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Holtzer R, Choi J, Motl RW, Foley FW, Wagshul ME, Hernandez ME, Izzetoglu M. Brain control of dual-task walking can be improved in aging and neurological disease. GeroScience 2024; 46:3169-3184. [PMID: 38221528 PMCID: PMC11009168 DOI: 10.1007/s11357-023-01054-3] [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: 11/07/2023] [Accepted: 12/22/2023] [Indexed: 01/16/2024] Open
Abstract
The peak prevalence of multiple sclerosis has shifted into older age groups, but co-occurring and possibly synergistic motoric and cognitive declines in this patient population are poorly understood. Dual-task-walking performance, subserved by the prefrontal cortex, and compromised in multiple sclerosis and aging, predicts health outcomes. Whether acute practice can improve dual-task walking performance and prefrontal cortex hemodynamic response efficiency in multiple sclerosis has not been reported. To address this gap in the literature, the current study examined task- and practice-related effects on dual-task-walking and associated brain activation in older adults with multiple sclerosis and controls. Multiple sclerosis (n = 94, mean age = 64.76 ± 4.19 years) and control (n = 104, mean age = 68.18 ± 7.01 years) participants were tested under three experimental conditions (dual-task-walk, single-task-walk, and single-task-alpha) administered over three repeated counterbalanced trials. Functional near-infrared-spectroscopy was used to evaluate task- and practice-related changes in prefrontal cortex oxygenated hemoglobin. Gait and cognitive performances declined, and prefrontal cortex oxygenated hemoglobin was higher in dual compared to both single task conditions in both groups. Gait and cognitive performances improved over trials in both groups. There were greater declines over trials in oxygenated hemoglobin in dual-task-walk compared to single-task-walk in both groups. Among controls, but not multiple sclerosis participants, declines over trials in oxygenated hemoglobin were greater in dual-task-walk compared to single-task-alpha. Dual-task walking and associated prefrontal cortex activation efficiency improved during a single session, but improvement in neural resource utilization, although significant, was attenuated in multiple sclerosis participants. These findings suggest encouraging brain adaptability in aging and neurological disease.
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Affiliation(s)
- Roee Holtzer
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
| | - Jaeun Choi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert W Motl
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois, Chicago, IL, USA
| | - Frederick W Foley
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Multiple Sclerosis Center, Holy Name Medical Center, Teaneck, NJ, USA
| | - Mark E Wagshul
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Manuel E Hernandez
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
- Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Meltem Izzetoglu
- Electrical and Computer Engineering, Villanova University, Villanova, PA, USA
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Jacobs S, Izzetoglu M, Holtzer R. The impact of music making on neural efficiency & dual-task walking performance in healthy older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:438-456. [PMID: 36999570 PMCID: PMC10544664 DOI: 10.1080/13825585.2023.2195615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/22/2023] [Indexed: 04/01/2023]
Abstract
Music making is linked to improved cognition and related neuroanatomical changes in children and adults; however, this has been relatively under-studied in aging. The purpose of this study was to assess neural, cognitive, and physical correlates of music making in aging using a dual-task walking (DTW) paradigm. Study participants (N = 415) were healthy adults aged 65 years or older, including musicians (n = 70) who were identified by current weekly engagement in musical activity. A DTW paradigm consisting of single- and dual-task conditions, as well as portable neuroimaging (functional near-infrared spectroscopy), was administered. Outcome measures included neural activation in the prefrontal cortex assessed across task conditions by recording changes in oxygenated hemoglobin, cognitive performance, and gait velocity. Linear mixed effects models examined the impact of music making on outcome measures in addition to moderating their change between task conditions. Across participants (53.3% women; 76 ± 6.55 years), neural activation increased from single- to dual-task conditions (p < 0.001); however, musicians demonstrated attenuated activation between a single cognitive interference task and dual-task walking (p = 0.014). Musicians also displayed significantly smaller decline in behavioral performance (p < 0.001) from single- to dual-task conditions and faster gait overall (p = 0.014). Given evidence of lower prefrontal cortex activation in the context of similar or improved behavioral performance, results indicate the presence of enhanced neural efficiency in older adult musicians. Furthermore, improved dual-task performance in older adult musicians was observed. Results have important clinical implications for healthy aging, as executive functioning plays an essential role in maintaining functional ability in older adulthood.
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Affiliation(s)
- Sydney Jacobs
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University, Villanova, PA, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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Moraca GAG, Orcioli-Silva D, Legutke BR, Gutierrez PP, Sirico TM, Zampier VC, Beretta VS, Gobbi LTB, Barbieri FA. Aerobic exercise on the treadmill combined with transcranial direct current stimulation on the gait of people with Parkinson's disease: A protocol for a randomized clinical trial. PLoS One 2024; 19:e0300243. [PMID: 38662740 PMCID: PMC11045059 DOI: 10.1371/journal.pone.0300243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 04/28/2024] Open
Abstract
Gait impairments negatively affect the quality of life of people with Parkinson's disease (PwPD). Aerobic exercise (AE) is an alternative to alleviate these impairments and its combination with transcranial direct current stimulation (tDCS) has demonstrated synergistic effects. However, the effect of multitarget tDCS application (i.e., motor, and prefrontal cortices simultaneously) combined with physical exercise on gait impairments is still little known. Thus, the proposed randomized clinical trial will verify the acute effects of AE combined with tDCS applied on motor and prefrontal cortices separately and simultaneously on gait (spatial-temporal and cortical activity parameters) in PwPD. Twenty-four PwPD in Hoehn & Yahr stages I-III will be recruited for this crossover study. PwPD will practice AE on treadmill simultaneously with the application of anodal tDCS during four intervention sessions on different days (∼ one week of interval). Active tDCS will be applied to the primary motor cortex, prefrontal cortex, and both areas simultaneously (multitarget), with an intensity of 2 mA for 20 min. For sham, the stimulation will remain at 2 mA for 10 s. The AE will last a total of 30 min, consisting of warm-up, main part (20 min with application of tDCS), and recovery. Exercise intensity will be controlled by heart rate. Spatial-temporal and cortical activity parameters will be acquired before and after each session during overground walking, walking with obstacle avoidance, and walking with a cognitive dual task at self-preferred velocity. An accelerometer will be positioned on the fifth lumbar vertebra to obtain the spatial-temporal parameters (i.e., step length, duration, velocity, and swing phase duration). Prefrontal cortex activity will be recorded from a portable functional near-infrared spectroscopy system and oxygenated and deoxygenated hemoglobin concentrations will be analyzed. Two-way ANOVAs with repeated measures for stimulation and moment will be performed. The findings of the study may contribute to improving gait in PwPD. Trial registration: Brazilian Clinical Trials Registry (RBR-738zkp7).
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Affiliation(s)
- Gabriel Antonio Gazziero Moraca
- Posture and Gait Studies Laboratory, Department of Physical Education, Institute of Biosciences, São Paulo State University, Rio Claro, São Paulo, Brazil
- Human Movement Research Laboratory, Department of Physical Education, School of Sciences, São Paulo State University, Bauru, São Paulo, Brazil
| | - Diego Orcioli-Silva
- Posture and Gait Studies Laboratory, Department of Physical Education, Institute of Biosciences, São Paulo State University, Rio Claro, São Paulo, Brazil
| | - Beatriz Regina Legutke
- Posture and Gait Studies Laboratory, Department of Physical Education, Institute of Biosciences, São Paulo State University, Rio Claro, São Paulo, Brazil
| | - Pedro Paulo Gutierrez
- Posture and Gait Studies Laboratory, Department of Physical Education, Institute of Biosciences, São Paulo State University, Rio Claro, São Paulo, Brazil
| | - Thiago Martins Sirico
- Posture and Gait Studies Laboratory, Department of Physical Education, Institute of Biosciences, São Paulo State University, Rio Claro, São Paulo, Brazil
| | - Vinicius Cavassano Zampier
- Posture and Gait Studies Laboratory, Department of Physical Education, Institute of Biosciences, São Paulo State University, Rio Claro, São Paulo, Brazil
- Human Movement Research Laboratory, Department of Physical Education, School of Sciences, São Paulo State University, Bauru, São Paulo, Brazil
| | - Victor Spiandor Beretta
- School of Technology and Sciences, Department of Physical Education, São Paulo State University, Presidente Prudente, São Paulo, Brazil
| | - Lilian Teresa Bucken Gobbi
- Posture and Gait Studies Laboratory, Department of Physical Education, Institute of Biosciences, São Paulo State University, Rio Claro, São Paulo, Brazil
| | - Fabio Augusto Barbieri
- Human Movement Research Laboratory, Department of Physical Education, School of Sciences, São Paulo State University, Bauru, São Paulo, Brazil
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Ding Q, Ou Z, Yao S, Wu C, Chen J, Shen J, Lan Y, Xu G. Cortical activation and brain network efficiency during dual tasks: An fNIRS study. Neuroimage 2024; 289:120545. [PMID: 38367652 DOI: 10.1016/j.neuroimage.2024.120545] [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: 08/30/2023] [Revised: 02/10/2024] [Accepted: 02/15/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVE Dual task (DT) is a commonly used paradigm indicative of executive functions. Brain activities during DT walking is usually measured by portable functional near infrared spectroscopy (fNIRS). Previous studies focused on cortical activation in prefrontal cortex and overlooked other brain regions such as sensorimotor cortices. This study is aimed at investigating the modulations of cortical activation and brain network efficiency in multiple brain regions from single to dual tasks with different complexities and their relationships with DT performance. METHODS Forty-two healthy adults [12 males; mean age: 27.7 (SD=6.5) years] participated in this study. Participants performed behavioral tasks with portable fNIRS simultaneous recording. There were three parts of behavioral tasks: cognitive tasks while standing (serial subtraction of 3's and 7's), walking alone and DT (walk while subtraction, including serial subtraction of 3's and 7's). Cognitive cost, walking cost and cost sum (i.e., sum of cognitive and walking costs) were calculated for DT. Cortical activation, local and global network efficiency were calculated for each task. RESULTS The cognitive cost was greater and the walking cost was less during DT with subtraction 3's compared with 7's (P's = 0.032 and 0.019, respectively). Cortical activation and network efficiency were differentially modulated among single and dual tasks (P's < 0.05). Prefrontal activation during DT was positively correlated with DT costs, while network efficiency was negatively correlated with DT costs (P's < 0.05). CONCLUSIONS Our results revealed prefrontal over-activation and reduced network efficiency in individuals with poor DT performance. Our findings suggest that reduced network efficiency could be a possible mechanism contributing to poor DT performance, which is accompanied by compensatory prefrontal over-activation.
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Affiliation(s)
- Qian Ding
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Zitong Ou
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Department of Rehabilitation Medicine, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shantong Yao
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Cheng Wu
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Department of Rehabilitation Medicine, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jing Chen
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Junhui Shen
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yue Lan
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China.
| | - Guangqing Xu
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
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Xu G, Zhou M, Chen Y, Song Q, Sun W, Wang J. Brain activation during standing balance control in dual-task paradigm and its correlation among older adults with mild cognitive impairment: a fNIRS study. BMC Geriatr 2024; 24:144. [PMID: 38341561 PMCID: PMC10859010 DOI: 10.1186/s12877-024-04772-1] [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: 11/13/2023] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND This study aimed to compare the balance ability and functional brain oxygenation in the prefrontal cortex (PFC) among older adults with mild cognitive impairment (MCI) under single and dual tasks, and also investigate their relationship. Neural regulatory mechanisms of the brain in the MCI were shed light on in balance control conditions. METHODS 21 older adults with MCI (female = 12, age: 71.19 ± 3.36 years) were recruited as the experimental group and 19 healthy older adults (female = 9, age: 70.16 ± 4.54 years) as the control group. Participants completed balance control of single task and dual task respectively. Functional near-infrared spectroscopy (fNIRS) and force measuring platform are used to collect hemodynamic signals of the PFC and center of pressure (COP) data during the balance task, respectively. RESULTS The significant Group*Task interaction effect was found in maximal displacement of the COP in the medial-lateral (ML) direction (D-ml), 95% confidence ellipse area (95%AREA), root mean square (RMS), the RMS in the ML direction (RMS-ml), the RMS in the anterior-posterior (AP) direction (RMS-ap), sway path (SP), the sway path in the ML direction (SP-ml), and the sway path in the AP direction (SP-ap). The significant group effect was detected for five regions of interest (ROI), namely the left Brodmann area (BA) 45 (L45), the right BA45 (R45), the right BA10 (R10), the left BA46 (L46), and the right BA11 (R11). Under single task, maximal displacement of the COP in the AP direction (D-ap), RMS, and RMS-ap were significantly negatively correlated with R45, L45, and R11 respectively. Under dual task, both RMS and 95%AREA were correlated positively with L45, and both L10 and R10 were positively correlated with RMS-ap. CONCLUSION The MCI demonstrated worse balance control ability as compared to healthy older adults. The greater activation of PFC under dual tasks in MCI may be considered a compensatory strategy for maintaining the standing balance. The brain activation was negatively correlated with balance ability under single task, and positively under dual task. TRIAL REGISTRATION ChiCTR2100044221 , 12/03/2021.
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Affiliation(s)
- Guocai Xu
- College of Sports and Health, Shandong Sport University, Jinan, Shandong, China
| | - Mian Zhou
- Rehabilitation Medicine Department, Weishan People's Hospital, Jining, Shandong, China
| | - Yan Chen
- College of Sports and Health, Shandong Sport University, Jinan, Shandong, China
| | - Qipeng Song
- College of Sports and Health, Shandong Sport University, Jinan, Shandong, China
| | - Wei Sun
- College of Sports and Health, Shandong Sport University, Jinan, Shandong, China
| | - Jiangna Wang
- College of Sports and Health, Shandong Sport University, Jinan, Shandong, China.
