Melike Kahya1, Kelly E Lyons2, Rajesh Pahwa2, Abiodun E Akinwuntan3, Jianghua He4, Hannes Devos5. 1. Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS. Electronic address: mkahya@kumc.edu. 2. Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS. 3. Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS; Office of the Dean, School of Health Professions, University of Kansas Medical Center, Kansas City, KS. 4. Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS. 5. Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS.
Abstract
OBJECTIVE: To investigate the reliability and validity of pupillary response during dual-task balance conditions in individuals with Parkinson disease (PD). DESIGN: Cross-sectional study. SETTING: University of Kansas Medical Center Parkinson's Disease and Movement Disorder Center. PARTICIPANTS: Participants (N=68) included individuals with PD (n=33) and healthy controls (n=35). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Pupillary response was the main outcome measure that was measured during the following conditions: single-task balance eyes open, single-task balance eyes occluded, dual-task eyes open, and dual-task eyes occluded. After each condition, the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) was administered to assess self-reported cognitive workload. To examine the test-retest reliability of the pupillary response, the conditions were administered twice for each individual within 2 hours. Intraclass correlation coefficients (ICC) were used to analyze the test-retest reliability of pupillary response in each condition for both groups. Pearson's r correlation was used to assess the convergent validity of pupillary response against the NASA-TLX. RESULTS: The test-retest reliability was excellent for both groups in almost all conditions (ICC>0.75). There were no correlations between pupillary response and the NASA-TLX. However, increased mental demand (a subitem of the NASA-TLX) significantly correlated with increased pupillary response in individuals with PD (r=0.38; P=.03). CONCLUSIONS: Pupillary response showed excellent test-retest reliability and validity during dual-task balance for individuals with PD and healthy controls. Overall, these results suggest that pupillary response represents a stable index of cognitive workload during dual-task balance in individuals with PD.
OBJECTIVE: To investigate the reliability and validity of pupillary response during dual-task balance conditions in individuals with Parkinson disease (PD). DESIGN: Cross-sectional study. SETTING: University of Kansas Medical Center Parkinson's Disease and Movement Disorder Center. PARTICIPANTS: Participants (N=68) included individuals with PD (n=33) and healthy controls (n=35). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Pupillary response was the main outcome measure that was measured during the following conditions: single-task balance eyes open, single-task balance eyes occluded, dual-task eyes open, and dual-task eyes occluded. After each condition, the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) was administered to assess self-reported cognitive workload. To examine the test-retest reliability of the pupillary response, the conditions were administered twice for each individual within 2 hours. Intraclass correlation coefficients (ICC) were used to analyze the test-retest reliability of pupillary response in each condition for both groups. Pearson's r correlation was used to assess the convergent validity of pupillary response against the NASA-TLX. RESULTS: The test-retest reliability was excellent for both groups in almost all conditions (ICC>0.75). There were no correlations between pupillary response and the NASA-TLX. However, increased mental demand (a subitem of the NASA-TLX) significantly correlated with increased pupillary response in individuals with PD (r=0.38; P=.03). CONCLUSIONS: Pupillary response showed excellent test-retest reliability and validity during dual-task balance for individuals with PD and healthy controls. Overall, these results suggest that pupillary response represents a stable index of cognitive workload during dual-task balance in individuals with PD.
Authors: Günther Deuschl; Carmen Schade-Brittinger; Paul Krack; Jens Volkmann; Helmut Schäfer; Kai Bötzel; Christine Daniels; Angela Deutschländer; Ulrich Dillmann; Wilhelm Eisner; Doreen Gruber; Wolfgang Hamel; Jan Herzog; Rüdiger Hilker; Stephan Klebe; Manja Kloss; Jan Koy; Martin Krause; Andreas Kupsch; Delia Lorenz; Stefan Lorenzl; H Maximilian Mehdorn; Jean Richard Moringlane; Wolfgang Oertel; Marcus O Pinsker; Heinz Reichmann; Alexander Reuss; Gerd-Helge Schneider; Alfons Schnitzler; Ulrich Steude; Volker Sturm; Lars Timmermann; Volker Tronnier; Thomas Trottenberg; Lars Wojtecki; Elisabeth Wolf; Werner Poewe; Jürgen Voges Journal: N Engl J Med Date: 2006-08-31 Impact factor: 91.245
Authors: Adam Szulewski; Andreas Gegenfurtner; Daniel W Howes; Marco L A Sivilotti; Jeroen J G van Merriënboer Journal: Adv Health Sci Educ Theory Pract Date: 2016-10-27 Impact factor: 3.853
Authors: Carolien Strouwen; Esther A L M Molenaar; Samyra H J Keus; Liesbeth Münks; Elke Heremans; Wim Vandenberghe; Bastiaan R Bloem; Alice Nieuwboer Journal: Parkinsonism Relat Disord Date: 2015-11-27 Impact factor: 4.891
Authors: Daniel Weintraub; Lana M Chahine; Keith A Hawkins; Andrew Siderowf; Shirley Eberly; David Oakes; John Seibyl; Matthew B Stern; Kenneth Marek; Danna Jennings Journal: Mov Disord Date: 2017-10-24 Impact factor: 10.338