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Nikoumanesh N, Chase CJ, Nagarajan R, Potter K, Martini DN. Frontal cortex neurometabolites and mobility in older adults: a preliminary study. Exp Brain Res 2024; 242:2013-2022. [PMID: 38949687 DOI: 10.1007/s00221-024-06881-0] [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: 02/22/2024] [Accepted: 06/19/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND The frontal cortex, relevant to global cognition and motor function, is recruited to compensate for mobility dysfunction in older adults. However, the in vivo neurophysiological (e.g., neurometabolites) underpinnings of the frontal cortex compensation for mobility dysfunction remain poorly understood. The purpose of this study was to investigate the relationships among frontal cortex neurophysiology, mobility, and cognition in healthy older adults. METHODS Magnetic Resonance Spectroscopy (MRS) quantified N-acetylasparate (tNAA) and total choline (tCho) concentrations and ratios in the frontal cortex in 21 older adults. Four inertial sensors recorded the Timed Up & Go (TUG) test. Cognition was assessed using the Flanker Inhibitory Control and Attention Test which requires conflict resolution because of response interference from flanking distractors during incongruent trials. Congruent trials require no conflict resolution. RESULTS tNAA concentration significantly related to the standing (p = 0.04) and sitting (p = 0.03) lean angles. tCho concentration (p = 0.04) and tCho ratio (p = 0.02) significantly related to TUG duration. tCho concentration significantly related to incongruent response time (p = 0.01). tCho ratio significantly related to both congruent (p = 0.009) and incongruent (p < 0.001) response times. Congruent (p = 0.02) and incongruent (p = 0.02) Flanker response times significantly related to TUG duration. CONCLUSIONS Altered levels of frontal cortex neurometabolites are associated with both mobility and cognitive abilities in healthy older adults. Identifying neurometabolites associated with frontal cortex compensation of mobility dysfunction could improve targeted therapies aimed at improving mobility in older adults.
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Affiliation(s)
- Nikou Nikoumanesh
- Department of Kinesiology, University of Massachusetts Amherst, Totman Building 30 Eastman Lane Amherst, Amherst, MA, 01003, USA
| | - Colleen J Chase
- Department of Kinesiology, University of Massachusetts Amherst, Totman Building 30 Eastman Lane Amherst, Amherst, MA, 01003, USA
| | - Rajakumar Nagarajan
- Human Magnetic Resonance Center, Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Katie Potter
- Department of Kinesiology, University of Massachusetts Amherst, Totman Building 30 Eastman Lane Amherst, Amherst, MA, 01003, USA
- Center for Personalized Health Monitoring, Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Douglas N Martini
- Department of Kinesiology, University of Massachusetts Amherst, Totman Building 30 Eastman Lane Amherst, Amherst, MA, 01003, USA.
- Center for Personalized Health Monitoring, Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
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Miura H, Ono Y, Suzuki T, Ogihara Y, Imai Y, Watanabe A, Tokikuni Y, Sakuraba S, Sawamura D. Regional brain activity and neural network changes in cognitive-motor dual-task interference: A functional near-infrared spectroscopy study. Neuroimage 2024; 297:120714. [PMID: 38950665 DOI: 10.1016/j.neuroimage.2024.120714] [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: 01/05/2024] [Revised: 06/25/2024] [Accepted: 06/28/2024] [Indexed: 07/03/2024] Open
Abstract
Previous neuroimaging studies have reported dual-task interference (DTi) and deterioration of task performance in a cognitive-motor dual task (DT) compared to that in a single task (ST). Greater frontoparietal activity is a neural signature of DTi; nonetheless, the underlying mechanism of cortical network in DTi still remains unclear. This study aimed to investigate the regional brain activity and neural network changes during DTi induced by highly demanding cognitive-motor DT. Thirty-four right-handed healthy young adults performed the spiral-drawing task. They underwent a paced auditory serial addition test (PASAT) simultaneously or independently while their cortical activity was measured using functional near-infrared spectroscopy. Motor performance was determined using the balanced integration score (BIS), a balanced index of drawing speed and precision. The cognitive task of the PASAT was administered with two difficulty levels defined by 1 s (PASAT-1 s) and 2 s (PASAT-2 s) intervals, allowing for the serial addition of numbers. Cognitive performance was determined using the percentage of correct responses. These motor and cognitive performances were significantly reduced during DT, which combined a drawing and a cognitive task at either difficulty level, compared to those in the corresponding ST conditions. The DT conditions were also characterized by significantly increased activity in the right dorsolateral prefrontal cortex (DLPFC) compared to that in the ST conditions. Multivariate Granger causality (GC) analysis of cortical activity in the selected frontoparietal regions of interest further revealed selective top-down causal connectivity from the right DLPFC to the right inferior parietal cortex during DTs. Furthermore, changes in the frontoparietal GC connectivity strength between the PASAT-2 s DT and ST conditions significantly correlated negatively with changes in the percentage of correct responses. Therefore, DTi can occur even in cognitively proficient young adults, and the right DLPFC and frontoparietal network being crucial neural mechanisms underlying DTi. These findings provide new insights into DTi and its underlying neural mechanisms and have implications for the clinical utility of cognitive-motor DTs applied to clinical populations with cognitive decline, such as those with psychiatric and brain disorders.
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Affiliation(s)
- Hiroshi Miura
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan; Department of Rehabilitation, Higashinaebo Hospital, Sapporo, Japan
| | - Yumie Ono
- Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University, Kawasaki, Japan
| | - Tatsuya Suzuki
- Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University, Kawasaki, Japan; Electrical Engineering Program, Graduate School of Science and Technology, Meiji University, Kawasaki, Japan
| | - Yuji Ogihara
- Department of Rehabilitation, Higashinaebo Hospital, Sapporo, Japan
| | - Yuna Imai
- Department of Rehabilitation, Higashinaebo Hospital, Sapporo, Japan
| | - Akihiro Watanabe
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, 060-0812, Japan
| | - Yukina Tokikuni
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, 060-0812, Japan
| | - Satoshi Sakuraba
- Department of Rehabilitation Sciences, Health Sciences University of Hokkaido, Tobetsu, Ishikari, Japan
| | - Daisuke Sawamura
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, 060-0812, Japan.
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Siva NK, Bauer C, Glover C, Stolin A, Chandi S, Melnick H, Marano G, Parker B, Mandich M, Lewis JW, Qi J, Gao S, Nott K, Majewski S, Brefczynski-Lewis JA. Real-time motion-enabling positron emission tomography of the brain of upright ambulatory humans. COMMUNICATIONS MEDICINE 2024; 4:117. [PMID: 38872007 PMCID: PMC11176317 DOI: 10.1038/s43856-024-00547-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/05/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Mobile upright PET devices have the potential to enable previously impossible neuroimaging studies. Currently available options are imagers with deep brain coverage that severely limit head/body movements or imagers with upright/motion enabling properties that are limited to only covering the brain surface. METHODS In this study, we test the feasibility of an upright, motion-compatible brain imager, our Ambulatory Motion-enabling Positron Emission Tomography (AMPET) helmet prototype, for use as a neuroscience tool by replicating a variant of a published PET/fMRI study of the neurocorrelates of human walking. We validate our AMPET prototype by conducting a walking movement paradigm to determine motion tolerance and assess for appropriate task related activity in motor-related brain regions. Human participants (n = 11 patients) performed a walking-in-place task with simultaneous AMPET imaging, receiving a bolus delivery of F18-Fluorodeoxyglucose. RESULTS Here we validate three pre-determined measure criteria, including brain alignment motion artifact of less than <2 mm and functional neuroimaging outcomes consistent with existing walking movement literature. CONCLUSIONS The study extends the potential and utility for use of mobile, upright, and motion-tolerant neuroimaging devices in real-world, ecologically-valid paradigms. Our approach accounts for the real-world logistics of an actual human participant study and can be used to inform experimental physicists, engineers and imaging instrumentation developers undertaking similar future studies. The technical advances described herein help set new priorities for facilitating future neuroimaging devices and research of the human brain in health and disease.
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Affiliation(s)
- Nanda K Siva
- Department of Neuroscience, West Virginia University, P.O. Box 9303, Morgantown, WV, USA
| | | | - Colson Glover
- Department of Neuroscience, West Virginia University, P.O. Box 9303, Morgantown, WV, USA
| | - Alexander Stolin
- Department of Neuroscience, West Virginia University, P.O. Box 9303, Morgantown, WV, USA
| | - Sonia Chandi
- Department of Neuroscience, West Virginia University, P.O. Box 9303, Morgantown, WV, USA
| | - Helen Melnick
- Department of Neuroscience, West Virginia University, P.O. Box 9303, Morgantown, WV, USA
| | - Gary Marano
- Department of Neuroscience, West Virginia University, P.O. Box 9303, Morgantown, WV, USA
| | - Benjamin Parker
- Department of Neuroscience, West Virginia University, P.O. Box 9303, Morgantown, WV, USA
| | - MaryBeth Mandich
- Department of Neuroscience, West Virginia University, P.O. Box 9303, Morgantown, WV, USA
| | - James W Lewis
- Department of Neuroscience, West Virginia University, P.O. Box 9303, Morgantown, WV, USA
| | - Jinyi Qi
- Department of Biomedical Engineering, University of California, Davis, Davis, CA, USA
| | - Si Gao
- Department of Neuroscience, West Virginia University, P.O. Box 9303, Morgantown, WV, USA
| | - Kaylee Nott
- Department of Neuroscience, West Virginia University, P.O. Box 9303, Morgantown, WV, USA
| | - Stan Majewski
- Department of Biomedical Engineering, University of California, Davis, Davis, CA, USA
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Holfelder B, Schott N. Associations Between Object Control Skills and Cognitive Functions in Boys, Younger and Older Men: Across-Sectional Study. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:489-498. [PMID: 37871343 DOI: 10.1080/02701367.2023.2265446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/26/2023] [Indexed: 10/25/2023]
Abstract
Purpose: This study aimed to explore the association of cognitive function and process- as well product-oriented outcomes of object control skills (OCS) in boys, younger and older men. Methods: A total of 77 male participants took part in this study, including 35 primary school children (9.04 ± 0.53 years), 22 younger adults (23.5 ± 2.34 years), and 20 older adults (69.5 ± 4.43 years). We assessed the process-oriented performance of throwing, kicking, and catching performance using the component approach. For the product-oriented performance, throwing and kicking velocity was recorded with a STALKER SOLO 2.0 radar gun. For catching, the number of caught balls was assessed. Cognitive function was evaluated using the Trail-Making-Test (TMT) one day later. Results: Younger adults performed better in both domains than the other two groups. The results of the children and older adults were comparable in the motor and cognitive domains. However, the older adults yielded significantly better results for the process-oriented catching and product-oriented throwing performances. Moderate to strong correlations exist between OCS- and TMT performance, with significant correlations predominantly between product-oriented OCS results and TMT in children. Conclusion: The results of both domains support a hypothetical lifespan developmental trajectory with a progression from childhood to younger adult age and a degression in older adults. Furthermore, our results suggest that the suspected relationship between motor and cognitive function depends on age, the analyzed cognitive and motor skills, and the applied methodological approach (process-oriented vs. product-oriented).