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Ross D, Wagshul ME, Izzetoglu M, Holtzer R. Cortical thickness moderates intraindividual variability in prefrontal cortex activation patterns of older adults during walking. J Int Neuropsychol Soc 2024; 30:117-127. [PMID: 37366047 PMCID: PMC10751394 DOI: 10.1017/s1355617723000371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Increased intraindividual variability (IIV) in behavioral and cognitive performance is a risk factor for adverse outcomes but research concerning hemodynamic signal IIV is limited. Cortical thinning occurs during aging and is associated with cognitive decline. Dual-task walking (DTW) performance in older adults has been related to cognition and neural integrity. We examined the hypothesis that reduced cortical thickness would be associated with greater increases in IIV in prefrontal cortex oxygenated hemoglobin (HbO2) from single tasks to DTW in healthy older adults while adjusting for behavioral performance. METHOD Participants were 55 healthy community-dwelling older adults (mean age = 74.84, standard deviation (SD) = 4.97). Structural MRI was used to quantify cortical thickness. Functional near-infrared spectroscopy (fNIRS) was used to assess changes in prefrontal cortex HbO2 during walking. HbO2 IIV was operationalized as the SD of HbO2 observations assessed during the first 30 seconds of each task. Linear mixed models were used to examine the moderation effect of cortical thickness throughout the cortex on HbO2 IIV across task conditions. RESULTS Analyses revealed that thinner cortex in several regions was associated with greater increases in HbO2 IIV from the single tasks to DTW (ps < .02). CONCLUSIONS Consistent with neural inefficiency, reduced cortical thickness in the PFC and throughout the cerebral cortex was associated with increases in HbO2 IIV from the single tasks to DTW without behavioral benefit. Reduced cortical thickness and greater IIV of prefrontal cortex HbO2 during DTW may be further investigated as risk factors for developing mobility impairments in aging.
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Affiliation(s)
- Daliah Ross
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Mark E. Wagshul
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University, Villanova, PA, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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Liu S, Rosso AL, Baillargeon EM, Weinstein AM, Rosano C, Torres-Oviedo G. Novel attentional gait index reveals a cognitive ability-related decline in gait automaticity during dual-task walking. Front Aging Neurosci 2024; 15:1283376. [PMID: 38274986 PMCID: PMC10808635 DOI: 10.3389/fnagi.2023.1283376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Gait automaticity refers to the ability to walk with minimal recruitment of attentional networks typically mediated through the prefrontal cortex (PFC). Reduced gait automaticity (i.e., greater use of attentional resources during walking) is common with aging, contributing to an increased risk of falls and reduced quality of life. A common assessment of gait automaticity involves examining PFC activation using near-infrared spectroscopy (fNIRS) during dual-task (DT) paradigms, such as walking while performing a cognitive task. However, neither PFC activity nor task performance in isolation measures automaticity accurately. For example, greater PFC activation could be interpreted as worse gait automaticity when accompanied by poorer DT performance, but when accompanied by better DT performance, it could be seen as successful compensation. Thus, there is a need to incorporate behavioral performance and PFC measurements for a more comprehensive evaluation of gait automaticity. To address this need, we propose a novel attentional gait index as an analytical approach that combines changes in PFC activity with changes in DT performance to quantify automaticity, where a reduction in automaticity will be reflected as an increased need for attentional gait control (i.e., larger index). Methods The index was validated in 173 participants (≥65 y/o) who completed DTs with two levels of difficulty while PFC activation was recorded with fNIRS. The two DTs consisted of reciting every other letter of the alphabet while walking over either an even or uneven surface. Results As DT difficulty increases, more participants showed the anticipated increase in the attentional control of gait (i.e., less automaticity) as measured by the novel index compared to PFC activation. Furthermore, when comparing across individuals, lower cognitive function was related to higher attentional gait index, but not PFC activation or DT performance. Conclusion The proposed index better quantified the differences in attentional control of gait between tasks and individuals by providing a unified measure that includes both brain activation and performance. This new approach opens exciting possibilities to assess participant-specific deficits and compare rehabilitation outcomes from gait automaticity interventions.
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Affiliation(s)
- Shuqi Liu
- Sensorimotor Learning Laboratory, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
| | - Andrea L. Rosso
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Emma M. Baillargeon
- Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrea M. Weinstein
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Caterina Rosano
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Gelsy Torres-Oviedo
- Sensorimotor Learning Laboratory, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
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Yuan X, Zhong X, Wang C, Dai Y, Yang Y, Jiang C. Temporo-Parietal cortex activation during motor imagery in older adults: A case study of Baduanjin. Brain Cogn 2023; 173:106103. [PMID: 37922628 DOI: 10.1016/j.bandc.2023.106103] [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: 05/03/2023] [Revised: 10/03/2023] [Accepted: 10/22/2023] [Indexed: 11/07/2023]
Abstract
Age-associated cognitive and motor decline is related to central nervous system injury in older adults. Motor imagery training (MIT), as an emerging rehabilitative intervention, can activate neural basis similar to that in actual exercise, so as to promote motor function in older adults. The complex motor skills rely on the functional integration of the cerebral cortex. Understanding the neural mechanisms underlying motor imagery in older adults would support its application in motor rehabilitation and slowing cognitive decline. Based on this, the present study used functional near infrared spectroscopy (fNIRS) to record the changes in oxygen saturation in older adults (20 participants; mean age, 64.8 ± 4.5 years) during Baduanjin motor execution (ME) and motor imagery (MI). ME significantly activated the left postcentral gyrus, while the oxy-hemoglobin concentration in the right middle temporal gyrus increased significantly during motor imagery. These results indicate that advanced ME activates brain regions related to sensorimotor function, and MI increases the activation of the frontal-parietal cortex related to vision. In older adults, MI overactivated the temporo-parietal region associated with vision, and tend to be activated in the right brain.
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Affiliation(s)
- Xiaoxia Yuan
- Beijing Key Laboratory of Physical Fitness Evaluation and Technical Analysis, Capital University of Physical Education and Sports, Beijing 100191, China; The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China; School of Sport, Exercise and Rehabilitation Sciences, The University of Birmingham, Birmingham B25 2TT, UK.
| | - Xiaoke Zhong
- Beijing Key Laboratory of Physical Fitness Evaluation and Technical Analysis, Capital University of Physical Education and Sports, Beijing 100191, China; The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China.
| | - Chen Wang
- Beijing Key Laboratory of Physical Fitness Evaluation and Technical Analysis, Capital University of Physical Education and Sports, Beijing 100191, China; The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China.
| | - Yuanfu Dai
- Beijing Key Laboratory of Physical Fitness Evaluation and Technical Analysis, Capital University of Physical Education and Sports, Beijing 100191, China; The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China.
| | - Yuan Yang
- Sports Department, Beihang University, Beijing 100191, China.
| | - Changhao Jiang
- Beijing Key Laboratory of Physical Fitness Evaluation and Technical Analysis, Capital University of Physical Education and Sports, Beijing 100191, China; The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China.
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Schmaderer LF, Meyer M, Reer R, Schumacher N. What happens in the prefrontal cortex? Cognitive processing of novel and familiar stimuli in soccer: An exploratory fNIRS study. Eur J Sport Sci 2023; 23:2389-2399. [PMID: 37535067 DOI: 10.1080/17461391.2023.2238699] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
The importance of both general and sport-specific perceptual-cognitive abilities in soccer players has been investigated in several studies. Although these perceptual-cognitive skills could contribute significantly to soccer players' expertise, the underlying cortical mechanisms have not been clarified yet. Examining activity changes in the prefrontal cortex under different cognitive demands may help to better understand the underlying mechanisms of sports expertise. The aim of this study was to analyse the prefrontal activity of soccer experts during general and sport-specific cognitive tasks. For this purpose, 39 semi-professional soccer players performed four perceptual-cognitive tests, two of which assessed general cognition, the other two assessed sport-specific cognition. Since soccer is a movement-intensive sport, two tests were performed in motion. While performing cognitive tests, prefrontal activity was recorded using functional near-infrared spectroscopy (fNIRS) (NIRSport, NIRx Medical Technologies, USA). Differences of prefrontal activity in general and sport-specific cognitive tasks were analysed using paired t-tests. The results showed significant increases in prefrontal activity during general cognitive tests (novel stimuli) compared to sport-specific tests (familiar stimuli). The comparatively lower prefrontal activity change during sport-specific cognition might be due to learned automatisms of experts in this field. These results seem in line with previous findings on novel and automated cognition, "repetition suppression theory" and "neural efficiency theory". Furthermore, the different cortical processes could be caused by altered prefrontal structures of experts and might represent a decisive factor for expertise in team sports. However, further research is needed to clarify the prefrontal involvement on expertise in general and sport-specific cognition.
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Affiliation(s)
- Lena F Schmaderer
- Institute of Human Movement Sciences, University of Hamburg, Hamburg, Germany
| | - Mathilda Meyer
- Institute of Human Movement Sciences, University of Hamburg, Hamburg, Germany
| | - Rüdiger Reer
- Institute of Human Movement Sciences, University of Hamburg, Hamburg, Germany
| | - Nils Schumacher
- Institute of Human Movement Sciences, University of Hamburg, Hamburg, Germany
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10
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Shkury E, Danziger-Schragenheim S, Katzir Z, Ezra Y, Giladi N, Mirelman A, Maidan I. Differences in EEG Event-Related Potentials during Dual Task in Parkinson's Disease Carriers and Non-Carriers of the G2019S-LRRK2 Mutation. SENSORS (BASEL, SWITZERLAND) 2023; 23:8266. [PMID: 37837096 PMCID: PMC10575245 DOI: 10.3390/s23198266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND The G2019S-LRRK2 gene mutation is a common cause of hereditary Parkinson's disease (PD), associated with a higher frequency of the postural instability gait difficulty (PIGD) motor phenotype yet with preserved cognition. This study investigated neurophysiological changes during motor and cognitive tasks in PD patients with and without the G2019S-LRRK2 mutation. METHODS 33 iPD patients and 22 LRRK2-PD patients performed the visual Go/NoGo task (VGNG) during sitting (single-task) and walking (dual-task) while wearing a 64-channel EEG cap. Event-related potentials (ERP) from Fz and Pz, specifically N200 and P300, were extracted and analyzed to quantify brain activity patterns. RESULTS The LRRK2-PD group performed better in the VGNG than the iPD group (group*task; p = 0.05). During Go, the iPD group showed reduced N2 amplitude and prolonged N2 latency during walking, whereas the LRRK2-PD group showed only shorter latency (group*task p = 0.027). During NoGo, opposite patterns emerged; the iPD group showed reduced N2 and increased P3 amplitudes during walking while the LRRK2-PD group demonstrated increased N2 and reduced P3 (N2: group*task, p = 0.010, P3: group*task, p = 0.012). CONCLUSIONS The LRRK2-PD group showed efficient early cognitive processes, reflected by N2, resulting in greater neural synchronization and prominent ERPs. These processes are possibly the underlying mechanisms for the observed better cognitive performance as compared to the iPD group. As such, future applications of intelligent medical sensing should be capable of capturing these electrophysiological patterns in order to enhance motor-cognitive functions.
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Affiliation(s)
- Eden Shkury
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Shani Danziger-Schragenheim
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Zoya Katzir
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Yael Ezra
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Nir Giladi
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Anat Mirelman
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Inbal Maidan
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
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11
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Ma D, Izzetoglu M, Holtzer R, Jiao X. Deep Learning Based Walking Tasks Classification in Older Adults Using fNIRS. IEEE Trans Neural Syst Rehabil Eng 2023; 31:3437-3447. [PMID: 37594868 PMCID: PMC11044905 DOI: 10.1109/tnsre.2023.3306365] [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] [Indexed: 08/20/2023]
Abstract
Decline in gait features is common in older adults and an indicator of increased risk of disability, morbidity, and mortality. Under dual task walking (DTW) conditions, further degradation in the performance of both the gait and the secondary cognitive task were found in older adults which were significantly correlated to falls history. Cortical control of gait, specifically in the pre-frontal cortex (PFC) as measured by functional near infrared spectroscopy (fNIRS), during DTW in older adults has recently been studied. However, the automatic classification of differences in cognitive activations under single and dual task gait conditions has not been extensively studied yet. In this paper, by considering single task walking (STW) as a lower attentional walking state and DTW as a higher attentional walking state, we aimed to formulate this as an automatic detection of low and high attentional walking states and leverage deep learning methods to perform their classification. We conduct analysis on the data samples which reveals the characteristics on the difference between HbO2 and Hb values that are subsequently used as additional features. We perform feature engineering to formulate the fNIRS features as a 3-channel image and apply various image processing techniques for data augmentation to enhance the performance of deep learning models. Experimental results show that pre-trained deep learning models that are fine-tuned using the collected fNIRS dataset together with gender and cognitive status information can achieve around 81% classification accuracy which is about 10% higher than the traditional machine learning algorithms. We present additional sensitivity metrics such as confusion matrix, precision and F1 score, as well as accuracy on two-way classification between condition pairings. We further performed an extensive ablation study to evaluate factors such as the voxel locations, channels of input images, zero-paddings and pre-training of deep learning model on their contribution or impact to the classification task. Results showed that using pre-trained model, all the voxel locations, and HbO2 - Hb as the third channel of the input image can achieve the best classification accuracy.
