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Shali RK, Setarehdan SK, Seifi B. Functional near-infrared spectroscopy based blood pressure variations and hemodynamic activity of brain monitoring following postural changes: A systematic review. Physiol Behav 2024; 281:114574. [PMID: 38697274 DOI: 10.1016/j.physbeh.2024.114574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/03/2024] [Accepted: 04/26/2024] [Indexed: 05/04/2024]
Abstract
Postural change from supine or sitting to standing up leads to displacement of 300 to 1000 mL of blood from the central parts of the body to the lower limb, which causes a decrease in venous return to the heart, hence decrease in cardiac output, causing a drop in blood pressure. This may lead to falling down, syncope, and in general reducing the quality of daily activities, especially in the elderly and anyone suffering from nervous system disorders such as Parkinson's or orthostatic hypotension (OH). Among different modalities to study brain function, functional near-infrared spectroscopy (fNIRS) is a neuroimaging method that optically measures the hemodynamic response in brain tissue. Concentration changes in oxygenated hemoglobin (HbO2) and deoxygenated hemoglobin (HHb) are associated with brain neural activity. fNIRS is significantly more tolerant to motion artifacts compared to fMRI, PET, and EEG. At the same time, it is portable, has a simple structure and usage, is safer, and much more economical. In this article, we systematically reviewed the literature to examine the history of using fNIRS in monitoring brain oxygenation changes caused by sudden changes in body position and its relationship with the blood pressure changes. First, the theory behind brain hemodynamics monitoring using fNIRS and its advantages and disadvantages are presented. Then, a study of blood pressure variations as a result of postural changes using fNIRS is described. It is observed that only 58 % of the references concluded a positive correlation between brain oxygenation changes and blood pressure changes. At the same time, 3 % showed a negative correlation, and 39 % did not show any correlation between them.
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Affiliation(s)
- Roya Kheyrkhah Shali
- School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.
| | - Seyed Kamaledin Setarehdan
- School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Behjat Seifi
- Faculty of Medical Science, University of Tehran, Tehran, Iran
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Saraiva M, Vilas-Boas JP, Castro MA. Postural Control and Muscle Activity during Dual-Task in Young Adults. Behav Sci (Basel) 2024; 14:403. [PMID: 38785895 PMCID: PMC11117846 DOI: 10.3390/bs14050403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
In everyday life, we recurrently perform two tasks simultaneously, which is called dual-tasking. A common dual task is smartphone use while standing or walking. According to previous studies, this task can compromise postural stability. However, few studies have analyzed lower limb muscle activity during dual-tasking using smartphones. This study aimed to assess the postural sway and muscle activity during dual-tasking in young adults. Thirty-six healthy young adults (23.08 ± 3.92 years) participated in this study. They performed a single task (ST: keeping a quiet standing posture) and a dual task (DT: keeping the ST while simultaneously performing a cognitive task on their smartphone). Postural sway was assessed through the center of pressure (CoP) analysis using a force platform: total CoP displacement, CoP displacement in the anterior-posterior and medial-lateral directions, mean total velocity of the CoP, mean velocity of the CoP in the anterior-posterior and medial-lateral directions, and 95% confidence ellipse sway area. A surface electromyography system recorded the muscle activity of the lumbar spinal erector and five muscles of the lower limb (bilaterally). The results showed an increase in postural sway from the ST to the DT in all CoP variables (p < 0.05), and muscle activity in most muscles analyzed decreased from the ST to the DT (p < 0.05). In conclusion, our results reflect a decentralization of attention from motor performance once postural sway increased and muscle activity decreased in dual-task conditions.
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Affiliation(s)
- Marina Saraiva
- Dr. Lopes Dias Health School, Sector of Physiotherapy, Polytechnic Institute of Castelo Branco, 6000-767 Castelo Branco, Portugal
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal;
- Centre for Mechanical Engineering, Materials and Processes, CEMMPRE, University of Coimbra, 3030-788 Coimbra, Portugal
| | - João Paulo Vilas-Boas
- Faculty of Sports and CIAFEL, University of Porto, 4200-450 Porto, Portugal;
- LABIOMEP-UP, Faculty of Sports and CIFI2D, The University of Porto, 4200-450 Porto, Portugal
| | - Maria António Castro
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal;
- Centre for Mechanical Engineering, Materials and Processes, CEMMPRE, University of Coimbra, 3030-788 Coimbra, Portugal
- School of Health Sciences, Sector of Physiotherapy, ciTechCare, CDRSP, Polytechnic University of Leiria, 2411-901 Leiria, Portugal
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Choi M, Kim HC, Youn I, Lee SJ, Lee JH. Use of functional magnetic resonance imaging to identify cortical loci for lower limb movements and their efficacy for individuals after stroke. J Neuroeng Rehabil 2024; 21:58. [PMID: 38627779 PMCID: PMC11020805 DOI: 10.1186/s12984-024-01319-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 01/29/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Identification of cortical loci for lower limb movements for stroke rehabilitation is crucial for better rehabilitation outcomes via noninvasive brain stimulation by targeting the fine-grained cortical loci of the movements. However, identification of the cortical loci for lower limb movements using functional MRI (fMRI) is challenging due to head motion and difficulty in isolating different types of movement. Therefore, we developed a custom-made MR-compatible footplate and leg cushion to identify the cortical loci for lower limb movements and conducted multivariate analysis on the fMRI data. We evaluated the validity of the identified loci using both fMRI and behavioral data, obtained from healthy participants as well as individuals after stroke. METHODS We recruited 33 healthy participants who performed four different lower limb movements (ankle dorsiflexion, ankle rotation, knee extension, and toe flexion) using our custom-built equipment while fMRI data were acquired. A subgroup of these participants (Dataset 1; n = 21) was used to identify the cortical loci associated with each lower limb movement in the paracentral lobule (PCL) using multivoxel pattern analysis and representational similarity analysis. The identified cortical loci were then evaluated using the remaining healthy participants (Dataset 2; n = 11), for whom the laterality index (LI) was calculated for each lower limb movement using the cortical loci identified for the left and right lower limbs. In addition, we acquired a dataset from 15 individuals with chronic stroke for regression analysis using the LI and the Fugl-Meyer Assessment (FMA) scale. RESULTS The cortical loci associated with the lower limb movements were hierarchically organized in the medial wall of the PCL following the cortical homunculus. The LI was clearer using the identified cortical loci than using the PCL. The healthy participants (mean ± standard deviation: 0.12 ± 0.30; range: - 0.63 to 0.91) exhibited a higher contralateral LI than the individuals after stroke (0.07 ± 0.47; - 0.83 to 0.97). The corresponding LI scores for individuals after stroke showed a significant positive correlation with the FMA scale for paretic side movement in ankle dorsiflexion (R2 = 0.33, p = 0.025) and toe flexion (R2 = 0.37, p = 0.016). CONCLUSIONS The cortical loci associated with lower limb movements in the PCL identified in healthy participants were validated using independent groups of healthy participants and individuals after stroke. Our findings suggest that these cortical loci may be beneficial for the neurorehabilitation of lower limb movement in individuals after stroke, such as in developing effective rehabilitation interventions guided by the LI scores obtained for neuronal activations calculated from the identified cortical loci across the paretic and non-paretic sides of the brain.
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Affiliation(s)
- Minseok Choi
- Department of Brain and Cognitive Engineering, Korea University, Seoul, South Korea
| | - Hyun-Chul Kim
- Department of Artificial Intelligence, Kyungpook National University, Daegu, South Korea
| | - Inchan Youn
- Bionics Research Center, Biomedical Research Division, Korea Institute of Science and Technology, Seoul, South Korea
| | - Song Joo Lee
- Bionics Research Center, Biomedical Research Division, Korea Institute of Science and Technology, Seoul, South Korea.
| | - Jong-Hwan Lee
- Department of Brain and Cognitive Engineering, Korea University, Seoul, South Korea.
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, South Korea.
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Boston, Massachusetts, USA.
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Sigurdsson HP, Alcock L, Firbank M, Wilson R, Brown P, Maxwell R, Bennett E, Pavese N, Brooks DJ, Rochester L. Developing a novel dual-injection FDG-PET imaging methodology to study the functional neuroanatomy of gait. Neuroimage 2024; 288:120531. [PMID: 38331333 DOI: 10.1016/j.neuroimage.2024.120531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 01/26/2024] [Accepted: 02/05/2024] [Indexed: 02/10/2024] Open
Abstract
Gait is an excellent indicator of physical, emotional, and mental health. Previous studies have shown that gait impairments in ageing are common, but the neural basis of these impairments are unclear. Existing methodologies are suboptimal and novel paradigms capable of capturing neural activation related to real walking are needed. In this study, we used a hybrid PET/MR system and measured glucose metabolism related to both walking and standing with a dual-injection paradigm in a single study session. For this study, 15 healthy older adults (10 females, age range: 60.5-70.7 years) with normal cognition were recruited from the community. Each participant received an intravenous injection of [18F]-2-fluoro-2-deoxyglucose (FDG) before engaging in two distinct tasks, a static postural control task (standing) and a walking task. After each task, participants were imaged. To discern independent neural functions related to walking compared to standing, we applied a bespoke dose correction to remove the residual 18F signal of the first scan (PETSTAND) from the second scan (PETWALK) and proportional scaling to the global mean, cerebellum, or white matter (WM). Whole-brain differences in walking-elicited neural activity measured with FDG-PET were assessed using a one-sample t-test. In this study, we show that a dual-injection paradigm in healthy older adults is feasible with biologically valid findings. Our results with a dose correction and scaling to the global mean showed that walking, compared to standing, increased glucose consumption in the cuneus (Z = 7.03), the temporal gyrus (Z = 6.91) and the orbital frontal cortex (Z = 6.71). Subcortically, we observed increased glucose metabolism in the supraspinal locomotor network including the thalamus (Z = 6.55), cerebellar vermis and the brainstem (pedunculopontine/mesencephalic locomotor region). Exploratory analyses using proportional scaling to the cerebellum and WM returned similar findings. Here, we have established the feasibility and tolerability of a novel method capable of capturing neural activations related to actual walking and extended previous knowledge including the recruitment of brain regions involved in sensory processing. Our paradigm could be used to explore pathological alterations in various gait disorders.