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Hong R, Wu Z, Peng K, Zhang J, He Y, Zhang Z, Gao Y, Jin Y, Su X, Zhi H, Guan Q, Pan L, Jin L. Kinect-based objective assessment of the acute levodopa challenge test in parkinsonism: a feasibility study. Neurol Sci 2024; 45:2661-2670. [PMID: 38183553 DOI: 10.1007/s10072-023-07296-5] [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: 11/11/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION The acute levodopa challenge test (ALCT) is an important and valuable examination but there are still some shortcomings with it. We aimed to objectively assess ALCT based on a depth camera and filter out the best indicators. METHODS Fifty-nine individuals with parkinsonism completed ALCT and the improvement rate (IR, which indicates the change in value before and after levodopa administration) of the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) was calculated. The kinematic features of the patients' movements in both the OFF and ON states were collected with an Azure Kinect depth camera. RESULTS The IR of MDS-UPDRS III was significantly correlated with the IRs of many kinematic features for arising from a chair, pronation-supination movements of the hand, finger tapping, toe tapping, leg agility, and gait (rs = - 0.277 ~ - 0.672, P < 0.05). Moderate to high discriminative values were found in the selected features in identifying a clinically significant response to levodopa with sensitivity, specificity, and area under the curve (AUC) in the range of 50-100%, 47.22%-97.22%, and 0.673-0.915, respectively. The resulting classifier combining kinematic features of toe tapping showed an excellent performance with an AUC of 0.966 (95% CI = 0.922-1.000, P < 0.001). The optimal cut-off value was 21.24% with sensitivity and specificity of 94.44% and 87.18%, respectively. CONCLUSION This study demonstrated the feasibility of measuring the effect of levodopa and objectively assessing ALCT based on kinematic data derived from an Azure Kinect-based system.
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Affiliation(s)
- Ronghua Hong
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, School of Medicine, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Zhuang Wu
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, School of Medicine, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Kangwen Peng
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Jingxing Zhang
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Yijing He
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Zhuoyu Zhang
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Yichen Gao
- IFLYTEK Suzhou Research Institute, Suzhou, China
| | - Yue Jin
- IFLYTEK Suzhou Research Institute, Suzhou, China
| | - Xiaoyun Su
- IFLYTEK Suzhou Research Institute, Suzhou, China
| | - Hongping Zhi
- IFLYTEK Suzhou Research Institute, Suzhou, China
| | - Qiang Guan
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Lizhen Pan
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China.
| | - Lingjing Jin
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, School of Medicine, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University, Shanghai, China.
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China.
- Collaborative Innovation Center for Brain Science, Tongji University, Shanghai, China.
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Dong Y, Mao M, Wu Y, Che C, Song Q, Sun W, Zhang C. Frontal and parietal cortices activation during walking is repeatable in older adults based on fNIRS. Heliyon 2024; 10:e30197. [PMID: 38756562 PMCID: PMC11096826 DOI: 10.1016/j.heliyon.2024.e30197] [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: 12/26/2023] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
Purpose This study aimed to explore the test-retest reliability of fNIRS in measuring frontal and parietal cortices activation during straight walking and turning walking in older adults, in order to provide a theoretical foundation for selecting assessment tools for clinical research on motor control and some diseases such as Parkinson's disease in older adults. Methods 18 healthy older participants (69.1 ± 0.7 years) were included in this study. The participants completed straight walking and figure-of-eight turning walking tasks at self-selected speeds. Intra-class correlation coefficients (ICCs) and Bland-Altman scatter plots were used to assess the test-retest reliability of oxyhemoglobin (HbO2) changes derived from fNIRS. p < 0.05 was considered statistically significant. Results The test-retest reliability of HbO2 in prefrontal cortex (ICC, 0.67-0.78) was good and excellent, in frontal motor cortex (ICC, 0.51-0.61) and parietal sensory cortex (ICC, 0.53-0.62) is fair and good when the older adults performed straight and turning walking tasks. Bland-Altman diagram shows that the data consistency is fair and good. Conclusion fNIRS can be used as a clinical measurement method to evaluate the brain activation of the older adults when walking in a straight line and turning, and the results are acceptable repeatability and consistency. However, it is necessary to strictly control the testing process and consider the possible changes in the repeated measurements.
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Affiliation(s)
- Yuqi Dong
- Graduate School, Shandong Sport University, Jinan, China
| | - Min Mao
- Graduate School, Shandong Sport University, Jinan, China
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Yunzhi Wu
- Graduate School, Shandong Sport University, Jinan, China
| | - Chengzhang Che
- Graduate School, Shandong Sport University, Jinan, China
| | - Qipeng Song
- Graduate School, Shandong Sport University, Jinan, China
| | - Wei Sun
- Graduate School, Shandong Sport University, Jinan, China
| | - Cui Zhang
- Graduate School, Shandong Sport University, Jinan, China
- Sports Biomechanics Lab, Shandong Institute of Sport Science, Jinan, China
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Hwang J, Liu C, Winesett SP, Chatterjee SA, Gruber AD, Swanson CW, Manini TM, Hass CJ, Seidler RD, Ferris DP, Roy A, Clark DJ. Prefrontal cortical activity during uneven terrain walking in younger and older adults. Front Aging Neurosci 2024; 16:1389488. [PMID: 38765771 PMCID: PMC11099210 DOI: 10.3389/fnagi.2024.1389488] [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: 02/21/2024] [Accepted: 04/15/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction Walking in complex environments increases the cognitive demand of locomotor control; however, our understanding of the neural mechanisms contributing to walking on uneven terrain is limited. We used a novel method for altering terrain unevenness on a treadmill to investigate the association between terrain unevenness and cortical activity in the prefrontal cortex, a region known to be involved in various cognitive functions. Methods Prefrontal cortical activity was measured with functional near infrared spectroscopy while participants walked on a novel custom-made terrain treadmill surface across four different terrains: flat, low, medium, and high levels of unevenness. The assessments were conducted in younger adults, older adults with better mobility function and older adults with worse mobility function. Mobility function was assessed using the Short Physical Performance Battery. The primary hypothesis was that increasing the unevenness of the terrain would result in greater prefrontal cortical activation in all groups. Secondary hypotheses were that heightened prefrontal cortical activation would be observed in the older groups relative to the younger group, and that prefrontal cortical activation would plateau at higher levels of terrain unevenness for the older adults with worse mobility function, as predicted by the Compensation Related Utilization of Neural Circuits Hypothesis. Results The results revealed a significant main effect of terrain, indicating a significant increase in prefrontal cortical activation with increasing terrain unevenness during walking in all groups. A significant main effect of group revealed that prefrontal cortical activation was higher in older adults with better mobility function compared to younger adults and older adults with worse mobility function in all pooled terrains, but there was no significant difference in prefrontal cortical activation between older adults with worse mobility function and younger adults. Contrary to our hypothesis, the older group with better mobility function displayed a sustained increase in activation but the other groups did not, suggestive of neural compensation. Additional findings were that task-related increases in prefrontal cortical activation during walking were lateralized to the right hemisphere in older adults with better mobility function but were bilateral in older adults with worse mobility function and younger adults. Discussion These findings support that compared to walking on a flat surface, walking on uneven terrain surfaces increases demand on cognitive control resources as measured by prefrontal cortical activation.
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Affiliation(s)
- Jungyun Hwang
- Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Chang Liu
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
- McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Steven P. Winesett
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
| | - Sudeshna A. Chatterjee
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, United States
| | - Anthony D. Gruber
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
| | - Clayton W. Swanson
- Department of Neurology, University of Florida, Gainesville, FL, United States
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
| | - Todd M. Manini
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, United States
| | - Chris J. Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Rachael D. Seidler
- McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Daniel P. Ferris
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
- McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Arkaprava Roy
- Department of Biostatistics, University of Florida, Gainesville, FL, United States
| | - David J. Clark
- Department of Neurology, University of Florida, Gainesville, FL, United States
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, United States
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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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Lu J, Zhang X, Shu Z, Han J, Yu N. A dynamic brain network decomposition method discovers effective brain hemodynamic sub-networks for Parkinson's disease. J Neural Eng 2024; 21:026047. [PMID: 38621377 DOI: 10.1088/1741-2552/ad3eb6] [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: 01/17/2024] [Accepted: 04/15/2024] [Indexed: 04/17/2024]
Abstract
Objective.Dopaminergic treatment is effective for Parkinson's disease (PD). Nevertheless, the conventional treatment assessment mainly focuses on human-administered behavior examination while the underlying functional improvements have not been well explored. This paper aims to investigate brain functional variations of PD patients after dopaminergic therapy.Approach.This paper proposed a dynamic brain network decomposition method and discovered brain hemodynamic sub-networks that well characterized the efficacy of dopaminergic treatment in PD. Firstly, a clinical walking procedure with functional near-infrared spectroscopy was developed, and brain activations during the procedure from fifty PD patients under the OFF and ON states (without and with dopaminergic medication) were captured. Then, dynamic brain networks were constructed with sliding-window analysis of phase lag index and integrated time-varying functional networks across all patients. Afterwards, an aggregated network decomposition algorithm was formulated based on aggregated effectiveness optimization of functional networks in spanning network topology and cross-validation network variations, and utilized to unveil effective brain hemodynamic sub-networks for PD patients. Further, dynamic sub-network features were constructed to characterize the brain flexibility and dynamics according to the temporal switching and activation variations of discovered sub-networks, and their correlations with differential treatment-induced gait alterations were analyzed.Results.The results demonstrated that PD patients exhibited significantly enhanced flexibility after dopaminergic therapy within a sub-network related to the improvement of motor functions. Other sub-networks were significantly correlated with trunk-related axial symptoms and exhibited no significant treatment-induced dynamic interactions.Significance.The proposed method promises a quantified and objective approach for dopaminergic treatment evaluation. Moreover, the findings suggest that the gait of PD patients comprises distinct motor domains, and the corresponding neural controls are selectively responsive to dopaminergic treatment.
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Affiliation(s)
- Jiewei Lu
- College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China
| | - Xinyuan Zhang
- College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China
| | - Zhilin Shu
- College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China
| | - Jianda Han
- College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China
- Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education, Nankai University, Tianjin, People's Republic of China
- Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, People's Republic of China
| | - Ningbo Yu
- College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China
- Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education, Nankai University, Tianjin, People's Republic of China
- Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, People's Republic of China
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10
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Martini DN, Mancini M, Antonellis P, McDonnell P, Vitorio R, Stuart S, King LA. Prefrontal Cortex Activity During Gait in People With Persistent Symptoms After Concussion. Neurorehabil Neural Repair 2024:15459683241240423. [PMID: 38506532 DOI: 10.1177/15459683241240423] [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: 03/21/2024]
Abstract
BACKGROUND Concussions result in transient symptoms stemming from a cortical metabolic energy crisis. Though this metabolic energy crisis typically resolves in a month, symptoms can persist for years. The symptomatic period is associated with gait dysfunction, the cortical underpinnings of which are poorly understood. Quantifying prefrontal cortex (PFC) activity during gait may provide insight into post-concussion gait dysfunction. The purpose of this study was to explore the effects of persisting concussion symptoms on PFC activity during gait. We hypothesized that adults with persisting concussion symptoms would have greater PFC activity during gait than controls. Within the concussed group, we hypothesized that worse symptoms would relate to increased PFC activity during gait, and that increased PFC activity would relate to worse gait characteristics. METHODS The Neurobehavior Symptom Inventory (NSI) characterized concussion symptoms. Functional near-infrared spectroscopy quantified PFC activity (relative concentration changes of oxygenated hemoglobin [HbO2]) in 14 people with a concussion and 25 controls. Gait was assessed using six inertial sensors in the concussion group. RESULTS Average NSI total score was 26.4 (13.2). HbO2 was significantly higher (P = .007) for the concussed group (0.058 [0.108]) compared to the control group (-0.016 [0.057]). Within the concussion group, HbO2 correlated with NSI total symptom score (ρ = .62; P = .02), sagittal range of motion (r = .79; P = .001), and stride time variability (r = -.54; P = .046). CONCLUSION These data suggest PFC activity relates to symptom severity and some gait characteristics in people with persistent concussion symptoms. Identifying the neurophysiological underpinnings to gait deficits post-concussion expands our knowledge of motor behavior deficits in people with persistent concussion symptoms.