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12
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Bonanno L, Cannuli A, Pignolo L, Marino S, Quartarone A, Calabrò RS, Cerasa A. Neural Plasticity Changes Induced by Motor Robotic Rehabilitation in Stroke Patients: The Contribution of Functional Neuroimaging. Bioengineering (Basel) 2023; 10:990. [PMID: 37627875 PMCID: PMC10451271 DOI: 10.3390/bioengineering10080990] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/07/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Robotic rehabilitation is one of the most advanced treatments helping people with stroke to faster recovery from motor deficits. The clinical impact of this type of treatment has been widely defined and established using clinical scales. The neurofunctional indicators of motor recovery following conventional rehabilitation treatments have already been identified by previous meta-analytic investigations. However, a clear definition of the neural correlates associated with robotic neurorehabilitation treatment has never been performed. This systematic review assesses the neurofunctional correlates (fMRI, fNIRS) of cutting-edge robotic therapies in enhancing motor recovery of stroke populations in accordance with PRISMA standards. A total of 7, of the initial yield of 150 articles, have been included in this review. Lessons from these studies suggest that neural plasticity within the ipsilateral primary motor cortex, the contralateral sensorimotor cortex, and the premotor cortices are more sensitive to compensation strategies reflecting upper and lower limbs' motor recovery despite the high heterogeneity in robotic devices, clinical status, and neuroimaging procedures. Unfortunately, the paucity of RCT studies prevents us from understanding the neurobiological differences induced by robotic devices with respect to traditional rehabilitation approaches. Despite this technology dating to the early 1990s, there is a need to translate more functional neuroimaging markers in clinical settings since they provide a unique opportunity to examine, in-depth, the brain plasticity changes induced by robotic rehabilitation.
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Affiliation(s)
- Lilla Bonanno
- IRCCS Centro Neurolesi Bonino Pulejo, 98123 Messina, Italy; (L.B.); (A.C.); (S.M.); (A.Q.)
| | - Antonio Cannuli
- IRCCS Centro Neurolesi Bonino Pulejo, 98123 Messina, Italy; (L.B.); (A.C.); (S.M.); (A.Q.)
| | | | - Silvia Marino
- IRCCS Centro Neurolesi Bonino Pulejo, 98123 Messina, Italy; (L.B.); (A.C.); (S.M.); (A.Q.)
| | - Angelo Quartarone
- IRCCS Centro Neurolesi Bonino Pulejo, 98123 Messina, Italy; (L.B.); (A.C.); (S.M.); (A.Q.)
| | | | - Antonio Cerasa
- S’Anna Institute, 88900 Crotone, Italy;
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy
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13
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Ma H, Li C, Zhu Y, Peng Y, Sun L. Gait parameter fitting and adaptive enhancement based on cerebral blood oxygen information. Front Hum Neurosci 2023; 17:1205858. [PMID: 37554408 PMCID: PMC10405458 DOI: 10.3389/fnhum.2023.1205858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/10/2023] [Indexed: 08/10/2023] Open
Abstract
Accurate recognition of patients' movement intentions and real-time adjustments are crucial in rehabilitation exoskeleton robots. However, some patients are unable to utilize electromyography (EMG) signals for this purpose due to poor or missing signals in their lower limbs. In order to address this issue, we propose a novel method that fits gait parameters using cerebral blood oxygen signals. Two types of walking experiments were conducted to collect brain blood oxygen signals and gait parameters from volunteers. Time domain, frequency domain, and spatial domain features were extracted from brain hemoglobin. The AutoEncoder-Decoder method is used for feature dimension reduction. A regression model based on the long short-term memory (LSTM) model was established to fit the gait parameters and perform incremental learning for new individual data. Cross-validation was performed on the model to enhance individual adaptivity and reduce the need for individual pre-training. The coefficient of determination (R2) for the gait parameter fit was 71.544%, with a mean square error (RMSE) of less than 3.321%. Following adaptive enhancement, the coefficient of R2 increased by 6.985%, while the RMSE decreased by 0.303%. These preliminary results indicate the feasibility of fitting gait parameters using cerebral blood oxygen information. Our research offers a new perspective on assisted locomotion control for patients who lack effective myoelectricity, thereby expanding the clinical application of rehabilitation exoskeleton robots. This work establishes a foundation for promoting the application of Brain-Computer Interface (BCI) technology in the field of sports rehabilitation.
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Affiliation(s)
| | - Chunguang Li
- Key Laboratory of Robotics and System of Jiangsu, School of Mechanical and Electric Engineering, Soochow University, Suzhou, China
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14
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Baek CY, Kim HD, Yoo DY, Kang KY, Lee JW. Change in activity patterns in the prefrontal cortex in different phases during the dual-task walking in older adults. J Neuroeng Rehabil 2023; 20:86. [PMID: 37420235 PMCID: PMC10327141 DOI: 10.1186/s12984-023-01211-x] [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: 03/02/2023] [Accepted: 06/30/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Studies using functional near-infrared spectroscopy (fNIRS) have shown that dual-task walking leads to greater prefrontal cortex (PFC) activation compared to the single-task walking task. However, evidence on age-related changes in PFC activity patterns is inconsistent. Therefore, this study aimed to explore the changes in the activation patterns of PFC subregions in different activation phases (early and late phases) during both single-task and dual-task walking in both older and younger adults. METHODS Overall, 20 older and 15 younger adults performed a walking task with and without a cognitive task. The activity of the PFC subregions in different phases (early and late phases) and task performance (gait and cognitive task) were evaluated using fNIRS and a gait analyzer. RESULTS The gait (slower speed and lower cadence) and cognitive performance (lower total response, correct response and accuracy rate, and higher error rate) of older adults was poorer during the dual task than that of younger adults. Right dorsolateral PFC activity in the early period in older adults was higher than that in younger adults, which declined precipitously during the late period. Conversely, the activity level of the right orbitofrontal cortex in the dual-task for older adults was lower than for younger adults. CONCLUSIONS These altered PFC subregion-specific activation patterns in older adults would indicate a decline in dual-task performance with aging.
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Affiliation(s)
- Chang Yoon Baek
- Department of Physical Therapy and School of Health and Environmental Science, College of Health Science, Korea University, Seoul, South Korea
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, 100 Ilsan-Ro, Ilsandong-Gu, Goyang-Si, Gyeonggi-do 10444 South Korea
| | - Hyeong Dong Kim
- Department of Physical Therapy and School of Health and Environmental Science, College of Health Science, Korea University, Seoul, South Korea
| | - Dong Yup Yoo
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, 100 Ilsan-Ro, Ilsandong-Gu, Goyang-Si, Gyeonggi-do 10444 South Korea
| | - Kyoung Yee Kang
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, 100 Ilsan-Ro, Ilsandong-Gu, Goyang-Si, Gyeonggi-do 10444 South Korea
| | - Jang Woo Lee
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, 100 Ilsan-Ro, Ilsandong-Gu, Goyang-Si, Gyeonggi-do 10444 South Korea
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15
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Nguyen T, Behrens M, Broscheid KC, Bielitzki R, Weber S, Libnow S, Malczewski V, Baldauf L, Milberger X, Jassmann L, Wustmann A, Meiler K, Drange S, Franke J, Schega L. Associations between gait performance and pain intensity, psychosocial factors, executive functions as well as prefrontal cortex activity in chronic low back pain patients: A cross-sectional fNIRS study. Front Med (Lausanne) 2023; 10:1147907. [PMID: 37215712 PMCID: PMC10196398 DOI: 10.3389/fmed.2023.1147907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/13/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Activities of daily living, such as walking, are impaired in chronic low back pain (CLBP) patients compared to healthy individuals. Thereby, pain intensity, psychosocial factors, cognitive functioning and prefrontal cortex (PFC) activity during walking might be related to gait performance during single and dual task walking (STW, DTW). However, to the best of our knowledge, these associations have not yet been explored in a large sample of CLBP patients. Method Gait kinematics (inertial measurement units) and PFC activity (functional near-infrared spectroscopy) during STW and DTW were measured in 108 CLBP patients (79 females, 29 males). Additionally, pain intensity, kinesiophobia, pain coping strategies, depression and executive functioning were quantified and correlation coefficients were calculated to determine the associations between parameters. Results The gait parameters showed small correlations with acute pain intensity, pain coping strategies and depression. Stride length and velocity during STW and DTW were (slightly to moderately) positively correlated with executive function test performance. Specific small to moderate correlations were found between the gait parameters and dorsolateral PFC activity during STW and DTW. Conclusion Patients with higher acute pain intensity and better coping skills demonstrated slower and less variable gait, which might reflect a pain minimization strategy. Psychosocial factors seem to play no or only a minor role, while good executive functions might be a prerequisite for a better gait performance in CLBP patients. The specific associations between gait parameters and PFC activity during walking indicate that the availability and utilization of brain resources are crucial for a good gait performance.
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Affiliation(s)
- Toan Nguyen
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Martin Behrens
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Kim-Charline Broscheid
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Robert Bielitzki
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Saskia Weber
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Saskia Libnow
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Victoria Malczewski
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Lukas Baldauf
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Xenia Milberger
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Lena Jassmann
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Anne Wustmann
- Department of Orthopaedic Surgery, Klinikum Magdeburg gGmbH, Magdeburg, Germany
| | - Katharina Meiler
- Department of Orthopaedic Surgery, Klinikum Magdeburg gGmbH, Magdeburg, Germany
| | - Steffen Drange
- Department of Orthopaedic Surgery, Klinikum Magdeburg gGmbH, Magdeburg, Germany
| | - Jörg Franke
- Department of Orthopaedic Surgery, Klinikum Magdeburg gGmbH, Magdeburg, Germany
| | - Lutz Schega
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
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16
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Wang D, Wang J, Zhao H, Liang Y, Zhang W, Li M, Liu H, Hu D, Zhang S, Xing E, Su Y, Yu W, Sun J, Yang A. The relationship between the prefrontal cortex and limb motor function in stroke: A study based on resting-state functional near-infrared spectroscopy. Brain Res 2023; 1805:148269. [PMID: 36736871 DOI: 10.1016/j.brainres.2023.148269] [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: 08/18/2022] [Revised: 01/13/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND With the ageing of the world population, the incidence of stroke has been increasing annually, becoming a public health problem affecting adult health. Limb motor dysfunction is one of the common complications of stroke and an important factor in disability. Therefore, restoring limb function is an important task in current rehabilitation. Accurate assessment of motor function in stroke patients is the basis for formulating effective rehabilitation strategies. With the development of neuroimaging technology, scholars have begun to study objective evaluation methods for limb motor dysfunction in stroke to determine reliable neural biomarkers to accurately identify brain functional activity and its relationship with limb motor function. The prefrontal cortex (PFC) plays an important role in motor control and in response to motor state changes. Our previous study found that the PFC network characteristics of stroke patients are related to their motor function status and the topological properties of the PFC network under resting state can predict the motor function of stroke patients to some extent. Therefore, this study used functional near-infrared spectroscopy (fNIRS) to evaluate prefrontal neuroplasticity markers and the relationships between such neural markers and limb motor function in stroke patients with limb motor dysfunction, which could be helpful to further clarify the relationship between brain neuroplasticity and cerebral haemodynamics. At the same time, through accurate and objective means of evaluation, it could be helpful for clinicians to formulate and optimize individualized rehabilitation treatment plans and accurately determine the rehabilitation efficacy and prognosis. METHODS This study recruited 17 S patients with limb motor dysfunction and 9 healthy subjects. fNIRS was used to collect 22 channels of cerebral blood oxygen signals in the PFC in the resting state. The differences in prefrontal oxygenated haemoglobin (HbO) and deoxygenated haemoglobin (HbR) concentrations were analysed between stroke patients and healthy subjects, and the lateralization index (LI) of HbO in stroke patients was also calculated. Pearson's correlation analysis was performed between the LI and the scores of the Fugl-Meyer Assessment Scale (FMA) of motor function in stroke patients. RESULTS The results found that the prefrontal HbO concentration was significantly decreased in stroke patients with limb motor dysfunction compared with healthy subjects, and there was a significant, positive correlation between the LI of the PFC and FMA scores in stroke patients. CONCLUSION These study results showed that stroke can cause cerebral haemodynamic changes in the PFC, and the functional imbalance of the left and right PFC in the resting state is correlated with the severity of limb motor dysfunction. Furthermore, we emphasize that the cerebral haemodynamic activity reflected by fNIRS could be used as a reliable neural biomarker for assessing limb motor dysfunction in stroke.
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Affiliation(s)
- Dan Wang
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Jie Wang
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Hongbo Zhao
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Yahui Liang
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Wenyue Zhang
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Mingxi Li
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Hua Liu
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Di Hu
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Sibin Zhang
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Enlong Xing
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Ying Su
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Wanchen Yu
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Jinyan Sun
- School of Medicine, Foshan University, Foshan, China.
| | - Aoran Yang
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China.
