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Richer N, Bradford JC, Ferris DP. Mobile neuroimaging: What we have learned about the neural control of human walking, with an emphasis on EEG-based research. Neurosci Biobehav Rev 2024; 162:105718. [PMID: 38744350 DOI: 10.1016/j.neubiorev.2024.105718] [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: 10/30/2023] [Revised: 04/18/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
Our understanding of the neural control of human walking has changed significantly over the last twenty years and mobile brain imaging methods have contributed substantially to current knowledge. High-density electroencephalography (EEG) has the advantages of being lightweight and mobile while providing temporal resolution of brain changes within a gait cycle. Advances in EEG hardware and processing methods have led to a proliferation of research on the neural control of locomotion in neurologically intact adults. We provide a narrative review of the advantages and disadvantages of different mobile brain imaging methods, then summarize findings from mobile EEG studies quantifying electrocortical activity during human walking. Contrary to historical views on the neural control of locomotion, recent studies highlight the widespread involvement of many areas, such as the anterior cingulate, posterior parietal, prefrontal, premotor, sensorimotor, supplementary motor, and occipital cortices, that show active fluctuations in electrical power during walking. The electrocortical activity changes with speed, stability, perturbations, and gait adaptation. We end with a discussion on the next steps in mobile EEG research.
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Affiliation(s)
- Natalie Richer
- Department of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, Manitoba, Canada.
| | - J Cortney Bradford
- US Army Combat Capabilities Development Command US Army Research Laboratory, Adelphi, MD, USA
| | - Daniel P Ferris
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
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2
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Kvist A, Bezuidenhout L, Johansson H, Albrecht F, Moulaee Conradsson D, Franzén E. Validation of fNIRS measurement of executive demand during walking with and without dual-task in younger and older adults and people with Parkinson's disease. Neuroimage Clin 2024; 43:103637. [PMID: 38964222 PMCID: PMC11278929 DOI: 10.1016/j.nicl.2024.103637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/28/2024] [Accepted: 06/29/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Walking with a concurrent cognitive task (dual-task walking) can pose a challenge to some populations due to aging or neurodegenerative disease. These tasks require cognitive resources involving the prefrontal cortex and can be studied using functional near-infrared spectroscopy (fNIRS). An important step in understanding fNIRS measures during such walking tasks is validating that measures reflect the demands of the tasks and not confounding sources or movement artifacts. AIM This study aimed to investigate the validity of fNIRS measures of prefrontal cortex activity as an indicator of executive demand during usual walking (single-task) and dual-task walking against clinical and objective measures of motor behavior in young adults, older adults, and people with Parkinson's disease (PD), by evaluating several validation hypotheses. METHODS In total, 133 participants were recruited from younger adults (18-50 years, n = 42), older adults (≥60 years, n = 49) and people with PD (≥60 years, n = 42). Activity in the prefrontal cortex during walking with and without an auditory Stroop task was measured with fNIRS. A combined hemoglobin measure (correlation-based signal improvement, CBSI) was calculated for use in a region of interest analysis in the dorsolateral prefrontal cortex (dlPFC). Pre-registered hypotheses regarding convergent validity, discriminant validity and known group validity were tested. An exploratory analysis of different hemoglobin measures was also performed. RESULTS Increases in dlPFC activity were found from single- to dual-task walking in the younger adults group and from rest to single-task walking in the older adults and PD groups. In line with hypotheses, a positive relationship was found between between dlPFC activity during dual-task walking and dual-task cost in the younger adults group, as well as a positive relationship to step time variability during single-task walking and a negative relationship to walking speed during single-task walking in the PD group. However, several clinical and gait measures lacked a relationship with dlPFC activity. CONCLUSION The fNIRS results point towards the CBSI measure of dlPFC activity being a valid measure of executive demand during both single and dual-task walking. Some relationships between clinical and gait measures and brain activity during walking need further investigation.
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Affiliation(s)
- Alexander Kvist
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
| | - Lucian Bezuidenhout
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa
| | - Hanna Johansson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Stockholm Sjukhem Foundation, Mariebergsgatan 22, 112 19 Stockholm, Sweden
| | - Franziska Albrecht
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - David Moulaee Conradsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Erika Franzén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Stockholm Sjukhem Foundation, Mariebergsgatan 22, 112 19 Stockholm, Sweden
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3
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Zhao YN, Han PP, Zhang XY, Bi X. Applications of Functional Near-Infrared Spectroscopy (fNIRS) Neuroimaging During Rehabilitation Following Stroke: A Review. Med Sci Monit 2024; 30:e943785. [PMID: 38879751 PMCID: PMC11188690 DOI: 10.12659/msm.943785] [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: 01/12/2024] [Accepted: 04/17/2024] [Indexed: 06/22/2024] Open
Abstract
Stroke is a cerebrovascular disease that impairs blood supply to localized brain tissue regions due to various causes. This leads to ischemic and hypoxic lesions, necrosis of the brain tissue, and a variety of functional disorders. Abnormal cortical activation and functional connectivity occur in the brain after a stroke, but the activation patterns and functional reorganization are not well understood. Rehabilitation interventions can enhance functional recovery in stroke patients. However, clinicians require objective measures to support their practice, as outcome measures for functional recovery are based on scale scores. Furthermore, the most effective rehabilitation measures for treating patients are yet to be investigated. Functional near-infrared spectroscopy (fNIRS) is a non-invasive neuroimaging method that detects changes in cerebral hemodynamics during task performance. It is widely used in neurological research and clinical practice due to its safety, portability, high motion tolerance, and low cost. This paper briefly introduces the imaging principle and the advantages and disadvantages of fNIRS to summarize the application of fNIRS in post-stroke rehabilitation.
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Affiliation(s)
- Yi-Ning Zhao
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, PR China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, PR China
| | - Ping-Ping Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, PR China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, PR China
| | - Xing-Yu Zhang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, PR China
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Xia Bi
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, PR China
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Holtzer R, Choi J, Motl RW, Foley FW, Wagshul ME, Hernandez ME, Izzetoglu M. Brain control of dual-task walking can be improved in aging and neurological disease. GeroScience 2024; 46:3169-3184. [PMID: 38221528 PMCID: PMC11009168 DOI: 10.1007/s11357-023-01054-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/22/2023] [Indexed: 01/16/2024] Open
Abstract
The peak prevalence of multiple sclerosis has shifted into older age groups, but co-occurring and possibly synergistic motoric and cognitive declines in this patient population are poorly understood. Dual-task-walking performance, subserved by the prefrontal cortex, and compromised in multiple sclerosis and aging, predicts health outcomes. Whether acute practice can improve dual-task walking performance and prefrontal cortex hemodynamic response efficiency in multiple sclerosis has not been reported. To address this gap in the literature, the current study examined task- and practice-related effects on dual-task-walking and associated brain activation in older adults with multiple sclerosis and controls. Multiple sclerosis (n = 94, mean age = 64.76 ± 4.19 years) and control (n = 104, mean age = 68.18 ± 7.01 years) participants were tested under three experimental conditions (dual-task-walk, single-task-walk, and single-task-alpha) administered over three repeated counterbalanced trials. Functional near-infrared-spectroscopy was used to evaluate task- and practice-related changes in prefrontal cortex oxygenated hemoglobin. Gait and cognitive performances declined, and prefrontal cortex oxygenated hemoglobin was higher in dual compared to both single task conditions in both groups. Gait and cognitive performances improved over trials in both groups. There were greater declines over trials in oxygenated hemoglobin in dual-task-walk compared to single-task-walk in both groups. Among controls, but not multiple sclerosis participants, declines over trials in oxygenated hemoglobin were greater in dual-task-walk compared to single-task-alpha. Dual-task walking and associated prefrontal cortex activation efficiency improved during a single session, but improvement in neural resource utilization, although significant, was attenuated in multiple sclerosis participants. These findings suggest encouraging brain adaptability in aging and neurological disease.
