Real-world analysis of depression-related adverse events associated with the adsorbed anthrax vaccine: integrating pharmacovigilance signals, machine learning risk prediction, and transcriptomic mecha

Parkinson’s disease (PD) is characterized by motor symptoms such as bradykinesia, rigidity, tremor, and postural instability. Among these symptoms, gait disturbances are particularly debilitating, as they reduce mobility, impair independence, and increase the risk of falls. Considerable research has investigated gait abnormalities in PD patients during usual walking and under dual-task conditions [,]. However, more complex tasks, such as obstacle walking, which demand motor control and cognitive engagement, have received less attention and are crucial for daily life. Obstacle walking requires precise motor execution and adaptive planning in response to environmental changes []. Compared with healthy adults, people with PD exhibit reduced step length and slower gait speed during obstacle walking [,]. Furthermore, compared with usual walking, obstacle walking leads to more pronounced gait impairments among individuals with PD []. Everyday walking often requires the integration of the cognitive and motor systems to adapt to environmental changes. This integration is essential for safe movement. Many factors affect obstacle walking performance, including attention, executive function and visuospatial ability [-]. Impairments in these domains can reduce gait stability and increase fall risk during obstacle walking in patients with PD []. Functional near-infrared spectroscopy (fNIRS) studies have revealed increased prefrontal cortex (PFC) activation during obstacle walking in PD patients, indicating greater cognitive load and reduced neural efficiency []. Motor-related cortical regions, including the premotor cortex (PMC) and supplementary motor area (SMA), also contribute to gait modulation under cognitively demanding conditions, such as dual-task walking []. The PMC integrates visuospatial information for movement adaptation []. The SMA contributes to internally guided sequences and anticipatory postural adjustments—both of which are critical for stepping over obstacles []. Collectively, the PMC and SMA enable adaptive gait and complex motor adjustments.