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Hunt R, Mills C, Frost G, Blackmore T, Miller-Dicks M. The visual control of locomotion when stepping onto moving surfaces: A comparison of younger and older adults. Exp Gerontol 2023; 174:112117. [PMID: 36758648 DOI: 10.1016/j.exger.2023.112117] [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: 11/02/2022] [Revised: 01/27/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
Stepping between static and moving surfaces presents a locomotor challenge associated with increased injury frequency and severity in older adults. The current study evaluates younger and older adults' behaviours when overcoming challenges sampling moving walkway and escalator environments. Twelve younger adults (18-40 years, Male = 8) and 15 older adults (60-81 years, Male = 5) were examined using an integration of optoelectronic motion capture and mobile eye-tracking. Participants were investigated approaching and stepping onto a flat conveyor belt (static or moving; with or without surface (demarcation) lines). Specifically, the four conditions were: (i) static surface without demarcation lines; (ii) static surface with demarcation lines; (iii) moving surface without demarcation lines; and (iv) moving surface with demarcation lines. A two (age group) x two (surface-condition) x two (demarcation-condition) linear mixed-model revealed no main or interaction effects (p > .05) for perturbation magnitude, indicating participants maintained successful locomotion. However, different adaptive behaviours were identified between conditions with moving and accuracy demands (e.g., moving surfaces increased step length, demarcations reduced step length). Between subject effects identified differences between age groups. Older adults utilised different behaviours, such as earlier gaze transfer from the final approach walkway step location. Overall, the current study suggests that adaptive behaviours emerge relative to the environment's specific demands and the individual's action capabilities.
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Affiliation(s)
- Rhys Hunt
- School of Sport, Health and Exercise Science, University of Portsmouth, United Kingdom.
| | - Chris Mills
- School of Sport, Health and Exercise Science, University of Portsmouth, United Kingdom
| | - Gillian Frost
- Health and Safety Executive, Science Division, United Kingdom
| | - Tim Blackmore
- School of Sport, Health and Exercise Science, University of Portsmouth, United Kingdom
| | - Matt Miller-Dicks
- School of Sport, Health and Exercise Science, University of Portsmouth, United Kingdom.
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18
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Stojan R, Mack M, Bock O, Voelcker-Rehage C. Inefficient frontal and parietal brain activation during dual-task walking in a virtual environment in older adults. Neuroimage 2023; 273:120070. [PMID: 37004827 DOI: 10.1016/j.neuroimage.2023.120070] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Walking while performing an additional cognitive task (dual-task walking; DT walking) is a common yet highly demanding behavior in daily life. Previous neuroimaging studies have shown that performance declines from single- (ST) to DT conditions are accompanied by increased prefrontal cortex (PFC) activity. This increment is particularly pronounced in older adults and has been explained either by compensation, dedifferentiation, or ineffective task processing in fronto-parietal circuits. However, there is only limited evidence for the hypothesized fronto-parietal activity changes measured under real life conditions such as walking. In this study, we therefore assessed brain activity in PFC and parietal lobe (PL), to investigate whether higher PFC activation during DT walking in older adults is related to compensation, dedifferentiation, or neural inefficiency. Fifty-six healthy older adults (69.11 ± 4.19 years, 30 female) completed three tasks (treadmill walking at 1 m/s, Stroop task, Serial 3's task) under ST and DT conditions (Walking + Stroop, Walking + Serial 3's), and a baseline Standing task. Behavioral outcomes were step time variability (Walking), Balance Integration Score BIS (Stroop), and number of correct calculations S3corr (Serial 3's). Brain activity was measured using functional near-infrared spectroscopy (fNIRS) over ventrolateral and dorsolateral PFC (vlPFC, dlPFC) and inferior and superior PL (iPL, sPL). Neurophysiological outcome measures were oxygenated (HbO2) and deoxygenated hemoglobin (HbR). Linear mixed models with follow-up estimated marginal means contrasts were applied to investigate region-specific upregulations of brain activation from ST to DT conditions. Furthermore, the relationships of DT-specific activations across all brain regions was analyzed as well as the relationship between changes in brain activation and changes in behavioral performance from ST to DT. Data indicated the expected upregulation from ST to DT and that DT-related upregulation was more pronounced in PFC (particularly in vlPFC) than in PL regions. Activation increases from ST to DT were positively correlated between all brain regions, and higher brain activation changes predicted higher declines in behavioral performance from ST to DT. Results were largely consistent for both DTs (Stroop and Serial 3's). These findings more likely suggest neural inefficiency and dedifferentiation in PFC and PL rather than fronto-parietal compensation during DT walking in older adults. Findings have implications for interpreting and promoting efficacy of long-term interventions to improve DT walking in older persons.
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O'Brien C, Holtzer R. Physical reserve: construct development and predictive utility. Aging Clin Exp Res 2023; 35:1055-1062. [PMID: 36848030 DOI: 10.1007/s40520-023-02371-5] [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: 12/07/2022] [Accepted: 02/15/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Physical reserve (PR) refers to one's ability to maintain physical functioning despite age, illness, or injury. The measurement and predictive utility of PR, however, are not well established. AIMS We quantified PR using a residual measurement approach by extracting standardized residuals from gait speed, while accounting for demographic and clinical/disease variables, and used it to predict fall-risk. METHODS Participants (n = 510; age ≥ 70ys) were enrolled in a longitudinal study. Falls were assessed annually (in-person) and bimonthly (via structured telephone interview). RESULTS General Estimating Equations (GEE) revealed that higher baseline PR was associated with reduced odds of reporting falls over repeated assessments in the total sample, and incident falls among those without fall's history. The protective effect of PR against fall risk remained significant when adjusting for multiple demographic and medical confounders. DISCUSSION/CONCLUSION We propose a novel framework to assessing PR and demonstrate that higher PR is protective against fall-risk in older adults.
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Affiliation(s)
- Catherine O'Brien
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
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20
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Effect of the Level of Physical Activity on Prefrontal Cortex Hemodynamics in Older Adults During Single- and Dual-Task Walking. J Aging Phys Act 2023; 31:96-104. [PMID: 35894956 DOI: 10.1123/japa.2021-0410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/25/2022] [Accepted: 05/17/2022] [Indexed: 02/03/2023]
Abstract
The present study aimed to examine the impact of the level of physical activity on prefrontal cortex activation in older adults during single- and dual-task walking. Thirty physically inactive and 36 active older adults (60-85 years old) performed six 2-min tasks on a treadmill: two static cognitive tasks, two single-task walking tests, and two dual-task walking tests. Hemodynamics at the level of the prefrontal cortex were measured continuously using functional near-infrared spectroscopy to evaluate cortical activation. The perceived difficulty of the task, cognitive performance, and gait parameters were also measured. During the walking tasks, the level of prefrontal cortex activation, the perceived difficulty of the task, cognitive performance, and motor parameters were not significantly different between active and inactive older adults. This unchanged activation with physical activity was likely the consequence of a similar motor and cognitive load and cardiorespiratory fitness in both active and inactive older adults.
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21
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De Sanctis P, Wagner J, Molholm S, Foxe JJ, Blumen HM, Horsthuis DJ. Neural signature of mobility-related everyday function in older adults at-risk of cognitive impairment. Neurobiol Aging 2023; 122:1-11. [PMID: 36463848 PMCID: PMC10281759 DOI: 10.1016/j.neurobiolaging.2022.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 11/10/2022]
Abstract
Assessment of everyday activities is central to the diagnosis of dementia. Yet, little is known about brain processes associated with everyday functional limitations, particularly during early stages of cognitive decline. Twenty-six older adults (mean = 74.9 y) were stratified by risk using the Montreal Cognitive Assessment battery (MoCA, range: 0- 30) to classify individuals as higher (22-26) and lower risk (27+) of cognitive impairment. We investigated everyday function using a gait task designed to destabilize posture and applied Mobile Brain/Body Imaging. We predicted that participants would increase step width to gain stability, yet the underlying neural signatures would be different for lower versus higher risk individuals. Step width and fronto-parietal activation increased during visually perturbed input. Frontomedial theta increased in higher risk individuals during perturbed and unperturbed inputs. Left sensorimotor beta decreased in lower risk individuals during visually perturbed input. Modulations in theta and beta power were associated with MoCA scores. Our findings suggest that older adults at-risk of cognitive impairment can be characterized by a unique neural signature of everyday function.
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Affiliation(s)
- Pierfilippo De Sanctis
- The Cognitive Neurophysiology Laboratory, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Neurology, Division of Cognitive & Motor Aging, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Johanna Wagner
- Computational Neuroscience, Institute for Neural Computation, University of California, San Diego, La Jolla, CA, USA
| | - Sophie Molholm
- The Cognitive Neurophysiology Laboratory, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA; The Dominick P. Purpura Department of Neuroscience, Rose F. Kennedy Intellectual and Developmental Disabilities Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - John J Foxe
- The Cognitive Neurophysiology Laboratory, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA; The Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Helena M Blumen
- Department of Neurology, Division of Cognitive & Motor Aging, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Geriatrics), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Douwe J Horsthuis
- The Cognitive Neurophysiology Laboratory, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
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22
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Holtzer R, Feldman JM, Jariwala SP, Izzetoglu M. Asthma history influences gait performance and associated prefrontal cortex activation patterns in older adults. Aging Clin Exp Res 2023; 35:407-411. [PMID: 36401064 PMCID: PMC10039461 DOI: 10.1007/s40520-022-02306-6] [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: 06/08/2022] [Accepted: 11/12/2022] [Indexed: 11/20/2022]
Abstract
Walking and cognition are interrelated due to dependence on shared brain regions that include the prefrontal cortex (PFC). Limited literature indicates that asthma is associated with poor mobility in older adults but the mechanisms underlying this relationship are unknown. Therefore, we tested the hypothesis that asthma history was associated with poor gait performance due to limited attention resources and neural inefficiency. Participants, older adults age ≥ 65 years reporting positive (n = 36) and negative (n = 36) history of asthma, walked under single and dual-task conditions with a functional near-infrared-spectroscopy (fNIRS) sensor placed on their forehead to assess task-related changes in PFC oxygenated hemoglobin (HbO2). Results showed that positive asthma history was associated with slower gait and higher fNIRS-derived HbO2 under dual-task walking. These findings suggest that limited attention resources and neural inefficiency underlie the association between asthma and poor walking performance in older adults.
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Affiliation(s)
- Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Jonathan M Feldman
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Pediatrics (Division of Academic General Pediatrics), Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Sunit P Jariwala
- Department of Medicine (Division of Allergy/Immunology), Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University, Villanova, PA, USA
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23
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Udina C, Avtzi S, Mota-Foix M, Rosso AL, Ars J, Kobayashi Frisk L, Gregori-Pla C, Durduran T, Inzitari M. Dual-task related frontal cerebral blood flow changes in older adults with mild cognitive impairment: A functional diffuse correlation spectroscopy study. Front Aging Neurosci 2022; 14:958656. [PMID: 36605362 PMCID: PMC9807627 DOI: 10.3389/fnagi.2022.958656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction In a worldwide aging population with a high prevalence of motor and cognitive impairment, it is paramount to improve knowledge about underlying mechanisms of motor and cognitive function and their interplay in the aging processes. Methods We measured prefrontal cerebral blood flow (CBF) using functional diffuse correlation spectroscopy during motor and dual-task. We aimed to compare CBF changes among 49 older adults with and without mild cognitive impairment (MCI) during a dual-task paradigm (normal walk, 2- forward count walk, 3-backward count walk, obstacle negotiation, and heel tapping). Participants with MCI walked slower during the normal walk and obstacle negotiation compared to participants with normal cognition (NC), while gait speed during counting conditions was not different between the groups, therefore the dual-task cost was higher for participants with NC. We built a linear mixed effects model with CBF measures from the right and left prefrontal cortex. Results MCI (n = 34) showed a higher increase in CBF from the normal walk to the 2-forward count walk (estimate = 0.34, 95% CI [0.02, 0.66], p = 0.03) compared to participants with NC, related to a right- sided activation. Both groups showed a higher CBF during the 3-backward count walk compared to the normal walk, while only among MCI, CFB was higher during the 2-forward count walk. Discussion Our findings suggest a differential prefrontal hemodynamic pattern in older adults with MCI compared to their NC counterparts during the dual-task performance, possibly as a response to increasing attentional demand.
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Affiliation(s)
- Cristina Udina
- REFiT Barcelona Research Group, Parc Sanitari Pere Virgili and Vall d’Hebron Research Institute (VHIR), Barcelona, Spain,Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain,*Correspondence: Cristina Udina,
| | - Stella Avtzi
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Miriam Mota-Foix
- Statistics and Bioinformatics Unit, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Andrea L. Rosso
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Joan Ars
- REFiT Barcelona Research Group, Parc Sanitari Pere Virgili and Vall d’Hebron Research Institute (VHIR), Barcelona, Spain,Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lisa Kobayashi Frisk
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Clara Gregori-Pla
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Turgut Durduran
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Marco Inzitari
- REFiT Barcelona Research Group, Parc Sanitari Pere Virgili and Vall d’Hebron Research Institute (VHIR), Barcelona, Spain,Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
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24
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Liu YC, Yang YR, Yeh NC, Ku PH, Lu CF, Wang RY. Multiarea Brain Activation and Gait Deterioration During a Cognitive and Motor Dual Task in Individuals With Parkinson Disease. J Neurol Phys Ther 2022; 46:260-269. [PMID: 35404916 DOI: 10.1097/npt.0000000000000402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE In people with Parkinson disease (PD), gait performance deteriorating during dual-task walking has been noted in previous studies. However, the effects of different types of dual tasks on gait performance and brain activation are still unknown. The purpose of this study was to investigate cognitive and motor dual-task walking performance on multiarea brain activity in individuals with PD. METHODS Twenty-eight participants with PD were recruited and performed single walking (SW), walking while performing a cognitive task (WCT), and walking while performing a motor task (WMT) at their self-selected speed. Gait performance including walking speed, stride length, stride time, swing cycle, temporal and spatial variability, and dual-task cost (DTC) was recorded. Brain activation of the prefrontal cortex (PFC), premotor cortex (PMC), and supplementary motor areas (SMA) were measured using functional near-infrared spectroscopy during walking. RESULTS Walking performance deteriorated upon performing a secondary task, especially the cognitive task. Also, a higher and more sustained activation in the PMC and SMA during WCT, as compared with the WMT and SW, in the late phase of walking was found. During WMT, however, the SMA and PMC did not show increased activation compared with during SW. Moreover, gait performance was negatively correlated with PMC and SMA activity during different walking tasks. DISCUSSION AND CONCLUSIONS Individuals with mild to moderate PD demonstrated gait deterioration during dual-task walking, especially during WCT. The SMA and PMC were further activated in individuals with PD when performing cognitive dual-task walking.Supplemental Digital Content is Available in the Text.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A383 ).