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Affiliation(s)
- Roee Holtzer
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
| | - Jaeun Choi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert W Motl
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois, Chicago, IL, USA
| | - Frederick W Foley
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Multiple Sclerosis Center, Holy Name Medical Center, Teaneck, NJ, USA
| | - Mark E Wagshul
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Manuel E Hernandez
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
- Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Meltem Izzetoglu
- Electrical and Computer Engineering, Villanova University, Villanova, PA, USA
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Wang S, Wang W, Chen J, Yu X. Alterations in brain functional connectivity in patients with mild cognitive impairment: A systematic review and meta-analysis of functional near-infrared spectroscopy studies. Brain Behav 2024; 14:e3414. [PMID: 38616330 PMCID: PMC11016629 DOI: 10.1002/brb3.3414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 04/16/2024] Open
Abstract
Emerging evidences suggest that cognitive deficits in individuals with mild cognitive impairment (MCI) are associated with disruptions in brain functional connectivity (FC). This systematic review and meta-analysis aimed to comprehensively evaluate alterations in FC between MCI individuals and healthy control (HC) using functional near-infrared spectroscopy (fNIRS). Thirteen studies were included in qualitative analysis, with two studies synthesized for quantitative meta-analysis. Overall, MCI patients exhibited reduced resting-state FC, predominantly in the prefrontal, parietal, and occipital cortex. Meta-analysis of two studies revealed a significant reduction in resting-state FC from the right prefrontal to right occipital cortex (standardized mean difference [SMD] = -.56; p < .001), left prefrontal to left occipital cortex (SMD = -.68; p < .001), and right prefrontal to left occipital cortex (SMD = -.53; p < .001) in MCI patients compared to HC. During naming animal-walking task, MCI patients exhibited enhanced FC in the prefrontal, motor, and occipital cortex, whereas a decrease in FC was observed in the right prefrontal to left prefrontal cortex during calculating-walking task. In working memory tasks, MCI predominantly showed increased FC in the medial and left prefrontal cortex. However, a decreased in prefrontal FC and a shifted in distribution from the left to the right prefrontal cortex were noted in MCI patients during a verbal frequency task. In conclusion, fNIRS effectively identified abnormalities in FC between MCI and HC, indicating disrupted FC as potential markers for the early detection of MCI. Future studies should investigate the use of task- and region-specific FC alterations as a sensitive biomarker for MCI.
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Affiliation(s)
- Shuangyan Wang
- Department of Geriatric Neurology, Guangzhou First People's HospitalThe Second Affiliated Hospital of South China University of TechnologyGuangzhouGuangdongChina
| | - Weijia Wang
- Department of LibrarySun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Jinglong Chen
- Department of Geriatric Neurology, Guangzhou First People's HospitalThe Second Affiliated Hospital of South China University of TechnologyGuangzhouGuangdongChina
| | - Xiaoqi Yu
- Department of Geriatric Neurology, Guangzhou First People's HospitalThe Second Affiliated Hospital of South China University of TechnologyGuangzhouGuangdongChina
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Saway BF, Palmer C, Hughes C, Triano M, Suresh RE, Gilmore J, George M, Kautz SA, Rowland NC. The evolution of neuromodulation for chronic stroke: From neuroplasticity mechanisms to brain-computer interfaces. Neurotherapeutics 2024; 21:e00337. [PMID: 38377638 PMCID: PMC11103214 DOI: 10.1016/j.neurot.2024.e00337] [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: 10/16/2023] [Revised: 02/05/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024] Open
Abstract
Stroke is one of the most common and debilitating neurological conditions worldwide. Those who survive experience motor, sensory, speech, vision, and/or cognitive deficits that severely limit remaining quality of life. While rehabilitation programs can help improve patients' symptoms, recovery is often limited, and patients frequently continue to experience impairments in functional status. In this review, invasive neuromodulation techniques to augment the effects of conventional rehabilitation methods are described, including vagus nerve stimulation (VNS), deep brain stimulation (DBS) and brain-computer interfaces (BCIs). In addition, the evidence base for each of these techniques, pivotal trials, and future directions are explored. Finally, emerging technologies such as functional near-infrared spectroscopy (fNIRS) and the shift to artificial intelligence-enabled implants and wearables are examined. While the field of implantable devices for chronic stroke recovery is still in a nascent stage, the data reviewed are suggestive of immense potential for reducing the impact and impairment from this globally prevalent disorder.
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Affiliation(s)
- Brian F Saway
- Department of Neurosurgery, Medical University of South Carolina, SC 29425, USA.
| | - Charles Palmer
- Department of Psychiatry, Medical University of South Carolina, SC 29425, USA
| | - Christopher Hughes
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Matthew Triano
- Department of Neurosurgery, Medical University of South Carolina, SC 29425, USA
| | - Rishishankar E Suresh
- College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Jordon Gilmore
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA
| | - Mark George
- Department of Psychiatry, Medical University of South Carolina, SC 29425, USA; Ralph H Johnson VA Health Care System, Charleston, SC 29425, USA
| | - Steven A Kautz
- Department of Health Science and Research, Medical University of South Carolina, SC 29425, USA; Ralph H Johnson VA Health Care System, Charleston, SC 29425, USA
| | - Nathan C Rowland
- Department of Neurosurgery, Medical University of South Carolina, SC 29425, USA; MUSC Institute for Neuroscience Discovery (MIND), Medical University of South Carolina, SC 29425, USA
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Ross D, Wagshul ME, Izzetoglu M, Holtzer R. Cortical thickness moderates intraindividual variability in prefrontal cortex activation patterns of older adults during walking. J Int Neuropsychol Soc 2024; 30:117-127. [PMID: 37366047 PMCID: PMC10751394 DOI: 10.1017/s1355617723000371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Increased intraindividual variability (IIV) in behavioral and cognitive performance is a risk factor for adverse outcomes but research concerning hemodynamic signal IIV is limited. Cortical thinning occurs during aging and is associated with cognitive decline. Dual-task walking (DTW) performance in older adults has been related to cognition and neural integrity. We examined the hypothesis that reduced cortical thickness would be associated with greater increases in IIV in prefrontal cortex oxygenated hemoglobin (HbO2) from single tasks to DTW in healthy older adults while adjusting for behavioral performance. METHOD Participants were 55 healthy community-dwelling older adults (mean age = 74.84, standard deviation (SD) = 4.97). Structural MRI was used to quantify cortical thickness. Functional near-infrared spectroscopy (fNIRS) was used to assess changes in prefrontal cortex HbO2 during walking. HbO2 IIV was operationalized as the SD of HbO2 observations assessed during the first 30 seconds of each task. Linear mixed models were used to examine the moderation effect of cortical thickness throughout the cortex on HbO2 IIV across task conditions. RESULTS Analyses revealed that thinner cortex in several regions was associated with greater increases in HbO2 IIV from the single tasks to DTW (ps < .02). CONCLUSIONS Consistent with neural inefficiency, reduced cortical thickness in the PFC and throughout the cerebral cortex was associated with increases in HbO2 IIV from the single tasks to DTW without behavioral benefit. Reduced cortical thickness and greater IIV of prefrontal cortex HbO2 during DTW may be further investigated as risk factors for developing mobility impairments in aging.
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Affiliation(s)
- Daliah Ross
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Mark E. Wagshul
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University, Villanova, PA, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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Zhang H, Cao X, Wang L, Tong Q, Sun H, Gan C, Shan A, Yuan Y, Zhang K. Transcutaneous auricular vagus nerve stimulation improves gait and cortical activity in Parkinson's disease: A pilot randomized study. CNS Neurosci Ther 2023; 29:3889-3900. [PMID: 37311693 PMCID: PMC10651956 DOI: 10.1111/cns.14309] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 03/17/2023] [Accepted: 05/30/2023] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVE In this randomized, double-blind, sham-controlled trial, we explored the effect of 20 Hz transcutaneous auricular vagus nerve stimulation (taVNS) on gait impairments in Parkinson's disease (PD) patients and investigated the underlying neural mechanism. METHODS In total, 22 PD patients and 14 healthy controls were enrolled. PD patients were randomized (1:1) to receive active or sham taVNS (same position as active taVNS group but without releasing current) twice a day for 1 week. Meanwhile, all subjects were measured activation in the bilateral frontal and sensorimotor cortex during usual walking by functional near-infrared spectroscopy. RESULTS PD patients showed instable gait with insufficient range of motion during usual walking. Active taVNS improved gait characteristics including step length, stride velocity, stride length, and step length variability compared with sham taVNS after completion of the 7-day therapy. No difference was found in the Unified Parkinson's Disease Rating Scale III, Timed Up and Go, Tinetti Balance, and Gait scores. Moreover, PD patients had higher relative change of oxyhemoglobin in the left dorsolateral prefrontal cortex, pre-motor area, supplementary motor area, primary motor cortex, and primary somatosensory cortex than HCs group during usual walking. Hemodynamic responses in the left primary somatosensory cortex were significantly decreased after taVNS therapy. CONCLUSION taVNS can relieve gait impairments and remodel sensorimotor integration in PD patients.