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Affiliation(s)
- Hilmar P Sigurdsson
- Clinical Ageing Research Unit, Translational and Clinical Research Institute, Faculty of Medical Sciences, Campus for Aging and Vitality, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK.
| | - Lisa Alcock
- Clinical Ageing Research Unit, Translational and Clinical Research Institute, Faculty of Medical Sciences, Campus for Aging and Vitality, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK; National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Michael Firbank
- Clinical Ageing Research Unit, Translational and Clinical Research Institute, Faculty of Medical Sciences, Campus for Aging and Vitality, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK
| | - Ross Wilson
- Clinical Ageing Research Unit, Translational and Clinical Research Institute, Faculty of Medical Sciences, Campus for Aging and Vitality, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK
| | - Philip Brown
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ross Maxwell
- Clinical Ageing Research Unit, Translational and Clinical Research Institute, Faculty of Medical Sciences, Campus for Aging and Vitality, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK
| | | | - Nicola Pavese
- Clinical Ageing Research Unit, Translational and Clinical Research Institute, Faculty of Medical Sciences, Campus for Aging and Vitality, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK; Department of Nuclear Medicine and PET, Institute of Clinical Medicine, Aarhus University, Denmark
| | - David J Brooks
- Clinical Ageing Research Unit, Translational and Clinical Research Institute, Faculty of Medical Sciences, Campus for Aging and Vitality, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK; Department of Nuclear Medicine and PET, Institute of Clinical Medicine, Aarhus University, Denmark
| | - Lynn Rochester
- Clinical Ageing Research Unit, Translational and Clinical Research Institute, Faculty of Medical Sciences, Campus for Aging and Vitality, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK; National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Trost W, Hars M, Fernandez N, Herrmann F, Chevalley T, Ferrari S, Gold G, Rizzoli R, Vuilleumier P, Trombetti A. Functional brain changes in sarcopenia: evidence for differential central neural mechanisms in dynapenic older women. Aging Clin Exp Res 2023; 35:1015-1025. [PMID: 37029271 PMCID: PMC10149465 DOI: 10.1007/s40520-023-02391-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/10/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND The European Working Group on Sarcopenia in Older People (EWGSOP2) recently revised its definition and diagnostic criteria for sarcopenia, placing muscle strength at the forefront. The pathogenesis of dynapenia (or low muscle strength) is still not fully understood, but there is emerging evidence that central neural factors constitute critical determinants. METHODS Our cross-sectional study included 59 community-dwelling older women (mean age 73.1 ± 4.9 years). Participants underwent detailed skeletal muscle assessments for muscle strength defined by handgrip strength and chair rise time measurements using the recently published EWGSOP2 cut-off points. Functional magnetic resonance imaging (fMRI) was assessed during the performance of a cognitive dual-task paradigm, consisting of a baseline, two single-tasks (motor and arithmetic) and one dual-task (motor and arithmetic combined). RESULTS Forty-seven percent (28/59) of participants were classified as dynapenic. fMRI results revealed a differential recruitment of motor circuits in the brain during the dual-task condition in dynapenic as compared with non-dynapenic participants. In particular, while the brain activity during the single-tasks did not differ between the two groups, only during the dual-task non-dynapenic participants showed significant increased activation in dorsolateral prefrontal and premotor cortex, and in supplementary motor area as compared to dynapenic participants. CONCLUSION Our results point to a dysfunctional involvement of brain networks associated with motor control in dynapenia in a multi-tasking paradigm. A better knowledge of the link between dynapenia and brain functions could provide new impulses in the diagnosis and interventions for sarcopenia.
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Affiliation(s)
- Wiebke Trost
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva 14, Switzerland
- Laboratory for Behavioural Neurology and Imaging of Cognition, Campus Biotech, University of Geneva, Geneva, Switzerland
| | - Mélany Hars
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva 14, Switzerland
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Natalia Fernandez
- Laboratory for Behavioural Neurology and Imaging of Cognition, Campus Biotech, University of Geneva, Geneva, Switzerland
| | - François Herrmann
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Thierry Chevalley
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva 14, Switzerland
| | - Serge Ferrari
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva 14, Switzerland
| | - Gabriel Gold
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - René Rizzoli
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva 14, Switzerland
| | - Patrik Vuilleumier
- Laboratory for Behavioural Neurology and Imaging of Cognition, Campus Biotech, University of Geneva, Geneva, Switzerland
| | - Andrea Trombetti
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva 14, Switzerland.
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland.
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Kvist A, Bezuidenhout L, Johansson H, Albrecht F, Ekman U, Conradsson DM, Franzén E. Using functional near-infrared spectroscopy to measure prefrontal cortex activity during dual-task walking and navigated walking: A feasibility study. Brain Behav 2023; 13:e2948. [PMID: 36917560 PMCID: PMC10097069 DOI: 10.1002/brb3.2948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 03/16/2023] Open
Abstract
INTRODUCTION While functional near-infrared spectroscopy (fNIRS) can provide insight into motor-cognitive deficits during ecologically valid gait conditions, the feasibility of using fNIRS during complex walking remains unknown. We tested the process and scientific feasibility of using an fNIRS device to measure cortical activity during complex walking tasks consisting of straight walking and navigated walking under single and dual-task (DT) conditions. METHODS Nineteen healthy people from 18 to 64 years (mean age: 45.7 years) participated in this study which consisted of three complex walking protocols: (i) straight walking, DT walking (walking while performing an auditory Stroop task) and single-task auditory Stroop, (ii) straight and navigated walking, and (iii) navigated walking and navigated DT walking. A rest condition (standing still) was also included in each protocol. Process feasibility outcomes included evaluation of the test procedures and participant experience during and after each protocol. Scientific feasibility outcomes included signal quality measures, and the ability to measure changes in concentration of deoxygenated and oxygenated hemoglobin in the prefrontal cortex. RESULTS All participants were able to complete the three protocols with most agreeing that the equipment was comfortable (57.9%) and that the testing duration was adequate (73.7%). Most participants did not feel tired (94.7%) with some experiencing pain (42.1%) during the protocols. The signal qualities were high for each protocol. Compared to the rest condition, there was an increase in oxygenated hemoglobin in the prefrontal cortex when performing dual-task walking and navigation. CONCLUSION We showed that our experimental setup was feasible for assessing activity in the prefrontal cortex with fNIRS during complex walking. The experimental setup was deemed acceptable and practicable. Signal quality was good during complex walking conditions and findings suggest that the different tasks elicit a differential brain activity, supporting scientific feasibility.
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Affiliation(s)
- Alexander Kvist
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Lucian Bezuidenhout
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Faculty of Community and Health Sciences, University of Western Cape, Cape Town, South Africa
| | - Hanna Johansson
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Franziska Albrecht
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Urban Ekman
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
| | - David Moulaee Conradsson
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Erika Franzén
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
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Hu Y, Liu T, Song S, Qin K, Chan W. The specific brain activity of dual task coordination: a theoretical conflict-control model based on a qualitative and quantitative review. JOURNAL OF COGNITIVE PSYCHOLOGY 2022. [DOI: 10.1080/20445911.2022.2143788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Yue Hu
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - Tianliang Liu
- Department of Psychology, The Southwest University, Chongqing, People’s Republic of China
| | - Sensen Song
- Department of Psychology, School of Humanities, Tongji University, Shanghai, People’s Republic of China
| | - Kaiyang Qin
- Social, Health & Organizational Psychology, Utrecht University, Utrecht, Netherlands
| | - Wai Chan
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
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Ladthavorlaphatt K, Surti FBS, Beishon LC, Panerai RB, Robinson TG. Challenging neurovascular coupling through complex and variable duration cognitive paradigms: A subcomponent analysis. Med Eng Phys 2022; 110:103921. [PMID: 36564144 DOI: 10.1016/j.medengphy.2022.103921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/04/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022]
Abstract
A similar pattern of cerebral blood velocity (CBv) response has been observed for neurovascular coupling (NVC) assessment with cognitive tasks of varying complexity and duration. This lack of specificity could result from parallel changes in arterial blood pressure (BP) and PaCO2, which could confound the estimates of NVC integrity. Healthy participants (n = 16) underwent recordings at rest (5 min sitting) and during randomized paradigms of different complexity (naming words (NW) beginning with P-, R-, V- words and serial subtractions (SS) of 100-2, 100-7, 1000-17, with durations of 5, 30 and 60 s). Bilateral CBv (middle cerebral arteries, transcranial Doppler), end-tidal CO2 (EtCO2, capnography), blood pressure (BP, Finapres) and heart rate (HR, ECG) were recorded continuously. The bilateral CBv response to all paradigms was classified under objective criteria to select only responders, then the repeated data were averaged between visits. Bilateral CBv change to tasks was decomposed into the relative contributions (subcomponents) of arterial BP (VBP; neurogenic), critical closing pressure (VCrCP; metabolic) and resistance area product (VRAP; myogenic). A temporal effect was demonstrated in bilateral VBP and VRAP during all tasks (p<0.002), increased VBP early (between 0 and 10 s) and followed by decreases of VRAP late (25-35 s) in the response. VCrCP varied by complexity and duration (p<0.046). The main contributions to CBv responses to cognitive tasks of different complexity and duration were VBP and VRAP, whilst a smaller contribution from VCrCP would suggest sensitivity to metabolic demands. Further studies are needed to assess the influence of different paradigms, ageing and cerebrovascular conditions.
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Affiliation(s)
- Kannaphob Ladthavorlaphatt
- Department of Cardiovascular Sciences, College of Life Sciences, Leicester Royal Infirmary, University of Leicester, Level 4, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, United Kingdom; Medical Diagnostics Unit, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand.
| | - Farhaana B S Surti
- Department of Cardiovascular Sciences, College of Life Sciences, Leicester Royal Infirmary, University of Leicester, Level 4, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, United Kingdom
| | - Lucy C Beishon
- Department of Cardiovascular Sciences, College of Life Sciences, Leicester Royal Infirmary, University of Leicester, Level 4, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, United Kingdom; NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Ronney B Panerai
- Department of Cardiovascular Sciences, College of Life Sciences, Leicester Royal Infirmary, University of Leicester, Level 4, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, United Kingdom; NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Thompson G Robinson
- Department of Cardiovascular Sciences, College of Life Sciences, Leicester Royal Infirmary, University of Leicester, Level 4, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, United Kingdom; NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom
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Saraiva M, Castro MA, Vilas-Boas JP. The Role of Sleep Quality and Physical Activity Level on Gait Speed and Brain Hemodynamics Changes in Young Adults-A Dual-Task Study. Eur J Investig Health Psychol Educ 2022; 12:1673-1681. [PMID: 36421323 PMCID: PMC9689950 DOI: 10.3390/ejihpe12110117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Walking requires attentional resources, and the studies using neuroimage techniques have grown to understand the interaction between cortical activity and motor performance. Previous studies reported a decline in gait performance and changes in the prefrontal cortex (PFC) activity during a dual-task performance compared to walking only. Some lifestyle factors, such as sleep and physical activity (PA) levels, can compromise walking performance and brain activity. Nonetheless, the studies are scarce. This study aimed to assess gait speed and hemodynamic response in the PFC during a cognitive dual-task (cog-DT) compared to walking only, and to analyze the correlation between PA and sleep quality (SQ) with gait performance and hemodynamic response in the PFC during a single task (ST) and cog-DT performance in young adults. A total of 18 healthy young adults (mean age ± SD = 24.11 ± 4.11 years) participated in this study. They performed a single motor task (mot-ST)—normal walking—and a cog-DT—walking while performing a cognitive task on a smartphone. Gait speed was collected using a motion capture system coupled with two force plates. The hemoglobin differences (Hb-diff), oxyhemoglobin ([oxy-Hb]) and deoxyhemoglobin ([deoxy-Hb]) concentrations in the PFC were obtained using functional near-infrared spectroscopy. The SQ and PA were assessed through the Pittsburg Sleep Quality Index and International Physical Activity Questionnaire-Short Form questionnaires, respectively. The results show a decrease in gait speed (p < 0.05), a decrease in [deoxy-Hb] (p < 0.05), and an increase in Hb-diff (p < 0.05) and [oxy-Hb] (p > 0.05) in the prefrontal cortex during the cog-DT compared to the single task. A positive correlation between SQ and Hb-diff during the cog-DT performance was found. In conclusion, the PFC’s hemodynamic response during the cog-DT suggests that young adults prioritize cognitive tasks over motor performance. SQ only correlates with the Hb-diff during the cog-DT, showing that poor sleep quality was associated with increased Hb-diff in the PFC. The gait performance and hemodynamic response do not correlate with physical activity level.