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Affiliation(s)
- Yan-Ci Liu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan (Y.C.L.); and Departments of Physical Therapy and Assistive Technology (Y.R.Y., N.C.Y., P.H.K., R.Y.W.) and Biomedical Imaging and Radiological science (C.F.L.), National Yang Ming Chiao Tung University, Taipei, Taiwan
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25
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Ayers E, Wang C, Verghese J. Validation of a "subjective motoric cognitive risk syndrome" screening tool for motoric cognitive risk syndrome-A prospective cohort study. Eur J Neurol 2022; 29:2925-2933. [PMID: 35748730 PMCID: PMC9875832 DOI: 10.1111/ene.15476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/02/2022] [Accepted: 06/19/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND PURPOSE Motoric cognitive risk syndrome (MCR) is a gait-based pre-dementia syndrome associated with risk of dementia. Ascertaining subjective cognitive and motoric complaints may facilitate early and remote identification of individuals with MCR as they are reported to precede and predict objective cognitive and motoric impairments in aging. METHODS The validity of five subjective motoric complaint (SMC) questions and 10 subjective cognitive complaint (SCC) questions was examined for discriminating MCR in 538 non-demented community-dwelling adults. Backward logistic regression was used to identify questions to develop a weighted score to define subjective MCR (MCR-S). Receiver operating characteristic analysis was applied to determine the discriminative ability of MCR-S for the objective MCR (MCR-O) definition based on SCCs and objectively measured gait. Cox proportional hazard models adjusted for potential confounders were used to examine the predictive validity of MCR-S for incident dementia. RESULTS Five subjective complaint questions (three SCC and two SMC) were associated with MCR-O. They were combined to define an MCR-S score (range 0-7) which yielded an area under the curve of 0.89 for discriminating MCR-O from receiver operating characteristic analysis. An optimal cut-score of 2 on the MCR-S score was determined to have good sensitivity (84%) and specificity (82%) for MCR-O. Over a median follow-up of 2.5 years, 29 participants developed dementia. Both MCR-S (adjusted hazard ratio 2.39) and MCR-O at baseline (adjusted hazard ratio 3.16) predicted risk of incident dementia. CONCLUSIONS Subjective MCR had high concordance with MCR-O and can provide a remote screening assessment for MCR-O, which can identify those at high risk for dementia.
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Affiliation(s)
- Emmeline Ayers
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA,Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
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26
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de Aratanha MA, Balardin JB, Cardoso do Amaral C, Lacerda SS, Sowmy TAS, Huppert TJ, Thomaz RB, Speciali DS, Machado B, Kozasa EH. The use of functional near infrared spectroscopy and gait analysis to characterize cognitive and motor processing in early-stage patients with multiple sclerosis. Front Neurol 2022; 13:937231. [PMID: 36105774 PMCID: PMC9464830 DOI: 10.3389/fneur.2022.937231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Dual-task paradigms are a known tool to evaluate possible impairments in the motor and cognitive function in patients with multiple sclerosis (MS). A technique to evaluate the cortical function during movement is functional near-infrared spectroscopy (fNIRS). The evaluation of the MS course or its treatment by associating fNIRS with gait measurements may be flexible and low-cost; however, there are no feasibility studies in the literature using these combined techniques in early-stage patients with MS. Objective To evaluate cortical hemodynamics using fNIRS and gait parameters in patients at early stages of MS and in healthy controls during a dual-task paradigm. Methods Participants performed cognitive tasks while walking to simulate daily activities. Cortical activation maps and gait variability were used to evaluate differences between 19 healthy controls and 20 patients with MS. Results and conclusion The results suggest an enhanced cortical activation in the motor planning areas already at the early stages of MS when compared to controls. We have also shown that a systematic analysis of the spatiotemporal gait variability parameters indicates differences in the patient population. The association of cortical and gait parameters may reveal possible compensatory mechanisms related to gait during dual tasking at the early stages of the disease.
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Affiliation(s)
| | | | - Carolina Cardoso do Amaral
- Hospital Israelita Albert Einstein, São Paulo, Brazil
- Department of Biomedical Engineering, Universidade Federal do ABC, Santo André, Brazil
| | | | | | - Theodore J. Huppert
- Departments of Radiology and Bioengineering, Clinical Science Translational Institute, Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States
| | | | | | | | - Elisa Harumi Kozasa
- Hospital Israelita Albert Einstein, São Paulo, Brazil
- *Correspondence: Elisa Harumi Kozasa
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27
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Sood P, Chatterjee SA, Skinner JW, Lysne PE, Sumonthee C, Wu SS, Cohen RA, Rose DK, Woods AJ, Clark DJ. Somatosensory impairment of the feet is associated with higher activation of prefrontal cortex during walking in older adults. Exp Gerontol 2022; 165:111845. [PMID: 35644417 PMCID: PMC9892701 DOI: 10.1016/j.exger.2022.111845] [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: 06/10/2021] [Revised: 12/18/2021] [Accepted: 05/23/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Over-activation of prefrontal cortex during walking has been reported in older adults versus young adults. Heighted activity in prefrontal cortex suggests a shift toward an executive control strategy to control walking. A potential contributing factor is degraded functioning of pattern-generating locomotor circuits in the central nervous system that are important to walking coordination. Somatosensory information is a crucial input to these circuits, so age-related impairment of somatosensation would be expected to compromise the neural control of walking. The present study tested the hypothesis that poorer somatosensation in the feet of older adults will be associated with greater recruitment of the prefrontal cortex during walking. This study also examines the extent to which somatosensory function and prefrontal activity are associated with performance on walking and balance assessments. METHODS Forty seven older adults (age 74.6 ± 6.8 years; 32 female) participated in walking assessments (typical walking and obstacle negotiation) and Berg Balance Test. During walking, prefrontal activity was measured with functional near infrared spectroscopy (fNIRS). Participants also underwent somatosensory testing with Semmes-Weinstein monofilaments. RESULTS The primary findings is that worse somatosensory monofilament level was associated with greater prefrontal cortical activity during typical walking (r = 0.38, p = 0.008) and obstacle negotiation (r = 0.40, p = 0.006). For the obstacle negotiation task, greater prefrontal activity was associated with faster walking speed (p = 0.004). Poorer somatosensation was associated with slower typical walking speed (p = 0.07) and obstacles walking speed (p < 0.001), as well as poorer balance scores (p = 0.03). CONCLUSIONS The study findings are consistent with a compensation strategy of recruiting prefrontal/executive control resources to overcome loss of somatosensory input to the central nervous system. Future research should further establish the mechanisms by which somatosensory impairments are linked to the neural control and performance of walking tasks, as well as develop intervention approaches.
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Affiliation(s)
- Pallavi Sood
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Sudeshna A. Chatterjee
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA,Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Jared W. Skinner
- Geriatric Research, Education, and Clinical Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
| | - Paige E. Lysne
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Chanoan Sumonthee
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Samuel S. Wu
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Ronald A. Cohen
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Dorian K. Rose
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA,Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Adam J. Woods
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - David J. Clark
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA,Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
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28
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Assad M, Galperin I, Giladi N, Mirelman A, Hausdorff JM, Maidan I. Disease severity and prefrontal cortex activation during obstacle negotiation among patients with Parkinson's disease: Is it all as expected? Parkinsonism Relat Disord 2022; 101:20-26. [PMID: 35759913 DOI: 10.1016/j.parkreldis.2022.06.006] [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: 03/08/2022] [Revised: 05/09/2022] [Accepted: 06/09/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous reports indicate that patients with Parkinson's disease (PD) activate the prefrontal cortex (PFC) during complex activities such as obstacle negotiation to compensate for impaired motor function. However, the influence of disease severity on PFC activation has not been systematically evaluated. Here, we examined the effects of disease severity on PFC activation during obstacle negotiation. METHODS 74 patients with PD (age 68.26 ± 7.54 yrs; 62.2% men) were divided into three groups based on Hoehn and Yahr stages. All patients walked along an obstacle course while negotiating anticipated and unanticipated obstacles (long/low available response time) at heights of 50 mm and 100 mm. PFC activation was measured using functional near-infrared spectroscopy (fNIRS) and was compared between groups and tasks using mixed model analyses. RESULTS Participants with more advanced PD (i.e., Hoehn & Yahr 3) had higher PFC activation levels when negotiating anticipated obstacles, compared to participants with milder PD (i.e., Hoehn & Yahr 1, 2) (p < 0.001). Moreover, higher LEDD correlated with higher prefrontal activation during the higher anticipated obstacle. In contrast, during the negotiation of unanticipated obstacles, the differences in PFC activation were not associated with disease severity in a linear manner. CONCLUSIONS The present study suggests that with increased disease severity, patients with PD rely more on the PFC when negotiating anticipated obstacles, perhaps to compensate for attention and motor deficits. These findings support the role of cognition in fall risk and the need to improve attention and cognition in fall prevention programs, especially among patients with more advanced disease.
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Affiliation(s)
- M Assad
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - I Galperin
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - N Giladi
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - A Mirelman
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - J M Hausdorff
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - I Maidan
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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29
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Ceïde ME, Eguchi D, Ayers EI, Lounsbury DW, Verghese J. Mediation Analyses of the Role of Apathy on Motoric Cognitive Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127376. [PMID: 35742625 PMCID: PMC9224534 DOI: 10.3390/ijerph19127376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/01/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023]
Abstract
Recent literature indicates that apathy is associated with poor cognitive and functional outcomes in older adults, including motoric cognitive risk syndrome (MCR), a predementia syndrome. However, the underlying biological pathway is unknown. The objectives of this study were to (1) examine the cross-sectional associations between inflammatory cytokines (Interleukin 6 (IL-6) and C-Reactive Protein (CRP)) and apathy and (2) explore the direct and indirect relationships of apathy and motoric cognitive outcomes as it relates to important cognitive risk factors. N = 347 older adults (≥65 years old) enrolled in the Central Control of Mobility in Aging Study (CCMA). Linear and logic regression models showed that IL-6, but not CRP was significantly associated with apathy adjusted for age, gender, and years of education (β = 0.037, 95% CI: 0.002-0.072, p = 0.04). Apathy was associated with a slower gait velocity (β = -14.45, 95% CI: -24.89-4.01, p = 0.01). Mediation analyses demonstrated that IL-6 modestly mediates the relationship between apathy and gait velocity, while apathy mediated the relationships between dysphoria and multimorbidity and gait velocity. Overall, our findings indicate that apathy may be an early predictor of motoric cognitive decline. Inflammation plays a modest role, but the underlying biology of apathy warrants further investigation.
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Affiliation(s)
- Mirnova E. Ceïde
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (E.I.A.); (J.V.)
- Department of Psychiatry and Behavioral Sciences and Medicine, Montefiore Medical Center, Bronx, NY 10467, USA
- Correspondence: ; Tel.: +1-347-920-0112; Fax: +1-718-430-3829
| | - Daniel Eguchi
- Medical Program, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Emmeline I. Ayers
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (E.I.A.); (J.V.)
| | - David W. Lounsbury
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Joe Verghese
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (E.I.A.); (J.V.)
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30
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St George RJ, Jayakody O, Healey R, Breslin M, Hinder MR, Callisaya ML. Cognitive inhibition tasks interfere with dual-task walking and increase prefrontal cortical activity more than working memory tasks in young and older adults. Gait Posture 2022; 95:186-191. [PMID: 35525151 DOI: 10.1016/j.gaitpost.2022.04.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/18/2022] [Accepted: 04/24/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Prior work suggests there may be greater reliance on executive function for walking in older people. The pre-frontal cortex (PFC), which controls aspects of executive function, is known to be active during dual-task walking (DTW). However, there is debate on how PFC activity during DTW is impacted by ageing and the requirements of the cognitive task. RESEARCH QUESTION Functional near infrared spectroscopy, was used to investigate how PFC activity during walking was affected by (i) healthy ageing; and (ii) dual-tasks that utilise inhibition or working memory aspects of executive function. METHODS Young (n = 26, 16 females, mean 20.9 years) and older (n = 26, 16 females, mean 70.3 years) adults performed five conditions: normal walking; Reciting Alternate Letters of the alphabet (RAL, requiring cognitive inhibition and working memory) during standing and walking; and serial subtraction by threes (SS3, requiring working memory alone) during standing and walking. Walking speed, cognitive performance, the PFC haemodynamic response, and fear of falling ratings were analysed using linear mixed-effects modelling. RESULTS Compared to quiet standing, PFC activity increased during normal walking for older adults but decreased for young adults (p < 0.01). Across both groups, fear of falling contributed to higher PFC activity levels when walking (p < 0.01). PFC activity increased during DTW, and this increase was greater when performing RAL compared to the SS3 task (p < 0.01). Although the rate of correct responses was higher for RAL, walking speed reduced more with RAL than SS3 in the young group (p = 0.01), and the rate of correct responses reduced more when walking with RAL than SS3 in the older group (p < 0.01). SIGNIFICANCE Older adults have increased levels of PFC activation during walking compared to younger adults and fear of falling is a cofounding factor. The interference between gait and a concurrent cognitive task is higher when the cognitive task requires inhibition.