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Affiliation(s)
- Heng Zhang
- Department of NeurologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Xing‐yue Cao
- Department of NeurologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Li‐na Wang
- Department of NeurologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Qing Tong
- Department of NeurologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Hui‐min Sun
- Department of NeurologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Cai‐ting Gan
- Department of NeurologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Ai‐di Shan
- Department of NeurologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Yong‐sheng Yuan
- Department of NeurologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Ke‐zhong Zhang
- Department of NeurologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
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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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Belluscio V, Cartocci G, Terbojevich T, Di Feo P, Inguscio BMS, Ferrari M, Quaresima V, Vannozzi G. Facilitating or disturbing? An investigation about the effects of auditory frequencies on prefrontal cortex activation and postural sway. Front Neurosci 2023; 17:1197733. [PMID: 37425019 PMCID: PMC10324668 DOI: 10.3389/fnins.2023.1197733] [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: 03/31/2023] [Accepted: 06/01/2023] [Indexed: 07/11/2023] Open
Abstract
Auditory stimulation activates brain areas associated with higher cognitive processes, like the prefrontal cortex (PFC), and plays a role in postural control regulation. However, the effects of specific frequency stimuli on upright posture maintenance and PFC activation patterns remain unknown. Therefore, the study aims at filling this gap. Twenty healthy adults performed static double- and single-leg stance tasks of 60s each under four auditory conditions: 500, 1000, 1500, and 2000 Hz, binaurally delivered through headphones, and in quiet condition. Functional near-infrared spectroscopy was used to measure PFC activation through changes in oxygenated hemoglobin concentration, while an inertial sensor (sealed at the L5 vertebra level) quantified postural sway parameters. Perceived discomfort and pleasantness were rated through a 0-100 visual analogue scale (VAS). Results showed that in both motor tasks, different PFC activation patterns were displayed at the different auditory frequencies and the postural performance worsened with auditory stimuli, compared to quiet conditions. VAS results showed that higher frequencies were considered more discomfortable than lower ones. Present data prove that specific sound frequencies play a significant role in cognitive resources recruitment and in the regulation of postural control. Furthermore, it supports the importance of exploring the relationship among tones, cortical activity, and posture, also considering possible applications with neurological populations and people with hearing dysfunctions.
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Affiliation(s)
- Valeria Belluscio
- Department of Movement, Human and Health Sciences, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Rome, Italy
- Fondazione Santa Lucia, Rome, Italy
| | - Giulia Cartocci
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
- BrainSigns Ltd, Rome, Italy
| | | | - Paolo Di Feo
- Department of Movement, Human and Health Sciences, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Rome, Italy
| | | | - Marco Ferrari
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Valentina Quaresima
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Rome, Italy
- Fondazione Santa Lucia, Rome, Italy
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Magnúsdóttir BB, Gylfason HF, Jóhannsdóttir KR. Blunted Cardiovascular Reactivity Predicts Worse Performance in Working Memory Tasks. Brain Sci 2023; 13:brainsci13040649. [PMID: 37190615 DOI: 10.3390/brainsci13040649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/29/2023] [Accepted: 04/09/2023] [Indexed: 05/17/2023] Open
Abstract
When we experience psychological challenges in the environment, our heart rate usually rises to make us more able to solve the task, but there is an individual difference in cardiovascular reactivity (CVR). Extreme CVR to environmental demands has been associated with worse health outcomes, with blunted CVR (little or no rise in heart rate) related to maladaptive behavior, including depression. The blunted CVR has been explained by motivational disengagement, which involves giving up on a task when facing obstacles. Disengagement is thought to be a habitual response that people might not be aware of, and, therefore, objective measures such as test performance might serve as a good measure of engagement. In this study, 66 participants solved different cognitive tasks while their CVR was measured. The aim was to test the association between test performance and reactivity, measured with the difference in heart rate at baseline and the mean heart rate while solving the tasks. Our results show a significant association between reactivity scores and performance in all tests, of various difficulty, indicating that blunted cardiovascular reactivity predicts poorer cognitive performance. Furthermore, we find an association between reactivity in one test and the performance in the other tests, suggesting that disengagement from environmental demands can be more general and not depend on the task at hand. The results, therefore, support earlier research suggesting that blunted CVR is associated with worse cognitive performance, and extends the literature by indicating that disengagement could be a more general maladaptive response to the environment.
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Wu Y, Dong Y, Tang Y, Wang W, Bo Y, Zhang C. Relationship between motor performance and cortical activity of older neurological disorder patients with dyskinesia using fNIRS: A systematic review. Front Physiol 2023; 14:1153469. [PMID: 37051020 PMCID: PMC10083370 DOI: 10.3389/fphys.2023.1153469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
Background: Neurological disorders with dyskinesia would seriously affect older people’s daily activities, which is not only associated with the degeneration or injury of the musculoskeletal or the nervous system but also associated with complex linkage between them. This study aims to review the relationship between motor performance and cortical activity of typical older neurological disorder patients with dyskinesia during walking and balance tasks.Methods: Scopus, PubMed, and Web of Science databases were searched. Articles that described gait or balance performance and cortical activity of older Parkinson’s disease (PD), multiple sclerosis, and stroke patients using functional near-infrared spectroscopy were screened by the reviewers. A total of 23 full-text articles were included for review, following an initial yield of 377 studies.Results: Participants were mostly PD patients, the prefrontal cortex was the favorite region of interest, and walking was the most popular test motor task, interventional studies were four. Seven studies used statistical methods to interpret the relationship between motor performance and cortical activation. The motor performance and cortical activation were simultaneously affected under difficult walking and balance task conditions. The concurrent changes of motor performance and cortical activation in reviewed studies contained the same direction change and different direction change.Conclusion: Most of the reviewed studies reported poor motor performance and increased cortical activation of PD, stroke and multiple sclerosis older patients. The external motor performance such as step speed were analyzed only. The design and results were not comprehensive and profound. More than 5 weeks walking training or physiotherapy can contribute to motor function promotion as well as cortices activation of PD and stroke patients. Thus, further study is needed for more statistical analysis on the relationship between motor performance and activation of the motor-related cortex. More different type and program sports training intervention studies are needed to perform.
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Affiliation(s)
- Yunzhi Wu
- Graduate School, Shandong Sport University, Jinan, Shandong, China
| | - Yuqi Dong
- Graduate School, Shandong Sport University, Jinan, Shandong, China
| | - Yunqi Tang
- College of Art and Design, Shaanxi University of Science and Technology, Xi’an, Shaanxi, China
| | - Weiran Wang
- Graduate School, Shandong Sport University, Jinan, Shandong, China
| | - Yulong Bo
- Graduate School, Shandong Sport University, Jinan, Shandong, China
| | - Cui Zhang
- Graduate School, Shandong Sport University, Jinan, Shandong, China
- Laboratory of Sports Biomechanics, Shandong Institute of Sport Science, Jinan, Shandong, China
- *Correspondence: Cui Zhang,
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Kvist A, Bezuidenhout L, Johansson H, Albrecht F, Ekman U, Conradsson DM, Franzén E. Using functional near-infrared spectroscopy to measure prefrontal cortex activity during dual-task walking and navigated walking: A feasibility study. Brain Behav 2023; 13:e2948. [PMID: 36917560 PMCID: PMC10097069 DOI: 10.1002/brb3.2948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 03/16/2023] Open
Abstract
INTRODUCTION While functional near-infrared spectroscopy (fNIRS) can provide insight into motor-cognitive deficits during ecologically valid gait conditions, the feasibility of using fNIRS during complex walking remains unknown. We tested the process and scientific feasibility of using an fNIRS device to measure cortical activity during complex walking tasks consisting of straight walking and navigated walking under single and dual-task (DT) conditions. METHODS Nineteen healthy people from 18 to 64 years (mean age: 45.7 years) participated in this study which consisted of three complex walking protocols: (i) straight walking, DT walking (walking while performing an auditory Stroop task) and single-task auditory Stroop, (ii) straight and navigated walking, and (iii) navigated walking and navigated DT walking. A rest condition (standing still) was also included in each protocol. Process feasibility outcomes included evaluation of the test procedures and participant experience during and after each protocol. Scientific feasibility outcomes included signal quality measures, and the ability to measure changes in concentration of deoxygenated and oxygenated hemoglobin in the prefrontal cortex. RESULTS All participants were able to complete the three protocols with most agreeing that the equipment was comfortable (57.9%) and that the testing duration was adequate (73.7%). Most participants did not feel tired (94.7%) with some experiencing pain (42.1%) during the protocols. The signal qualities were high for each protocol. Compared to the rest condition, there was an increase in oxygenated hemoglobin in the prefrontal cortex when performing dual-task walking and navigation. CONCLUSION We showed that our experimental setup was feasible for assessing activity in the prefrontal cortex with fNIRS during complex walking. The experimental setup was deemed acceptable and practicable. Signal quality was good during complex walking conditions and findings suggest that the different tasks elicit a differential brain activity, supporting scientific feasibility.
