{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:21:47Z","timestamp":1772252507309,"version":"3.50.1"},"reference-count":73,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T00:00:00Z","timestamp":1662681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Stuttgart through the Institutional Open Access Program (IOAP)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background and Aims. Most research on Parkinson\u2019s disease (PD) focuses on describing symptoms and movement characteristics. Studies rarely focus on the early detection of PD and the search for suitable markers of a prodromal stage. Early detection is important, so treatments that may potentially change the course of the disease can be attempted early on. While gait disturbances are less pronounced in the early stages of the disease, the prevalence, and severity increase with disease progression. Therefore, postural instability and gait difficulties could be identified as sensitive biomarkers. The aim was to evaluate the discriminatory power of the Trail-Walking Test (TWT; Schott, 2015) as a potential diagnostic instrument to improve the predictive power of the clinical evaluation concerning the severity of the disease and record the different aspects of walking. Methods. A total of 20 older healthy (M = 72.4 years, SD = 5.53) adults and 43 older adults with PD and the motor phenotypes postural instability\/gait difficulty (PIGD; M = 69.7 years, SD = 8.68) and tremor dominant (TD; M = 68.2 years, SD = 8.94) participated in the study. The participants performed a motor-cognitive dual task (DT) of increasing cognitive difficulty in which they had to walk a given path (condition 1), walk to numbers in ascending order (condition 2), and walk to numbers and letters alternately and in ascending order (condition 3). Results. With an increase in the cognitive load, the time to complete the tasks (seconds) became longer in all groups, F(1.23, 73.5) = 121, p &lt; 0.001, \u02732p = 0.670. PIGD showed the longest times in all conditions of the TWT, F(2, 60) = 8.15, p &lt; 0.001, \u02732p = 0.214. Mutual interferences in the cognitive and motor domain can be observed. However, clear group-specific patterns cannot be identified. A differentiation between the motor phenotypes of PD is especially feasible with the purely motor condition (TWT-M; AUC = 0.685, p = 0.44). Conclusions. PD patients with PIGD must be identified by valid, well-evaluated clinical tests that allow for a precise assessment of the disease\u2019s individual fall risk, the severity of the disease, and the prognosis of progression. The TWT covers various aspects of mobility, examines the relationship between cognitive functions and walking, and enables differentiation of the motor phenotypes of PD.<\/jats:p>","DOI":"10.3390\/brainsci12091217","type":"journal-article","created":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T04:54:41Z","timestamp":1662699281000},"page":"1217","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Profiles of Motor-Cognitive Interference in Parkinson\u2019s Disease\u2014The Trail-Walking-Test to Discriminate between Motor Phenotypes"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7633-3835","authenticated-orcid":false,"given":"Thomas J.","family":"Klotzbier","sequence":"first","affiliation":[{"name":"Institute of Sport and Movement Science, University of Stuttgart, 70569 Stuttgart, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadja","family":"Schott","sequence":"additional","affiliation":[{"name":"Institute of Sport and Movement Science, University of Stuttgart, 70569 Stuttgart, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0806-4397","authenticated-orcid":false,"given":"Quincy J.","family":"Almeida","sequence":"additional","affiliation":[{"name":"Movement Disorders Research & Rehabilitation Centre, Department of Kinesiology, Wilfrid Laurier University, Waterloo, ON N2L 3C5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1212\/WNL.0b013e3181f39d0e","article-title":"Mild cognitive impairment in Parkinson disease: A multicenter pooled analysis","volume":"75","author":"Aarsland","year":"2010","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1111\/j.1750-3639.2010.00373.x","article-title":"Profile of cognitive impairment in Parkinson\u2019s disease","volume":"20","author":"Watson","year":"2010","journal-title":"Brain Pathol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1016\/S1474-4422(10)70212-X","article-title":"Neuropsychological and clinical heterogeneity of cognitive impairment and dementia in patients with Parkinson\u2019s disease","volume":"9","author":"Kehagia","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1001\/archneur.60.3.387","article-title":"Prevalence and characteristics of dementia in Parkinson disease: An 8-year prospective study","volume":"60","author":"Aarsland","year":"2003","journal-title":"Arch. 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