School of Human Kinetics/Faculty of Health,
University of Ottawa
New Investigator Award: $90,000 over two years
Postural instability and gait disturbances in Parkinson’s disease: Role of mild cognitive impairments
For people with Parkinson’s disease who develop unstable posture and an unsteady gait, or who freeze in place suddenly, falls are a major hazard. These people could also be at higher risk of developing mild cognitive impairment and dementia – but researchers don’t yet know why.
At the University of Ottawa, Julie Nantel, who specializes in biomechanics, is investigating the relationship between gait disorders and cognitive impairment. “Nobody knows exactly what the mechanisms are that cause freezing of gait – and there’s no good treatment for freezing of gait,” says Nantel.
Although some people respond to levodopa, the medication used to replace dopamine that is depleted in the brain cells of people with Parkinson’s disease, for other people the drug does not reduce balance and gait problems. “Freezing of gait is a major problem,” says Nantel. “People tend to stay at home and avoid going outside because … they are afraid of falling when they go out on the street.”
It’s also stressful for people to think they might eventually develop cognitive problems, and they worry about the effect on their families, Nantel says.
She wants to develop tools, called metrics, to explain the different gait patterns in people with Parkinson’s who freeze, and those who don’t. Through a study that involves giving people with Parkinson’s a succession of cognitive tasks as they step in place to perform balance or locomotion tests, Nantel also hopes to pinpoint the relationship between cognitive impairment and freezing. Her goal is to better understand the basic mechanisms causing both freezing of gait and cognitive impairment and to predict who is more at risk of developing these problems. This could lead to the development of new rehabilitation strategies to help people with Parkinson’s stay active and independent as long a possible.
Nantel is motivated to work with people with Parkinson’s disease because of their positive attitude and willingness to try different ideas. “If there is something they can do to help, they do it. They really understand that research is imperative to better understand this disease and ultimately help them with their symptoms,” she says.