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Affiliation(s)
- Rebecca J St George
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Sandy Bay, Australia; Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia.
| | - Oshadi Jayakody
- Department of Medicine, Albert Einstein College of Medicine, New York, USA
| | - Rebecca Healey
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Sandy Bay, Australia
| | - Monique Breslin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Mark R Hinder
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Sandy Bay, Australia
| | - Michele L Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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31
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Guharajan D, Holtzer R. Association of Affect and Performance in Dual-Task Walking in Non-demented Older Adults. J Aging Health 2022; 34:1062-1070. [PMID: 35477303 DOI: 10.1177/08982643221087836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: We examined whether individual differences in positive and negative affective states predicted dual-task costs using an established Dual-Task Walking protocol in non-demented older adults. We hypothesized that positive and negative affect would be associated with smaller and larger dual-task costs, respectively. Methods: Participants (N = 403; mean age = 76.22 ± 6.55; females = 56%) completed the Positive and Negative Affect Schedule and the walking protocol involving three conditions: Single-Task-Alpha, Single-Task-Walk (STW), and Dual-Task-Walk (DTW). Gait velocity was assessed via an instrumented walkway. Results: Negative affect was associated with greater decline in gait velocity from STW to DTW (95% confidence interval [-0.73 to -0.03]) but not the decline of the rate of correct letter generation. There was no significant relationship between positive affect and DTW performance. Discussion: Findings suggest negative affect is adversely associated with allocation of attentional resources, leading to worse mobility outcomes in older adults.
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Affiliation(s)
- Deepan Guharajan
- Ferkauf Graduate School of Psychology, 184694Yeshiva University, Bronx, NY, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, 184694Yeshiva University, Bronx, NY, USA.,Department of Neurology, Albert Einstein College of Medicine184694, Bronx, NY, USA
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32
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Holtzer R. Volitional control of walking in aging. Aging (Albany NY) 2022; 14:2440-2441. [PMID: 35344509 PMCID: PMC9004554 DOI: 10.18632/aging.203986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/25/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY 10461, USA
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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33
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Hupfeld KE, Geraghty JM, McGregor HR, Hass CJ, Pasternak O, Seidler RD. Differential Relationships Between Brain Structure and Dual Task Walking in Young and Older Adults. Front Aging Neurosci 2022; 14:809281. [PMID: 35360214 PMCID: PMC8963788 DOI: 10.3389/fnagi.2022.809281] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/31/2022] [Indexed: 12/13/2022] Open
Abstract
Almost 25% of all older adults experience difficulty walking. Mobility difficulties for older adults are more pronounced when they perform a simultaneous cognitive task while walking (i.e., dual task walking). Although it is known that aging results in widespread brain atrophy, few studies have integrated across more than one neuroimaging modality to comprehensively examine the structural neural correlates that may underlie dual task walking in older age. We collected spatiotemporal gait data during single and dual task walking for 37 young (18–34 years) and 23 older adults (66–86 years). We also collected T1-weighted and diffusion-weighted MRI scans to determine how brain structure differs in older age and relates to dual task walking. We addressed two aims: (1) to characterize age differences in brain structure across a range of metrics including volumetric, surface, and white matter microstructure; and (2) to test for age group differences in the relationship between brain structure and the dual task cost (DTcost) of gait speed and variability. Key findings included widespread brain atrophy for the older adults, with the most pronounced age differences in brain regions related to sensorimotor processing. We also found multiple associations between regional brain atrophy and greater DTcost of gait speed and variability for the older adults. The older adults showed a relationship of both thinner temporal cortex and shallower sulcal depth in the frontal, sensorimotor, and parietal cortices with greater DTcost of gait. Additionally, the older adults showed a relationship of ventricular volume and superior longitudinal fasciculus free-water corrected axial and radial diffusivity with greater DTcost of gait. These relationships were not present for the young adults. Stepwise multiple regression found sulcal depth in the left precentral gyrus, axial diffusivity in the superior longitudinal fasciculus, and sex to best predict DTcost of gait speed, and cortical thickness in the superior temporal gyrus to best predict DTcost of gait variability for older adults. These results contribute to scientific understanding of how individual variations in brain structure are associated with mobility function in aging. This has implications for uncovering mechanisms of brain aging and for identifying target regions for mobility interventions for aging populations.
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Affiliation(s)
- Kathleen E. Hupfeld
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Justin M. Geraghty
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Heather R. McGregor
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - C. J. Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Ofer Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Rachael D. Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
- University of Florida Norman Fixel Institute for Neurological Diseases, Gainesville, FL, United States
- *Correspondence: Rachael D. Seidler
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34
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Clark DJ, Hawkins KA, Winesett SP, Cox BA, Pesquera S, Miles JW, Fuller DD, Fox EJ. Enhancing Locomotor Learning With Transcutaneous Spinal Electrical Stimulation and Somatosensory Augmentation: A Pilot Randomized Controlled Trial in Older Adults. Front Aging Neurosci 2022; 14:837467. [PMID: 35309891 PMCID: PMC8924500 DOI: 10.3389/fnagi.2022.837467] [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: 12/16/2021] [Accepted: 02/10/2022] [Indexed: 11/18/2022] Open
Abstract
This study investigated locomotor learning of a complex terrain walking task in older adults, when combined with two adjuvant interventions: transcutaneous spinal direct current stimulation (tsDCS) to increase lumbar spinal cord excitability, and textured shoe insoles to increase somatosensory feedback to the spinal cord. The spinal cord has a crucial contribution to control of walking, and is a novel therapeutic target for rehabilitation of older adults. The complex terrain task involved walking a 10-meter course consisting of nine obstacles and three sections of compliant (soft) walking surface. Twenty-three participants were randomly assigned to one of the following groups: sham tsDCS and smooth insoles (sham/smooth; control group), sham tsDCS and textured insoles (sham/textured), active tsDCS and smooth insoles (active/smooth), and active tsDCS and textured insoles (active/textured). The first objective was to assess the feasibility, tolerability, and safety of the interventions. The second objective was to assess preliminary efficacy for increasing locomotor learning, as defined by retention of gains in walking speed between a baseline visit of task practice, and a subsequent follow-up visit. Variability of the center of mass while walking over the course was also evaluated. The change in executive control of walking (prefrontal cortical activity) between the baseline and follow-up visits was measured with functional near infrared spectroscopy. The study results demonstrated feasibility based on enrollment and retention of participants, tolerability based on self-report, and safety based on absence of adverse events. Preliminary efficacy was supported based on trends showing larger gains in walking speed and more pronounced reductions in mediolateral center of mass variability at the follow-up visit in the groups randomized to active tsDCS or textured insoles. These data justify future larger studies to further assess dosing and efficacy of these intervention approaches. In conclusion, rehabilitation interventions that target spinal control of walking present a potential opportunity for enhancing walking function in older adults.
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Affiliation(s)
- David J. Clark
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
- *Correspondence: David J. Clark,
| | - Kelly A. Hawkins
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
- Department of Physical Therapy, University of Florida, Gainesville, FL, United States
| | - Steven P. Winesett
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Brigette A. Cox
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
| | - Sarah Pesquera
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
| | - Jon W. Miles
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
| | - David D. Fuller
- Department of Physical Therapy, University of Florida, Gainesville, FL, United States
| | - Emily J. Fox
- Department of Physical Therapy, University of Florida, Gainesville, FL, United States
- Brooks Rehabilitation, Jacksonville, FL, United States
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35
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EEG-explained cortical correlates of transfemoral amputees during balancing with vibrotactile feedback: A pilot study. Med Eng Phys 2022; 101:103772. [DOI: 10.1016/j.medengphy.2022.103772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/24/2021] [Accepted: 02/08/2022] [Indexed: 11/21/2022]
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36
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Khalil K, Asgher U, Ayaz Y. Novel fNIRS study on homogeneous symmetric feature-based transfer learning for brain-computer interface. Sci Rep 2022; 12:3198. [PMID: 35210460 PMCID: PMC8873341 DOI: 10.1038/s41598-022-06805-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 01/04/2022] [Indexed: 01/23/2023] Open
Abstract
The brain-computer interface (BCI) provides an alternate means of communication between the brain and external devices by recognizing the brain activities and translating them into external commands. The functional Near-Infrared Spectroscopy (fNIRS) is becoming popular as a non-invasive modality for brain activity detection. The recent trends show that deep learning has significantly enhanced the performance of the BCI systems. But the inherent bottleneck for deep learning (in the domain of BCI) is the requirement of the vast amount of training data, lengthy recalibrating time, and expensive computational resources for training deep networks. Building a high-quality, large-scale annotated dataset for deep learning-based BCI systems is exceptionally tedious, complex, and expensive. This study investigates the novel application of transfer learning for fNIRS-based BCI to solve three objective functions (concerns), i.e., the problem of insufficient training data, reduced training time, and increased accuracy. We applied symmetric homogeneous feature-based transfer learning on convolutional neural network (CNN) designed explicitly for fNIRS data collected from twenty-six (26) participants performing the n-back task. The results suggested that the proposed method achieves the maximum saturated accuracy sooner and outperformed the traditional CNN model on averaged accuracy by 25.58% in the exact duration of training time, reducing the training time, recalibrating time, and computational resources.
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Affiliation(s)
- Khurram Khalil
- National Center of Artificial Intelligence (NCAI), School of Mechanical and Manufacturing Engineering (SMME), National University of Sciences and Technology (NUST), Islamabad, 44000, Pakistan
| | - Umer Asgher
- National Center of Artificial Intelligence (NCAI), School of Mechanical and Manufacturing Engineering (SMME), National University of Sciences and Technology (NUST), Islamabad, 44000, Pakistan.,Department of Mechatronics Engineering, College of Electrical and Mechanical Engineering, National University of Sciences and Technology (NUST), Islamabad, 44000, Pakistan
| | - Yasar Ayaz
- National Center of Artificial Intelligence (NCAI), School of Mechanical and Manufacturing Engineering (SMME), National University of Sciences and Technology (NUST), Islamabad, 44000, Pakistan.
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37
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Hassan SA, Bonetti LV, Kasawara KT, Beal DS, Rozenberg D, Reid WD. Decreased automaticity contributes to dual task decrements in older compared to younger adults. Eur J Appl Physiol 2022; 122:965-974. [PMID: 35084541 DOI: 10.1007/s00421-022-04891-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/09/2022] [Indexed: 12/20/2022]
Abstract
PURPOSE To contrast older and younger adults' prefrontal cortex (PFC) neural activity (through changes in oxygenated hemoglobin) during single and dual tasks, and to compare decrements in task performance. METHODS Changes in oxygenated hemoglobin of dorsolateral PFC were monitored using functional near-infrared spectroscopy during single tasks of spelling backwards (cognitive task) and 30 m preferred paced walk; and a dual task combining both. Gait velocity was measured by a pressure sensitive mat. RESULTS Twenty sex-matched younger (27.6 ± 3.5 years) and 17 older adults (71.2 ± 4.9 years) were recruited. The left PFC oxygenated hemoglobin decreased from start (1st quintile) to the end (5th quintile) of the walking task in younger adults ( - 0.03 ± 0.03 to - 0.72 ± 0.20 µM; p < .05) unlike the non-significant change in older adults (0.03 ± 0.06 to - 0.41 ± 0.32 µM, p > .05). Overall, oxygenation increased bilaterally during dual versus single walk task in older adults (Left PFC: 0.22 ± 0.16 vs. - 0.23 ± 0.21 µM, respectively; Right PFC: 0.17 ± 0.18 vs. - 0.33 ± 0.22 µM, respectively), but only in right PFC in younger adults ( - 0.02 ± 0.15 vs. - 0.47 ± 0.13 µM). Older adults exhibited lower velocity during the dual task compared to younger adults (1.03 ± 0.16 vs. 1.20 ± 0.17 m/s, respectively). Older age was associated with dual task cost on velocity during walking after adjusting for confounding variables. CONCLUSIONS Age-related cognitive decline in older adults may increase neural activity for cognitive tasks and diminish walking automaticity that may lead to decrements during dual tasking; the greater PFC increases in the oxygenated hemoglobin and lower velocity may be due to increased cognitive load and limited attentional resources.
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Affiliation(s)
- S Ahmed Hassan
- Physical Therapy, University of Toronto, Toronto, ON, Canada.