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Affiliation(s)
- Marina Saraiva
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal
- Faculty of Sports and CIAFEL, University of Porto, 4200-450 Porto, Portugal
- Correspondence:
| | - Maria António Castro
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal
- Department of Mechanical Engineering, CEMMPRE, University of Coimbra, 3030-788 Coimbra, Portugal
- Sector of Physiotherapy, School of Health Sciences, Polytechnic Institute of Leiria, 2411-901 Leiria, Portugal
| | - João Paulo Vilas-Boas
- Faculty of Sports and CIAFEL, University of Porto, 4200-450 Porto, Portugal
- LABIOMEP-UP, Faculty of Sports and CIFI2D, University of Porto, 4200-450 Porto, Portugal
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10
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Sui SX, Hendy AM, Teo WP, Moran JT, Nuzum ND, Pasco JA. A Review of the Measurement of the Neurology of Gait in Cognitive Dysfunction or Dementia, Focusing on the Application of fNIRS during Dual-Task Gait Assessment. Brain Sci 2022; 12:brainsci12080968. [PMID: 35892409 PMCID: PMC9331540 DOI: 10.3390/brainsci12080968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/16/2022] [Accepted: 07/20/2022] [Indexed: 12/07/2022] Open
Abstract
Poor motor function or physical performance is a predictor of cognitive decline. Additionally, slow gait speed is associated with poor cognitive performance, with gait disturbances being a risk factor for dementia. Parallel declines in muscular and cognitive performance (resulting in cognitive frailty) might be driven primarily by muscle deterioration, but bidirectional pathways involving muscle–brain crosstalk through the central and peripheral nervous systems are likely to exist. Following screening, early-stage parallel declines may be manageable and modifiable through simple interventions. Gait–brain relationships in dementia and the underlying mechanisms are not fully understood; therefore, the current authors critically reviewed the literature on the gait–brain relationship and the underlying mechanisms and the feasibility/accuracy of assessment tools in order to identify research gaps. The authors suggest that dual-task gait is involved in concurrent cognitive and motor activities, reflecting how the brain allocates resources when gait is challenged by an additional task and that poor performance on dual-task gait is a predictor of dementia onset. Thus, tools or protocols that allow the identification of subtle disease- or disorder-related changes in gait are highly desirable to improve diagnosis. Functional near-infrared spectroscopy (fNIRS) is a non-invasive, cost-effective, safe, simple, portable, and non-motion-sensitive neuroimaging technique, widely used in studies of clinical populations such as people suffering from Alzheimer’s disease, depression, and other chronic neurological disorders. If fNIRS can help researchers to better understand gait disturbance, then fNIRS could form the basis of a cost-effective means of identifying people at risk of cognitive dysfunction and dementia. The major research gap identified in this review relates to the role of the central/peripheral nervous system when performing dual tasks.
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Affiliation(s)
- Sophia X. Sui
- Instiute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC 3216, Australia; (J.T.M.); (J.A.P.)
- Correspondence: ; Tel.: +61-3-4215-3306-53306; Fax: +61-3-4215-3491
| | - Ashlee M. Hendy
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3216, Australia; (A.M.H.); (N.D.N.)
| | - Wei-Peng Teo
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 308232, Singapore;
| | - Joshua T. Moran
- Instiute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC 3216, Australia; (J.T.M.); (J.A.P.)
| | - Nathan D. Nuzum
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3216, Australia; (A.M.H.); (N.D.N.)
| | - Julie A. Pasco
- Instiute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC 3216, Australia; (J.T.M.); (J.A.P.)
- Department of Medicine—Western Campus, The University of Melbourne, St Albans, VIC 3010, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- Barwon Health, University Hospital Geelong, Geelong, VIC 3220, Australia
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11
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Huang S, Zhou X, Liu Y, Luo J, Lv Z, Shang P, Zhang W, Lin B, Huang Q, Feng Y, Wang W, Tao S, Wang Y, Zhang C, Chen L, Shi L, Luo Y, Mok VCT, Pan S, Xie H. High Fall Risk Associated With Memory Deficit and Brain Lobes Atrophy Among Elderly With Amnestic Mild Cognitive Impairment and Mild Alzheimer's Disease. Front Neurosci 2022; 16:896437. [PMID: 35757554 PMCID: PMC9213689 DOI: 10.3389/fnins.2022.896437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives This study aimed to primarily examine the association between memory deficit and increased fall risk, second, explore the underlying neuroanatomical linkage of this association in the elderly with aMCI and mild AD. Methods In this cross-sectional study, a total of 103 older adults were included (55 cognitively normal, CN; 48 cognitive impairment, CI, elderly with aMCI, and mild AD). Memory was assessed by the Auditory Verbal Learning Test (AVLT). Fall risk was evaluated by the Timed Up and Go (TUG) Test, heel strike angles, and stride speed, which were collected by an inertial-sensor-based wearable instrument (the JiBuEn™ gait analysis system). Brain volumes were full-automatic segmented and quantified using AccuBrain® v1.2 from three-dimensional T1-weighted (3D T1W) MR images. Multivariable regression analysis was used to examine the extent of the association between memory deficit and fall risk, the association of brain volumes with memory, and fall risk. Age, sex, education, BMI, and HAMD scores were adjusted. Sensitivity analysis was conducted. Results Compared to CN, participants with aMCI and mild AD had poorer cognitive performance (p < 0.001), longer TUG time (p = 0.018), and smaller hippocampus and medial temporal volumes (p = 0.037 and 0.029). In the CI group, compared to good short delayed memory (SDM) performance (AVLT > 5), the elderly with bad SDM performance (AVLT ≤ 3) had longer TUG time, smaller heel strike angles, and slower stride speed. Multivariable regression analysis showed that elderly with poor memory had higher fall risk than relative good memory performance among cognitive impairment elderly. The TUG time increased by 2.1 s, 95% CI, 0.54∼3.67; left heel strike angle reduced by 3.22°, 95% CI, −6.05 to −0.39; and stride speed reduced by 0.09 m/s, 95% CI, −0.19 to −0.00 for the poor memory elderly among the CI group, but not found the association in CN group. In addition, serious medial temporal atrophy (MTA), small volumes of the frontal lobe and occipital lobe were associated with long TUG time and small heel strike angles; small volumes of the temporal lobe, frontal lobe, and parietal lobe were associated with slow stride speed. Conclusion Our findings suggested that memory deficit was associated with increased fall risk in the elderly with aMCI and mild AD. The association might be mediated by the atrophy of medial temporal, frontal, and parietal lobes. Additionally, increased fall risk, tested by TUG time, heel stride angles, and stride speed, might be objective and convenient kinematics markers for dynamic monitoring of both memory function and fall risk.
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Affiliation(s)
- Shuyun Huang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China.,Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xinhan Zhou
- Department of Imaging, First People's Hospital of Foshan, Foshan, China
| | - Yajing Liu
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Jiali Luo
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Zeping Lv
- National Research Center for Rehabilitation Technical Aids, Rehabilitation Hospital, Beijing, China
| | - Pan Shang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Weiping Zhang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Biqing Lin
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Qiulan Huang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - YanYun Feng
- Department of Imaging, First People's Hospital of Foshan, Foshan, China
| | - Wei Wang
- Department of Imaging, First People's Hospital of Foshan, Foshan, China
| | - Shuai Tao
- Dalian Key Laboratory of Smart Medical and Health, Dalian University, Dalian, China
| | - Yukai Wang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Chengguo Zhang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Lushi Chen
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,BrainNow Research Institute, Shenzhen, China
| | - Yishan Luo
- BrainNow Research Institute, Shenzhen, China
| | - Vincent C T Mok
- Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Suyue Pan
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Haiqun Xie
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
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12
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Influence of Cognitive Task Difficulty in Postural Control and Hemodynamic Response in the Prefrontal Cortex during Static Postural Standing. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
In daily life, we perform several tasks simultaneously, and it is essential to have adequate postural control to succeed. Furthermore, when performing two or more tasks concurrently, changes in postural oscillation are expected due to the competition for the attentional resources. The aim of this study was to evaluate and compare the center of pressure (CoP) behavior and the hemodynamic response of the prefrontal cortex during static postural standing while performing cognitive tasks of increasing levels of difficulty on a smartphone in young adults. Participants were 35 healthy young adults (mean age ± SD = 22.91 ± 3.84 years). Postural control was assessed by the CoP analysis (total excursion of the CoP (TOTEX CoP), displacements of the CoP in medial–lateral (CoP-ML) and anterior–posterior (CoP-AP) directions, mean total velocity displacement of CoP (MVELO CoP), mean displacement velocity of CoP in medial–lateral (MVELO CoP-ML) and anterior–posterior (MVELO CoP-AP) directions, and 95% confidence ellipse sway area (CEA)), the hemodynamic response by the oxyhemoglobin ([oxy-Hb]), deoxyhemoglobin ([deoxy-Hb]), and total hemoglobin ([total-Hb]) concentrations using a force plate and functional near-infrared spectroscopy (fNIR), respectively. The results showed that the difficult cognitive task while performing static postural standing caused an increase in all CoP variables in analysis (p < 0.05) and of [oxy-Hb] (p < 0.05), [deoxy-Hb] (p < 0.05) and [total-Hb] (p < 0.05) compared to the postural task. In conclusion, the increase in the cognitive demands negatively affected the performance of the postural task when performing them concurrently, compared to the postural task alone. The difficult cognitive task while performing the postural task presented a greater influence on postural sway and activation of the prefrontal cortex than the postural task and the easy cognitive task.
