The challenge of dual-tasking for Parkinson's patients

We at Gondola Medical Technologies have observed that dual-tasking is a real challenge for many patients with neurological disorders such as Parkinson's disease. The ability to walk while talking or thinking about a complex problem is often taken for granted. It usually does not require much cognitive effort. However, walking is not that simple, as it relies on efficient coordination of multiple muscles and continuous posture adjustments. Most people will perceive it as almost automatic because it is largely managed by a set of deep brain nuclei in our subconscious called the basal ganglia.

Pathological conditions such as Parkinson's, stroke and other neurological disorders are known to interfere with the normal functioning of the basal ganglia, turning walking and many other automatic actions of daily life into a real challenge for the brain. When the basal ganglia fail to coordinate complex sets of actions, other areas of the brain must take responsibility for this task for which, however, they are not optimally structured (Wu T, 2015). Cortical areas, designed physiologically and anatomically to perform higher cognitive tasks, are often forced to become responsible for most automatic behaviors, such as walking, as the glycemic nuclei deteriorate. This results in the appearance of the early gait abnormalities that we observe in most Parkinson's and other neurological patients. As cortical areas take control of walking, this process becomes less automatic for patients, whose brains need to think about planning, execution, and completion of each step.