at a designated position from the starting position, or remained standing at the starting position. The 700 ms of recorded EEG before movement onset was used for single-trial classification of trials based on action type and direction (left walk, forward walk, right walk, left point, right point, and stand) as well as action type regardless of direction (stand, walk, point). Classification using regularized LDA was performed on PCA reduced feature space composed of levels 1-9 coefficients from a discrete wavelet decomposition using the Daubechies 4 wavelet. We achieved significant classification for all conditions, with errors as low as 17% when averaged across nine subjects. LDA and PCA highly weighted frequency ranges that included MRPs, with smaller contributions from frequency ranges that included mu and beta idle motor rhythms. Additionally, error patterns suggested a spatial structure to the EEG signal. Future applications of the cortical gait intent signal may include an additional dimension of control for prosthetics, preemptive corrective feedback for gait disturbances, or human computer interfaces.