Cognition as a mediator for gait and balance impairments in GBA-related Parkinson’s disease

Rosie Morris, Douglas N Martini, Katrina Ramsey, Valerie E Kelly, Katrijn Smulders, Amie Hiller, Kathryn A Chung, Shu-Ching Hu, Cyrus P Zabetian, Kathleen L Poston, Ignacio F Mata, Karen L Edwards, Jodi Lapidus, Brenna Cholerton, Thomas J Montine, Joseph F Quinn, Fay Horak*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Downloads (Pure)

Abstract

The extent to which the heterogeneity of gait and balance problems in PD may be explained by genetic variation is unknown. Variants in the glucocerebrosidase (GBA) gene are the strongest known genetic risk factor for PD and are associated with greater motor and cognitive severity. However, the impact of GBA variants on comprehensive measures of gait and balance and their relationship to cognition remains unknown. We aimed to determine differences in gait and balance impairments in those with and without GBA variants (mutation carriers and E326K polymorphism) and explore direct and indirect effects of GBA status on gait, balance, and cognition. 332 participants, 43 of whom had GBA variants, were recruited. Participants completed a comprehensive, objective assessment of gait and standing balance using body-worn inertial sensors. Group differences in gait and balance between PD with and without GBA variants were assessed with linear regression, adjusting for age, gender, clinical testing site, disease duration, and apolipoprotein E (APOE) ɛ4 status. Structural equation modeling (SEM) explored direct relationships between GBA status and gait and balance and indirect relationships between GBA status and gait and balance via cognition. The GBA variant group had more impaired gait (pace and variability) and balance (sway area/jerk and sway velocity), than the non-GBA variant group. SEM demonstrated cognition as a mediator of GBA status on gait and balance. The close relationships among GBA, gait/balance, and cognition suggest potential for novel therapeutics to target the GBA pathway and/or cognition to improve mobility in PD GBA variants.

Original languageEnglish
Article number78
Number of pages8
JournalNPJ Parkinson's Disease
Volume8
Issue number1
Early online date20 Jun 2022
DOIs
Publication statusE-pub ahead of print - 20 Jun 2022

Fingerprint

Dive into the research topics of 'Cognition as a mediator for gait and balance impairments in GBA-related Parkinson’s disease'. Together they form a unique fingerprint.

Cite this