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Affiliation(s)
- Alexander Kvist
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Lucian Bezuidenhout
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Faculty of Community and Health Sciences, University of Western Cape, Cape Town, South Africa
| | - Hanna Johansson
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Franziska Albrecht
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Urban Ekman
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
| | - David Moulaee Conradsson
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Erika Franzén
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
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14
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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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15
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Kitatani R, Furukawa K, Sakaue D, Otsuru N, Onishi H. Influences of different cognitive loads on central common neural drives to the ankle muscles during dual-task walking. Neurosci Lett 2023; 804:137214. [PMID: 36990269 DOI: 10.1016/j.neulet.2023.137214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/22/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023]
Abstract
While dual-task walking with additional cognitive tasks may decrease walking performance, many studies have also shown increases in walking performance during dual tasks, especially as cognitive load increases. However, the neural mechanisms that cause changes in postural control during dual tasks according to the difference in cognitive load remain unclear. Therefore, this study aimed to investigate the influence of different cognitive loads on the neural control of muscle activity during dual-task walking using intra- and intermuscular coherence analyses. Eighteen healthy young adults were subjected to treadmill walking measurements in a single-task condition (normal walking without cognitive load) and two dual-task conditions (watching digits and digit 2-back task) with the measurements of reaction time to auditory stimulation. During walking with the digit 2-back task, stride-time variability was significantly reduced compared to that during normal walking, and reaction time was significantly delayed compared to those during normal walking and walking with watching digits. The peak value of the tibialis anterior intramuscular coherence in the beta band (15-35 Hz) significantly increased during walking with the digit 2-back task than that during walking with watching digits. The present results suggest that young adults can increase their central common neural drive and decrease their walking variability for concentration on cognitive tasks during dual-task walking.
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16
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Holtzer R, Feldman JM, Jariwala SP, Izzetoglu M. Asthma history influences gait performance and associated prefrontal cortex activation patterns in older adults. Aging Clin Exp Res 2023; 35:407-411. [PMID: 36401064 PMCID: PMC10039461 DOI: 10.1007/s40520-022-02306-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/12/2022] [Indexed: 11/20/2022]
Abstract
Walking and cognition are interrelated due to dependence on shared brain regions that include the prefrontal cortex (PFC). Limited literature indicates that asthma is associated with poor mobility in older adults but the mechanisms underlying this relationship are unknown. Therefore, we tested the hypothesis that asthma history was associated with poor gait performance due to limited attention resources and neural inefficiency. Participants, older adults age ≥ 65 years reporting positive (n = 36) and negative (n = 36) history of asthma, walked under single and dual-task conditions with a functional near-infrared-spectroscopy (fNIRS) sensor placed on their forehead to assess task-related changes in PFC oxygenated hemoglobin (HbO2). Results showed that positive asthma history was associated with slower gait and higher fNIRS-derived HbO2 under dual-task walking. These findings suggest that limited attention resources and neural inefficiency underlie the association between asthma and poor walking performance in older adults.
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Affiliation(s)
- Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Jonathan M Feldman
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Pediatrics (Division of Academic General Pediatrics), Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Sunit P Jariwala
- Department of Medicine (Division of Allergy/Immunology), Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University, Villanova, PA, USA
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17
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He X, Lei L, Yu G, Lin X, Sun Q, Chen S. Asymmetric cortical activation in healthy and hemiplegic individuals during walking: A functional near-infrared spectroscopy neuroimaging study. Front Neurol 2023; 13:1044982. [PMID: 36761919 PMCID: PMC9905619 DOI: 10.3389/fneur.2022.1044982] [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: 09/15/2022] [Accepted: 12/22/2022] [Indexed: 01/26/2023] Open
Abstract
Background This study investigated the cortical activation mechanism underlying locomotor control during healthy and hemiplegic walking. Methods A total of eight healthy individuals with right leg dominance (male patients, 75%; mean age, 40.06 ± 4.53 years) and six post-stroke patients with right hemiplegia (male patients, 86%; mean age, 44.41 ± 7.23 years; disease course, 5.21 ± 2.63 months) completed a walking task at a treadmill speed of 2 km/h and a functional electrical stimulation (FES)-assisted walking task, respectively. Functional near-infrared spectroscopy (fNIRS) was used to detect hemodynamic changes in neuronal activity in the bilateral sensorimotor cortex (SMC), supplementary motor area (SMA), and premotor cortex (PMC). Results fNIRS cortical mapping showed more SMC-PMC-SMA locomotor network activation during hemiplegic walking than during healthy gait. Furthermore, more SMA and PMC activation in the affected hemisphere was observed during the FES-assisted hemiplegic walking task than during the non-FES-assisted task. The laterality index indicated asymmetric cortical activation during hemiplegic gait, with relatively greater activation in the unaffected (right) hemisphere during hemiplegic gait than during healthy walking. During hemiplegic walking, the SMC and SMA were predominantly activated in the unaffected hemisphere, whereas the PMC was predominantly activated in the affected hemisphere. No significant differences in the laterality index were noted between the other groups and regions (p > 0.05). Conclusion An important feature of asymmetric cortical activation was found in patients with post-stroke during the walking process, which was the recruitment of more SMC-SMA-PMC activation than in healthy individuals. Interestingly, there was no significant lateralized activation during hemiplegic walking with FES assistance, which would seem to indicate that FES may help hemiplegic walking recover the balance in cortical activation. These results, which are worth verifying through additional research, suggest that FES used as a potential therapeutic strategy may play an important role in motor recovery after stroke.
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Affiliation(s)
- Xiaokuo He
- Department of Rehabilitative Medicine, Fifth Hospital of Xiamen, Xiamen, China
| | - Lei Lei
- Department of Rehabilitative Medicine, Fifth Hospital of Xiamen, Xiamen, China
| | - Guo Yu
- Department of Rehabilitative Medicine, Fifth Hospital of Xiamen, Xiamen, China
| | - Xin Lin
- Department of Rehabilitative Medicine, Fifth Hospital of Xiamen, Xiamen, China
| | - Qianqian Sun
- Department of Rehabilitative Medicine, Xiangyang Central Hospital, Xiangyang, Hubei, China,Qianqian Sun ✉
| | - Shanjia Chen
- Department of Rehabilitative Medicine, Fifth Hospital of Xiamen, Xiamen, China,Department of Rehabilitative Medicine, The First Affiliated Hospital of Xiamen University, Xiamen, China,*Correspondence: Shanjia Chen ✉
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18
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Wang Q, Dai W, Xu S, Zhu S, Sui Y, Kan C, Shen Y, Zhu Y, Guo C, Wang T. Brain activation of the PFC during dual-task walking in stroke patients: A systematic review and meta-analysis of functional near-infrared spectroscopy studies. Front Neurosci 2023; 17:1111274. [PMID: 36875661 PMCID: PMC9980909 DOI: 10.3389/fnins.2023.1111274] [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: 11/29/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Background Dual-task walking is a good paradigm to measure the walking ability of stroke patients in daily life. It allows for a better observation of brain activation under dual-task walking to assess the impact of the different tasks on the patient when combining with functional near-infrared spectroscopy (fNIRS). This review aims to summarize the cortical change of the prefrontal cortex (PFC) detected in single-task and dual-task walking in stroke patients. Methods Six databases (Medline, Embase, PubMed, Web of Science, CINAHL, and Cochrane Library) were systematically searched for relevant studies, from inception to August 2022. Studies that measured the brain activation of single-task and dual-task walking in stroke patients were included. The main outcome of the study was PFC activity measured using fNIRS. In addition, a subgroup analysis was also performed for study characteristics based on HbO to analyze the different effects of disease duration and the type of dual task. Results Ten articles were included in the final review, and nine articles were included in the quantitative meta-analysis. The primary analysis showed more significant PFC activation in stroke patients performing dual-task walking than single-task walking (SMD = 0.340, P = 0.02, I 2 = 7.853%, 95% CI = 0.054-0.626). The secondary analysis showed a significant difference in PFC activation when performing dual-task walking and single-task walking in chronic patients (SMD = 0.369, P = 0.038, I 2 = 13.692%, 95% CI = 0.020-0.717), but not in subacute patients (SMD = 0.203, P = 0.419, I 2 = 0%, 95% CI = -0.289-0.696). In addition, performing walking combining serial subtraction (SMD = 0.516, P < 0.001, I 2 = 0%, 95% CI = 0.239-0.794), obstacle crossing (SMD = 0.564, P = 0.002, I 2 = 0%, 95% CI = 0.205-0.903), or a verbal task (SMD = 0.654, P = 0.009, I 2 = 0%, 95% CI = 0.164-1.137) had more PFC activation than single-task walking, while performing the n-back task did not show significant differentiation (SMD = 0.203, P = 0.419, I 2 = 0%, 95% CI = -0.289-0.696). Conclusions Different dual-task paradigms produce different levels of dual-task interference in stroke patients with different disease durations, and it is important to choose the matching dual-task type in relation to the walking ability and cognitive ability of the patient, in order to better improve the assessment and training effects. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42022356699.