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13
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Tassani S, Mancini M, Perilli E, Ramírez J. Editorial: Cross-Disciplinary Approaches to Characterize Gait and Posture Disturbances in Aging and Related Diseases. Front Bioeng Biotechnol 2022; 10:888910. [PMID: 35497327 PMCID: PMC9039217 DOI: 10.3389/fbioe.2022.888910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/16/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Simone Tassani
- BCN MedTech, DTIC, Universitat Pompeu Fabra, Barcelona, Spain
- *Correspondence: Simone Tassani,
| | - Martina Mancini
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Egon Perilli
- Medical Device Research Institute, College of Science and Engineering, Flinders University, Adelaide, SA, Australia
| | - Juan Ramírez
- Mechanical Engineering Department, Universidad Nacional de Colombia, Medellin, Colombia
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14
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Ramírez F, Gutiérrez M. Dual-Task Gait as a Predictive Tool for Cognitive Impairment in Older Adults: A Systematic Review. Front Aging Neurosci 2021; 13:769462. [PMID: 35002676 PMCID: PMC8740025 DOI: 10.3389/fnagi.2021.769462] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/06/2021] [Indexed: 01/21/2023] Open
Abstract
The use of the dual-task model as a cognitive-motor interface has been extensively investigated in cross-sectional studies as a training task in cognitive impairment. However, few existing longitudinal studies prove the usefulness of this tool as a clinical marker of cognitive impairment in older people. What is the evidence in prospective studies about dual-task gait as a predictor of cognitive impairment in older adults? This study aims to review and discuss the current state of knowledge in prospective studies on the use of dual-task gait as a predictive tool for cognitive impairment in older adults. The methodology used was a systematic review, according to the PRISMA criteria for the search, summarize and report. A search in 3 databases (Pubmed, Web of Science, and Scopus) was carried out until April 2021. The search terms used were: "(gait OR walking) AND (cognitive decline) AND (dual-task) AND (follow-up OR longitudinal OR long-term OR prospective OR cohort OR predict)." We included prospective research articles with older people with cognitive evaluation at the beginning and the end of the follow-up and dual-task gait paradigm as initial evaluation associated with the presentation of cognitive impairment prediction using any dual-task gait parameters. After exclusion criteria, 12 studies were reviewed. The results indicate that eight studies consider dual-task gait parameters a useful cognitive-motor tool, finding that some of the evaluated parameters of dual-task gait significantly correlate with cognitive impairment over time. The most promising DT parameters associated with cognitive impairment prediction seem to be gait speed, speed cost, DT time, numbers of words during DT, among others. In sum, this study reviews the variety of dual-task gait parameters and their relevance as a simple tool for early cognitive impairment screening, opening a diagnostic window for the screening of cognitive impairment in older people.
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Affiliation(s)
- Felipe Ramírez
- Programa Magíster en Kinesiología Gerontológica, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
| | - Myriam Gutiérrez
- Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad de Las Américas, Santiago, Chile
- Centro de Estudio del Movimiento Humano, Escuela de Kinesiología, Facultad de Odontología y Salud, Universidad Diego Portales, Santiago, Chile
- Unidad de Cerebro Saludable, Hospital Clínico Universidad de Chile, Santiago, Chile
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15
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Jeanvoine H, Labriffe M, Tannou T, Navasiolava N, Ter Minassian A, Girot JB, Leiber LM, Custaud MA, Annweiler C, Dinomais M. Specific age-correlated activation of top hierarchical motor control areas during gait-like plantar stimulation: An fMRI study. Hum Brain Mapp 2021; 43:833-843. [PMID: 34738281 PMCID: PMC8720193 DOI: 10.1002/hbm.25691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 12/26/2022] Open
Abstract
A better understanding of gait disorders that are associated with aging is crucial to prevent adverse outcomes. The functional study of gait remains a thorny issue due to technical constraints inherent to neuroimaging procedures, as most of them require to stay supine and motionless. Using an MRI‐compatible system of boots reproducing gait‐like plantar stimulation, we investigated the correlation between age and brain fMRI activation during simulated gait in healthy adults. Sixty‐seven right‐handed healthy volunteers aged between 20 and 77 years old (49.2 ± 18.0 years; 35 women) were recruited. Two paradigms were assessed consecutively: (a) gait‐like plantar stimulation and (b) chaotic and not gait‐related plantar stimulation. Resulting statistical parametric maps were analyzed with a multiple‐factor regression that included age and a threshold determined by Monte‐Carlo simulation to fulfill a family‐wise error rate correction of p < .05. In the first paradigm, there was an age‐correlated activation of the right pallidum, thalamus and putamen. The second paradigm showed an age‐correlated deactivation of both primary visual areas (V1). The subtraction between results of the first and second paradigms showed age‐correlated activation of the right presupplementary motor area (Brodmann Area [BA] 6) and right mid‐dorsolateral prefrontal cortex (BA9‐10). Our results show age‐correlated activity in areas that have been associated with the control of gait, highlighting the relevance of this simulation model for functional gait study. The specific progressive activation of top hierarchical control areas in simulated gait and advancing age corroborate a progressive loss of automation in healthy older adults.
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Affiliation(s)
- Henry Jeanvoine
- Department of Radiology, Angers University Hospital, University of Angers, Angers, France
| | - Matthieu Labriffe
- Department of Radiology, Angers University Hospital, University of Angers, Angers, France.,Laboratoire Angevin de Recherche en Ingénierie des Systèmes, EA7315, University of Angers, Angers, France
| | - Thomas Tannou
- Department of Geriatrics, Besançon University Hospital, University of Franche-Comté, Besançon, France.,Integrative and Clinical Neurosciences, EA 481, University of Franche-Comté, Besançon, France.,Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - Nastassia Navasiolava
- Clinical Research Center, Angers University Hospital, University of Angers, Angers, France
| | - Aram Ter Minassian
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes, EA7315, University of Angers, Angers, France.,Department of Anesthesia and Critical Care, Angers University Hospital, Angers, France
| | - Jean-Baptiste Girot
- Department of Radiology, Angers University Hospital, University of Angers, Angers, France.,Laboratoire Angevin de Recherche en Ingénierie des Systèmes, EA7315, University of Angers, Angers, France
| | - Louis-Marie Leiber
- Department of Radiology, Angers University Hospital, University of Angers, Angers, France.,Laboratoire Angevin de Recherche en Ingénierie des Systèmes, EA7315, University of Angers, Angers, France
| | - Marc-Antoine Custaud
- Clinical Research Center, Angers University Hospital, University of Angers, Angers, France.,Laboratoire de Biologie Neuro-Vasculaire et Mitochondriale Intégrée, UMR CNRS 6214 INSERM U1083, University of Angers, Angers, France
| | - Cédric Annweiler
- Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic-Angers University Hospital, UPRES EA 4638-University of Angers, Angers, France.,Department of Medical Biophysics, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Mickaël Dinomais
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes, EA7315, University of Angers, Angers, France.,Department of Physical and Rehabilitation Medicine, Angers University Hospital, University of Angers, Angers, France
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16
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Collett J, Fleming MK, Meester D, Al-Yahya E, Wade DT, Dennis A, Salvan P, Meaney A, Cockburn J, Dawes J, Johansen-Berg H, Dawes H. Dual-task walking and automaticity after Stroke: Insights from a secondary analysis and imaging sub-study of a randomised controlled trial. Clin Rehabil 2021; 35:1599-1610. [PMID: 34053250 PMCID: PMC8524683 DOI: 10.1177/02692155211017360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To test the extent to which initial walking speed influences dual-task performance after walking intervention, hypothesising that slow walking speed affects automatic gait control, limiting executive resource availability. DESIGN A secondary analysis of a trial of dual-task (DT) and single-task (ST) walking interventions comparing those with good (walking speed ⩾0.8 m s-1, n = 21) and limited (walking speed <0.79 m s-1, n = 24) capacity at baseline. SETTING Community. SUBJECTS Adults six-months post stroke with walking impairment. INTERVENTIONS Twenty sessions of 30 minutes treadmill walking over 10 weeks with (DT) or without (ST) cognitive distraction. Good and limited groups were formed regardless of intervention received. MAIN MEASURES A two-minute walk with (DT) and without (ST) a cognitive distraction assessed walking. fNIRS measured prefrontal cortex activation during treadmill walking with (DT) and without (ST) Stroop and planning tasks and an fMRI sub-study used ankle-dorsiflexion to simulate walking. RESULTS ST walking improved in both groups (∆baseline: Good = 8.9 ± 13.4 m, limited = 5.3±8.9 m, Group × time = P < 0.151) but only the good walkers improved DT walking (∆baseline: Good = 10.4 ± 13.9 m, limited = 1.3 ± 7.7 m, Group × time = P < 0.025). fNIRS indicated increased ispilesional prefrontal cortex activation during DT walking following intervention (P = 0.021). fMRI revealed greater DT cost activation for limited walkers, and increased resting state connectivity of contralesional M1 with cortical areas associated with conscious gait control at baseline. After the intervention, resting state connectivity between ipsilesional M1 and bilateral superior parietal lobe, involved in integrating sensory and motor signals, increased in the good walkers compared with limited walkers. CONCLUSION In individual who walk slowly it may be difficult to improve dual-task walking ability.Registration: ISRCTN50586966.
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Affiliation(s)
- Johnny Collett
- Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
| | - Melanie K Fleming
- Wellcome Centre for Integrative Neuroimaging (WIN), FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Daan Meester
- Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
| | - Emad Al-Yahya
- Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK.,School of Rehabilitation Science, The University of Jordan, Amman, Jordan
| | - Derick T Wade
- Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
| | - Andrea Dennis
- Wellcome Centre for Integrative Neuroimaging (WIN), FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Piergiorgio Salvan
- Wellcome Centre for Integrative Neuroimaging (WIN), FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Andrew Meaney
- Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
| | | | - Joanna Dawes
- Department of Health Sciences, Division of Physiotherapy, Brunel University, London, UK
| | - Heidi Johansen-Berg
- Wellcome Centre for Integrative Neuroimaging (WIN), FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Helen Dawes
- Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK.,Wellcome Centre for Integrative Neuroimaging (WIN), FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
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17
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Kahya M, Lyons KE, Pahwa R, Akinwuntan AE, He J, Devos H. Pupillary Response to Postural Demand in Parkinson's Disease. Front Bioeng Biotechnol 2021; 9:617028. [PMID: 33987171 PMCID: PMC8111006 DOI: 10.3389/fbioe.2021.617028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/09/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Individuals with Parkinson’s disease (PD) may need to spend more mental and physical effort (i.e., cognitive workload) to maintain postural control. Pupillary response reflects cognitive workload during postural control tasks in healthy controls but has not been investigated as a measure of postural demand in PD. Objectives: To compare pupillary response during increased postural demand using vision occlusion and dual tasking between individuals with PD and healthy controls. Methods: Thirty-three individuals with PD and thirty-five healthy controls were recruited. The four conditions lasted 60 s and involved single balance task with eyes open; single balance task with eyes occluded; dual task with eyes open; dual task with eyes occluded. The dual task comprised the Auditory Stroop test. Pupillary response was recorded using an eye tracker. The balance was assessed by using a force plate. Two-way Repeated Measures ANOVA and LSD post-hoc tests were employed to compare pupillary response and Center of Pressure (CoP) displacement across the four conditions and between individuals with PD and healthy controls. Results: Pupillary response was higher in individuals with PD compared to healthy controls (p = 0.009) and increased with more challenging postural conditions in both groups (p < 0.001). The post-hoc analysis demonstrated increased pupillary response in the single balance eyes occluded (p < 0.001), dual task eyes open (p = 0.01), and dual task eyes occluded (p < 0.001) conditions compared to single task eyes open condition. Conclusion: Overall, the PD group had increased pupillary response with increased postural demand compared to the healthy controls. In the future, pupillary response can be a potential tool to understand the neurophysiological underpinnings of falls risk in the PD population.