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Affiliation(s)
- Douglas N Martini
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Martina Mancini
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | | | - Paul McDonnell
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Rodrigo Vitorio
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Samuel Stuart
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Laurie A King
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
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11
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Kao PC, Pierro MA, Gonzalez DM. Performance during attention-demanding walking conditions in older adults. Gait Posture 2024; 109:70-77. [PMID: 38281432 DOI: 10.1016/j.gaitpost.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/08/2024] [Accepted: 01/18/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Conventional balance and gait assessments for fall risk screening are often conducted under unperturbed conditions. However, older adults can allocate their attention to motor tasks (balance or walking) without revealing performance deficiencies, posing a challenge in identifying those with compromised gait and balance. RESEARCH QUESTIONS Do community-dwelling older adults exhibit greater changes in cognitive and/or walking performance under balance-challenging conditions compared to typical dual-task walking conditions? METHODS Twenty-nine healthy, community-dwelling older adults performed four cognitive tasks (visual and auditory Stroop tasks, Clock task, and Paced Auditory Serial Addition Test) while walking with and without lateral treadmill sways (Perturbed vs. Unperturbed) and during standing. We calculated dual-task costs (DTC) and walking perturbation effects (WPE) as the percentage of change in cognitive and walking performance between dual and single-task conditions and between Perturbed and Unperturbed conditions, respectively. RESULTS Older adults exhibited similar DTC and WPE on cognitive task performance. However, in walking performance, they demonstrated significantly greater WPE than DTC across all gait and stability measures (p < 0.01), including the mean and variability of stride and margins of stability (MOS) measures, the variability of trunk movement and lower-limb joint angles, and the local stability measures. Older adults took shorter but wider steps, exhibited shorter MOSAP but greater MOSML, and experienced increased movement variability and walking instability to a greater extent than during dual-task walking. Overall, changes in variability and stability measures were more pronounced than those in mean gait measures. SIGNIFICANCE Introducing destabilizing perturbations to increase the task demands of balance and gait assessments is a more effective method to challenge older adults compared to simply adding a concurrent cognitive task. Fall screening assessments for community-dwelling older adults should incorporate balance-challenging conditions, such as introducing gait perturbations.
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Affiliation(s)
- Pei-Chun Kao
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA, United States; New England Robotics Validation and Experimentation (NERVE) Center, University of Massachusetts Lowell, Lowell, MA, United States.
| | - Michaela A Pierro
- Biomedical Engineering and Biotechnology Program, University of Massachusetts Lowell, Lowell, MA, United States
| | - Daniela M Gonzalez
- Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, MA, United States
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Lau CI, Liu MN, Cheng FY, Wang HC, Walsh V, Liao YY. Can transcranial direct current stimulation combined with interactive computerized cognitive training boost cognition and gait performance in older adults with mild cognitive impairment? a randomized controlled trial. J Neuroeng Rehabil 2024; 21:26. [PMID: 38365761 PMCID: PMC10874043 DOI: 10.1186/s12984-024-01313-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/24/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Older adults with Mild Cognitive Impairment (MCI) are often subject to cognitive and gait deficits. Interactive Computerized Cognitive Training (ICCT) may improve cognitive function; however, the effect of such training on gait performance is limited. Transcranial Direct Current Stimulation (tDCS) improves cognition and gait performance. It remains unclear whether combining tDCS with ICCT produces an enhanced synergistic effect on cognition and complex gait performance relative to ICCT alone. This study aimed to compare the effects of tDCS combined with ICCT on cognition and gait performance in older adults with MCI. METHOD Twenty-one older adults with MCI were randomly assigned to groups receiving either anodal tDCS and ICCT ( tDCS + ICCT ) or sham tDCS and ICCT ( sham + ICCT ). Participants played Nintendo Switch cognitive games for 40 min per session, simultaneously receiving either anodal or sham tDCS over the left dorsolateral prefrontal cortex for the first 20 min. Cognitive and gait assessments were performed before and after 15 training sessions. RESULTS The global cognition, executive function, and working-memory scores improved in both groups, but there were no significant interaction effects on cognitive outcomes. Additionally, the group × time interactions indicated that tDCS + ICCT significantly enhanced dual-task gait performance in terms of gait speed (p = 0.045), variability (p = 0.016), and dual-task cost (p = 0.039) compared to sham + ICCT. CONCLUSION The combined effect of tDCS and ICCT on cognition was not superior to that of ICCT alone; however, it had a significant impact on dual-task gait performance. Administering tDCS as an adjunct to ICCT may thus provide additional benefits for older adults with MCI. TRIAL REGISTRATION This trial was registered at http://www. CLINICALTRIALS in.th/ (TCTR 20,220,328,009).
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Affiliation(s)
- Chi Ieong Lau
- Dementia Center, Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, UK
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Mu-N Liu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Fang-Yu Cheng
- Institute of Long-Term Care, MacKay Medical College, New Taipei, Taiwan
| | - Han-Cheng Wang
- Dementia Center, Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Vincent Walsh
- Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, UK
| | - Ying-Yi Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
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13
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Wang L, Zhang X, Wang L, Guo M, Yang Q, Chen X, Sha H. Association of Age with Dual-Task Objective Cognitive Indicators and Gait Parameters in Older Adults. J Alzheimers Dis 2024; 99:993-1004. [PMID: 38728188 DOI: 10.3233/jad-240066] [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] [Indexed: 05/12/2024]
Abstract
Background Early recognition of dementia like Alzheimer's disease is crucial for disease diagnosis and treatment, and existing objective tools for early screening of cognitive impairment are limited. Objective To investigate age-related behavioral indicators of dual-task cognitive performance and gait parameters and to explore potential objective markers of early cognitive decline. Methods The community-based cognitive screening data was analyzed. Hierarchical cluster analysis and Pearson correlation analysis were performed on the 9-item subjective cognitive decline (SCD-9) scores, walking-cognitive dual-task performance, walking speed, and gait parameters of 152 participants. The significant differences of indicators that may related to cognitive decline were statistically analyzed across six age groups. A mathematical model with age as the independent variable and motor cognition composite score as the dependent variable was established to observe the trend of motor cognition dual-task performance with age. Results Strong correlation was found between motor cognitive scores and SCD and age. Gait parameters like the mean value of ankle angle, the left-right difference rate of ankle angle and knee angle and the coefficient of variation of gait cycle showed an excellent correlation with age. Motor cognition scores showed a decreasing trend with age. The slope of motor cognition scores with age after 50 years (k = -1.06) was six times higher than that before 50 years (k = -0.18). Conclusions Cognitive performance and gait parameters in the walking-cognitive dual-task state are promising objective markers that could characterize age-related cognitive decline.
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Affiliation(s)
- Linlin Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Xuezhen Zhang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Institut National des Sciences Appliquées de Lyon, Lyon, France
| | - Lei Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Miaomiao Guo
- School of Health Sciences & Biomedical Engineering, Hebei University of Technology, Tianjin, China
| | | | - Xiaogang Chen
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Hong Sha
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
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Tung C, Lord SR, Pelicioni PHS, Sturnieks DL, Menant JCC. Prefrontal and Motor Planning Cortical Activity during Stepping Tasks Is Related to Task Complexity but Not Concern about Falling in Older People: A fNIRS Study. Brain Sci 2023; 13:1675. [PMID: 38137123 PMCID: PMC10742256 DOI: 10.3390/brainsci13121675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/20/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
This study investigated the effect of concern about falling on neural efficiency during stepping in older people. Community-dwellers aged >65 years were categorised as having low (n = 71) and high (n = 28) concerns about falling based on the Iconographical Falls Efficacy Scale (IconFES 10-item, scores <19 and ≥19, respectively). Participants performed a choice stepping reaction time test (CSRT), an inhibitory CSRT (iCSRT), and a Stroop stepping test (SST)) on a computerised step mat. Cortical activity was recorded using functional near-infrared spectroscopy. There were no significant differences in stepping response times or cortical activity in the dorsolateral prefrontal cortex (DLPFC), supplementary motor area (SMA), and premotor cortex (PMC) between those with and without concern about falling. However, stepping response times and cortical activity in the PFC, SMA, and PMC were significantly higher in the SST compared with the CSRT in the whole sample. PMC activity was also higher in the SST compared to the iCSRT. These findings demonstrate that cortical activity is higher in cognitively demanding stepping tasks that require selective attention and inhibition in healthy older people. The lack of association between concern about falling and neural efficiency during stepping in this older sample may reflect their only moderate scores on the IconFES.
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Affiliation(s)
- Carmen Tung
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia; (C.T.); (S.R.L.); (P.H.S.P.); (D.L.S.)
| | - Stephen Ronald Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia; (C.T.); (S.R.L.); (P.H.S.P.); (D.L.S.)
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Kensington, NSW 2052, Australia
| | - Paulo Henrique Silva Pelicioni
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia; (C.T.); (S.R.L.); (P.H.S.P.); (D.L.S.)
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Kensington, NSW 2052, Australia
| | - Daina Louise Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia; (C.T.); (S.R.L.); (P.H.S.P.); (D.L.S.)
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Kensington, NSW 2052, Australia
- Ageing Future Institute, University of New South Wales, Kensington, NSW 2052, Australia
| | - Jasmine Charlotte Christiane Menant
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia; (C.T.); (S.R.L.); (P.H.S.P.); (D.L.S.)
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Kensington, NSW 2052, Australia
- Ageing Future Institute, University of New South Wales, Kensington, NSW 2052, Australia
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15
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Bazzi H, Cacace AT. Altered gait parameters in distracted walking: a bio-evolutionary and prognostic health perspective on passive listening and active responding during cell phone use. Front Integr Neurosci 2023; 17:1135495. [PMID: 38027460 PMCID: PMC10668124 DOI: 10.3389/fnint.2023.1135495] [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: 12/31/2022] [Accepted: 08/21/2023] [Indexed: 12/01/2023] Open
Abstract
The underpinnings of bipedal gait are reviewed from an evolutionary biology and prognostic health perspective to better understand issues and concerns related to cell phone use during ambulation and under conditions of distraction and interference. We also consider gait-related health issues associated with the fear of or risk of falling and include prognostic dimensions associated with cognitive decline, dementia, and mortality. Data were acquired on 21 healthy young adults without hearing loss, vestibular, balance, otological or neurological dysfunction using a computerized walkway (GAITRite® Walkway System) combined with specialized software algorithms to extract gait parameters. Four experimental conditions and seven temporo-spatial gait parameters were studied: gait velocity, cadence, stride length, ambulatory time, single-support time, double-support time, and step count. Significant main effects were observed for ambulation time, velocity, stride velocity, and double-support time. The greatest impact of distraction and interference occurred during the texting condition, although other significant effects occurred when participants were verbally responding to queries and passively listening to a story. These experimental observations show that relatively simple distraction and interference tasks implemented through the auditory sensory modality can induce significant perturbations in gait while individuals were ambulating and using a cell phone. Herein, emphasis is placed on the use of quantifiable gait parameters in medical, psychological, and audiological examinations to serve as a foundation for identifying and potentially averting gait-related disturbances.
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Affiliation(s)
- Hassan Bazzi
- Department of Biological Sciences, Wayne State University, Detroit, MI, United States
| | - Anthony T. Cacace
- Department of Communication Sciences and Disorders, Wayne State University, Detroit, MI, United States
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Lee SA, Kim JY, Park JH. Feasibility of Virtual Shopping Budget-Management Training on Executive Functions in Healthy Young Adults: A Pilot Study. Brain Sci 2023; 13:1573. [PMID: 38002533 PMCID: PMC10669887 DOI: 10.3390/brainsci13111573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
To date, budget management in virtual shopping training has not been given much importance. The main objective of this study was to investigate the effects of virtual shopping budget-management training on executive functions and brain activation. Sixteen participants were randomly assigned to the experimental group that received virtual shopping budget-management training or the waitlist control group for a total of 16 sessions. To examine the effects of virtual shopping budget-management training on brain activation, HbO2 was measured in the prefrontal cortex via functional near-infrared spectroscopy (fNIRS) during the Trail Making Test Part B (TMT-B) and Stroop test. Mann-Whitney and Wilcoxon signed-rank tests were used to compare outcomes between and within the two groups. The virtual shopping budget-management training showed no significant difference in all outcomes between both groups (p > 0.05). No significant differences were observed in HbO2 levels during both TMT-B (p > 0.05) and the Stroop test (p > 0.05). However, in the pre-post comparisons, there was a significant difference in the TMT-B (p < 0.05) and Stroop test (p < 0.05) in the experimental group. In this study, although we did not find a distinct advantage in training, it confirmed its potential for clinical benefits in healthy young adults through training.