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Affiliation(s)
- Qinglei Wang
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China
| | - Wenjun Dai
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Sheng Xu
- Department of Rehabilitation, Changzhou Dean Hospital, Changzhou, China
| | - Shizhe Zhu
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China
| | - Youxin Sui
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China
| | - Chaojie Kan
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China.,Department of Rehabilitation, Changzhou Dean Hospital, Changzhou, China
| | - Ying Shen
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yi Zhu
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chuan Guo
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tong Wang
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Bonilauri A, Sangiuliano Intra F, Rossetto F, Borgnis F, Baselli G, Baglio F. Whole-Head Functional Near-Infrared Spectroscopy as an Ecological Monitoring Tool for Assessing Cortical Activity in Parkinson's Disease Patients at Different Stages. Int J Mol Sci 2022; 23:ijms232314897. [PMID: 36499223 PMCID: PMC9736501 DOI: 10.3390/ijms232314897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
Functional near-infrared spectroscopy (fNIRS) is increasingly employed as an ecological neuroimaging technique in assessing age-related chronic neurological disorders, such as Parkinson's disease (PD), mainly providing a cross-sectional characterization of clinical phenotypes in ecological settings. Current fNIRS studies in PD have investigated the effects of motor and non-motor impairment on cortical activity during gait and postural stability tasks, but no study has employed fNIRS as an ecological neuroimaging tool to assess PD at different stages. Therefore, in this work, we sought to investigate the cortical activity of PD patients during a motor grasping task and its relationship with both the staging of the pathology and its clinical variables. This study considered 39 PD patients (age 69.0 ± 7.64, 38 right-handed), subdivided into two groups at different stages by the Hoehn and Yahr (HY) scale: early PD (ePD; N = 13, HY = [1; 1.5]) and moderate PD (mPD; N = 26, HY = [2; 2.5; 3]). We employed a whole-head fNIRS system with 102 measurement channels to monitor brain activity. Group-level activation maps and region of interest (ROI) analysis were computed for ePD, mPD, and ePD vs. mPD contrasts. A ROI-based correlation analysis was also performed with respect to contrasted subject-level fNIRS data, focusing on age, a Cognitive Reserve Index questionnaire (CRIQ), disease duration, the Unified Parkinson's Disease Rating Scale (UPDRS), and performances in the Stroop Color and Word (SCW) test. We observed group differences in age, disease duration, and the UPDRS, while no significant differences were found for CRIQ or SCW scores. Group-level activation maps revealed that the ePD group presented higher activation in motor and occipital areas than the mPD group, while the inverse trend was found in frontal areas. Significant correlations with CRIQ, disease duration, the UPDRS, and the SCW were mostly found in non-motor areas. The results are in line with current fNIRS and functional and anatomical MRI scientific literature suggesting that non-motor areas-primarily the prefrontal cortex area-provide a compensation mechanism for PD motor impairment. fNIRS may serve as a viable support for the longitudinal assessment of therapeutic and rehabilitation procedures, and define new prodromal, low-cost, and ecological biomarkers of disease progression.
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Affiliation(s)
- Augusto Bonilauri
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Francesca Sangiuliano Intra
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, CADITER, 20148 Milan, Italy
- Faculty of Education, Free University of Bolzano-Bozen, 39042 Brixen, Italy
- Correspondence:
| | - Federica Rossetto
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, CADITER, 20148 Milan, Italy
| | - Francesca Borgnis
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, CADITER, 20148 Milan, Italy
| | - Giuseppe Baselli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Francesca Baglio
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, CADITER, 20148 Milan, Italy
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20
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Saraiva M, Castro MA, Vilas-Boas JP. The Role of Sleep Quality and Physical Activity Level on Gait Speed and Brain Hemodynamics Changes in Young Adults-A Dual-Task Study. Eur J Investig Health Psychol Educ 2022; 12:1673-1681. [PMID: 36421323 PMCID: PMC9689950 DOI: 10.3390/ejihpe12110117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Walking requires attentional resources, and the studies using neuroimage techniques have grown to understand the interaction between cortical activity and motor performance. Previous studies reported a decline in gait performance and changes in the prefrontal cortex (PFC) activity during a dual-task performance compared to walking only. Some lifestyle factors, such as sleep and physical activity (PA) levels, can compromise walking performance and brain activity. Nonetheless, the studies are scarce. This study aimed to assess gait speed and hemodynamic response in the PFC during a cognitive dual-task (cog-DT) compared to walking only, and to analyze the correlation between PA and sleep quality (SQ) with gait performance and hemodynamic response in the PFC during a single task (ST) and cog-DT performance in young adults. A total of 18 healthy young adults (mean age ± SD = 24.11 ± 4.11 years) participated in this study. They performed a single motor task (mot-ST)—normal walking—and a cog-DT—walking while performing a cognitive task on a smartphone. Gait speed was collected using a motion capture system coupled with two force plates. The hemoglobin differences (Hb-diff), oxyhemoglobin ([oxy-Hb]) and deoxyhemoglobin ([deoxy-Hb]) concentrations in the PFC were obtained using functional near-infrared spectroscopy. The SQ and PA were assessed through the Pittsburg Sleep Quality Index and International Physical Activity Questionnaire-Short Form questionnaires, respectively. The results show a decrease in gait speed (p < 0.05), a decrease in [deoxy-Hb] (p < 0.05), and an increase in Hb-diff (p < 0.05) and [oxy-Hb] (p > 0.05) in the prefrontal cortex during the cog-DT compared to the single task. A positive correlation between SQ and Hb-diff during the cog-DT performance was found. In conclusion, the PFC’s hemodynamic response during the cog-DT suggests that young adults prioritize cognitive tasks over motor performance. SQ only correlates with the Hb-diff during the cog-DT, showing that poor sleep quality was associated with increased Hb-diff in the PFC. The gait performance and hemodynamic response do not correlate with physical activity level.
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Affiliation(s)
- Marina Saraiva
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal
- Faculty of Sports and CIAFEL, University of Porto, 4200-450 Porto, Portugal
- Correspondence:
| | - Maria António Castro
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal
- Department of Mechanical Engineering, CEMMPRE, University of Coimbra, 3030-788 Coimbra, Portugal
- Sector of Physiotherapy, School of Health Sciences, Polytechnic Institute of Leiria, 2411-901 Leiria, Portugal
| | - João Paulo Vilas-Boas
- Faculty of Sports and CIAFEL, University of Porto, 4200-450 Porto, Portugal
- LABIOMEP-UP, Faculty of Sports and CIFI2D, University of Porto, 4200-450 Porto, Portugal
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Chen Y, Cao Z, Mao M, Sun W, Song Q, Mao D. Increased cortical activation and enhanced functional connectivity in the prefrontal cortex ensure dynamic postural balance during dual-task obstacle negotiation in the older adults: A fNIRS study. Brain Cogn 2022; 163:105904. [PMID: 36063567 DOI: 10.1016/j.bandc.2022.105904] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/15/2022] [Accepted: 08/22/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE By analyzing the cortical activation and functional connectivity of the prefrontal cortex (PFC) during dual-task obstacle negotiation in the older adults, cognitive resources allocation and neural regulatory mechanisms of aging brain were shed light on in complex walking conditions. METHODS Twenty-eight healthy right-handed subjects participated in the study, including 15 men and 13 women (age: 68.6 ± 4.1 years, height: 162.96 ± 6.05 cm, weight: 63.63 ± 9.64 kg). There were four tasks: Normal Walk (NW), Obstacle Negotiation during Normal Walk (NW + ON), Walk while performing Cognitive Task (WCT), and Obstacle Negotiation during Walk while performing Cognitive Task (WCT + ON). Participants wore functional near-infrared spectroscopy (fNIRS) to collect hemodynamic signals from various regions of interest (ROIs) in the PFC, while the three-dimensional motion capture system was used to test the gait velocity. Cognitive task data was recorded. RESULTS In WCT + ON, the HbO2 concentration change value (△HbO2) of the left dorsolateral prefrontal cortex was significantly greater than that in the other three tasks (p < 0.05), and the△HbO2 of the right dorsolateral prefrontal cortex was significantly greater than that in NW + ON (p < 0.05). The gait velocities in the four tasks were significantly different (p < 0.05) (NW > WCT > NW + ON > WCT + ON). There was no significant difference in cognitive performance between in the WCT and WCT + ON (p > 0.05). In WCT + ON, the left and right dorsolateral prefrontal areas had strong functional connectivity and the left frontal pole was most widely connected to the other ROIs. Compared to that in NW, the functional connectivity of the left prefrontal lobe was significantly enhanced in WCT + ON (p < 0.05). CONCLUSIONS As walking difficulty increased, the PFC activation in the older adults changed from right-sided to bilateral activation, indicating that the left PFC cognitive resources compensated for the right PFC in dual-task obstacle negotiation. The cognitive resources recruitment in dual-task obstacle negotiation might be achieved by synchronization and coordination of associated brain areas in the PFC, primarily to maintain dynamic postural balance when walking.