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Affiliation(s)
- Melike Kahya
- Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, United States
| | - Kelly E Lyons
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Rajesh Pahwa
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Abiodun E Akinwuntan
- Office of the Dean, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States.,Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jianghua He
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, United States
| | - Hannes Devos
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
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18
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Kirby KM, Pillai S, Brouillette RM, Keller JN, De Vito AN, Bernstein JP, Van Gemmert AWA, Carmichael OT. Neuroimaging, Behavioral, and Gait Correlates of Fall Profile in Older Adults. Front Aging Neurosci 2021; 13:630049. [PMID: 33679378 PMCID: PMC7935539 DOI: 10.3389/fnagi.2021.630049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/27/2021] [Indexed: 11/20/2022] Open
Abstract
Prior research has suggested that measurements of brain functioning and performance on dual tasks (tasks which require simultaneous performance) are promising candidate predictors of fall risk among older adults. However, no prior study has investigated whether brain function measurements during dual task performance could improve prediction of fall risks and whether the type of subtasks used in the dual task paradigm affects the strength of the association between fall characteristics and dual task performance. In this study, 31 cognitively normal, community-dwelling older adults provided a self-reported fall profile (number of falls and fear of falling), completed a gait dual task (spell a word backward while walking on a GaitRite mat), and completed a supine dual task (rhythmic finger tapping with one hand while completing the AX continuous performance task (AX-CPT) with the other hand) during functional magnetic resonance imaging (fMRI). Gait performance, AX-CPT reaction time and accuracy, finger tapping cadence, and brain functioning in finger-tapping-related and AX-CPT-related brain regions all showed declines in the dual task condition compared to the single task condition. Dual-task gait, AX-CPT and finger tapping performance, and brain functioning were all independent predictors of fall profile. No particular measurement domain stood out as being the most strongly associated measure with fall variables. Fall characteristics are determined by multiple factors; brain functioning, motor task, and cognitive task performance in challenging dual-task conditions all contribute to the risk of falling.
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Affiliation(s)
- Krystal M Kirby
- Fine Motor Control and Learning Laboratory (FMCL), School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States.,Biomedical Imaging Center, Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Sreekrishna Pillai
- Biomedical Imaging Center, Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Robert M Brouillette
- Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Jeffrey N Keller
- Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Alyssa N De Vito
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - John P Bernstein
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Arend W A Van Gemmert
- Fine Motor Control and Learning Laboratory (FMCL), School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Owen T Carmichael
- Biomedical Imaging Center, Pennington Biomedical Research Center, Baton Rouge, LA, United States
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19
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Prefrontal Cortex Involvement during Dual-Task Stair Climbing in Healthy Older Adults: An fNIRS Study. Brain Sci 2021; 11:brainsci11010071. [PMID: 33430358 PMCID: PMC7825747 DOI: 10.3390/brainsci11010071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 11/17/2022] Open
Abstract
Executive function and motor control deficits adversely affect gait performance with age, but the neural correlates underlying this interaction during stair climbing remains unclear. Twenty older adults (72.7 ± 6.9 years) completed single tasks: standing and responding to a response time task (SC), ascending or descending stairs (SMup, SMdown); and a dual-task: responding while ascending or descending stairs (DTup, DTdown). Prefrontal hemodynamic response changes (∆HbO2, ∆HbR) were examined using functional near-infrared spectroscopy (fNIRS), gait speed was measured using in-shoe smart insoles, and vocal response time and accuracy were recorded. Findings revealed increased ∆HbO2 (p = 0.020) and slower response times (p < 0.001) during dual- versus single tasks. ∆HbR (p = 0.549), accuracy (p = 0.135) and gait speed (p = 0.475) were not significantly different between tasks or stair climbing conditions. ∆HbO2 and response time findings suggest that executive processes are less efficient during dual-tasks. These findings, in addition to gait speed and accuracy maintenance, may provide insights into the neural changes that precede performance declines. To capture the subtle differences between stair ascent and descent and extend our understanding of the neural correlates of stair climbing in older adults, future studies should examine more difficult cognitive tasks.
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20
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Agathos CP, Ramanoël S, Bécu M, Bernardin D, Habas C, Arleo A. Postural Control While Walking Interferes With Spatial Learning in Older Adults Navigating in a Real Environment. Front Aging Neurosci 2020; 12:588653. [PMID: 33281600 PMCID: PMC7689348 DOI: 10.3389/fnagi.2020.588653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/16/2020] [Indexed: 11/21/2022] Open
Abstract
Cognitive demands for postural control increase with aging and cognitive-motor interference (CMI) exists for a number of walking situations, especially with visuo-spatial cognitive tasks. Such interference also influences spatial learning abilities among older adults; however, this is rarely considered in research on aging in spatial navigation. We posited that visually and physically exploring an unknown environment may be subject to CMI for older adults. We investigated potential indicators of postural control interfering with spatial learning. Given known associations between age-related alterations in gait and brain structure, we also examined potential neuroanatomical correlates of this interference. Fourteen young and 14 older adults had to find an invisible goal in an unfamiliar, real, ecological environment. We measured walking speed, trajectory efficiency (direct route over taken route) and goal fixations (proportion of visual fixations toward the goal area). We calculated the change in walking speed between the first and last trials and adaptation indices for all three variables to quantify their modulation across learning trials. All participants were screened with a battery of visuo-cognitive tests. Eighteen of our participants (10 young, 8 older) also underwent a magnetic resonance imaging (MRI) examination. Older adults reduced their walking speed considerably on the first, compared to the last trial. The adaptation index of walking speed correlated positively with those of trajectory efficiency and goal fixations, indicating a reduction in resource sharing between walking and encoding the environment. The change in walking speed correlated negatively with gray matter volume in superior parietal and occipital regions and the precuneus. We interpret older adults’ change in walking speed as indicative of CMI, similar to dual task costs. This is supported by the correlations between the adaptation indices and between the change in walking speed and gray matter volume in brain regions that are important for navigation, given that they are involved in visual attention, sensory integration and encoding of space. These findings under ecological conditions in a natural spatial learning task question what constitutes dual tasking in older adults and they can lead future research to reconsider the actual cognitive burden of postural control in aging navigation research.
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Affiliation(s)
| | - Stephen Ramanoël
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France.,University of Côte d'Azur, LAMHESS, Nice, France
| | - Marcia Bécu
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Delphine Bernardin
- Vision Sciences Department, Essilor International R&D, Paris, France.,Essilor Canada Ltd., Montreal, QC, Canada
| | | | - Angelo Arleo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
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21
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Functional MRI Reveals Locomotion-Control Neural Circuits in Human Brainstem. Brain Sci 2020; 10:brainsci10100757. [PMID: 33092164 PMCID: PMC7589833 DOI: 10.3390/brainsci10100757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 11/17/2022] Open
Abstract
The cuneiform nucleus (CN) and the pedunculopontine nucleus (PPN) in the midbrain control coordinated locomotion in vertebrates, but whether similar mechanisms exist in humans remain to be elucidated. Using functional magnetic resonance imaging, we found that simulated gait evoked activations in the CN, PPN, and other brainstem regions in humans. Brain networks were constructed for each condition using functional connectivity. Bilateral CN–PPN and the four pons–medulla regions constituted two separate modules under all motor conditions, presenting two brainstem functional units for locomotion control. Outside- and inside-brainstem nodes were connected more densely although the links between the two groups were sparse. Functional connectivity and network analysis revealed the role of brainstem circuits in dual-task walking and walking automaticity. Together, our findings indicate that the CN, PPN, and other brainstem regions participate in locomotion control in humans.
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22
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Reinhardt J, Rus-Oswald OG, Bürki CN, Bridenbaugh SA, Krumm S, Michels L, Stippich C, Kressig RW, Blatow M. Neural Correlates of Stepping in Healthy Elderly: Parietal and Prefrontal Cortex Activation Reflects Cognitive-Motor Interference Effects. Front Hum Neurosci 2020; 14:566735. [PMID: 33132879 PMCID: PMC7550687 DOI: 10.3389/fnhum.2020.566735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/19/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Julia Reinhardt
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Radiology, Division of Diagnostic and Interventional Neuroradiology, University Hospital of Basel, University of Basel, Basel, Switzerland
- *Correspondence: Julia Reinhardt,
| | - Oana G. Rus-Oswald
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
| | - Céline N. Bürki
- Department of Radiology, Division of Diagnostic and Interventional Neuroradiology, University Hospital of Basel, University of Basel, Basel, Switzerland
- University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
| | | | - Sabine Krumm
- University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
| | - Lars Michels
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christoph Stippich
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Reto W. Kressig
- University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
| | - Maria Blatow
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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23
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Joo SY, Cho YS, Lee KJ, Lee SY, Seo CH. Frontal lobe oxyhemoglobin levels in patients with lower extremity burns assessed using a functional near-Infrared spectroscopy device during usual walking: a pilot study. Comput Methods Biomech Biomed Engin 2020; 24:115-121. [PMID: 32915075 DOI: 10.1080/10255842.2020.1812583] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Understanding the mechanisms associated with locomotor networks may be of benefit for rehabilitation of burn victims with neurological locomotor deficits. A wearable functional near-infrared spectroscopy (fNIRS) device has been developed for studying cortical hemodynamics. OBJECTIVES To investigate cortical brain activity during usual walking, we examined patterns of cortical activation using fNIRS device (NIRSIT®; OBELAB Inc., Seoul, Korea), in patients with neurological injury caused by lower extremity burns. METHODS This cross-sectional study assessed 15 patients with lower extremity burns, 10 patients with upper extremity burns, and 11 healthy controls. We measured walking-related cortical activity using an fNIRS device at baseline and during usual walking. RESULTS There was no significant difference between the burns groups in terms of age (43.50 ± 14.08 and 44.67 ± 6.92 years, P = 1.00), pain score of NRS (Numeric rating scale) (5.83 ± 1.19 and 6.67 ± 1.21, P = 0.18) or the mean time since injury (228.50 ± 83.43 and 199.33 ± 68.84 days, P = 0.78). Measures showed increased cortical activation in the prefrontal cortex in patients with lower extremity burns than in patients with healthy controls(P = 0.015). The measured HbO2 datas of the regions during usual walking in patients with lower extremity burn were insignificantly higher compared with the datas in patient with upper extremity burn (P = 0.302). CONCLUSIONS The patients with neurological injury due to lower extremity burns significantly rely more on cognitive resources even when performing a usual walking task.
