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. 2017;59(2):707-721.
doi: 10.3233/JAD-170149.

Motor Phenotype in Neurodegenerative Disorders: Gait and Balance Platform Study Design Protocol for the Ontario Neurodegenerative Research Initiative (ONDRI)

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Motor Phenotype in Neurodegenerative Disorders: Gait and Balance Platform Study Design Protocol for the Ontario Neurodegenerative Research Initiative (ONDRI)

Manuel Montero-Odasso et al. J Alzheimers Dis. .
Free PMC article


Background: The association of cognitive and motor impairments in Alzheimer's disease and other neurodegenerative diseases is thought to be related to damage in the common brain networks shared by cognitive and cortical motor control processes. These common brain networks play a pivotal role in selecting movements and postural synergies that meet an individual's needs. Pathology in this "highest level" of motor control produces abnormalities of gait and posture referred to as highest-level gait disorders. Impairments in cognition and mobility, including falls, are present in almost all neurodegenerative diseases, suggesting common mechanisms that still need to be unraveled.

Objective: To identify motor-cognitive profiles across neurodegenerative diseases in a large cohort of patients.

Methods: Cohort study that includes up to 500 participants, followed every year for three years, across five neurodegenerative disease groups: Alzheimer's disease/mild cognitive impairment, frontotemporal degeneration, vascular cognitive impairment, amyotrophic lateral sclerosis, and Parkinson's disease. Gait and balance will be assessed using accelerometers and electronic walkways, evaluated at different levels of cognitive and sensory complexity, using the dual-task paradigm.

Results: Comparison of cognitive and motor performances across neurodegenerative groups will allow the identification of motor-cognitive phenotypes through the standardized evaluation of gait and balance characteristics.

Conclusions: As part of the Ontario Neurodegenerative Research Initiative (ONDRI), the gait and balance platform aims to identify motor-cognitive profiles across neurodegenerative diseases. Gait assessment, particularly while dual-tasking, will help dissect the cognitive and motor contribution in mobility and cognitive decline, progression to dementia syndromes, and future adverse outcomes including falls and mortality.

Keywords: Alzheimer’s disease; Parkinson’s disease; amyotrophic lateral sclerosis; balance; dementia; dual-tasking; frontotemporal dementia; gait; neurodegeneration; vascular cognitive impairment.


The Ontario Neurodegenerative Disease Research Initiative workflow. Dashed arrows represent single time assessments.
Equipment that will be used to assess gait and balance performance: (a) GaitRITE® mat for gait assessments; (b) Wii board adapted to assess balance control during rest conditions and sit-to-stand transitions; (c) Accelerometers attached to hips and ankles will be used in sites where they are available.
Potential mechanism affecting the common brain structures and networks that regulate gait control and cognitive performance. Adapted from Montero-Odasso et al. [5].

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