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Affiliation(s)
- Yan Chen
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; College of Sport and Health, Shandong Sport University, Jinan, Shandong 250102, China.
| | - Zhenjing Cao
- College of Sport and Health, Shandong Sport University, Jinan, Shandong 250102, China
| | - Min Mao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Wei Sun
- College of Sport and Health, Shandong Sport University, Jinan, Shandong 250102, China
| | - Qipeng Song
- College of Sport and Health, Shandong Sport University, Jinan, Shandong 250102, China
| | - Dewei Mao
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; College of Sport and Health, Shandong Sport University, Jinan, Shandong 250102, China.
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22
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Ayaz H, Baker WB, Blaney G, Boas DA, Bortfeld H, Brady K, Brake J, Brigadoi S, Buckley EM, Carp SA, Cooper RJ, Cowdrick KR, Culver JP, Dan I, Dehghani H, Devor A, Durduran T, Eggebrecht AT, Emberson LL, Fang Q, Fantini S, Franceschini MA, Fischer JB, Gervain J, Hirsch J, Hong KS, Horstmeyer R, Kainerstorfer JM, Ko TS, Licht DJ, Liebert A, Luke R, Lynch JM, Mesquida J, Mesquita RC, Naseer N, Novi SL, Orihuela-Espina F, O’Sullivan TD, Peterka DS, Pifferi A, Pollonini L, Sassaroli A, Sato JR, Scholkmann F, Spinelli L, Srinivasan VJ, St. Lawrence K, Tachtsidis I, Tong Y, Torricelli A, Urner T, Wabnitz H, Wolf M, Wolf U, Xu S, Yang C, Yodh AG, Yücel MA, Zhou W. Optical imaging and spectroscopy for the study of the human brain: status report. NEUROPHOTONICS 2022; 9:S24001. [PMID: 36052058 PMCID: PMC9424749 DOI: 10.1117/1.nph.9.s2.s24001] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This report is the second part of a comprehensive two-part series aimed at reviewing an extensive and diverse toolkit of novel methods to explore brain health and function. While the first report focused on neurophotonic tools mostly applicable to animal studies, here, we highlight optical spectroscopy and imaging methods relevant to noninvasive human brain studies. We outline current state-of-the-art technologies and software advances, explore the most recent impact of these technologies on neuroscience and clinical applications, identify the areas where innovation is needed, and provide an outlook for the future directions.
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Affiliation(s)
- Hasan Ayaz
- Drexel University, School of Biomedical Engineering, Science, and Health Systems, Philadelphia, Pennsylvania, United States
- Drexel University, College of Arts and Sciences, Department of Psychological and Brain Sciences, Philadelphia, Pennsylvania, United States
| | - Wesley B. Baker
- Children’s Hospital of Philadelphia, Division of Neurology, Philadelphia, Pennsylvania, United States
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Giles Blaney
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - David A. Boas
- Boston University Neurophotonics Center, Boston, Massachusetts, United States
- Boston University, College of Engineering, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Heather Bortfeld
- University of California, Merced, Departments of Psychological Sciences and Cognitive and Information Sciences, Merced, California, United States
| | - Kenneth Brady
- Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Department of Anesthesiology, Chicago, Illinois, United States
| | - Joshua Brake
- Harvey Mudd College, Department of Engineering, Claremont, California, United States
| | - Sabrina Brigadoi
- University of Padua, Department of Developmental and Social Psychology, Padua, Italy
| | - Erin M. Buckley
- Georgia Institute of Technology, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
- Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia, United States
| | - Stefan A. Carp
- Massachusetts General Hospital, Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
| | - Robert J. Cooper
- University College London, Department of Medical Physics and Bioengineering, DOT-HUB, London, United Kingdom
| | - Kyle R. Cowdrick
- Georgia Institute of Technology, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Joseph P. Culver
- Washington University School of Medicine, Department of Radiology, St. Louis, Missouri, United States
| | - Ippeita Dan
- Chuo University, Faculty of Science and Engineering, Tokyo, Japan
| | - Hamid Dehghani
- University of Birmingham, School of Computer Science, Birmingham, United Kingdom
| | - Anna Devor
- Boston University, College of Engineering, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Turgut Durduran
- ICFO – The Institute of Photonic Sciences, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain
- Institució Catalana de Recerca I Estudis Avançats (ICREA), Barcelona, Spain
| | - Adam T. Eggebrecht
- Washington University in St. Louis, Mallinckrodt Institute of Radiology, St. Louis, Missouri, United States
| | - Lauren L. Emberson
- University of British Columbia, Department of Psychology, Vancouver, British Columbia, Canada
| | - Qianqian Fang
- Northeastern University, Department of Bioengineering, Boston, Massachusetts, United States
| | - Sergio Fantini
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - Maria Angela Franceschini
- Massachusetts General Hospital, Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
| | - Jonas B. Fischer
- ICFO – The Institute of Photonic Sciences, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain
| | - Judit Gervain
- University of Padua, Department of Developmental and Social Psychology, Padua, Italy
- Université Paris Cité, CNRS, Integrative Neuroscience and Cognition Center, Paris, France
| | - Joy Hirsch
- Yale School of Medicine, Department of Psychiatry, Neuroscience, and Comparative Medicine, New Haven, Connecticut, United States
- University College London, Department of Medical Physics and Biomedical Engineering, London, United Kingdom
| | - Keum-Shik Hong
- Pusan National University, School of Mechanical Engineering, Busan, Republic of Korea
- Qingdao University, School of Automation, Institute for Future, Qingdao, China
| | - Roarke Horstmeyer
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
- Duke University, Department of Electrical and Computer Engineering, Durham, North Carolina, United States
- Duke University, Department of Physics, Durham, North Carolina, United States
| | - Jana M. Kainerstorfer
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
- Carnegie Mellon University, Neuroscience Institute, Pittsburgh, Pennsylvania, United States
| | - Tiffany S. Ko
- Children’s Hospital of Philadelphia, Division of Cardiothoracic Anesthesiology, Philadelphia, Pennsylvania, United States
| | - Daniel J. Licht
- Children’s Hospital of Philadelphia, Division of Neurology, Philadelphia, Pennsylvania, United States
| | - Adam Liebert
- Polish Academy of Sciences, Nalecz Institute of Biocybernetics and Biomedical Engineering, Warsaw, Poland
| | - Robert Luke
- Macquarie University, Department of Linguistics, Sydney, New South Wales, Australia
- Macquarie University Hearing, Australia Hearing Hub, Sydney, New South Wales, Australia
| | - Jennifer M. Lynch
- Children’s Hospital of Philadelphia, Division of Cardiothoracic Anesthesiology, Philadelphia, Pennsylvania, United States
| | - Jaume Mesquida
- Parc Taulí Hospital Universitari, Critical Care Department, Sabadell, Spain
| | - Rickson C. Mesquita
- University of Campinas, Institute of Physics, Campinas, São Paulo, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, São Paulo, Brazil
| | - Noman Naseer
- Air University, Department of Mechatronics and Biomedical Engineering, Islamabad, Pakistan
| | - Sergio L. Novi
- University of Campinas, Institute of Physics, Campinas, São Paulo, Brazil
- Western University, Department of Physiology and Pharmacology, London, Ontario, Canada
| | | | - Thomas D. O’Sullivan
- University of Notre Dame, Department of Electrical Engineering, Notre Dame, Indiana, United States
| | - Darcy S. Peterka
- Columbia University, Zuckerman Mind Brain Behaviour Institute, New York, United States
| | | | - Luca Pollonini
- University of Houston, Department of Engineering Technology, Houston, Texas, United States
| | - Angelo Sassaroli
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - João Ricardo Sato
- Federal University of ABC, Center of Mathematics, Computing and Cognition, São Bernardo do Campo, São Paulo, Brazil
| | - Felix Scholkmann
- University of Bern, Institute of Complementary and Integrative Medicine, Bern, Switzerland
- University of Zurich, University Hospital Zurich, Department of Neonatology, Biomedical Optics Research Laboratory, Zürich, Switzerland
| | - Lorenzo Spinelli
- National Research Council (CNR), IFN – Institute for Photonics and Nanotechnologies, Milan, Italy
| | - Vivek J. Srinivasan
- University of California Davis, Department of Biomedical Engineering, Davis, California, United States
- NYU Langone Health, Department of Ophthalmology, New York, New York, United States
- NYU Langone Health, Department of Radiology, New York, New York, United States
| | - Keith St. Lawrence
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Western University, Department of Medical Biophysics, London, Ontario, Canada