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Affiliation(s)
- So Young Joo
- Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Yoon Soo Cho
- Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Kuem Ju Lee
- Department of Rehabilitation & Assistive Technology, Korea National Rehabilitation Research Institute, National Rehabilitation Center, Seoul, Korea
| | - Seung Yeol Lee
- Department of Physical Medicine and Rehabilitation, College of Medicine, Soonchunhyang University Hospital, Bucheon, Korea
| | - Cheong Hoon Seo
- Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
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Zhou X, Zhang C, Li L, Zhang Y, Zhang W, Yin W, Yu X, Zhu X, Qian Y, Sun Z. Altered Brain Function in Cerebral Small Vessel Disease Patients With Gait Disorders: A Resting-State Functional MRI Study. Front Aging Neurosci 2020; 12:234. [PMID: 33110408 PMCID: PMC7487416 DOI: 10.3389/fnagi.2020.00234] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/06/2020] [Indexed: 02/02/2023] Open
Abstract
Gait disturbances are important clinical features of cerebral small vessel disease (CSVD) that increase the risk of falls and disability. Brain structural alterations and gait disturbances in CSVD patients have been well demonstrated. However, intrinsic resting cerebral function patterns in CSVD patients with gait disorders remain largely unknown. Fifty-eight CSVD patients were enrolled in our studies and categorized into the gait disorder group (CSVD-GD, n = 29) and no-gait disorder group (CSVD-NGD, n = 29) based on a gait examination. Gait was quantitatively assessed with the Timed Up and Go test and the intelligent device for energy expenditure and activity (IDEEA). Functional MRI and fractional amplitude of low-frequency fluctuation (fALFF) analyses were employed to explore local intrinsic neural oscillation alterations. Functional connectivity based on fALFF results was calculated to detect the potential changes in remote connectivity. Compared with the CSVD-NGD group, the CSVD-GD group showed decreased fALFF in regions mainly located in the sensorimotor network and frontoparietal network, such as the left supplementary motor area (SMA.L) and the left superior parietal gyrus, and increased fALFF in the right inferior frontal gyrus (orbital part), the left caudate, and the left precuneus. Moreover, the CSVD-GD patients exhibited lower connectivity between the SMA.L and temporal lobe, which was related to gait speed. The fALFF value of the SMA.L was associated with cadence. This study highlights the regional and network interaction abnormalities of the SMA in CSVD patients with gait disturbances. These findings could provide further insight into the neural mechanisms of gait disturbances in CSVD.
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Affiliation(s)
- Xia Zhou
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chao Zhang
- Department of Neurology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Linlin Li
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yimei Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wei Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wenwen Yin
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xianfeng Yu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaoqun Zhu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yinfeng Qian
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhongwu Sun
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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25
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Penko AL, Streicher MC, Dey T, Rosenfeldt AB, Alberts JL. Parkinson's gait kinematics deteriorates across multiple cognitive domains under dual-task paradigms. Clin Neurol Neurosurg 2020; 197:106083. [PMID: 32683199 DOI: 10.1016/j.clineuro.2020.106083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/09/2020] [Accepted: 07/09/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The symptoms of Parkinson's disease (PD) in many circumstances lead to gait dysfunction which contribute to decreased mobility, reduced quality of life, and increased risk of falling. Dual-task conditions have been shown to amplify gait dysfunction from a spatiotemporal parameter standpoint; however, less is known regarding gait joint kinematics under dual-task conditions in PD, specifically across multiple cognitive domains. The purpose of this project was to systematically characterize lower extremity joint kinematics in individuals with mild-moderate PD under dual-task paradigms across multiple cognitive domains. PATIENTS AND METHODS Twenty-three individuals with idiopathic Parkinson's disease participated in this observational study evaluating hip, knee, and ankle joint kinematics while walking on a self-paced treadmill under dual-task conditions that taxed memory, attention, verbal fluency, and information processing. RESULTS Gait velocity and range of motion at the ankle, knee, and hip decreased (p < 0.05) under all of the dual-task conditions. Hip kinematics were affected to a greater extent than the ankle and knee, with reduction in flexion and extension during all timestamps of the gait cycle (p < 0.05) under all dual-task conditions. CONCLUSION The worsening of gait kinematics under dual-task conditions regardless of the aspect of cognition being challenged suggest that information processing and motor output are unable to withstand dual-task loads without consequence. These study results provide insight for target areas to focus on during therapeutic interventions in order to help minimize gait kinematic decrements observed under dual-task conditions.
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Affiliation(s)
- Amanda L Penko
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | | | - Tanujit Dey
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Anson B Rosenfeldt
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - Jay L Alberts
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA; Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA.
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26
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Gasser B. Equipment Became Better in Backcountry Skiing-Did Severity of Injuries Decrease? An Analysis from the Swiss Alps. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030901. [PMID: 32024065 PMCID: PMC7037766 DOI: 10.3390/ijerph17030901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/28/2020] [Accepted: 01/30/2020] [Indexed: 11/16/2022]
Abstract
Background: Large technical developments in avalanche transceivers as well as in ski–shoe-binding units should make backcountry skiing a safer sport and as a consequence, yield to a decrease in the number and severity of mountain emergency events. Methods: From 2009–2018, a total of 3044 mountain emergencies (953 females and 2091 males) were identified from the SAC (Swiss Alpine Club) central registry while backcountry skiing. These were classified descriptively by cause, whereby the severity of the mountain emergency was quantified with a NACA-Score (National Advisory Committee for Aeronautics Score). Results: A total of 1357 falls (44.6%), 558 emergencies caused by avalanches (18.3%), 408 cases of blocking (13.4%), 214 cases of illnesses (7.0%), 202 cases of losing way (6.6%), 138 cases of a crevasse accident (4.5%), and material failure in 30 cases (1%) were registered. For the remaining 137 cases (4.5%), no classification or rare forms were detected. No substantial sex differences were found in severity of injury, however looking at the two endpoints of the observed time frame, a significant increase in NACA-Score from 2009 to 2018 (2.1 ± 1.8 up to 2.6 ± 2.1, p < 0.01) was detected. Conclusions: The increase in the severity of mountain emergencies while backcountry skiing in the last decade might be due to the fact that too many inexperienced absolve backcountry tours. The tendency might be promoted by the improved material in the way that it seems easier to absolve a tour while underestimating potential hazards.
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Affiliation(s)
- Benedikt Gasser
- Swiss Registries and Data Linkage - Swiss RDL, University of Bern, 3012 Berne, Switzerland
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27
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Abstract
Injuries from Falls in Backcountry Skiing - an Analysis from the Swiss Alps Abstract. Ski mountaineering is becoming increasingly popular. In addition to positive aspects, there are also dangers involved whereby falls must be mentioned particularly. Using the central register of the SAC (Swiss Alpine Club), a total of 756 male and 593 female cases of falls in the ten-year period from 2009-2018 were analyzed using the NACA score and case reports. It was found that around 90 % of the analyzed cases in women concerned the lower extremity with the knee (55 %) as the most common localization. Similarly, in men around two thirds were affected by the lower extremity, with the knee being the most common location with around 43 %. This could be caused by an unoptimized binding behavior, which is why it is recommended not to set the bindings too hard and to test the correct release behavior regularly.
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Affiliation(s)
- Benedikt Gasser
- Swiss Registries and Data Linkage (Swiss RDL), Universität Bern
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28
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Lucas M, Wagshul ME, Izzetoglu M, Holtzer R. Moderating Effect of White Matter Integrity on Brain Activation During Dual-Task Walking in Older Adults. J Gerontol A Biol Sci Med Sci 2019; 74:435-441. [PMID: 29917044 DOI: 10.1093/gerona/gly131] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Indexed: 11/14/2022] Open
Abstract
Using multimodal neuroimaging methods, the current study was designed to examine the relationship between white matter microstructural integrity (WMI) and changes in prefrontal cortex (PFC) oxygenated hemoglobin (HbO2) during active walking in older adults. Consistent with neural inefficiency, we hypothesized that worse WMI would be associated with a greater increase in PFC HbO2 from single to dual-task walking in the context of worse or similar gait performance. Fifty-five cognitively healthy older adults (mean age = 74.76 years, 49% women) underwent diffusion tensor imaging (DTI) to derive a whole-brain measure of fractional anisotropy (FA) and functional Near Infrared Spectroscopy (fNIRS), which measured PFC HbO2 during walking tasks. Gait velocity was assessed using an instrumented walkway. A linear mixed effects model revealed that HbO2 levels increased from single to dual-task walking (P < 0.01) given the greater cognitive demands inherent in the latter condition. Moreover, WMI moderated the effect of dual tasking on PFC HbO2 (P < 0.05). Specifically, worse WMI was associated with a larger increase in PFC HbO2 levels from single to dual-task walking in the context of similar gait velocity. Results suggest that compromised WMI may be a mechanism underlying inefficient brain response to cognitive demands of locomotion.
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Affiliation(s)
- Melanie Lucas
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
| | - Mark E Wagshul
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, New York.,Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York
| | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University, Pennsylvania
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York.,Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
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29
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Noohi F, Kinnaird C, De Dios Y, Kofman I, Wood SJ, Bloomberg JJ, Mulavara AP, Sienko KH, Polk TA, Seidler RD. Deactivation of somatosensory and visual cortices during vestibular stimulation is associated with older age and poorer balance. PLoS One 2019; 14:e0221954. [PMID: 31513630 PMCID: PMC6742389 DOI: 10.1371/journal.pone.0221954] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/19/2019] [Indexed: 12/11/2022] Open
Abstract
Aging is associated with peripheral and central declines in vestibular processing and postural control. Here we used functional MRI to investigate age differences in neural vestibular representations in response to pneumatic tap stimulation. We also measured the amount of body sway in multiple balance tasks outside of the MRI scanner to assess the relationship between individuals' balance ability and their vestibular neural response. We found a general pattern of activation in canonical vestibular cortex and deactivation in cross modal sensory regions in response to vestibular stimulation. We found that activation amplitude of the vestibular cortex was correlated with age, with younger individuals exhibiting higher activation. Deactivation of visual and somatosensory regions increased with age and was associated with poorer balance. The results demonstrate that brain activations and deactivations in response to vestibular stimuli are correlated with balance, and the pattern of these correlations varies with age. The findings also suggest that older adults exhibit less sensitivity to vestibular stimuli, and may compensate by differentially reweighting visual and somatosensory processes.