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St 4th Floor, Toronto, ON, Canada.
| | - Leandro Viçosa Bonetti
- Physical Therapy, University of Toronto, Toronto, ON, Canada
- Post-Graduation Program in Health Sciences, Universidade de Caxias Do Sul, Caxias Do Sul, Rio Grande do Sul, Brazil
- Department of Physical Therapy, Universidade de Caxias Do Sul, Caxias Do Sul, Rio Grande do Sul, Brazil
| | | | - Deryk S Beal
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
| | - Dmitry Rozenberg
- Temerty Faculty of Medicine, Division of Respirology, University Health Network, Toronto, ON, Canada
- Toronto General Hospital Research Institute, Toronto, ON, Canada
| | - W Darlene Reid
- Physical Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehab-University Health Network, Toronto, ON, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
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38
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Ramanoël S, Durteste M, Delaux A, de Saint Aubert JB, Arleo A. Future trends in brain aging research: Visuo-cognitive functions at stake during mobility and spatial navigation. AGING BRAIN 2022; 2:100034. [PMID: 36908887 PMCID: PMC9997160 DOI: 10.1016/j.nbas.2022.100034] [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: 01/19/2022] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/28/2022] Open
Abstract
Aging leads to a complex pattern of structural and functional changes, gradually affecting sensorimotor, perceptual, and cognitive processes. These multiscale changes can hinder older adults' interaction with their environment, progressively reducing their autonomy in performing tasks relevant to everyday life. Autonomy loss can further be aggravated by the onset and progression of neurodegenerative disorders (e.g., age-related macular degeneration at the sensory input level; and Alzheimer's disease at the cognitive level). In this context, spatial cognition offers a representative case of high-level brain function that involves multimodal sensory processing, postural control, locomotion, spatial orientation, and wayfinding capabilities. Hence, studying spatial behavior and its neural bases can help identify early markers of pathogenic age-related processes. Until now, the neural correlates of spatial cognition have mostly been studied in static conditions thereby disregarding perceptual (other than visual) and motor aspects of natural navigation. In this review, we first demonstrate how visuo-motor integration and the allocation of cognitive resources during locomotion lie at the heart of real-world spatial navigation. Second, we present how technological advances such as immersive virtual reality and mobile neuroimaging solutions can enable researchers to explore the interplay between perception and action. Finally, we argue that the future of brain aging research in spatial navigation demands a widespread shift toward the use of naturalistic, ecologically valid experimental paradigms to address the challenges of mobility and autonomy decline across the lifespan.
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Affiliation(s)
- Stephen Ramanoël
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France.,Université Côte d'Azur, LAMHESS, Nice, France
| | - Marion Durteste
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Alexandre Delaux
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | | | - Angelo Arleo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
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39
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Bishnoi A, Chaparro GN, Hernandez ME. Effect of Heart Rate Reserve on Prefrontal Cortical Activation While Dual-Task Walking in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:47. [PMID: 35010305 PMCID: PMC8751037 DOI: 10.3390/ijerph19010047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
Hypertension is considered a risk factor for cardiovascular health and non-amnestic cognitive impairment in older adults. While heart rate reserve (HRR) has been shown to be a risk factor for hypertension, how impaired HRR in older adults can lead to cognitive impairment is still unclear. The objective of this study was to examine the effects of HRR on prefrontal cortical (PFC) activation under varying dual-task demands in older adults. Twenty-eight older adults (50-82 years of age) were included in this study and divided into higher (n = 14) and lower (n = 14) HRR groups. Participants engaged in the cognitive task which was the Modified Stroop Color Word Test (MSCWT) on a self-paced treadmill while walking. Participants with higher HRR demonstrated increased PFC activation in comparison to lower HRR, even after controlling for covariates in analysis. Furthermore, as cognitive task difficulty increased (from neutral to congruent to incongruent to switching), PFC activation increased. In addition, there was a significant interaction between tasks and HRR group, with older adults with higher HRR demonstrating increases in PFC activation, faster gait speed, and increased accuracy, relative to those with lower HRR, when going from neutral to switching tasks. These results provide evidence of a relationship between HRR and prefrontal cortical activation and cognitive and physical performance, suggesting that HRR may serve as a biomarker for cognitive health of an older adult with or without cardiovascular risk.
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Affiliation(s)
- Alka Bishnoi
- Department of Kinesiology and Community Health, College of Applied Health Science, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA;
| | - Gioella N. Chaparro
- Department of Kinesiology, California State University, Dominguez Hills, Carson, CA 90747, USA;
| | - Manuel E. Hernandez
- Department of Kinesiology and Community Health, College of Applied Health Science, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA;
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40
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Kim J, Lee G, Lee J, Kim YH. Changes in Cortical Activity during Preferred and Fast Speed Walking under Single- and Dual-Tasks in the Young-Old and Old-Old Elderly. Brain Sci 2021; 11:brainsci11121551. [PMID: 34942853 PMCID: PMC8699214 DOI: 10.3390/brainsci11121551] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 01/05/2023] Open
Abstract
In the elderly, walking while simultaneously engaging in other activities becomes more difficult. This study aimed to examine the changes in cortical activity during walking with aging. We try to reveal the effects of an additional task and increased walking speed on cortical activation in the young-old and the old-old elderly. Twenty-seven young-old (70.2 ± 3.0 years) and 23 old-old (78.0 ± 2.3 years) participated in this study. Each subject completed four walking tasks on the treadmill, a 2 × 2 design; two single-task (ST) walking conditions with self-selected walking speed (SSWS) and fast walking speed (FWS), and two dual-task (DT) walking conditions with SSWS and FWS. Functional near-infrared spectroscopy was applied for measurement of cerebral oxyhemoglobin (oxyHb) concentration during walking. Cortical activities were increased during DT conditions compared with ST conditions but decreased during the FWS compared with the SSWS on the primary leg motor cortex, supplementary motor area, and dorsolateral prefrontal cortex in both the young-old and the old-old. These oxyHb concentration changes were significantly less prominent in the old-old than in the young-old. This study demonstrated that changes in cortical activity during dual-task walking are lower in the old-old than in the young-old, reflecting the reduced adaptive plasticity with severe aging.
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Affiliation(s)
- Jinuk Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (J.K.); (G.L.)
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06355, Korea
| | - Gihyoun Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (J.K.); (G.L.)
| | - Jungsoo Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (J.K.); (G.L.)
- Correspondence: (J.L.); (Y.-H.K.); Tel.: +82-2-3410-2832 (J.L.); +82-2-3410-2824 (Y.-H.K.)
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (J.K.); (G.L.)
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06355, Korea
- Department of Medical Device Management & Research, Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul 06355, Korea
- Correspondence: (J.L.); (Y.-H.K.); Tel.: +82-2-3410-2832 (J.L.); +82-2-3410-2824 (Y.-H.K.)
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Liebherr M, Corcoran AW, Alday PM, Coussens S, Bellan V, Howlett CA, Immink MA, Kohler M, Schlesewsky M, Bornkessel-Schlesewsky I. EEG and behavioral correlates of attentional processing while walking and navigating naturalistic environments. Sci Rep 2021; 11:22325. [PMID: 34785702 PMCID: PMC8595363 DOI: 10.1038/s41598-021-01772-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 11/03/2021] [Indexed: 11/28/2022] Open
Abstract
The capacity to regulate one's attention in accordance with fluctuating task demands and environmental contexts is an essential feature of adaptive behavior. Although the electrophysiological correlates of attentional processing have been extensively studied in the laboratory, relatively little is known about the way they unfold under more variable, ecologically-valid conditions. Accordingly, this study employed a 'real-world' EEG design to investigate how attentional processing varies under increasing cognitive, motor, and environmental demands. Forty-four participants were exposed to an auditory oddball task while (1) sitting in a quiet room inside the lab, (2) walking around a sports field, and (3) wayfinding across a university campus. In each condition, participants were instructed to either count or ignore oddball stimuli. While behavioral performance was similar across the lab and field conditions, oddball count accuracy was significantly reduced in the campus condition. Moreover, event-related potential components (mismatch negativity and P3) elicited in both 'real-world' settings differed significantly from those obtained under laboratory conditions. These findings demonstrate the impact of environmental factors on attentional processing during simultaneously-performed motor and cognitive tasks, highlighting the value of incorporating dynamic and unpredictable contexts within naturalistic designs.
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Affiliation(s)
- Magnus Liebherr
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden. .,Department of General Psychology: Cognition, University Duisburg-Essen, Duisburg, Germany.
| | - Andrew W. Corcoran
- grid.1026.50000 0000 8994 5086Cognitive and Systems Neuroscience Research Hub, University of South Australia, Adelaide, Australia ,grid.1002.30000 0004 1936 7857Cognition and Philosophy Laboratory, Monash University, Melbourne, Australia
| | - Phillip M. Alday
- grid.1026.50000 0000 8994 5086Cognitive and Systems Neuroscience Research Hub, University of South Australia, Adelaide, Australia
| | - Scott Coussens
- grid.1026.50000 0000 8994 5086Cognitive and Systems Neuroscience Research Hub, University of South Australia, Adelaide, Australia
| | - Valeria Bellan
- grid.1026.50000 0000 8994 5086Cognitive and Systems Neuroscience Research Hub, University of South Australia, Adelaide, Australia ,grid.1026.50000 0000 8994 5086Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, Australia
| | - Caitlin A. Howlett
- grid.1026.50000 0000 8994 5086Cognitive and Systems Neuroscience Research Hub, University of South Australia, Adelaide, Australia ,grid.1026.50000 0000 8994 5086Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, Australia
| | - Maarten A. Immink
- grid.1026.50000 0000 8994 5086Cognitive and Systems Neuroscience Research Hub, University of South Australia, Adelaide, Australia ,grid.1014.40000 0004 0367 2697Sport, Health, Activity, Performance and Exercise Research Centre, Flinders University, Adelaide, Australia
| | - Mark Kohler
- grid.1026.50000 0000 8994 5086Cognitive and Systems Neuroscience Research Hub, University of South Australia, Adelaide, Australia ,grid.1010.00000 0004 1936 7304School of Psychology, University of Adelaide, Adelaide, Australia
| | - Matthias Schlesewsky
- grid.1026.50000 0000 8994 5086Cognitive and Systems Neuroscience Research Hub, University of South Australia, Adelaide, Australia
| | - Ina Bornkessel-Schlesewsky
- grid.1026.50000 0000 8994 5086Cognitive and Systems Neuroscience Research Hub, University of South Australia, Adelaide, Australia
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42
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Udina C, Ayers E, Inzitari M, Verghese J. Walking While Talking and Prefrontal Oxygenation in Motoric Cognitive Risk Syndrome: Clinical and Pathophysiological Aspects. J Alzheimers Dis 2021; 84:1585-1596. [PMID: 34744077 DOI: 10.3233/jad-210239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Motoric cognitive risk syndrome (MCR) combines slow gait and cognitive complaints and has been proposed as a predementia syndrome. The nature of dual-task performance in MCR has not been established. OBJECTIVE To assess differences in dual-task performance between participants with and without MCR and to study the prefrontal cortex (PFC)-based brain activity during dual-task using functional near-infrared spectroscopy. METHODS Cohort study of community-dwelling non-demented older adults included in the "Central Control of Mobility in Aging" study. Comprehensive assessment included global cognition and executive function tests along with clinical variables. Dual-task paradigm consisted in walking while reciting alternate letters of the alphabet (WWT) on an electronic walkway. We compared dual-task performance between MCR (n = 60) and No MCR (n = 478) participants and assessed the relationship of dual-task performance with cognitive function. In a subsample, we compared PFC oxygenation during WWT between MCR (n = 32) and No MCR (n = 293). RESULTS In our sample of 538 high-functioning older adults (76.6±6.5 years), with 11.2% prevalence of MCR, dual-task cost was not significantly different, compared to No MCR participants. Among MCR participants, no significant relationship was found between WWT velocity and cognitive function, whereas No MCR participants with better cognitive function showed faster WWT velocities. PFC oxygenation during WWT was higher in MCR compared to No MCR (1.02±1.25 versus 0.66±0.83, p = 0.03). CONCLUSION MCR participants showed no significant differences in the dual-task cost while exhibiting higher PFC oxygenation during dual-task walking. The dual-task performance (WWT velocity) in MCR participants was not related to cognition.
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Affiliation(s)
- Cristina Udina
- REFiT Barcelona Research Group, Parc Sanitari Pere Virgili and Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Medicine Department, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Marco Inzitari
- REFiT Barcelona Research Group, Parc Sanitari Pere Virgili and Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Medicine Department, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Joe Verghese
- Albert Einstein College of Medicine, Bronx, NY, USA
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Holtzer R, Ross D, O'Brien C, Izzetoglu M, Wagshul ME. Cognitive Reserve Moderates the Efficiency of Prefrontal Cortex Activation Patterns of Gait in Older Adults. J Gerontol A Biol Sci Med Sci 2021; 77:1836-1844. [PMID: 34606598 DOI: 10.1093/gerona/glab288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cognitive Reserve (CR) protects against cognitive decline, but whether CR influences the efficiency of cortical control of gait has not been reported. The current study addressed this important gap in the literature. Specifically, we determined the role of CR in moderating the efficiency of functional Near-Infrared-Spectroscopy (fNIRS)-derived HbO2 in the prefrontal cortex (PFC) assessed during active walking. We hypothesized that higher CR would be associated with more efficient brain activation patterns. METHODS Participants were 55 (mean age=74.84; %female=49.1) older adults who underwent the combined walking/fNIRS protocol and had MRI data. We used an established dual-task walking paradigm that consisted of three task conditions: Single-Task-Walk (STW), Single-Task-Alpha (STA, cognitive task) and Dual-Task-Walk (DTW). Using the residuals approach, CR was derived from a word-reading test score by removing variance accounted for by socio-demographic variables, tests of current cognitive functions and a measure of structural brain integrity. RESULTS CR moderated the change in fNIRS-derived HbO2 in the PFC across tasks. Higher CR was associated with smaller increases in fNIRS-derived HbO2 from the single tasks to dual task walking (CR x DTW compared to STW: estimate = .183; p < .001; CR x DTW compared to STA: estimate =.257; p < .001). The moderation effect of CR remained significant when adjusting for multiple covariates and concurrent moderation effects of measures of gait performance, current cognitive functions and structural integrity of the brain. CONCLUSION The current study provided first evidence that higher CR was associated with better neural efficiency of walking in older adults.