| | - Ilias Tachtsidis
- University College London, Department of Medical Physics and Biomedical Engineering, London, United Kingdom
| | - Yunjie Tong
- Purdue University, Weldon School of Biomedical Engineering, West Lafayette, Indiana, United States
| | - Alessandro Torricelli
- Politecnico di Milano, Dipartimento di Fisica, Milan, Italy
- National Research Council (CNR), IFN – Institute for Photonics and Nanotechnologies, Milan, Italy
| | - Tara Urner
- Georgia Institute of Technology, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Heidrun Wabnitz
- Physikalisch-Technische Bundesanstalt (PTB), Berlin, Germany
| | - Martin Wolf
- University of Zurich, University Hospital Zurich, Department of Neonatology, Biomedical Optics Research Laboratory, Zürich, Switzerland
| | - Ursula Wolf
- University of Bern, Institute of Complementary and Integrative Medicine, Bern, Switzerland
| | - Shiqi Xu
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
| | - Changhuei Yang
- California Institute of Technology, Department of Electrical Engineering, Pasadena, California, United States
| | - Arjun G. Yodh
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania, United States
| | - Meryem A. Yücel
- Boston University Neurophotonics Center, Boston, Massachusetts, United States
- Boston University, College of Engineering, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Wenjun Zhou
- University of California Davis, Department of Biomedical Engineering, Davis, California, United States
- China Jiliang University, College of Optical and Electronic Technology, Hangzhou, Zhejiang, China
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23
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Relation between Cortical Activation and Effort during Robot-Mediated Walking in Healthy People: A Functional Near-Infrared Spectroscopy Neuroimaging Study (fNIRS). SENSORS 2022; 22:s22155542. [PMID: 35898041 PMCID: PMC9329983 DOI: 10.3390/s22155542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 02/01/2023]
Abstract
Force and effort are important components of a motor task that can impact rehabilitation effectiveness. However, few studies have evaluated the impact of these factors on cortical activation during gait. The purpose of the study was to investigate the relation between cortical activation and effort required during exoskeleton-mediated gait at different levels of physical assistance in healthy individuals. Twenty-four healthy participants walked 10 m with an exoskeleton that provided four levels of assistance: 100%, 50%, 0%, and 25% resistance. Functional near-infrared spectroscopy (fNIRS) was used to measure cerebral flow dynamics with a 20-channel (plus two reference channels) device that covered most cortical motor regions bilaterally. We measured changes in oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR). According to HbO2 levels, cortical activation only differed slightly between the assisted conditions and rest. In contrast, bilateral and widespread cortical activation occurred during the two unassisted conditions (somatosensory, somatosensory association, primary motor, premotor, and supplementary motor cortices). A similar pattern was seen for HbR levels, with a smaller number of significant channels than for HbO2. These results confirmed the hypothesis that there is a relation between cortical activation and level of effort during gait. This finding should help to optimize neurological rehabilitation strategies to drive neuroplasticity.
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24
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Sui SX, Hendy AM, Teo WP, Moran JT, Nuzum ND, Pasco JA. A Review of the Measurement of the Neurology of Gait in Cognitive Dysfunction or Dementia, Focusing on the Application of fNIRS during Dual-Task Gait Assessment. Brain Sci 2022; 12:brainsci12080968. [PMID: 35892409 PMCID: PMC9331540 DOI: 10.3390/brainsci12080968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/16/2022] [Accepted: 07/20/2022] [Indexed: 12/07/2022] Open
Abstract
Poor motor function or physical performance is a predictor of cognitive decline. Additionally, slow gait speed is associated with poor cognitive performance, with gait disturbances being a risk factor for dementia. Parallel declines in muscular and cognitive performance (resulting in cognitive frailty) might be driven primarily by muscle deterioration, but bidirectional pathways involving muscle–brain crosstalk through the central and peripheral nervous systems are likely to exist. Following screening, early-stage parallel declines may be manageable and modifiable through simple interventions. Gait–brain relationships in dementia and the underlying mechanisms are not fully understood; therefore, the current authors critically reviewed the literature on the gait–brain relationship and the underlying mechanisms and the feasibility/accuracy of assessment tools in order to identify research gaps. The authors suggest that dual-task gait is involved in concurrent cognitive and motor activities, reflecting how the brain allocates resources when gait is challenged by an additional task and that poor performance on dual-task gait is a predictor of dementia onset. Thus, tools or protocols that allow the identification of subtle disease- or disorder-related changes in gait are highly desirable to improve diagnosis. Functional near-infrared spectroscopy (fNIRS) is a non-invasive, cost-effective, safe, simple, portable, and non-motion-sensitive neuroimaging technique, widely used in studies of clinical populations such as people suffering from Alzheimer’s disease, depression, and other chronic neurological disorders. If fNIRS can help researchers to better understand gait disturbance, then fNIRS could form the basis of a cost-effective means of identifying people at risk of cognitive dysfunction and dementia. The major research gap identified in this review relates to the role of the central/peripheral nervous system when performing dual tasks.
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Affiliation(s)
- Sophia X. Sui
- Instiute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC 3216, Australia; (J.T.M.); (J.A.P.)
- Correspondence: ; Tel.: +61-3-4215-3306-53306; Fax: +61-3-4215-3491
| | - Ashlee M. Hendy
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3216, Australia; (A.M.H.); (N.D.N.)
| | - Wei-Peng Teo
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 308232, Singapore;
| | - Joshua T. Moran
- Instiute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC 3216, Australia; (J.T.M.); (J.A.P.)
| | - Nathan D. Nuzum
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3216, Australia; (A.M.H.); (N.D.N.)
| | - Julie A. Pasco
- Instiute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC 3216, Australia; (J.T.M.); (J.A.P.)
- Department of Medicine—Western Campus, The University of Melbourne, St Albans, VIC 3010, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- Barwon Health, University Hospital Geelong, Geelong, VIC 3220, Australia
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25
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Dreyer-Alster S, Menascu S, Aloni R, Givon U, Dolev M, Achiron A, Kalron A. Motoric cognitive risk syndrome in people with multiple sclerosis: prevalence and correlations with disease-related factors. Ther Adv Neurol Disord 2022; 15:17562864221109744. [PMID: 35813608 PMCID: PMC9260572 DOI: 10.1177/17562864221109744] [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: 03/02/2022] [Accepted: 06/09/2022] [Indexed: 11/21/2022] Open
Abstract
Background: The motoric cognitive risk (MCR) syndrome, defined as the coexistence of slow
gait and subjective cognitive complaints, has as yet not been researched in
people with multiple sclerosis (pwMS). Objective: To examine the prevalence of the MCR syndrome in pwMS and its association
with disability, disease duration, perceived fatigue, and fear of
falling. Methods: The study comprised 618 pwMS [43.7 (SD = 12.6) years, 61.7% females]. Gait
speed was measured by the GAITRite™ electronic walkway (CIR Systems, Inc.
Haverton, PA, USA). Cognitive status was defined according to the global
cognitive score computed by the NeuroTrax™ cognitive battery (NeuroTrax
Corporation, Medina, NY, USA). The sample was divided into four main groups:
‘normal’, ‘cognitively impaired’, ‘gait impaired’ or ‘MCR’. Perceived
fatigue was assessed by the Modified Fatigue Impact Scale; fear of falling
by the Falls Efficacy Scale International. Results: Sixty-three (10.2%) patients were diagnosed with MCR. The percentage of
subjects categorized as MCR was 26.0% in severely disabled pwMS compared
with 10.9%, 6.0%, and 4.6% in moderately, mildly and very mildly disabled
pwMS, respectively. Subjects in the MCR group presented with elevated
fatigue compared with patients classified as normal [49.7 (SD = 23.3) vs
26.5 (SD = 19.2), p < 0.001]. Fear of falling was
significantly higher in the MCR and gait impairment groups compared with the
cognitively impaired and normal groups. Conclusions: The current study corroborates the presence of MCR in pwMS. Nevertheless,
future longitudinal research is warranted to better understand its
application.