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Affiliation(s)
- Si-An Lee
- Department of ICT Convergence, The Graduate School, Soonchunhyang University, Asan 31538, Republic of Korea; (S.-A.L.); (J.-Y.K.)
| | - Ji-Yea Kim
- Department of ICT Convergence, The Graduate School, Soonchunhyang University, Asan 31538, Republic of Korea; (S.-A.L.); (J.-Y.K.)
| | - Jin-Hyuck Park
- Department of Occupational Therapy, College of Medical Science, Soonchunhyang University, Asan 31538, Republic of Korea
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Xiao Y, Zhou J, Zhou R, Liu Y, Lü J, Huang L. Fronto-parietal theta high-definition transcranial alternating current stimulation may modulate working memory under postural control conditions in young healthy adults. Front Hum Neurosci 2023; 17:1265600. [PMID: 38021229 PMCID: PMC10666918 DOI: 10.3389/fnhum.2023.1265600] [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: 07/23/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Objects This study aimed to investigate the immediate effects of fronto-parietal θ HD-tACS on a dual task of working memory-postural control. Methods In this within-subject cross-over pilot study, we assessed the effects of 20 min of 6 Hz-tACS targeting both the left dorsolateral prefrontal cortex (lDLPFC) and posterior parietal cortex (PPC) in 20 healthy adults (age: 21.6 ± 1.3 years). During each session, single- and dual-task behavioral tests (working memory single-task, static tandem standing, and a dual-task of working memory-postural control) and closed-eye resting-state EEG were assessed before and immediately after stimulation. Results Within the tACS group, we found a 5.3% significant decrease in working memory response time under the dual-task following tACS (t = -3.157, p = 0.005, Cohen's d = 0.742); phase synchronization analysis revealed a significant increase in the phase locking value (PLV) of θ band between F3 and P3 after tACS (p = 0.010, Cohen's d = 0.637). Correlation analyses revealed a significant correlation between increased rs-EEG θ power in the F3 and P3 channels and faster reaction time (r = -0.515, p = 0.02; r = -0.483, p = 0.031, respectively) in the dual-task working memory task after tACS. However, no differences were observed on either upright postural control performance or rs-EEG results (p-values <0.05). Conclusion Fronto-parietal θ HD-tACS has the potential of being a neuromodulatory tool for improving working memory performance in dual-task situations, but its effect on the modulation of concurrently performed postural control tasks requires further investigation.
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Affiliation(s)
- Yanwen Xiao
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shenshan Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Shanwei, Guangdong, China
| | - Junhong Zhou
- Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, United States
| | - Rong Zhou
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Yu Liu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Jiaojiao Lü
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Lingyan Huang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
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Melo RS, Cardeira CSF, Rezende DSA, Guimarães-do-Carmo VJ, Lemos A, de Moura-Filho AG. Effectiveness of the aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in healthy community-dwelling older adults: A systematic review and meta-analysis. PLoS One 2023; 18:e0291193. [PMID: 37683025 PMCID: PMC10490910 DOI: 10.1371/journal.pone.0291193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Opting to use aquatic or land-based physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in community-dwelling older adults (CDOAs) is still a questionable clinical decision for physiotherapists. OBJECTIVE Assess the quality of evidence from randomized or quasi-randomized controlled trials that used aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in CDOAs. METHODS Articles were surveyed in the following databases: MEDLINE/PubMed, EMBASE, SCOPUS, LILACS, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, CINAHL, SciELO and Google Scholar, published in any language, up to July 31, 2023. Two independent reviewers extracted the data and assessed evidence quality. The risk of bias of the trials was evaluated by the Cochrane tool and evidence quality by GRADE approach. Review Manager software was used to conduct the meta-analyses. RESULTS 3007 articles were identified in the searches, remaining 33 studies to be read in full, with 11 trials being eligible for this systematic review. The trials included presented low evidence quality for the balance, gait, quality of life and fear of falling. Land-based and aquatic physical therapy exercises improved the outcomes analyzed; however, aquatic physical therapy exercises were more effective in improving balance, gait, quality of life and reducing fear of falling in CDOAs. The meta-analysis showed that engaging in aquatic physical therapy exercises increases the functional reach, through of the anterior displacement of the center of pressure of CDOAs by 6.36cm, compared to land-based physical therapy exercises, assessed by the Functional Reach test: [CI:5.22 to 7.50], (p<0.00001), presenting low quality evidence. CONCLUSIONS Aquatic physical therapy exercises are more effective than their land-based counterparts in enhancing balance, gait, quality of life and reducing the fear of falling in CDOAs. However, due to methodological limitations of the trials, this clinical decision remains inconclusive. It is suggested that new trials be conducted with greater methodological rigor, in order to provide high-quality evidence on the use of the aquatic physical therapy exercises to improve the outcomes analyzed in CDOAs.
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Affiliation(s)
- Renato S. Melo
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | | | | | - Andrea Lemos
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Alberto Galvão de Moura-Filho
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
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Baek CY, Kim HD, Yoo DY, Kang KY, Woo Lee J. Effect of automaticity induced by treadmill walking on prefrontal cortex activation and dual-task performance in older adults. PLoS One 2023; 18:e0287252. [PMID: 37535522 PMCID: PMC10399859 DOI: 10.1371/journal.pone.0287252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/02/2023] [Indexed: 08/05/2023] Open
Abstract
As individuals age, they may experience a decline in gait automaticity, which requires increased attentional resources for the control of gait. This age-related decline in gait automaticity has been shown to contribute to higher prefrontal cortex (PFC) activation and lower dual-task performance during dual-task walking in older adults. This study is to investigate the effect of treadmill walking on PFC activation and dual-task performance in older adults. A total of 20 older adults (mean age, 64.35 ± 2.74 years) and 20 younger adults (mean age, 30.00 ± 3.15 years) performed single- and dual-task walking in overground and treadmill conditions. A wearable functional near-infrared spectroscopy and gait analyzer were used to analyze PFC activation and dual-task performance, respectively. To determine the dual-task (gait and cognitive) performance, the dual-task cost (DTC) was calculated using the following formula: (single-task - dual-task)/single-task × 100. In both groups, dual-task treadmill walking led to reduced PFC activation and reduced DTC compared to dual-task overground walking. Furthermore, despite a higher DTC in gait variability, correct response, total response, response index and a higher error score in older adults than in younger adults during overground walking, there was no difference in treadmill walking. The difference in PFC activation between single- and dual-tasks was also observed only in overground walking. Performing dual-task walking on a treadmill compared to overground walking results in different levels of dual-task performance and PFC activity. Specifically, older adults are able to maintain similar levels of dual-task performance as younger adults while walking on a treadmill, with reduced PFC activation due to the automaticity induced by the treadmill. Therefore, older adults who exhibit low dual-task performance during overground walking may be able to improve their performance while walking on a treadmill with fewer attentional resources.
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Affiliation(s)
- Chang Yoon Baek
- Department of Physical Therapy, College of Health Science, Korea University, Seoul, Republic of Korea
- Department of Rehabilitation medicine, National Health Insurance Ilsan Hospital, Ilsan, Republic of Korea
| | - Hyeong Dong Kim
- Department of Physical Therapy, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Dong Yup Yoo
- Department of Rehabilitation medicine, National Health Insurance Ilsan Hospital, Ilsan, Republic of Korea
| | - Kyoung Yee Kang
- Department of Rehabilitation medicine, National Health Insurance Ilsan Hospital, Ilsan, Republic of Korea
| | - Jang Woo Lee
- Department of Rehabilitation medicine, National Health Insurance Ilsan Hospital, Ilsan, Republic of Korea
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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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21
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Pavlou M, Costafreda SG, Galsworthy W, Korres G, Bamiou DE. The interplay between cognition, functional and dual-task gait in persons with a vestibular disorder versus healthy controls. Sci Rep 2023; 13:10130. [PMID: 37349351 PMCID: PMC10287746 DOI: 10.1038/s41598-023-35904-z] [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: 07/25/2022] [Accepted: 05/25/2023] [Indexed: 06/24/2023] Open
Abstract
Close links exist between vestibular function and cognition. Dual-task (DT) tests may have ecological validity to assess the impact of daily life cognitive-motor demands in people with vestibular dysfunction (PwVD), functional gait and falls risk. The present paper aimed at building predictive models for functional gait under DT conditions, while clarifying the impact of vestibular dysfunction, individual characteristics, varying task types and motor-cognitive demands. Case-controlled observational study with 39 PwVD and 62 healthy participants. The Functional Gait Assessment (FGA), with and without an additional motor, numeracy, or literacy task, was completed. Multiple linear regression was used to fit models to predict FGA under single and DT performance. Dual task cost (DTC, %) was calculated to assess DT interference on FGA performance using the equation: 100*(single task score-dual task score)/single-task score. Following Bonferroni corrections for multiple comparisons (corrected alpha level of 0.003), PwVD had poorer performance than controls for all FGA conditions (p < 0.001), motor (- 3.94%; p = 0.002) and numeracy (- 22.77%; p = 0.001) DTCs and spatial working memory (p = 0.002). The literacy DTC was marginally significant (- 19.39% p = 0.005). FGA single and DT motor, numeracy, and literacy models explained 76%, 76%, 66% and 67% of the variance respectively for PwVD. Sustained attention, visual memory and sex contributed to all models; short-term visual recognition memory, balance confidence, and migraine contributed to some models. Cognitive performance is impaired in PwVD. Motor, numeracy and literacy tasks impair functional gait performance. Cognitive assessment and FGA with a numeracy or literacy cognitive component should be included within assessment protocols and considered in the provision of targeted interventions for PwVD.
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Affiliation(s)
- Marousa Pavlou
- Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, Shepherd's House, Guy's Campus, London, SE1 1UL, UK.
- Department of Neuro-Otology, University College London Hospitals, London, UK.
| | - Sergi G Costafreda
- Biomedical Research Centre, University College London Hospitals, London, UK
| | - William Galsworthy
- Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, Shepherd's House, Guy's Campus, London, SE1 1UL, UK
| | - George Korres
- Department of Neuro-Otology, University College London Hospitals, London, UK
| | - Doris-Eva Bamiou
- Department of Neuro-Otology, University College London Hospitals, London, UK
- Ear Institute, University College London, London, UK
- Biomedical Research Centre, University College London Hospitals, London, UK
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Weng WH, Yang YR, Yeh NC, Ku PH, Wang PS, Liao YY, Wang RY. Gait performance and prefrontal cortex activation during single and dual task walking in older adults with different cognitive levels. Front Aging Neurosci 2023; 15:1177082. [PMID: 37333460 PMCID: PMC10272571 DOI: 10.3389/fnagi.2023.1177082] [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: 03/01/2023] [Accepted: 05/19/2023] [Indexed: 06/20/2023] Open
Abstract
Background Growing evidence shows the cognitive function influences the motor performance. The prefrontal cortex (PFC) as a part of the executive locomotor pathway is also important for cognitive function. This study investigated the differences in motor function and brain activity among older adults with different cognitive levels, and examined the significance of cognition on motor functions. Methods Normal control (NC), individuals with mild cognitive impairment (MCI) or mild dementia (MD) were enrolled in this study. All participants received a comprehensive assessment including cognitive function, motor function, PFC activity during walking, and fear of fall. The assessment of cognitive function included general cognition, attention, executive function, memory, and visuo-spatial. The assessment of motor function included timed up and go (TUG) test, single walking (SW), and cognitive dual task walking (CDW). Results Individuals with MD had worse SW, CDW and TUG performance as compared to individuals with MCI and NC. These gait and balance performance did not differ significantly between MCI and NC. Motor functions all correlated with general cognition, attention, executive function, memory, and visuo-spatial ability. Attention ability measured by trail making test A (TMT-A) was the best predictor for TUG and gait velocity. There were no significant differences in PFC activity among three groups. Nevertheless, the PFC activated more during CDW as compared with SW in individuals with MCI (p = 0.000), which was not demonstrated in the other two groups. Conclusion MD demonstrated worse motor function as compared to NC and MCI. The greater PFC activity during CDW in MCI may be considered as a compensatory strategy for maintaining the gait performance. Motor function was related to the cognitive function, and the TMT A was the best predictor for the gait related performance in present study among older adults.