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Affiliation(s)
- Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University.,Department of Neurology, Albert Einstein College of Medicine
| | - Daliah Ross
- Ferkauf Graduate School of Psychology, Yeshiva University
| | | | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University
| | - Mark E Wagshul
- Department of Radiology, Albert Einstein College of Medicine
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Lee J, Holtzer R. Independent associations of apathy and depressive symptoms with perceived social support in healthy older adults. Aging Ment Health 2021; 25:1796-1802. [PMID: 32426992 DOI: 10.1080/13607863.2020.1768217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Apathy symptoms are common in healthy older adults and may manifest independently of depressive symptoms. Perceived social support is considered a protective factor against adverse health outcomes in aging. We investigated the differential associations of apathy and depressive symptoms with perceived social support in older adults. METHOD The sample (n = 295) included community dwelling healthy older adults. Apathy was assessed with the Apathy Evaluation Scale, depression with the Geriatric Depression Scale, and perceived social support with the Medical Outcomes Study-Social Support Survey. RESULTS Fully adjusted multiple linear regression revealed that, when jointly modeled as predictors, both apathy (standardized β= -0.214 p<.05) and depressive symptoms (standardized β= -0.157 p<.05) had significant negative associations with perceived social support. DISCUSSION We provide the first evidence that apathy and depressive symptoms have independent associations with perceived social support in older adults.
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Affiliation(s)
- Jennifer Lee
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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O’Brien C, Holtzer R. Cognitive Reserve Moderates Associations Between Walking Performance Under Single- and Dual-Task Conditions and Incident Mobility Impairment in Older Adults. J Gerontol A Biol Sci Med Sci 2021; 76:e314-e320. [PMID: 34153107 PMCID: PMC8691058 DOI: 10.1093/gerona/glab178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Among older adults, walking performance is a reliable indicator of adverse health outcomes including incident mobility impairment. Whereas, attention and executive functions have been implicated in cognitive control of locomotion, much less is known about the role of cognitive reserve (CR) in predicting mobility impairments among older adults. Specifically, whether CR moderates the relationship between gait performance and incident mobility impairment has not been reported. To address this gap in the literature, we examined whether gait performance under single-task walk (STW) and dual-task walk (DTW) conditions predicted incident mobility impairment and whether CR moderated this relationship. METHOD Participants were 176 (mean age = 75.57; % female = 53) older adults with baseline Short Physical Performance Battery (SPPB) scores of 10-12. Participants completed neuropsychological testing, the SPPB, and a DTW protocol. CR was evaluated using the Wide Range Achievement Test, third edition. Participants were followed for 3 years; individuals whose SPPB scores declined below 10 were defined as incident cases of mobility impairment (n = 42). RESULTS Moderation analyses revealed significant interaction effects of CR with walking velocity under STW (b = 0.09, 95% CI [0.01, 0.17], z = 2.30, p = .02) and DTW (b = 0.10, 95% CI [0.02, 0.17], z = 2.55, p = .01) conditions, wherein slower gait predicted increased risk of incident mobility impairment among individuals with lower CR. CONCLUSION These findings extend knowledge about the interrelation of cognitive and mobility functions, revealing the critical role of CR in identifying older adults at risk of developing incident mobility impairment.
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Affiliation(s)
- Catherine O’Brien
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
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46
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Walsh GS. Visuomotor control dynamics of quiet standing under single and dual task conditions in younger and older adults. Neurosci Lett 2021; 761:136122. [PMID: 34293417 DOI: 10.1016/j.neulet.2021.136122] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/23/2021] [Accepted: 07/15/2021] [Indexed: 11/16/2022]
Abstract
Visual input facilitates stable postural control; however, ageing alters visual gaze strategies and visual input processing times. Understanding the complex interaction between visual gaze behaviour and the effects of age may inform future interventions to improve postural control in older adults. The purpose of this study was to determine effects of age and dual task on gaze and postural sway dynamics, and the sway-gaze complexity coupling to explore the coupling between sensory input and motor output. Ten older and 10 younger adults performed single and dual task quiet standing while gaze behaviour and centre of mass motion were recorded. The complexity and stability of postural sway, saccade characteristics, visual input duration and complexity of gaze were calculated in addition to sway-gaze coupling quantified by cross-sample entropy. Dual tasking increased complexity and decreased stability of sway with increased gaze complexity and visual input duration, suggesting greater automaticity of sway with greater exploration of the visual field but with longer visual inputs to maintain postural stability in dual task conditions. In addition, older adults had lower complexity and stability of sway than younger adults indicating less automated and stable postural control. Older adults also demonstrated lower gaze complexity, longer visual input durations and greater sway-gaze coupling. These findings suggest older adults adopted a strategy to increase the capacity for visual information input, whilst exploring less of the visual field than younger adults.
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Affiliation(s)
- Gregory S Walsh
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford, UK.
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47
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Bhatt M, Mahana B, Ko JH, Kolesar TA, Kanitkar A, Szturm T. Computerized Dual-Task Testing of Gait Visuomotor and Cognitive Functions in Parkinson's Disease: Test-Retest Reliability and Validity. Front Hum Neurosci 2021; 15:706230. [PMID: 34335213 PMCID: PMC8320846 DOI: 10.3389/fnhum.2021.706230] [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: 05/07/2021] [Accepted: 06/15/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Mobility and cognitive impairments in Parkinson's disease (PD) often coexist and are prognostic of adverse health events. Consequently, assessment and training that simultaneously address both gait function and cognition are important to consider in rehabilitation and promotion of healthy aging. For this purpose, a computer game-based rehabilitation treadmill platform (GRP) was developed for dual-task (DT) assessment and training. OBJECTIVE The first objective was to establish the test-retest reliability of the GRP assessment protocol for DT gait, visuomotor and executive cognitive function in PD patients. The second objective was to examine the effect of task condition [single task (ST) vs. DT] and disease severity (stage 2 vs. stage 3) on gait, visuomotor and cognitive function. METHODS Thirty individuals aged 55 to 70 years, diagnosed with PD; 15 each at Hoehn and Yahr scale stage 2 (PD-2) and 3 (PD-3) performed a series of computerized visuomotor and cognitive game tasks while sitting (ST) and during treadmill walking (DT). A treadmill instrumented with a pressure mat was used to record center of foot pressure and compute the average and coefficient of variation (COV) of step time, step length, and drift during 1-min, speed-controlled intervals. Visuomotor and cognitive game performance measures were quantified using custom software. Testing was conducted on two occasions, 1 week apart. RESULTS With few exceptions, the assessment protocol showed moderate to high intraclass correlation coefficient (ICC) values under both ST and DT conditions for the spatio-temporal gait measures (average and COV), as well as the visuomotor tracking and cognitive game performance measures. A significant decline in gait, visuomotor, and cognitive game performance measures was observed during DT compared to ST conditions, and in the PD-3 compared to PD-2 groups. CONCLUSION The high to moderate ICC values along with the lack of systematic errors in the measures indicate that this tool has the ability to repeatedly record reliable DT interference (DTI) effects over time. The use of interactive digital media provides a flexible method to produce and evaluate DTI for a wide range of executive cognitive activities. This also proves to be a sensitive tool for tracking disease progression. CLINICAL TRIAL REGISTRATION www.ClinicalTrials.gov, identifier NCT03232996.
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Affiliation(s)
- Mayank Bhatt
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Bhuvan Mahana
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Ji Hyun Ko
- Department of Human Anatomy and Cell Science, University of Manitoba, Winnipeg, MB, Canada
| | - Tiffany A. Kolesar
- Department of Human Anatomy and Cell Science, University of Manitoba, Winnipeg, MB, Canada
| | - Anuprita Kanitkar
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Tony Szturm
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
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Ross D, Wagshul ME, Izzetoglu M, Holtzer R. Prefrontal cortex activation during dual-task walking in older adults is moderated by thickness of several cortical regions. GeroScience 2021; 43:1959-1974. [PMID: 34165696 DOI: 10.1007/s11357-021-00379-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/23/2021] [Indexed: 12/21/2022] Open
Abstract
Dual tasking, a defined facet of executive control processes, is subserved, in part, by the prefrontal cortex (PFC). Previous functional near-infrared spectroscopy (fNIRS) studies revealed elevated PFC oxygenated hemoglobin (HbO2) under Dual-Task-Walk (DTW) compared to Single-Task Walk (STW) conditions. Based on the concept of neural inefficiency (i.e., greater activation coupled with similar or worse performance), we hypothesized that decreased cortical thickness across multiple brain regions would be associated with greater HbO2 increases from STW to DTW. Participants were 55 healthy community-dwelling older adults, whose cortical thickness was measured via MRI. HbO2 levels in the PFC, measured via fNIRS, were assessed during active walking under STW and DTW conditions. Statistical analyses were adjusted for demographics and behavioral performance. Linear mixed-effects models revealed that the increase in HbO2 from STW to DTW was moderated by cortical thickness in several regions. Specifically, thinner cortex in specific regions of the frontal, parietal, temporal, and occipital lobes, cingulate cortex, and insula was associated with greater increases in HbO2 levels from single to dual-task walking. In conclusion, participants with thinner cortex in regions implicated in higher order control of walking employed greater neural resources, as measured by increased HbO2, in the PFC during DTW, without demonstrating benefits to behavioral performance. To our knowledge, this is the first study to examine cortical thickness as a marker of neural inefficiency during active walking.
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Affiliation(s)
- Daliah Ross
- Ferkauf Graduate School of Psychology, Yeshiva University, 1225 Morris Park Avenue, Van Etten Building, Bronx, NY, 10461, USA
| | - Mark E Wagshul
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University, Villanova, PA, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, 1225 Morris Park Avenue, Van Etten Building, Bronx, NY, 10461, USA. .,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
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Fettrow T, Hupfeld K, Tays G, Clark DJ, Reuter-Lorenz PA, Seidler RD. Brain activity during walking in older adults: Implications for compensatory versus dysfunctional accounts. Neurobiol Aging 2021; 105:349-364. [PMID: 34182403 DOI: 10.1016/j.neurobiolaging.2021.05.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 05/19/2021] [Accepted: 05/23/2021] [Indexed: 11/25/2022]
Abstract
A prominent trend in the functional brain imaging literature is that older adults exhibit increased brain activity compared to young adults to perform a given task. This phenomenon has been extensively studied for cognitive tasks, with the field converging on interpretations described in two alternative accounts. One account interprets over-activation in older adults as reflecting neural dysfunction (increased brain activity - indicates poorer performance), whereas another interprets it as neural compensation (increased brain activity - supports better performance). Here we review studies that have recorded brain activity and walking measurements in older adults, and we categorize their findings as reflecting either neural dysfunction or neural compensation. Based on this synthesis, we recommend including multiple task difficulty levels in future work to help differentiate if and when compensation fails as the locomotion task becomes more difficult. Using multiple task difficulty levels with neuroimaging will lead to a more advanced understanding of how age-related changes in locomotor brain activity fit with existing accounts of brain aging and support the development of targeted neural rehabilitation techniques.
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Affiliation(s)
- Tyler Fettrow
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA.
| | - Kathleen Hupfeld
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Grant Tays
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - David J Clark
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA; Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
| | | | - Rachael D Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA; Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
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50
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Pakray H, Seng E, Izzetoglu M, Holtzer R. The Effects of Perceived Pain in the Past Month on Prefrontal Cortex Activation Patterns Assessed During Cognitive and Motor Performances in Older Adults. PAIN MEDICINE 2021; 22:303-314. [PMID: 33621331 DOI: 10.1093/pm/pnaa404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Pain is prevalent and functionally impactful in older adults. The prefrontal cortex is involved in pain perception, attentional control, and cortical control of locomotion. Although pain is a known moderator of attentional capacity, its moderating effect on cortical control of locomotion has not been assessed. This study aimed to examine the effects of subjective pain on changes in functional near-infrared spectroscopy-derived measurements of oxygenated hemoglobin (HbO2), gait velocity, and cognitive accuracy from single- to dual-task walking conditions among older adults. SUBJECTS The sample consisted of 383 healthy older adults (55% female). METHODS Participants completed two single tasks (Single-Task-Walk [STW] and Cognitive Interference [Alpha]) and the Dual-Task-Walk (DTW), during which participants performed the two single tasks simultaneously. The Medical Outcomes Study Pain Severity Scale and Pain Effects Scale were used to assess pain severity and interference. ProtoKinetics Movement Analysis Software was used to assess gait velocity and rate of correct letter generation to assess cognitive accuracy. Functional Near-Infrared Spectroscopy (fNIRS) was used to assess HbO2 during active walking. RESULTS Linear mixed-effects models revealed that HbO2 increased from single- to dual-task conditions. Perceived pain presence was associated with an attenuated increase in HbO2 from Alpha to DTW. Among those with pain, worse pain severity was associated with an attenuated increase in HbO2 from STW to DTW. Pain interference did not moderate the increase in HbO2 from single to dual tasks. Pain did not have a moderating effect on behavioral outcomes. CONCLUSIONS Task-related changes in the hemodynamic response in the prefrontal cortex during walking may be a sensitive marker of the effects of subjective pain on brain function in healthy older adults.
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Affiliation(s)
- Hannah Pakray
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Elizabeth Seng
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA.,Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Meltem Izzetoglu
- College of Engineering, Villanova University, Villanova, Pennsylvania, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA.,Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
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