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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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Lapanan K, Kantha P, Nantachai G, Hemrungrojn S, Maes M. The prefrontal cortex hemodynamic responses to dual-task paradigms in older adults: A systematic review and meta-analysis. Heliyon 2023; 9:e17812. [PMID: 37519646 PMCID: PMC10372207 DOI: 10.1016/j.heliyon.2023.e17812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/16/2023] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
Background Functional near-infrared spectroscopy (fNIRS) is a method to measure cerebral hemodynamics. Determining the changes in prefrontal cortex (PFC) hemodynamics during dual-task paradigms is essential in explaining alterations in physical activities, especially in older adults. Aims To systematically review and meta-analyze the effects of dual-task paradigms on PFC hemodynamics in older adults. Methods The search was conducted in PubMed, Scopus, and Web of Science from inception until March 2023 to identify studies on the effects of dual-task paradigms on PFC hemodynamics. The meta-analysis included variables of cerebral hemodynamics, such as oxygenated hemoglobin (HbO2) and deoxygenated hemoglobin (HbR). The heterogeneity of the included studies was determined using the I2 statistic. Additionally, subgroup analysis was conducted to compare the effects of different types of cognitive tasks. Results A total of 37 studies were included in the systematic review, 25 studies comprising 2224 older adults were included in the meta-analysis. Our findings showed that inhibitory control and working memory tasks significantly increased HbO2 in the PFC by 0.53 (p < 0.01, 95% CI = 0.37 to 0.70) and 0.13 (p < 0.01, 95% CI = 0.08 to 0.18) μmol/L, respectively. Overall, HbO2 was significantly increased during dual-task paradigms by 0.36 μmol/L (P < 0.01, 95% CI = 0.27 to 0.45). Moreover, dual-task paradigms also decreased HbR in the PFC by 0.04 (P < 0.01, 95% CI = -0.07 to -0.01). Specifically, HbR decreased by 0.08 during inhibitory control tasks (p < 0.01, 95% CI = -0.13 to -0.02), but did not change during working memory tasks. Conclusion Cognitive tasks related to inhibitory control required greater cognitive demands, indicating higher pfc activation during dual-task paradigms in older adults. for clinical implications, the increase in pfc oxygenated hemoglobin and decrease in pfc deoxygenated hemoglobin may help explain why older adults are more likely to fall during daily activities.
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Affiliation(s)
- Kulvara Lapanan
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Phunsuk Kantha
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Gallayaporn Nantachai
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Somdet Phra Sangharaj Nyanasamvara Geriatric Hospital, Department of Medical Services, Ministry of Public Health, Chon Buri Province, Thailand
| | - Solaphat Hemrungrojn
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
- Mental Health Center, University of Electronic Science and Technology of China, Chengdu 611731, China
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Holtzer R, Choi J, Motl RW, Foley FW, Picone MA, Lipton ML, Izzetoglu M, Hernandez M, Wagshul ME. Individual reserve in aging and neurological disease. J Neurol 2023; 270:3179-3191. [PMID: 36906731 PMCID: PMC10008128 DOI: 10.1007/s00415-023-11656-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/12/2023] [Accepted: 02/28/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Cognitive and physical functions correlate and delineate aging and disease trajectories. Whereas cognitive reserve (CR) is well-established, physical reserve (PR) is poorly understood. We, therefore, developed and evaluated a novel and more comprehensive construct, individual reserve (IR), comprised of residual-derived CR and PR in older adults with and without multiple sclerosis (MS). We hypothesized that: (a) CR and PR would be positively correlated; (b) low CR, PR, and IR would be associated with worse study outcomes; (c) associations of brain atrophy with study outcomes would be stronger in lower compared to higher IR due to compensatory mechanisms conferred by the latter. METHODS Older adults with MS (n = 66, mean age = 64.48 ± 3.84 years) and controls (n = 66, mean age = 68.20 ± 6.09 years), underwent brain MRI, cognitive assessment, and motoric testing. We regressed the repeatable battery for the assessment of neuropsychological status and short physical performance battery on brain pathology and socio-demographic confounders to derive independent residual CR and PR measures, respectively. We combined CR and PR to define a 4-level IR variable. The oral symbol digit modalities test (SDMT) and timed-25-foot-walk-test (T25FW) served as outcome measures. RESULTS CR and PR were positively correlated. Low CR, PR and IR were associated with worse SDMT and T25FW performances. Reduced left thalamic volume, a marker of brain atrophy, was associated with poor SDMT and T25FW performances only in individuals with low IR. The presence of MS moderated associations between IR and T25FW performance. CONCLUSION IR is a novel construct comprised of cognitive and physical dimensions representing collective within-person reserve capacities.
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Affiliation(s)
- Roee Holtzer
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA.
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
| | - Jaeun Choi
- Department of Epidemiology and 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
| | - Mary Ann Picone
- Multiple Sclerosis Center, Holy Name Medical Center, Teaneck, NJ, USA
| | - Michael L Lipton
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Meltem Izzetoglu
- Villanova University, Electrical and Computer Engineering, Villanova, PA, USA
| | - Manuel Hernandez
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Mark E Wagshul
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
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Holtzer R, Zhu X, Rosso AL, Rosano C. Cognitive reserve and risk of mobility impairment in older adults. J Am Geriatr Soc 2022; 70:3096-3104. [PMID: 35978534 DOI: 10.1111/jgs.17979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/16/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cognitive reserve (CR) protects against cognitive decline and dementia but its relation to mobility impairment has not been established. To address this important gap in the literature, we conducted a longitudinal investigation to test the hypothesis that higher baseline CR was associated with a lower risk of developing mobility impairment in older adults. METHODS Participants were dementia-free older adults who received brain magnetic resonance imaging and had gait speed assessments during follow-up. Using the residuals approach, CR was computed as the variance in the Modified Mini-Mental Status Examination total score, that was left after accounting for structural brain integrity, education, and race. Mobility impairment was defined using a validated cutoff score in gait speed of 0.8 m/s. Logistic regression models using general estimating equations were utilized to examine longitudinal associations between baseline CR and the risk of developing mobility impairment across repeated assessments. RESULTS Of the participants (n = 237; mean age = 82 years; %female = 56%) who were free of mobility impairment at baseline, 103 developed mobility impairment during follow-up (mean = 3.1 years). Higher CR at baseline was associated with a lower risk of developing incident mobility impairment-odds ratio (OR) = 0.819, 0.67-0.98, p = 0.038 (unadjusted); OR = 0.815, 0.67-0.99, p = 0.04 (adjusted for socio-demographic variables and depression); OR = 0.819, 0.68-0.88, p = 0.035 (adjusted for illness history); OR = 0.824, 0.68-0.99, p = 0.045 (adjusted for white matter hyperintensities); OR = 0.795, 0.65-0.95, p = 0.016 (adjusted for falls history). CONCLUSION Higher CR at baseline was protective against developing incident mobility impairment during follow-up among community-residing older adults.
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Affiliation(s)
- Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, New York, USA.,Department of Neurology, Albert Einstein College of Medicine, New York, New York, USA
| | - Xiaonan Zhu
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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