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Affiliation(s)
- Wei-Han Weng
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yea-Ru Yang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Nai-Chen Yeh
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Hsin Ku
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Shan Wang
- Department of Neurology, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
| | - Ying-Yi Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ray-Yau Wang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
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23
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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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Patelaki E, Foxe JJ, Mantel EP, Kassis G, Freedman EG. Paradoxical improvement of cognitive control in older adults under dual-task walking conditions is associated with more flexible reallocation of neural resources: A Mobile Brain-Body Imaging (MoBI) study. Neuroimage 2023; 273:120098. [PMID: 37037381 DOI: 10.1016/j.neuroimage.2023.120098] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/28/2023] [Accepted: 04/07/2023] [Indexed: 04/12/2023] Open
Abstract
Combining walking with a demanding cognitive task is traditionally expected to elicit decrements in gait and/or cognitive task performance. However, it was recently shown that, in a cohort of young adults, most participants improved performance when walking was added to performance of a Go/NoGo response inhibition task. The present study aims to extend these previous findings to an older adult cohort, to investigate whether this improvement when dual-tasking is observed in healthy older adults. Mobile Brain/Body Imaging (MoBI) was used to record electroencephalographic (EEG) activity, three-dimensional (3D) gait kinematics and behavioral responses in the Go/NoGo task, during sitting or walking on a treadmill, in 34 young adults and 37 older adults. Increased response accuracy during walking, independent of age, was found to correlate with slower responses to stimuli (r = 0.44) and with walking-related EEG amplitude modulations over frontocentral regions (r = 0.47) during the sensory gating (N1) and conflict monitoring (N2) stages of inhibition, and over left-lateralized prefrontal regions (r = 0.47) during the stage of inhibitory control implementation. These neural activity changes are related to the cognitive component of inhibition, and they were interpreted as signatures of behavioral improvement during walking. On the other hand, aging, independent of response accuracy during walking, was found to correlate with slower treadmill walking speeds (r = -0.68) and attenuation in walking-related EEG amplitude modulations over left-dominant frontal (r = -0.44) and parietooccipital regions (r = 0.48) during the N2 stage, and over centroparietal regions (r = 0.48) during the P3 stage. These neural activity changes are related to the motor component of inhibition, and they were interpreted as signatures of aging. Older adults whose response accuracy 'paradoxically' improved during walking manifested neural signatures of both behavioral improvement and aging, suggesting that their flexibility in reallocating neural resources while walking might be maintained for the cognitive but not for the motor inhibitory component. These distinct neural signatures of aging and behavior can potentially be used to identify 'super-agers', or individuals at risk for cognitive decline due to aging or neurodegenerative disease.
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Affiliation(s)
- Eleni Patelaki
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, New York, 14642, USA; Department of Biomedical Engineering, University of Rochester, 201 Robert B. Goergen Hall Rochester, New York, 14627, USA
| | - John J Foxe
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, New York, 14642, USA.
| | - Emma P Mantel
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, New York, 14642, USA
| | - George Kassis
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, New York, 14642, USA
| | - Edward G Freedman
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, New York, 14642, USA.
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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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Zhou J, Cattaneo G, Yu W, Lo OY, Gouskova NA, Delgado-Gallén S, Redondo-Camós M, España-Irla G, Solana-Sánchez J, Tormos JM, Lipsitz LA, Bartrés-Faz D, Pascual-Leone A, Manor B. The age-related contribution of cognitive function to dual-task gait in middle-aged adults in Spain: observations from a population-based study. THE LANCET. HEALTHY LONGEVITY 2023; 4:e98-e106. [PMID: 36870341 PMCID: PMC9992865 DOI: 10.1016/s2666-7568(23)00009-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Poor dual-task gait performance is associated with a risk of falls and cognitive decline in adults aged 65 years or older. When and why dual-task gait performance begins to deteriorate is unknown. This study aimed to characterise the relationships between age, dual-task gait, and cognitive function in middle age (ie, aged 40-64 years). METHODS We conducted a secondary analysis of data from community-dwelling adults aged 40-64 years that took part in the Barcelona Brain Health Initiative (BBHI) study, an ongoing longitudinal cohort study in Barcelona, Spain. Participants were eligible for inclusion if they were able to walk independently without assistance and had completed assessments of both gait and cognition at the time of analysis and ineligble if they could not understand the study protocol, had any clinically diagnosed neurological or psychiatric diseases, were cognitively impaired, or had lower-extremity pain, osteoarthritis, or rheumatoid arthritis that could cause abnormal gait. Stride time and stride time variability were measured under single-task (ie, walking only) and dual-task (ie, walking while performing serial subtractions) conditions. Dual-task cost (DTC; the percentage increase in the gait outcomes from single-task to dual-task conditions) to each gait outcome was calculated and used as the primary measure in analyses. Global cognitive function and composite scores of five cognitive domains were derived from neuropsychological testing. We used locally estimated scatterplot smoothing to characterise the relationship between age and dual-task gait, and structural equation modelling to establish whether cognitive function mediated the association between observed biological age and dual tasks. FINDINGS 996 people were recruited to the BBHI study between May 5, 2018, and July 7, 2020, of which 640 participants completed gait and cognitive assessments during this time (mean 24 days [SD 34] between first and second visit) and were included in our analysis (342 men and 298 women). Non-linear associations were observed between age and dual-task performance. Starting at 54 years, the DTC to stride time (β=0·27 [95% CI 0·11 to 0·36]; p<0·0001) and stride time variability (0·24 [0·08 to 0·32]; p=0·0006) increased with advancing age. In individuals aged 54 years or older, decreased global cognitive function correlated with increased DTC to stride time (β=-0·27 [-0·38 to -0·11]; p=0·0006) and increased DTC to stride time variability (β=-0·19 [-0·28 to -0·08]; p=0·0002). INTERPRETATION Dual-task gait performance begins to deteriorate in the sixth decade of life and, after this point, interindividual variance in cognition explains a substantial portion of dual-task performance. FUNDING La Caixa Foundation, Institut Guttmann, and Fundació Abertis.
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Affiliation(s)
- Junhong Zhou
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, USA; Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Wanting Yu
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, USA
| | - On-Yee Lo
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, USA; Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Natalia A Gouskova
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, USA; Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Selma Delgado-Gallén
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Redondo-Camós
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Goretti España-Irla
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Javier Solana-Sánchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep M Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lewis A Lipsitz
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, USA; Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - David Bartrés-Faz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain; Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences and August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, USA; Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Roslindale, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, USA; Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Li Y, Xu Z, Xie H, Fu R, Lo WLA, Cheng X, Yang J, Ge L, Yu Q, Wang C. Changes in cortical activation during upright stance in individuals with chronic low back pain: An fNIRS study. Front Hum Neurosci 2023; 17:1085831. [PMID: 36816497 PMCID: PMC9936824 DOI: 10.3389/fnhum.2023.1085831] [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: 11/02/2022] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Postural control deficits are a potential cause of persistent and recurrent pain in patients with chronic low back pain (CLBP). Although some studies have confirmed that the dorsolateral prefrontal cortex (DLPFC) contributes to pain regulation in CLBP, its role in the postural control of patients with CLBP remains unclear. Therefore, this study aimed to investigate the DLPFC activation of patients with CLBP and healthy controls under different upright stance task conditions. Methods Twenty patients with CLBP (26.50 ± 2.48 years) and 20 healthy controls (25.75 ± 3.57 years) performed upright stance tasks under three conditions: Task-1 was static balance with eyes open; Task-2 was static balance with eyes closed; Task-3 involved dynamic balance on an unstable surface with eyes open. A wireless functional near-infrared spectroscopy (fNIRS) system measured cortical activity, including the bilateral DLPFC, pre-motor cortex (PMC) and supplementary motor area (SMA), the primary motor cortex (M1), the primary somatosensory cortex (S1), and a force platform measured balance parameters during upright stance. Results The two-way repeated measures ANOVA results showed significant interaction in bilateral PMC/SMA activation. Moreover, patients with CLBP had significantly increased right DLPFC activation and higher sway 32 area and velocity than healthy controls during upright stance. Discussion Our results imply that PMC/SMA and DLPFC maintain standing balance. The patients with CLBP have higher cortical activity and upright stance control deficits, which may indicate that the patients with CLBP have low neural efficiency and need more motor resources to maintain balance.
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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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Benitez-Lugo ML, Suárez-Serrano C, Galvao-Carmona A, Vazquez-Marrufo M, Chamorro-Moriana G. Effectiveness of feedback-based technology on physical and cognitive abilities in the elderly. Front Aging Neurosci 2022; 14:1050518. [PMID: 36438005 PMCID: PMC9686288 DOI: 10.3389/fnagi.2022.1050518] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/25/2022] [Indexed: 08/26/2023] Open
Abstract
Aging raises a social and health challenge because the passing of time causes changes in cognitive and physical functions that impair functionality and quality of life. In addition, advancements in technology and information technology have led to the development of new techniques for retraining based on the feedback technology provides. To solve the negative consequences of aging, a randomized clinical trial was carried out to assess the effectiveness of a protocol using feedback-based technology to improve physical and cognitive functions in older adults. For the purpose of this study, 200 patients were selected from a Social and Community Services Center in the province of Seville and only 46 of them became participants of the study (after applying the inclusion criteria). These patients were divided into two groups: control and experimental. Physical and cognitive abilities were assessed using the Miniexamen cognoscitivo Test (an adaptation of the MiniMental examination test), Yesevage's Depression Scale, Oddball Test, Attention Network Test, Berg Scale, Tinetti Scale, and Timed Up and Go Test. The intervention applied to the experimental group consisted of a supervised protocol using the Nintendo® Wii video game console and the Wii-Fit© video game during 16 sessions, 2 times a week with a duration of 30 min per session. The control group did not receive any treatment. The experimental group showed statistically significant improvements in all the physical variables (balance, gait, autonomy, and fall risk), as other authors had proven, and in memory and reaction times; there were no improvements in attention networks. The control group (placebo) even showed a decrease in their functions, with worse results on the Timed up and Go test Scale. The intervention using feedback-based technology has been proven effective in improving physical and cognitive abilities and in preventing and promoting healthy aging.
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Correno MB, Hansen C, Chardon M, Milane T, Bianchini E, Vuillerme N. Association between Backward Walking and Cognition in Parkinson Disease: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12810. [PMID: 36232110 PMCID: PMC9566137 DOI: 10.3390/ijerph191912810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
Backward walking often occurs in everyday life. It is more complex than forward walking and is associated with decreased coordination. However, it is unclear if a reduced backward walking performance is associated with impaired cognition. This could be particularly relevant as gait and cognitive deficits commonly occur in Parkinson's disease. The objective of this systematic review was to synthesize the evidence on the association between backward walking and cognition in persons with Parkinson's disease. The electronic databases PubMed and Web of Science were systematically searched, and the quality of eligible studies was assessed. Two studies met the inclusion criteria, but study protocols, investigated population, and outcome measures differed substantially. One study showed lower backward walking speed in patients with Parkinson's disease with poorer attention test performances. The second study showed a weak correlation between executive cognitive functions and backward walking speed. Given the low number of studies, the heterogenous study design, and the inconsistent results, the present review highlights the need to further investigate the association between backward walking and cognition in patients with Parkinson's disease.
