A social dancing pilot intervention for older adults at high risk for Alzheimer's disease and related dementias.

Close to 6 million older US adults have Alzheimer's disease or related dementias, yet there is currently no cure or effective treatment. This single-blind randomized controlled trial (clinicaltrials.gov: NCT03475316) aims to establish feasibility, and explore the relative efficacy, of a 6-month social ballroom dancing intervention versus a 6-month active control intervention (treadmill walking) for improving executive function in 32 older adults at increased risk for Alzheimer's disease or related dementias. Dementia-at-risk status is determined with cut-scores on the memory impairment screen (≥3 to ≤6) and/or the AD8 Dementia Screening Interview (≥1). The primary outcome is a composite executive function score from digit-symbol substitution, flanker interference and walking-while-talking tasks. The secondary outcome is functional neuroplasticity during fMRI-adapted versions of digit-symbol substitution, flanker interference and walking-while-talking.

Brain imaging of locomotion in neurological conditions.

Impaired locomotion is a frequent and major source of disability in patients with neurological conditions. Different neuroimaging methods have been used to understand the brain substrates of locomotion in various neurological diseases (mainly in Parkinson's disease) during actual walking, and while resting (using mental imagery of gait, or brain-behavior correlation analyses). These studies, using structural (i.e., MRI) or functional (i.e., functional MRI or functional near infra-red spectroscopy) brain imaging, electrophysiology (i.e., EEG), non-invasive brain stimulation (i.e., transcranial magnetic stimulation, or transcranial direct current stimulation) or molecular imaging methods (i.e., PET, or SPECT) reveal extended brain networks involving both grey and white matters in key cortical (i.e., prefrontal cortex) and subcortical (basal ganglia and cerebellum) regions associated with locomotion. However, the specific roles of the various pathophysiological mechanisms encountered in each neurological condition on the phenotype of gait disorders still remains unclear. After reviewing the results of individual brain imaging techniques across the common neurological conditions, such as Parkinson's disease, dementia, stroke, or multiple sclerosis, we will discuss how the development of new imaging techniques and computational analyses that integrate multivariate correlations in "large enough datasets" might help to understand how individual pathophysiological mechanisms express clinically as an abnormal gait. Finally, we will explore how these new analytic methods could drive our rehabilitative strategies.

Motor imagery of walking and walking while talking: a pilot randomized-controlled trial protocol for older adults.

Over a third of community-residing elderly have clinical gait abnormalities, and gait impairment is associated with morbidity, mortality and dementia. Motor imagery - envisioning motor actions without actual execution - has been used to improve gait in Parkinson's disease and poststroke, but the efficacy of motor imagery in healthy elderly is unknown. This single-blind pilot randomized-controlled trial aims to establish feasibility and explore the efficacy of a 3-month, telephone-based motor imagery intervention - that involves imagined walking, imagined talking and imagined walking while talking for improving gait in 48 healthy elderly. The primary outcomes will be gait speed during actual walking and walking while talking. Secondary outcomes will include cognitive performance during actual talking and walking while talking, and functional neuroplasticity during imagined walking and walking while talking. This clinical trial has been registered on clinicaltrials.gov (identifier NCT02762604).