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Affiliation(s)
- Fatemeh Noohi
- Department of Kinesiology, University of Michigan, Ann Arbor, MI, United States of America
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States of America
- * E-mail:
| | - Catherine Kinnaird
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States of America
| | | | - Igor Kofman
- KBRwyle, Houston, TX, United States of America
| | - Scott J. Wood
- NASA Johnson Space Center, Houston, TX, United States of America
| | | | | | - Kathleen H. Sienko
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States of America
| | - Thad A. Polk
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States of America
| | - Rachael D. Seidler
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, United States of America
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30
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Gilat M, Dijkstra BW, D'Cruz N, Nieuwboer A, Lewis SJG. Functional MRI to Study Gait Impairment in Parkinson's Disease: a Systematic Review and Exploratory ALE Meta-Analysis. Curr Neurol Neurosci Rep 2019; 19:49. [PMID: 31214901 DOI: 10.1007/s11910-019-0967-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW Whilst gait impairment is a main cause for disability in Parkinson's disease (PD), its neural control remains poorly understood. We performed a systematic review and meta-analysis of neuroimaging studies of surrogate features of gait in PD. FINDINGS Assessing the results from PET or SPECT scans after a period of actual walking as well as fMRI during mental imagery or virtual reality (VR) gait paradigms, we found a varying pattern of gait-related brain activity. Overall, a decrease in activation of the SMA during gait was found in PD compared to elderly controls. In addition, the meta-analysis showed that the most consistent gait-related activation was situated in the cerebellar locomotor region (CLR) in PD. Despite methodological heterogeneity, the combined neuroimaging studies of gait provide new insights into its neural control in PD, suggesting that CLR activation likely serves a compensatory role in locomotion.
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Affiliation(s)
- Moran Gilat
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, PO Box1501, Leuven, Belgium.
| | - Bauke W Dijkstra
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, PO Box1501, Leuven, Belgium
| | - Nicholas D'Cruz
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, PO Box1501, Leuven, Belgium
| | - Alice Nieuwboer
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, PO Box1501, Leuven, Belgium
| | - Simon J G Lewis
- Brain and Mind Centre, University of Sydney, Sydney, Australia
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31
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Conradsson D, Halvarsson A. The effects of dual-task balance training on gait in older women with osteoporosis: A randomized controlled trial. Gait Posture 2019; 68:562-568. [PMID: 30640156 DOI: 10.1016/j.gaitpost.2019.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/20/2018] [Accepted: 01/03/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although there is a growing body of literature showing promising effects of balance training on gait in older adults, little is known about the effects of dual-task training on varying domains of spatial and temporal gait parameters. RESEARCH QUESTION Does the short-term effects of dual-task balance training differ between single and dual-task gait in older women with osteoporosis with regards to different gait domains (pace, rhythm, variability, asymmetry and postural control)? METHODS Elderly women with osteoporosis who experienced fear of falling and/or ≥1 fall the last 12 months were recruited. Ninety-five participants were randomized to 12 weeks of balance training or to a control group. The participants in the training group (n = 65) received 12 weeks (3 times/week) of balance and gait exercises including dual-tasks, and the control group (n = 30) received care as usual. Single- and dual-task gait were assessed before and after the intervention with an electronic walkway system and analyzed using non-parametric statistics and effect sizes. RESULTS 68 participants completed the study. The training group walked faster for single- and dual-task gait following training (P ≤ .044) by increasing their cadence (P ≤ .012) and reducing step and swing time (P ≤ .045) compared with the control group. Significant between-group differences in favor of the training group were found for gait variability during dual-task gait (P ≤ .041). The improvement in speed were greater for dual- than single-task gait (0.10 vs. 0.05 m/s) and the effect sizes revealed small to medium effects for dual-task gait, and either non-existent or small for single-task gait. SIGNIFICANCE Greater training effects found on a variety of domains of dual-task gait compared to single-task gait support the role of cognitively demanding exercises for the maintenance of safe ambulation in older women with osteoporosis.
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Affiliation(s)
- David Conradsson
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Stockholm, Sweden; Karolinska University Hospital, Allied Health Professionals Function, Function Area Occupational Therapy & Physiotherapy, Stockholm, Sweden.
| | - Alexandra Halvarsson
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Stockholm, Sweden; Karolinska University Hospital, Allied Health Professionals Function, Function Area Occupational Therapy & Physiotherapy, Stockholm, Sweden.
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Groff BR, Antonellis P, Schmid KK, Knarr BA, Stergiou N. Stride-time variability is related to sensorimotor cortical activation during forward and backward walking. Neurosci Lett 2019; 692:150-158. [PMID: 30367957 PMCID: PMC6351206 DOI: 10.1016/j.neulet.2018.10.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 10/10/2018] [Indexed: 11/25/2022]
Abstract
Previous research has used functional near-infrared spectroscopy (fNIRS) to show that motor areas of the cortex are activated more while walking backward compared to walking forward. It is also known that head movement creates motion artifacts in fNIRS data. The aim of this study was to investigate cortical activation during forward and backward walking, while also measuring head movement. We hypothesized that greater activation in motor areas while walking backward would be concurrent with increased head movement. Participants performed forward and backward walking on a treadmill. Participants wore motion capture markers on their head to quantify head movement and pressure sensors on their feet to calculate stride-time. fNIRS was placed over motor areas of the cortex to measure cortical activation. Measurements were compared for forward and backward walking conditions. No significant differences in body movement or head movement were observed between forward and backward walking conditions, suggesting that conditional differences in movement did not influence fNIRS results. Stride-time was significantly shorter during backward walking than during forward walking, but not more variable. There were no differences in activation for motor areas of the cortex when outliers were removed. However, there was a positive correlation between stride-time variability and activation in the primary motor cortex. This positive correlation between motor cortex activation and stride-time variability suggests that forward walking variability may be represented in the primary motor cortex.
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Affiliation(s)
- Boman R Groff
- Department of Biomechanics and Center for Research in Human Movement Variability, College of Education, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE, 68182-0860, USA
| | - Prokopios Antonellis
- Department of Biomechanics and Center for Research in Human Movement Variability, College of Education, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE, 68182-0860, USA
| | - Kendra K Schmid
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, 984375 Nebraska Medical Center, Omaha, NE, 68198-4375, USA
| | - Brian A Knarr
- Department of Biomechanics and Center for Research in Human Movement Variability, College of Education, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE, 68182-0860, USA
| | - Nicholas Stergiou
- Department of Biomechanics and Center for Research in Human Movement Variability, College of Education, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE, 68182-0860, USA; Department of Environmental, Agricultural, and Occupational Health, College of Public Health, University of Nebraska Medical Center, 984388 Nebraska Medical Center, Omaha, NE, 68198-4388, USA.
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Fernandez NB, Hars M, Trombetti A, Vuilleumier P. Age-related changes in attention control and their relationship with gait performance in older adults with high risk of falls. Neuroimage 2019; 189:551-559. [PMID: 30660655 DOI: 10.1016/j.neuroimage.2019.01.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/28/2018] [Accepted: 01/11/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Falls are the leading cause of injury-related deaths in the elderly worldwide. Both gait impairment and cognitive decline have been shown to constitute major fall risk factors. However, further investigations are required to establish a more precise link between the influence of age on brain systems mediating executive cognitive functions and their relationship with gait disturbances, and thus help define novel markers and better guide remediation strategies to prevent falls. METHODS Event-related functional magnetic resonance imaging (fMRI) was used to evaluate age-related effects on the recruitment of executive control brain network in selective attention task, as measured with a flanker paradigm. Brain activation patterns were compared between twenty young (21 years ± 2.5) and thirty-four old participants (72 years ± 5.3) with high fall risks. We then determined to what extend age-related differences in activation patterns were associated with alterations in several gait parameters, measured with electronic devices providing a precise quantitative evaluation of gait, as well as with alterations in several aspects of cognitive and physical abilities. RESULTS We found that both young and old participants recruited a distributed fronto-parietal-occipital network during interference by incongruent distractors in the flanker task. However, additional activations were observed in posterior parieto-occipital areas in the older relative to the younger participants. Furthermore, a differential recruitment of both the left dorsal parieto-occipital sulcus and precuneus was significantly correlated with higher gait variability. Besides, decreased activation in the right cerebellum was found in the older with poorer cognitive processing speed scores. CONCLUSIONS Overall results converge to indicate greater sensitivity to attention interference and heightened recruitment of cortical executive control systems in the elderly with fall risks. Critically, this change was associated with selective increases in gait variability indices, linking attentional control with gait performance in elderly with high risks of falls.
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Affiliation(s)
- Natalia B Fernandez
- Laboratory of Behavioral Neurology and Imaging of Cognition, Dept. of Neurosciences, University Medical Center, University of Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Switzerland.
| | - Mélany Hars
- Division of Bone Diseases, Dept. of Internal Medicine Specialties, Geneva University Hospitals, Faculty of Medicine, Switzerland
| | - Andrea Trombetti
- Division of Bone Diseases, Dept. of Internal Medicine Specialties, Geneva University Hospitals, Faculty of Medicine, Switzerland
| | - Patrik Vuilleumier
- Laboratory of Behavioral Neurology and Imaging of Cognition, Dept. of Neurosciences, University Medical Center, University of Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Switzerland
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Gasser B. [The Older the Hiker, the More Severe the Injury - a Retrospective Analysis of Mountain Hiking Accidents in the Swiss Alps from 2009 to 2018]. PRAXIS 2019; 108:1065-1071. [PMID: 31822226 DOI: 10.1024/1661-8157/a003328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The Older the Hiker, the More Severe the Injury - a Retrospective Analysis of Mountain Hiking Accidents in the Swiss Alps from 2009 to 2018 Abstract. Hiking is a regular activity of the elderly, however, the question of a relationship between age and the severity of a mountaineering accident is still unanswered. A total of 10 185 hikers was analyzed between the years 2009 and 2018. For every mountain accident, the NACA score was available allowing to conduct regression analysis between age and NACA scores. The results show that elderly hikers had higher NACA scores compared to younger ones, implying more severe events in the elderly. The tendency of more severe mountain accidents can be attributed to several reasons. Especially emphasized should be falls that are probably favoured by the age-dependent decrease of postural stability, turning a fall into a downfall, predisposing more severe events.