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Affiliation(s)
- Mathias Baptiste Correno
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France
- Department of Neurology, Kiel University, UKSH Campus Kiel, Arnold-Heller-Str. 3, Haus D, 24105 Kiel, Germany
| | - Clint Hansen
- Department of Neurology, Kiel University, UKSH Campus Kiel, Arnold-Heller-Str. 3, Haus D, 24105 Kiel, Germany
| | | | - Tracy Milane
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France
- Department of Neurology, Kiel University, UKSH Campus Kiel, Arnold-Heller-Str. 3, Haus D, 24105 Kiel, Germany
| | - Edoardo Bianchini
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00185 Rome, Italy
| | - Nicolas Vuillerme
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France
- LabCom Telecom4Health, Orange Labs & Université Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, 38000 Grenoble, France
- Institut Universitaire de France, 75005 Paris, France
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Bianchini E, Warmerdam E, Romijnders R, Hansen C, Pontieri FE, Maetzler W. Cognitive dual-task cost depends on the complexity of the cognitive task, but not on age and disease. Front Neurol 2022; 13:964207. [PMID: 36313514 PMCID: PMC9615561 DOI: 10.3389/fneur.2022.964207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Dual-tasking (DT) while walking is common in daily life and can affect both gait and cognitive performance depending on age, attention prioritization, task complexity and medical condition. The aim of the present study was to investigate the effects of DT on cognitive DT cost (DTC) (i) in a dataset including participants of different age groups, with different neurological disorders and chronic low-back pain (cLBP) (ii) at different levels of cognitive task complexity, and (iii) in the context of a setting relevant to daily life, such as combined straight walking and turning. Materials and methods Ninety-one participants including healthy younger and older participants and patients with Parkinson's disease, Multiple Sclerosis, Stroke and cLBP performed a simple reaction time (SRT) task and three numerical Stroop tasks under the conditions congruent (StC), neutral (StN) and incongruent (StI). The tasks were performed both standing (single task, ST) and walking (DT), and DTC was calculated. Mixed ANOVAs were used to determine the effect of group and task complexity on cognitive DTC. Results A longer response time in DT than in ST was observed during SRT. However, the response time was shorter in DT during StI. DTC decreased with increasing complexity of the cognitive task. There was no significant effect of age and group on cognitive DTC. Conclusion Our results suggest that regardless of age and disease group, simple cognitive tasks show the largest and most stable cognitive effects during DT. This may be relevant to the design of future observational studies, clinical trials and for clinical routine.
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Affiliation(s)
- Edoardo Bianchini
- Department of Neurology, Kiel University, Kiel, Germany
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Elke Warmerdam
- Department of Neurology, Kiel University, Kiel, Germany
- Division of Surgery, Saarland University, Homburg, Germany
| | - Robbin Romijnders
- Department of Neurology, Kiel University, Kiel, Germany
- Faculty of Engineering, Kiel University, Kiel, Germany
| | - Clint Hansen
- Department of Neurology, Kiel University, Kiel, Germany
| | - Francesco E. Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Santa Lucia Foundation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Walter Maetzler
- Department of Neurology, Kiel University, Kiel, Germany
- *Correspondence: Walter Maetzler
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Lin CC, Bair WN, Willson J. Age differences in brain activity in dorsolateral prefrontal cortex and supplementary motor areas during three different walking speed tasks. Hum Mov Sci 2022; 85:102982. [DOI: 10.1016/j.humov.2022.102982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022]
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Payne AM, McKay JL, Ting LH. The cortical N1 response to balance perturbation is associated with balance and cognitive function in different ways between older adults with and without Parkinson's disease. Cereb Cortex Commun 2022; 3:tgac030. [PMID: 36043162 PMCID: PMC9415190 DOI: 10.1093/texcom/tgac030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 12/02/2022] Open
Abstract
Mechanisms underlying associations between balance and cognitive impairments in older adults with and without Parkinson's disease are poorly understood. Balance disturbances evoke a cortical N1 response that is associated with both balance and cognitive abilities in unimpaired populations. We hypothesized that the N1 response reflects neural mechanisms that are shared between balance and cognitive function, and would therefore be associated with both balance and cognitive impairments in Parkinson's disease. Although N1 responses did not differ at the group level, they showed different associations with balance and cognitive function in the Parkinson's disease vs. control groups. In the control group, higher N1 amplitudes were correlated with lower cognitive set shifting ability and lower balance confidence. However, in Parkinson's disease, narrower N1 widths (i.e., shorter durations) were associated with greater parkinsonian motor symptom severity, lower balance ability and confidence, lower mobility, and lower overall cognitive function. Despite different relationships across populations, the present results suggest the N1 response reflects neural processes related to both balance and cognitive function. A better understanding of neural mechanisms linking balance and cognitive function could provide insight into associations between balance and cognitive decline in aging populations.
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Affiliation(s)
- Aiden M Payne
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, GA 30332, USA
| | - J Lucas McKay
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA 30322, USA,Jean & Paul Amos Parkinson’s Disease & Movement Disorders Program, Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Lena H Ting
- Corresponding author: Lena H. Ting, Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, 1441 Clifton Rd, Rm R225, Atlanta, GA 30322, USA.
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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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Broscheid KC, Behrens M, Dettmers C, Jöbges M, Schega L. Effects of a 6-Min Treadmill Walking Test on Dual-Task Gait Performance and Prefrontal Hemodynamics in People With Multiple Sclerosis. Front Neurol 2022; 13:822952. [PMID: 35463151 PMCID: PMC9022001 DOI: 10.3389/fneur.2022.822952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/14/2022] [Indexed: 11/30/2022] Open
Abstract
Fatigue is one of the most limiting symptoms in people with multiple sclerosis (pwMS) and can be subdivided into trait and state fatigue. Activity-induced state fatigue describes the temporary decline in motor and/or cognitive performance (motor and cognitive performance fatigability, respectively) and/or the increase in the perception of fatigue (perceived fatigability) in response to motor or cognitive tasks. To the best of our knowledge, the effects of a 6-min walk test (6MWT), which was often used to assess motor performance fatigability in pwMS, on motor-cognitive dual-task performance (i.e., walking + arithmetic task) and prefrontal cortex (PFC) hemodynamics are not well-known. This is of importance, since daily activities are often performed as multitasks and a worse dual-task walking performance is associated with an increased risk of falling. Consequently, we investigated the effect of a fast 6MWT (comfort velocity + 15%) performed on a treadmill on motor-cognitive performance fatigability (spatio-temporal gait parameters/accuracy during the arithmetic task) and perceived fatigability measures (rating of perceived exhaustion; RPE) as well as PFC hemodynamics recorded during dual-task walking in pwMS and healthy controls (HCs). Twenty pwMS (48.3 ± 9.0 years; 13 females/7 males; expanded disability status scale 2.7 ± 1.0, first diagnosis 13.8 ± 8.8 years) and 24 HC with similar age and sex (48.6 ± 7.9 years; 17 females/7 males) were included. Only cognitive performance fatigability (increased error rate) during dual-task walking was found after the fast 6MWT on the treadmill in pwMS. However, the changes in gait parameters did not indicate motor performance fatigability, although both the groups reported perceived fatigability (increased RPE) after the fast 6MWT. Moreover, no change in the PFC activation was detected in both groups. Our results suggest that the intensity and/or duration of the fast 6MWT was not sufficient to induce motor performance fatigability in pwMS. These factors should be addressed by future studies on this topic, which should also consider further parameters, e.g., muscular oxygenation and/or myoelectrical activity, to verify that exercise intensity and/or duration was appropriate to induce motor performance fatigability in pwMS.
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Affiliation(s)
- Kim-Charline Broscheid
- Department of Sport Science, Chair of Health and Physical Activity, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
- *Correspondence: Kim-Charline Broscheid
| | - Martin Behrens
- Department of Sport Science, Chair of Health and Physical Activity, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | | | | | - Lutz Schega
- Department of Sport Science, Chair of Health and Physical Activity, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Gait Impairment in Traumatic Brain Injury: A Systematic Review. SENSORS 2022; 22:s22041480. [PMID: 35214382 PMCID: PMC8875145 DOI: 10.3390/s22041480] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/24/2022] [Accepted: 02/10/2022] [Indexed: 02/06/2023]
Abstract
Introduction: Gait impairment occurs across the spectrum of traumatic brain injury (TBI); from mild (mTBI) to moderate (modTBI), to severe (sevTBI). Recent evidence suggests that objective gait assessment may be a surrogate marker for neurological impairment such as TBI. However, the most optimal method of objective gait assessment is still not well understood due to previous reliance on subjective assessment approaches. The purpose of this review was to examine objective assessment of gait impairments across the spectrum of TBI. Methods: PubMed, AMED, OVID and CINAHL databases were searched with a search strategy containing key search terms for TBI and gait. Original research articles reporting gait outcomes in adults with TBI (mTBI, modTBI, sevTBI) were included. Results: 156 citations were identified from the search, of these, 13 studies met the initial criteria and were included into the review. The findings from the reviewed studies suggest that gait is impaired in mTBI, modTBI and sevTBI (in acute and chronic stages), but methodological limitations were evident within all studies. Inertial measurement units were most used to assess gait, with single-task, dual-task and obstacle crossing conditions used. No studies examined gait across the full spectrum of TBI and all studies differed in their gait assessment protocols. Recommendations for future studies are provided. Conclusion: Gait was found to be impaired in TBI within the reviewed studies regardless of severity level (mTBI, modTBI, sevTBI), but methodological limitations of studies (transparency and reproducibility) limit clinical application. Further research is required to establish a standardised gait assessment procedure to fully determine gait impairment across the spectrum of TBI with comprehensive outcomes and consistent protocols.
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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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Hoang I, Paire-Ficout L, Derollepot R, Perrey S, Devos H, Ranchet M. Increased prefrontal activity during usual walking in aging. Int J Psychophysiol 2022; 174:9-16. [DOI: 10.1016/j.ijpsycho.2022.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 10/10/2021] [Accepted: 01/24/2022] [Indexed: 10/19/2022]
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Kotegawa K, Teramoto W. Association of executive function capacity with gait motor imagery ability and PFC activity: An fNIRS study. Neurosci Lett 2022; 766:136350. [PMID: 34785311 DOI: 10.1016/j.neulet.2021.136350] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 11/25/2022]
Abstract
Individual differences exist in gait motor imagery ability. However, little is known about the underlying neural mechanisms. We previously conducted a study using functional near-infrared spectroscopy (fNIRS), which showed that participants who overestimated mental walking times to a greater degree exhibited greater activation in the right prefrontal cortex (PFC). The PFC is implicated in executive functions (EFs), including working memory (WM). Thus, this study investigated whether individual differences in EF capacity are associated with gait motor imagery ability and PFC activity. Thirty volunteers participated (mean age: 21.7 ± 1.8 years) in the study. Their EF capacity was assessed by the Trail Making Test - Part B (TMT-B). We measured the accuracy of gait motor imagery and PFC activity during mental walking using fNIRS, while changing task difficulty by varying the path width. The results showed that the overestimation of mental walking time over actual walking time and right PFC activity increased with an increase in the TMT-B times. These results suggest that the EF capacity, including WM, is strongly associated with gait motor imagery ability and right PFC activity. The brain network that includes the right PFC may play an important role in the maintenance and manipulation of gait motor imagery.
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Affiliation(s)
- Kohei Kotegawa
- Department of Rehabilitation, Faculty of Health Science, Kumamoto Health Science University, 325, Izumi, Kumamoto 861-5598, Japan; Graduate School of Social and Cultural Sciences, Kumamoto University, 2-40-1 Kurokami, Kumamoto 860-8555, Japan.
| | - Wataru Teramoto
- Graduate School of Humanities and Social Sciences, Kumamoto University, 2-40-1 Kurokami, Kumamoto 860-8555, Japan.
