The impact of nocturnal hypokinesia on supervised and unsupervised mobility in people with Parkinson’s disease

Nocturnal hypokinesia (NH) is a disabling and underrecognized symptom of Parkinson’s disease (PD), affecting nighttime movements and sleep quality. However, its impact on daytime mobility remains unclear. This study investigated supervised and unsupervised mobility in propensity score-matched mild-to-moderate PD patients with (PD NH + ) and without NH (PD NH − ).

Eighty-eight participants (44 PD NH+ and 44 PD NH-) underwent clinical assessments, mobility tests (i.e., 20-m forward walking, instrumented Timed-Up-and-Go and 3-metre backward walking test), and 5-day monitoring of average daily steps (AvDS) through a commercial activity tracker (Garmin Vivosmart 4). PD NH+ demonstrated worse functional mobility, reduced turning velocity, slower backwards walking, and fewer AvDS than PD NH-. Furthermore, NH severity correlated negatively with most supervised measures and with AvDS.

However, sensitivity analyses controlling for fear of falling attenuated group differences in supervised mobility to non-significance, suggesting a preliminary nature of these findings. The association between NH severity and daily step count showed greater robustness. These findings suggest that NH could be associated with impaired daytime mobility and worse motor function.

These findings highlight the importance of targeted interventions to address both nocturnal and diurnal mobility impairments in PD. This research was performed as part of Edoardo Bianchini’s PhD (Sapienza University of Rome, Italy & University Grenoble Alpes, France) and funded through Doctoral Bursary from Sapienza University of Rome (Student Number 1472455). The research was supported by Sapienza University of Rome as part of the programme Sapienza Research Call 2020, grant n.

AR120172B97AF626 and Research Call 2022, grant n. AR222181683A15AA and by funding from the French government, managed by the National Research Agency (ANR) under the France 2030 programme (MIAI Cluster) (ANR-23-IACL-0006) and under the “Investissements d’avenir” programme (ANR-10-AIRT-0005 and ANR-15-IDEX-0002). This work also forms part of a broader translational and interdisciplinary GaitAlps research programme (NV).

The authors sincerely thank all people that were involved in the data collection, from study participants to students who aided and assisted during assessments. Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy Edoardo Bianchini, Pietro Lombardo, Domiziana Rinaldi, Lanfranco De Carolis, Marika Alborghetti & Marco Salvetti University Grenoble Alpes, CNRS, Grenoble INP, LIG Sangria, Grenoble, France Edoardo Bianchini, Tracy Milane, Clint Hansen & Nicolas Vuillerme Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy IRCCS Neuromed Institute, Pozzilli, Italy Department of Neurology, Kiel University, Kiel, Germany Institut Universitaire de France, Paris, France Correspondence to Edoardo Bianchini or Nicolas Vuillerme. The authors declare no competing interests.