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Affiliation(s)
- Benedikt Gasser
- Swiss Health & Performance Lab, Institut für Anatomie, Universität Bern
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McIsaac TL, Fritz NE, Quinn L, Muratori LM. Cognitive-Motor Interference in Neurodegenerative Disease: A Narrative Review and Implications for Clinical Management. Front Psychol 2018; 9:2061. [PMID: 30425673 PMCID: PMC6218850 DOI: 10.3389/fpsyg.2018.02061] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 10/05/2018] [Indexed: 11/13/2022] Open
Abstract
This paper provides a narrative review of cognitive motor interference in neurodegeneration, including brain imaging findings specific to interference effects in neurodegenerative disease, and dual task assessment and intervention in Parkinson’s disease (PD), multiple sclerosis (MS), and Huntington’s disease (HD). In a healthy central nervous system the ability to process information is limited. Limitations in capacity to select and attend to inputs influence the ability to prepare and perform multiple tasks. As a result, the system balances demands, switching attention to the most task-relevant information as it becomes available. Limitations may become more apparent in persons with neurodegenerative diseases (ND) with system-specific impairments in PD, MS, and HD. These ND affect both cognitive and motor function and are thus particularly susceptible to dual task interference. Issues related to performer and task characteristics and implications of these findings for both the standard assessment of dual task abilities as well as development and evaluation of interventions aimed at improving dual task ability are discussed. In addition, we address the need for optimizing individualized assessment, intervention and evaluation of dual task function by choosing cognitive and motor tasks and measures that are sensitive to and appropriate for the individual’s level of function. Finally, we use current evidence to outline a 5-step process of clinical decision making that uses the dual task taxonomy as a framework for assessment and intervention.
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Affiliation(s)
- Tara L McIsaac
- Department of Physical Therapy, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, United States
| | - Nora E Fritz
- Program in Physical Therapy and Department of Neurology, Wayne State University, Detroit, MI, United States
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
| | - Lisa M Muratori
- Department of Physical Therapy, SHTM, Stony Brook University, Stony Brook, NY, United States
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Toyomura A, Yokosawa K, Shimojo A, Fujii T, Kuriki S. Turning a cylindrical treadmill with feet: An MR-compatible device for assessment of the neural correlates of lower-limb movement. J Neurosci Methods 2018; 307:14-22. [PMID: 29924979 DOI: 10.1016/j.jneumeth.2018.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/24/2018] [Accepted: 06/12/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Locomotion, which is one of the most basic motor functions, is critical for performing various daily-life activities. Despite its essential function, assessment of brain activity during lower-limb movement is still limited because of the constraints of existing brain imaging methods. NEW METHOD Here, we describe an MR-compatible, cylindrical treadmill device that allows participants to perform stepping movements on an MRI scanner table. The device was constructed from wood and all of the parts were handmade by the authors. RESULTS We confirmed the MR-compatibility of the device by evaluating the temporal signal-to-noise ratio of 64 voxels of a phantom during scanning. Brain activity was measured while twenty participants turned the treadmill with feet in sync with metronome sounds. The rotary speed of the cylinder was encoded by optical fibers. The post/pre-central gyrus and cerebellum showed significant activity during the movements, which was comparable to the activity patterns reported in previous studies. Head movement on the y- and z-axes was influenced more by lower-limb movement than was head movement on the x-axis. Among the 60 runs (3 runs × 20 participants), head movement during two of the runs (3.3%) was excessive due to the lower-limb movement. COMPARISON WITH EXISTING METHODS Compared to MR-compatible devices proposed in the previous studies, the advantage of this device may be simple structure and replicability to realize stepping movement with a supine position. CONCLUSIONS Collectively, our results suggest that the treadmill device is useful for evaluating lower-limb-related neural activity.
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Affiliation(s)
- Akira Toyomura
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8514, Japan; Research and Education Center for Brain Science, Hokkaido University, Kita 15, Nishi 7 Kita-ku, Sapporo 060-8638, Japan.
| | - Koichi Yokosawa
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5 Kita-ku, Sapporo 060-0812, Japan
| | - Atsushi Shimojo
- Department of Pediatrics, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7 Kita-ku, Sapporo 060-8638, Japan
| | - Tetsunoshin Fujii
- Department of Psychology, Graduate School of Letters, Hokkaido University, Kita 10, Nishi 7 Kita-ku, Sapporo 060-0810, Japan
| | - Shinya Kuriki
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5 Kita-ku, Sapporo 060-0812, Japan
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Heraud N, Alexandre F, Gueugnon M, Davy C, Tremey E, Oliver N, Varray A. Impact of Chronic Obstructive Pulmonary Disease on Cognitive and Motor Performances in Dual-Task Walking. COPD 2018; 15:277-282. [PMID: 29799281 DOI: 10.1080/15412555.2018.1469607] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
When two tasks are performed simultaneously, they compete for attentional resources, resulting in a performance decrement in one or both tasks. Patients with attention disorders have a reduced ability to perform several tasks simultaneously (e.g., talking while walking), which increases the fall risk and frailty. This study assessed the cognitive and motor performances of patients with COPD and healthy controls within a dual-task walking paradigm. A subobjective was to assess the impact of a pulmonary rehabilitation program on the dual-task performances in COPD. Twenty-five patients with COPD and 20 controls performed a cognitive task (subtraction) and a 15-m walking test separately (single-task; ST) and jointly (dual-task; DT). In addition, a subsample of 10 patients performed the same evaluations 5 weeks later after a pulmonary rehabilitation program following current recommendations. Cognitive and gait performances in ST showed no differences between patients with COPD and controls (all p > 0.05). However, COPD patients exhibited a greater increase in gait variability than controls in DT (4.07 ± 1.46% vs. 2.17 ± 0.7%, p < 0.001). The pulmonary rehabilitation program had no effect on the dual-task impairment for the subsample of patients (p = 0.87). This study provides evidence of insufficient attentional resources to successfully deal with DT in patients with COPD, and this was expressed through an exaggerated increase in gait variability in DT walking. Given the high risk of falls and disability associated with altered gait variability, dual-task training interventions should be considered in pulmonary rehabilitation programs.
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Affiliation(s)
- Nelly Heraud
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France
| | - François Alexandre
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France
| | - Mathieu Gueugnon
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France
| | - Corentin Davy
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France
| | - Emilie Tremey
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France
| | - Nicolas Oliver
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France
| | - Alain Varray
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France.,b Euromov, University of Montpellier , Montpellier , France
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Paraskevoudi N, Balcı F, Vatakis A. "Walking" through the sensory, cognitive, and temporal degradations of healthy aging. Ann N Y Acad Sci 2018; 1426:72-92. [PMID: 29741265 DOI: 10.1111/nyas.13734] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/17/2018] [Accepted: 03/22/2018] [Indexed: 02/03/2023]
Abstract
As we age, there is a wide range of changes in motor, sensory, cognitive, and temporal processing due to alterations in the functioning of the central nervous and musculoskeletal systems. Specifically, aging is associated with degradations in gait; altered processing of the individual sensory systems; modifications in executive control, memory, and attention; and changes in temporal processing. These age-related alterations are often inter-related and have been suggested to result from shared neural substrates. Additionally, the overlap between these brain areas and those controlling walking raises the possibility of facilitating performance in several tasks by introducing protocols that can efficiently target all four domains. Attempts to counteract these negative effects of normal aging have been focusing on research to prevent falls and/or enhance cognitive processes, while ignoring the potential multisensory benefits accompanying old age. Research shows that the aging brain tends to increasingly rely on multisensory integration to compensate for degradations in individual sensory systems and for altered neural functioning. This review covers the age-related changes in the above-mentioned domains and the potential to exploit the benefits associated with multisensory integration in aging so as to improve one's mobility and enhance sensory, cognitive, and temporal processing.
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Affiliation(s)
- Nadia Paraskevoudi
- Multisensory and Temporal Processing Lab (MultiTimeLab), Department of History and Philosophy of Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Fuat Balcı
- Department of Psychology, Koç University, Istanbul, Turkey
| | - Argiro Vatakis
- Multisensory and Temporal Processing Lab (MultiTimeLab), Department of History and Philosophy of Science, National and Kapodistrian University of Athens, Athens, Greece
- Cognitive Systems Research Institute, Athens, Greece
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Bürki CN, Bridenbaugh SA, Reinhardt J, Stippich C, Kressig RW, Blatow M. Imaging gait analysis: An fMRI dual task study. Brain Behav 2017; 7:e00724. [PMID: 28828204 PMCID: PMC5561304 DOI: 10.1002/brb3.724] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 03/24/2017] [Accepted: 03/28/2017] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION In geriatric clinical diagnostics, gait analysis with cognitive-motor dual tasking is used to predict fall risk and cognitive decline. To date, the neural correlates of cognitive-motor dual tasking processes are not fully understood. To investigate these underlying neural mechanisms, we designed an fMRI paradigm to reproduce the gait analysis. METHODS We tested the fMRI paradigm's feasibility in a substudy with fifteen young adults and assessed 31 healthy older adults in the main study. First, gait speed and variability were quantified using the GAITRite© electronic walkway. Then, participants lying in the MRI-scanner were stepping on pedals of an MRI-compatible stepping device used to imitate gait during functional imaging. In each session, participants performed cognitive and motor single tasks as well as cognitive-motor dual tasks. RESULTS Behavioral results showed that the parameters of both gait analyses, GAITRite© and fMRI, were significantly positively correlated. FMRI results revealed significantly reduced brain activation during dual task compared to single task conditions. Functional ROI analysis showed that activation in the superior parietal lobe (SPL) decreased less from single to dual task condition than activation in primary motor cortex and in supplementary motor areas. Moreover, SPL activation was increased during dual tasks in subjects exhibiting lower stepping speed and lower executive control. CONCLUSION We were able to simulate walking during functional imaging with valid results that reproduce those from the GAITRite© gait analysis. On the neural level, SPL seems to play a crucial role in cognitive-motor dual tasking and to be linked to divided attention processes, particularly when motor activity is involved.
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Affiliation(s)
- Céline N Bürki
- Division of Diagnostic and Interventional Neuroradiology Department of Radiology University of Basel Hospital and University of Basel Basel Switzerland.,Felix Platter-Hospital University Center for Medicine of Aging and University of Basel Basel Switzerland
| | - Stephanie A Bridenbaugh
- Felix Platter-Hospital University Center for Medicine of Aging and University of Basel Basel Switzerland
| | - Julia Reinhardt
- Division of Diagnostic and Interventional Neuroradiology Department of Radiology University of Basel Hospital and University of Basel Basel Switzerland
| | - Christoph Stippich
- Division of Diagnostic and Interventional Neuroradiology Department of Radiology University of Basel Hospital and University of Basel Basel Switzerland
| | - Reto W Kressig
- Felix Platter-Hospital University Center for Medicine of Aging and University of Basel Basel Switzerland
| | - Maria Blatow
- Division of Diagnostic and Interventional Neuroradiology Department of Radiology University of Basel Hospital and University of Basel Basel Switzerland
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