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Prefrontal Cortex Brain Activation During Texting and Walking: A Functional Near-Infrared Spectroscopy Feasibility Study. Motor Control 2022; 26:487-496. [DOI: 10.1123/mc.2022-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/20/2022] [Accepted: 04/09/2022] [Indexed: 11/18/2022]
Abstract
Texting while walking is an increasingly common, potentially dangerous task but its functional brain correlates have yet to be reported. Therefore, we evaluated prefrontal cortex (PFC) activation patterns during single- and dual-task texting and walking in healthy adults. Thirteen participants (29–49 years) walked under single- and dual-task conditions involving mobile phone texting or a serial-7s subtraction task, while measuring PFC activation (functional near-infrared spectroscopy) and behavioral task performance (inertial sensors, mobile application). Head lowering during texting increased PFC activation. Texting further increased PFC activation, and decreased gait performance similarly to serial-7 subtraction. Our results support the key role of executive control in texting while walking.
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Liao YY, Liu MN, Wang HC, Walsh V, Lau CI. Combining Transcranial Direct Current Stimulation With Tai Chi to Improve Dual-Task Gait Performance in Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial. Front Aging Neurosci 2021; 13:766649. [PMID: 34966268 PMCID: PMC8710779 DOI: 10.3389/fnagi.2021.766649] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/22/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Engaging in a secondary task while walking increases motor-cognitive interference and exacerbates fall risk in older adults with mild cognitive impairment (MCI). Previous studies have demonstrated that Tai Chi (TC) may improve cognitive function and dual-task gait performance. Intriguingly, with emerging studies also indicating the potential of transcranial direct current stimulation (tDCS) in enhancing such motor-cognitive performance, whether combining tDCS with TC might be superior to TC alone is still unclear. The purpose of this study was to investigate the effects of combining tDCS with TC on dual-task gait in patients with MCI. Materials and Methods: Twenty patients with MCI were randomly assigned to receive either anodal or sham tDCS, both combined with TC, for 36 sessions over 12 weeks. Subjects received 40 min of TC training in each session. During the first 20 min, they simultaneously received either anodal or sham tDCS over the left dorsolateral prefrontal cortex. Outcome measures included dual-task gait performance and other cognitive functions. Results: There were significant interaction effects between groups on the cognitive dual task walking. Compared to sham, the anodal tDCS group demonstrated a greater improvement on cadence and dual task cost of speed. Conclusion: Combining tDCS with TC may offer additional benefits over TC alone in enhancing dual-task gait performance in patients with MCI. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [TCTR20201201007].
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Affiliation(s)
- Ying-Yi Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Mu-N Liu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Han-Cheng Wang
- Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Vincent Walsh
- Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Chi Ieong Lau
- Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, United Kingdom.,Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan.,College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.,Department of Neurology, University Hospital, Taipai, Macao SAR, China
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Orcioli-Silva D, Islam A, Baker MR, Gobbi LTB, Rochester L, Pantall A. Bi-Anodal Transcranial Direct Current Stimulation Combined With Treadmill Walking Decreases Motor Cortical Activity in Young and Older Adults. Front Aging Neurosci 2021; 13:739998. [PMID: 34924993 PMCID: PMC8681021 DOI: 10.3389/fnagi.2021.739998] [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: 07/12/2021] [Accepted: 11/01/2021] [Indexed: 01/05/2023] Open
Abstract
Background: Walking in the "real world" involves motor and cognitive processes. In relation to this, declines in both motor function and cognition contribute to age-related gait dysfunction. Transcranial direct current stimulation (tDCS) and treadmill walking (STW) have potential to improve gait, particularly during dual-task walking (DTW); walking whilst performing a cognitive task. Our aims were to analyze effects of combined anodal tDCS + STW intervention on cortical activity and gait during DTW. Methods: Twenty-three young adults (YA) and 21 older adults (OA) were randomly allocated to active or sham tDCS stimulation groups. Participants performed 5-min of mixed treadmill walking (alternating 30 s bouts of STW and DTW) before and after a 20-min intervention of active or sham tDCS + STW. Anodal electrodes were placed over the left prefrontal cortex (PFC) and the vertex (Cz) using 9 cm2 electrodes at 0.6 mA. Cortical activity of the PFC, primary motor cortex (M1), premotor cortex (PMC), and supplementary motor area (SMA) bilaterally were recorded using a functional near-infrared spectroscopy (fNIRS) system. Oxygenated hemoglobin (HbO2) levels were analyzed as indicators of cortical activity. An accelerometer measured gait parameters. We calculated the difference between DTW and STW for HbO2 and gait parameters. We applied linear mixed effects models which included age group (YA vs. OA), stimulation condition (sham vs. active), and time (pre- vs. post-intervention) as fixed effects. Treadmill belt speed was a covariate. Partial correlation tests were also performed. Results: A main effect of age group was observed. OA displayed higher activity bilaterally in the PFC and M1, unilaterally in the right PMC and higher gait variability than YA. M1 activity decreased in both YA and OA following active tDCS + STW. There was no overall effect of tDCS + STW on PFC activity or gait parameters. However, negative correlations were observed between changes in left PFC and stride length variability following active tDCS + STW intervention. Conclusion: Increased activity in multiple cortical areas during DTW in OA may act as a compensatory mechanism. Reduction in M1 activity following active tDCS + STW with no observed gait changes suggests improved neural efficiency.
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Affiliation(s)
- Diego Orcioli-Silva
- Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, Brazil.,Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Aisha Islam
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mark R Baker
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Lilian Teresa Bucken Gobbi
- Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, Brazil.,Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Lynn Rochester
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Annette Pantall
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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43
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Payne AM, Palmer JA, McKay JL, Ting LH. Lower Cognitive Set Shifting Ability Is Associated With Stiffer Balance Recovery Behavior and Larger Perturbation-Evoked Cortical Responses in Older Adults. Front Aging Neurosci 2021; 13:742243. [PMID: 34938171 PMCID: PMC8685437 DOI: 10.3389/fnagi.2021.742243] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/16/2021] [Indexed: 11/25/2022] Open
Abstract
The mechanisms underlying associations between cognitive set shifting impairments and balance dysfunction are unclear. Cognitive set shifting refers to the ability to flexibly adjust behavior to changes in task rules or contexts, which could be involved in flexibly adjusting balance recovery behavior to different contexts, such as the direction the body is falling. Prior studies found associations between cognitive set shifting impairments and severe balance dysfunction in populations experiencing frequent falls. The objective of this study was to test whether cognitive set shifting ability is expressed in successful balance recovery behavior in older adults with high clinical balance ability (N = 19, 71 ± 7 years, 6 female). We measured cognitive set shifting ability using the Trail Making Test and clinical balance ability using the miniBESTest. For most participants, cognitive set shifting performance (Trail Making Test B-A = 37 ± 20 s) was faster than normative averages (46 s for comparable age and education levels), and balance ability scores (miniBESTest = 25 ± 2/28) were above the threshold for fall risk (23 for people between 70 and 80 years). Reactive balance recovery in response to support-surface translations in anterior and posterior directions was assessed in terms of body motion, muscle activity, and brain activity. Across participants, lower cognitive set shifting ability was associated with smaller peak center of mass displacement during balance recovery, lower directional specificity of late phase balance-correcting muscle activity (i.e., greater antagonist muscle activity 200-300 ms after perturbation onset), and larger cortical N1 responses (100-200 ms). None of these measures were associated with clinical balance ability. Our results suggest that cognitive set shifting ability is expressed in balance recovery behavior even in the absence of profound clinical balance disability. Specifically, our results suggest that lower flexibility in cognitive task performance is associated with lower ability to incorporate the directional context into the cortically mediated later phase of the motor response. The resulting antagonist activity and stiffer balance behavior may help explain associations between cognitive set shifting impairments and frequent falls.
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Affiliation(s)
- Aiden M. Payne
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, GA, United States
| | - Jacqueline A. Palmer
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - J. Lucas McKay
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, United States,Jean and Paul Amos PD and Movement Disorders Program, Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
| | - Lena H. Ting
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, GA, United States,Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States,*Correspondence: Lena H. Ting,
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44
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Vuong V, Patterson KK, Cole LP, Henechowicz TL, Sheridan C, Green REA, Thaut MH. Relationship Between Cognition and Gait at 2- and 12-Months Post-Traumatic Brain Injury. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:726452. [PMID: 36188837 PMCID: PMC9397897 DOI: 10.3389/fresc.2021.726452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022]
Abstract
Background: A common and debilitating challenge experienced by people with TBI is gait-associated mobility impairment and persisting cognitive impairments. Cognitive and physical impairments are often addressed independently during rehabilitation, however, increasing evidence links cognitive and motor processes more closely.Objectives: (1) To determine if correlations exist between measures of cognitive and gait recovery, post-TBI. (2) To investigate the predictive power of cognition at 2-months on gait outcomes at 12-months post-TBI.Methods: In this secondary, longitudinal study of cognitive and neural recovery, data from 93 participants admitted to an inpatient neurorehabilitation program were analyzed. Spatiotemporal gait variables [velocity, step time variability (STV), step length variability (SLV)] were collected along with cognitive variables [Trail Making Test-B (TMT-B), Digit Span-Forward (DS-F)]. Spearman's correlation coefficients were calculated between gait and cognitive variables. Multilinear and step wise regression analyses were calculated to determine predictive value of cognitive variables at 2-months on gait performance at 12-months-post TBI.Results: At 2-months post-injury, TMT-B was significantly correlated with gait velocity and STV; and DS-F was significantly correlated with velocity. At 12-months post-injury, TMT-B and DS-F was still significant correlated with velocity. TMT-B at 2-months was correlated with SLV and STV at 12-months; and DS-F correlated significantly with velocity. Regression models showed TMT-B at 2-months predicting STV, SLV, and velocity at 12-months.Conclusions: Significant associations and predictions between physical and cognitive recovery post-TBI were observed in this study. Future directions may consider a “neural internetwork” model as a salient rehabilitation approach in TBI that integrates physical and cognitive functions.
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Affiliation(s)
- Veronica Vuong
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- *Correspondence: Veronica Vuong
| | - Kara K. Patterson
- Knowledge, Innovation, Talent, Everywhere (KITE) Research Institute, University Health Network, Toronto, ON, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lauren Patricia Cole
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Tara Lynn Henechowicz
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Conor Sheridan
- Knowledge, Innovation, Talent, Everywhere (KITE) Research Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Robin E. A. Green
- Knowledge, Innovation, Talent, Everywhere (KITE) Research Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michael H. Thaut
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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45
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Heaw YC, Singh DKA, Tan MP, Kumar S. Bidirectional association between executive and physical functions among older adults: A systematic review. Australas J Ageing 2021; 41:20-41. [PMID: 34724301 DOI: 10.1111/ajag.13008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 09/15/2021] [Accepted: 09/26/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We aimed to examine the bidirectional associations between specific executive function (EF) and physical function (PF) subdomains among older adults. METHODS A systematic literature search (MEDLINE, EMBASE, PsycINFO, EBSCOHOST, Scopus and EmCare) was undertaken from February 2018 to May 2020. Observational studies measuring associations between EF and PF subdomains among older adults were included. RESULTS Twenty-nine studies met the inclusion criteria. Twenty-seven studies reported associations between EF and PF. There were bidirectional associations between slower processing speed and slower gait speed; slower processing speed and lower muscle strength; and lower verbal fluency and slower gait speed. Lower muscle strength was unilaterally associated with lower working memory. CONCLUSIONS We found consistent bidirectional associations between processing speed with gait speed and muscle strength, and verbal fluency and gait speed. There was a unidirectional association between muscle strength and working memory. Common causal mechanisms for EF and PF require further studies.
