This proof-of-concept study demonstrates the feasibility and sensitivity of using mobile EEG to assess inhibitory control while walking in Parkinson's disease, with condition-dependent behavioral and electrophysiological patterns suggesting levodopa primarily affects early sensory-perceptual components and DBS modulates later cognitive components.
Key Findings
Results
People with Parkinson's disease off-levodopa/off-DBS demonstrated reduced response accuracy and treadmill-walking speed compared to healthy controls during dual-task walking.
Ten people with Parkinson's disease were compared with 37 control participants
Comparison was made specifically in the off-levodopa/off-DBS condition versus controls
Both behavioral measures — response accuracy on the inhibitory control task and treadmill-walking speed — were reduced in the Parkinson's disease group
This group-level comparison served as the primary between-group analysis in the study
Results
Response accuracy during dual-task walking improved primarily in the on-levodopa/on-DBS condition compared to the off-levodopa/off-DBS condition in within-subject analyses.
Within-subject analyses across four levodopa/DBS conditions were exploratory in nature
The four conditions were: off-levodopa/off-DBS, on-levodopa/off-DBS, off-levodopa/on-DBS, and on-levodopa/on-DBS
The combined on-levodopa/on-DBS condition showed the most prominent improvement in response accuracy
Authors characterized these within-subject findings as exploratory and hypothesis-generating given the small sample size of 10 participants
Results
Levodopa primarily modulated early sensory-perceptual event-related potential components over bilateral frontocentral regions during dual-task walking.
Event-related potentials were recorded using mobile EEG during an inhibitory control task performed while walking on a treadmill
The modulation by levodopa was observed in early components, consistent with sensory-perceptual processing stages
The topographic distribution of levodopa effects was over bilateral frontocentral regions
These electrophysiological findings were described as condition-dependent and distinguished from DBS effects
Results
Deep brain stimulation modulated later cognitive event-related potential components over right prefrontal and right parietal regions during dual-task walking.
DBS effects were distinct from levodopa effects in both timing (later components) and topography (right-lateralized regions)
The affected regions were right prefrontal and right parietal cortex
Later ERP components are generally associated with higher-order cognitive processing such as response inhibition and decision-making
The differential regional and temporal patterns of levodopa versus DBS modulation suggest these treatments affect different aspects of cognitive processing during walking
Results
Combining mobile EEG with an inhibitory control task during treadmill walking in Parkinson's disease was demonstrated to be feasible and sensitive to condition-dependent changes.
The study used mobile EEG to capture neural signals during walking, addressing methodological challenges previously limiting such research
Both behavioral and electrophysiological measures showed sensitivity to levodopa and DBS condition differences
The paradigm successfully captured event-related potentials during active walking across four treatment conditions
Authors concluded the approach provides 'preliminary guidance for the design of future, adequately powered studies examining combined levodopa and DBS effects on cognition-gait interactions'
What This Means
This research suggests that it is feasible to measure brain activity using a wearable EEG headset while people with Parkinson's disease walk on a treadmill and simultaneously perform a cognitive task that requires inhibitory control (suppressing responses to certain stimuli). Ten people with Parkinson's disease were tested under four combinations of their treatments — medication (levodopa) on or off, and deep brain stimulation (DBS) on or off — and their brain signals and behavioral performance were compared to 37 healthy control participants. People with Parkinson's disease performed worse on both the cognitive task and walking speed when their treatments were turned off, compared to healthy controls.
The study found that levodopa and DBS appear to affect different aspects of brain processing during dual-task walking. Levodopa influenced earlier brain responses associated with sensory and perceptual processing, particularly in frontocentral brain regions on both sides. DBS, on the other hand, influenced later brain responses linked to higher-order cognitive processing, specifically in right-sided prefrontal and parietal regions. When both treatments were active simultaneously, patients showed the greatest improvement in cognitive task accuracy while walking.
This research matters because walking difficulties combined with cognitive challenges are a major problem for people with Parkinson's disease and contribute to falls and reduced quality of life. Understanding how current treatments like levodopa and DBS affect the brain during these combined tasks could help clinicians optimize treatment strategies. The study is small and exploratory, but it establishes that mobile EEG is a viable tool for this type of research, and the findings provide a foundation for designing larger studies to more definitively characterize how these treatments interact to support cognition and movement.
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Lizarraga K, Patelaki E, Kim M, Kim J, McDermott M, Weber M, et al.. (2026). Mobile EEG assessment of inhibitory control during dual-task walking in Parkinson's disease.. Parkinsonism & related disorders. https://doi.org/10.1016/j.parkreldis.2026.108317