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Affiliation(s)
- Yu Chi Heaw
- Physiotherapy Programme and Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Physiotherapy Programme, Faculty of Health and Life Sciences, INTI International University, Nilai, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme and Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Saravana Kumar
- Allied Health and Human Performance Unit, City East Campus, University of South Australia, Adelaide, South Australia, Australia
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46
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Belli VD, Orcioli-Silva D, Beretta VS, Vitório R, Zampier VC, Nóbrega-Sousa P, Conceição NRD, Gobbi LTB. Prefrontal Cortical Activity During Preferred and Fast Walking in Young and Older Adults: An fNIRS Study. Neuroscience 2021; 473:81-89. [PMID: 34455013 DOI: 10.1016/j.neuroscience.2021.08.019] [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] [Received: 12/04/2020] [Revised: 08/10/2021] [Accepted: 08/19/2021] [Indexed: 12/11/2022]
Abstract
Age-related changes may affect the performance during fast walking speed. Although, several studies have been focused on the contribution of the prefrontal cortex (PFC) during challenging walking tasks, the neural mechanism underling fast walking speed in older people remain poorly understood. Therefore, the aim of this study was to investigate the influence of aging on PFC activity during overground walking at preferred and fast speeds. Twenty-five older adults (67.37 ± 5.31 years) and 24 young adults (22.70 ± 1.30 years) walked overground in two conditions: preferred speed and fast walking speed. Five trials were performed for each condition. A wireless functional near-infrared spectroscopy (fNIRS) system measured PFC activity. Gait parameters were evaluated using the GAITRite system. Overall, older adults presented higher PFC activity than young adults in both conditions. Speed-related change in PFC activity was observed for older adults, but not for young adults. Older adults significantly increased activity in the left PFC from the preferred to fast walking condition whereas young adults had similar levels of PFC activity across conditions. Our findings suggest that older adults need to recruit additional prefrontal cognitive resources to control walking, indicating a compensatory mechanism. In addition, left PFC seems to be involved in the modulation of gait speed in older adults.
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Affiliation(s)
- Vinicius de Belli
- São Paulo State University (UNESP), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil
| | - Diego Orcioli-Silva
- São Paulo State University (UNESP), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil; Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Victor Spiandor Beretta
- São Paulo State University (UNESP), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil; Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Rodrigo Vitório
- São Paulo State University (UNESP), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil; Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil; Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | - Vinicius Cavassano Zampier
- São Paulo State University (UNESP), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil; Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Priscila Nóbrega-Sousa
- São Paulo State University (UNESP), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil; Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Núbia Ribeiro da Conceição
- São Paulo State University (UNESP), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil; Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Lilian Teresa Bucken Gobbi
- São Paulo State University (UNESP), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil; Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil.
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47
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Ibitoye RT, Castro P, Desowska A, Cooke J, Edwards AE, Guven O, Arshad Q, Murdin L, Kaski D, Bronstein AM. Small vessel disease disrupts EEG postural brain networks in 'unexplained dizziness in the elderly'. Clin Neurophysiol 2021; 132:2751-2762. [PMID: 34583117 PMCID: PMC8559782 DOI: 10.1016/j.clinph.2021.07.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/15/2021] [Accepted: 07/25/2021] [Indexed: 11/28/2022]
Abstract
Unexplained dizziness in the elderly may result from
cerebral small vessel disease. Dizzy elderly patients differed from controls in EEG
power when standing. EEG power when standing correlated with subjective
(perceived) instability.
Objective To examine the hypothesis that small vessel disease
disrupts postural networks in older adults with unexplained dizziness in the
elderly (UDE). Methods Simultaneous electroencephalography and postural sway
measurements were undertaken in upright, eyes closed standing, and sitting
postures (as baseline) in 19 younger adults, 33 older controls and 36 older
patients with UDE. Older adults underwent magnetic resonance imaging to
determine whole brain white matter hyperintensity volumes, a measure of small
vessel disease. Linear regression was used to estimate the effect of instability
on electroencephalographic power and connectivity. Results Ageing increased theta and alpha desynchronisation on
standing. In older controls, delta and gamma power increased, and theta and
alpha power reduced with instability. Dizzy older patients had higher white
matter hyperintensity volumes and more theta desynchronisation during periods of
instability. White matter hyperintensity volume and delta power during periods
of instability were correlated, positively in controls but negatively in dizzy
older patients. Delta power correlated with subjective dizziness and
instability. Conclusions Neural resource demands of postural control increase
with age, particularly in patients with UDE, driven by small vessel
disease. Significance EEG correlates of postural control saturate in older
adults with UDE, offering a neuro-physiological basis to this common
syndrome.
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Affiliation(s)
- R T Ibitoye
- Neuro-otology Unit, Imperial College London, London, UK; The Computational, Cognitive and Clinical Neuroimaging Laboratory (C3NL), Imperial College London, London, UK
| | - P Castro
- Neuro-otology Unit, Imperial College London, London, UK
| | - A Desowska
- The Computational, Cognitive and Clinical Neuroimaging Laboratory (C3NL), Imperial College London, London, UK
| | - J Cooke
- Neuro-otology Unit, Imperial College London, London, UK
| | - A E Edwards
- Neuro-otology Unit, Imperial College London, London, UK
| | - O Guven
- Neuro-otology Unit, Imperial College London, London, UK
| | - Q Arshad
- Neuro-otology Unit, Imperial College London, London, UK; inAmind Laboratory, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - L Murdin
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - D Kaski
- Neuro-otology Unit, Imperial College London, London, UK; Department of Clinical and Movement Neurosciences, University College London, London, UK
| | - A M Bronstein
- Neuro-otology Unit, Imperial College London, London, UK.
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48
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Goh HT, Pearce M, Vas A. Task matters: an investigation on the effect of different secondary tasks on dual-task gait in older adults. BMC Geriatr 2021; 21:510. [PMID: 34563129 PMCID: PMC8465774 DOI: 10.1186/s12877-021-02464-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/29/2021] [Indexed: 11/12/2022] Open
Abstract
Background Dual-task gait performance declines as humans age, leading to increased fall risk among older adults. It is unclear whether different secondary cognitive tasks mediate age-related decline in dual-task gait. This study aimed to examine how type and difficulty level of the secondary cognitive tasks differentially affect dual-task gait in older adults. Methods Twenty young and twenty older adults participated in this single-session study. We employed four different types of secondary tasks and each consisted of two difficulty levels, yielding eight different dual-task conditions. The dual-task conditions included walking and 1) counting backward by 3 s or by 7 s; 2) remembering a 5-item or 7-item lists; 3) responding to a simple or choice reaction time tasks; 4) generating words from single or alternated categories. Gait speed and cognitive task performance under single- and dual-task conditions were used to compute dual-task cost (DTC, %) with a greater DTC indicating a worse performance. Results A significant three-way interaction was found for the gait speed DTC (p = .04). Increased difficulty in the reaction time task significantly increased gait speed DTC for older adults (p = .01) but not for young adults (p = .90). In contrast, increased difficulty level in the counting backward task significantly increased gait speed DTC for young adults (p = .03) but not for older adults (p = .85). Both groups responded similarly to the increased task difficulty in the other two tasks. Conclusions Older adults demonstrated a different response to dual-task challenges than young adults. Aging might have different impacts on various cognitive domains and result in distinctive dual-task gait interference patterns.
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Affiliation(s)
- Hui-Ting Goh
- School of Physical Therapy-Dallas, Texas Woman's University, Dallas, TX, USA.
| | - Miranda Pearce
- School of Physical Therapy-Dallas, Texas Woman's University, Dallas, TX, USA
| | - Asha Vas
- School of Occupational Therapy-Dallas, Texas Woman's University, Dallas, TX, USA
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49
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PARK JINHYUCK. CAN COGNITIVE TRAINING USING A TABLET COMPUTER ENHANCE COGNITIVE FUNCTION OF HEALTHY OLDER ADULTS? AN ALTERNATING-TREATMENT DESIGN. J MECH MED BIOL 2021. [DOI: 10.1142/s0219519421400443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Even though a variety of cognitive interventions have been conducted to ameliorate age-related cognitive declines, the effects of cognitive intervention using activities in everyday life are still unknown. The purpose of this study was to compare the effects between tablet computer-based productive and receptive cognitive engagement using an alternating-treatment design. Three healthy older adults performed a total of 19 sessions consisting of three baseline periods and 16 alternating training sessions. The training sessions were divided into four blocks and each block involved four treatment sessions. Productive and receptive engagements were randomly allocated to four treatment sessions. All participants alternatively received productive engagement that requires learning new practical applications and receptive engagement requiring little new learning such as listening to music. Prefrontal cortex (PFC) activity using functional near-infrared spectroscopy and executive function through the Trail Making Test were assessed at the baseline and the end of each session. All data were visually analyzed. Visual analysis results showed that the productive engagement was associated with higher PFC activity and faster performance in the Trail Making Test, compared to those utilizing receptive engagement. These results suggest that productive engagement might be effective in facilitating PFC activity and improving the executive function of healthy older adults, indicating cognitively challenging activities are more beneficial relative to nonchallenging activities.
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Affiliation(s)
- JIN-HYUCK PARK
- College of Medical Science, Soonchunhyang University, Soonchunhyang-ro 22-20, Republic of Korea
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50
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Zhou J, Manor B, Yu W, Lo OY, Gouskova N, Salvador R, Katz R, Cornejo Thumm P, Brozgol M, Ruffini G, Pascual-Leone A, Lipsitz LA, Hausdorff JM. Targeted tDCS Mitigates Dual-Task Costs to Gait and Balance in Older Adults. Ann Neurol 2021; 90:428-439. [PMID: 34216034 DOI: 10.1002/ana.26156] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Among older adults, the ability to stand or walk while performing cognitive tasks (ie, dual-tasking) requires coordinated activation of several brain networks. In this multicenter, double-blinded, randomized, and sham-controlled study, we examined the effects of modulating the excitability of the left dorsolateral prefrontal cortex (L-DLPFC) and the primary sensorimotor cortex (SM1) on dual-task performance "costs" to standing and walking. METHODS Fifty-seven older adults without overt illness or disease completed 4 separate study visits during which they received 20 minutes of transcranial direct current stimulation (tDCS) optimized to facilitate the excitability of the L-DLPFC and SM1 simultaneously, or each region separately, or neither region (sham). Before and immediately after stimulation, participants completed a dual-task paradigm in which they were asked to stand and walk with and without concurrent performance of a serial-subtraction task. RESULTS tDCS simultaneously targeting the L-DLPFC and SM1, as well as tDCS targeting the L-DLPFC alone, mitigated dual-task costs to standing and walking to a greater extent than tDCS targeting SM1 alone or sham (p < 0.02). Blinding efficacy was excellent and participant subjective belief in the type of stimulation received (real or sham) did not contribute to the observed functional benefits of tDCS. INTERPRETATION These results demonstrate that in older adults, dual-task decrements may be amenable to change and implicate L-DPFC excitability as a modifiable component of the control system that enables dual-task standing and walking. tDCS may be used to improve resilience and the ability of older results to walk and stand under challenging conditions, potentially enhancing everyday functioning and reducing fall risks. ANN NEUROL 2021.
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Affiliation(s)
- Junhong Zhou
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA.,Beth Israel Deaconess Medical Center, Boston, MA.,Harvard Medical School, Boston, MA
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA.,Beth Israel Deaconess Medical Center, Boston, MA.,Harvard Medical School, Boston, MA
| | - Wanting Yu
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA
| | - On-Yee Lo
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA.,Beth Israel Deaconess Medical Center, Boston, MA.,Harvard Medical School, Boston, MA
| | - Natalia Gouskova
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA
| | | | | | - Pablo Cornejo Thumm
- Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Marina Brozgol
- Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA.,Harvard Medical School, Boston, MA.,Guttman Brain Health Institute, Institut Guttmann de Neurorehabilitació, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Lewis A Lipsitz
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA.,Beth Israel Deaconess Medical Center, Boston, MA.,Harvard Medical School, Boston, MA
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sagol School of Neuroscience and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Rush Alzheimer's Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
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