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Affiliation(s)
| | - Shay Menascu
- Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Roy Aloni
- Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Uri Givon
- Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Mark Dolev
- Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Anat Achiron
- Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Alon Kalron
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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26
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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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27
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Holtzer R. Volitional control of walking in aging. Aging (Albany NY) 2022; 14:2440-2441. [PMID: 35344509 PMCID: PMC9004554 DOI: 10.18632/aging.203986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/25/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY 10461, USA
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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28
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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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29
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Bishnoi A, Chaparro GN, Hernandez ME. Effect of Heart Rate Reserve on Prefrontal Cortical Activation While Dual-Task Walking in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:47. [PMID: 35010305 PMCID: PMC8751037 DOI: 10.3390/ijerph19010047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
Hypertension is considered a risk factor for cardiovascular health and non-amnestic cognitive impairment in older adults. While heart rate reserve (HRR) has been shown to be a risk factor for hypertension, how impaired HRR in older adults can lead to cognitive impairment is still unclear. The objective of this study was to examine the effects of HRR on prefrontal cortical (PFC) activation under varying dual-task demands in older adults. Twenty-eight older adults (50-82 years of age) were included in this study and divided into higher (n = 14) and lower (n = 14) HRR groups. Participants engaged in the cognitive task which was the Modified Stroop Color Word Test (MSCWT) on a self-paced treadmill while walking. Participants with higher HRR demonstrated increased PFC activation in comparison to lower HRR, even after controlling for covariates in analysis. Furthermore, as cognitive task difficulty increased (from neutral to congruent to incongruent to switching), PFC activation increased. In addition, there was a significant interaction between tasks and HRR group, with older adults with higher HRR demonstrating increases in PFC activation, faster gait speed, and increased accuracy, relative to those with lower HRR, when going from neutral to switching tasks. These results provide evidence of a relationship between HRR and prefrontal cortical activation and cognitive and physical performance, suggesting that HRR may serve as a biomarker for cognitive health of an older adult with or without cardiovascular risk.
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Affiliation(s)
- Alka Bishnoi
- Department of Kinesiology and Community Health, College of Applied Health Science, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA;
| | - Gioella N. Chaparro
- Department of Kinesiology, California State University, Dominguez Hills, Carson, CA 90747, USA;
| | - Manuel E. Hernandez
- Department of Kinesiology and Community Health, College of Applied Health Science, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA;
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Maidan I, Hacham R, Galperin I, Giladi N, Holtzer R, Hausdorff JM, Mirelman A. Neural Variability in the Prefrontal Cortex as a Reflection of Neural Flexibility and Stability in Patients With Parkinson Disease. Neurology 2021; 98:e839-e847. [PMID: 34906983 DOI: 10.1212/wnl.0000000000013217] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 11/24/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Functional Near-Infrared Spectroscopy (fNIRS) studies provide direct evidence to the important role of the prefrontal cortex (PFC) during walking in aging and Parkinson's disease (PD). Most studies mainly explored mean HbO2 levels, while moment-to-moment variability measures have been rarely investigated. Variability measures can inform on flexibility that is imperative for adaptive function. We hypothesized that patients with PD will show less variability in HbO2 signals during walking compared to healthy controls. METHODS 206 participants, 57 healthy controls (age: 68.9±1.0 years; 27 women) and 149 idiopathic PD patients (age: 69.8±0.6 years, 50 women, disease duration: 8.27±5.51 years) performed usual walking and dual-task walking (serial 3 subtractions) with an fNIRS system placed on the forehead. HbO2 variability was calculated using the standard deviation (SD), range, and mean detrended time series of fNIRS-derived HbO2 signal evaluated during each walking task. HbO2 variability was compared between groups and between walking tasks using mixed model analyses. RESULTS Higher variability (SD, range, mean detrended time series) was observed during dual-task walking, compared to usual walking (p<0.025), but this was derived from the differences within the healthy control group (group X task interaction: p<0.007). On the other hand, task repetition demonstrated reduced variability in healthy controls but increased variability in patients with PD (interaction group*walk-repetition: p<0.048). The MDS-UPDRS motor score correlated with HbO2 range (r=0.142, p=0.050) and HbO2 SD (r=0.173, p=0.018) during usual walking in all participants. DISCUSSION In this study, we suggest a new way to interpret changes in HbO2 variability. We relate increased HbO2 variability to flexible adaptation to environmental challenges and decreased HbO2 variability to the stability of performance. Our results show that both are limited in PD however, further investigation of these concepts is required. Moreover, HbO2 variability measures are an important aspect of brain function that adds new insights into the role of PFC during walking with aging and PD. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that patients with PD have more variability within Hb02 signals during usual-walking, compared to healthy controls, but not during dual-task walking.
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Affiliation(s)
- Inbal Maidan
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel .,Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Roni Hacham
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ira Galperin
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nir Giladi
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Roee Holtzer
- Yeshiva University and Albert Einstein College of Medicine, New York, USA
| | - Jeffrey M Hausdorff
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel.,Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Anat Mirelman
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Holtzer R, Ross D, O'Brien C, Izzetoglu M, Wagshul ME. Cognitive Reserve Moderates the Efficiency of Prefrontal Cortex Activation Patterns of Gait in Older Adults. J Gerontol A Biol Sci Med Sci 2021; 77:1836-1844. [PMID: 34606598 DOI: 10.1093/gerona/glab288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cognitive Reserve (CR) protects against cognitive decline, but whether CR influences the efficiency of cortical control of gait has not been reported. The current study addressed this important gap in the literature. Specifically, we determined the role of CR in moderating the efficiency of functional Near-Infrared-Spectroscopy (fNIRS)-derived HbO2 in the prefrontal cortex (PFC) assessed during active walking. We hypothesized that higher CR would be associated with more efficient brain activation patterns. METHODS Participants were 55 (mean age=74.84; %female=49.1) older adults who underwent the combined walking/fNIRS protocol and had MRI data. We used an established dual-task walking paradigm that consisted of three task conditions: Single-Task-Walk (STW), Single-Task-Alpha (STA, cognitive task) and Dual-Task-Walk (DTW). Using the residuals approach, CR was derived from a word-reading test score by removing variance accounted for by socio-demographic variables, tests of current cognitive functions and a measure of structural brain integrity. RESULTS CR moderated the change in fNIRS-derived HbO2 in the PFC across tasks. Higher CR was associated with smaller increases in fNIRS-derived HbO2 from the single tasks to dual task walking (CR x DTW compared to STW: estimate = .183; p < .001; CR x DTW compared to STA: estimate =.257; p < .001). The moderation effect of CR remained significant when adjusting for multiple covariates and concurrent moderation effects of measures of gait performance, current cognitive functions and structural integrity of the brain. CONCLUSION The current study provided first evidence that higher CR was associated with better neural efficiency of walking in older adults.
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Affiliation(s)
- Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University.,Department of Neurology, Albert Einstein College of Medicine
| | - Daliah Ross
- Ferkauf Graduate School of Psychology, Yeshiva University
| | | | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University
| | - Mark E Wagshul
- Department of Radiology, Albert Einstein College of Medicine
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Ross D, Wagshul ME, Izzetoglu M, Holtzer R. Prefrontal cortex activation during dual-task walking in older adults is moderated by thickness of several cortical regions. GeroScience 2021; 43:1959-1974. [PMID: 34165696 DOI: 10.1007/s11357-021-00379-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/23/2021] [Indexed: 12/21/2022] Open
Abstract
Dual tasking, a defined facet of executive control processes, is subserved, in part, by the prefrontal cortex (PFC). Previous functional near-infrared spectroscopy (fNIRS) studies revealed elevated PFC oxygenated hemoglobin (HbO2) under Dual-Task-Walk (DTW) compared to Single-Task Walk (STW) conditions. Based on the concept of neural inefficiency (i.e., greater activation coupled with similar or worse performance), we hypothesized that decreased cortical thickness across multiple brain regions would be associated with greater HbO2 increases from STW to DTW. Participants were 55 healthy community-dwelling older adults, whose cortical thickness was measured via MRI. HbO2 levels in the PFC, measured via fNIRS, were assessed during active walking under STW and DTW conditions. Statistical analyses were adjusted for demographics and behavioral performance. Linear mixed-effects models revealed that the increase in HbO2 from STW to DTW was moderated by cortical thickness in several regions. Specifically, thinner cortex in specific regions of the frontal, parietal, temporal, and occipital lobes, cingulate cortex, and insula was associated with greater increases in HbO2 levels from single to dual-task walking. In conclusion, participants with thinner cortex in regions implicated in higher order control of walking employed greater neural resources, as measured by increased HbO2, in the PFC during DTW, without demonstrating benefits to behavioral performance. To our knowledge, this is the first study to examine cortical thickness as a marker of neural inefficiency during active walking.
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Affiliation(s)
- Daliah Ross
- Ferkauf Graduate School of Psychology, Yeshiva University, 1225 Morris Park Avenue, Van Etten Building, Bronx, NY, 10461, USA
| | - Mark E Wagshul
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University, Villanova, PA, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, 1225 Morris Park Avenue, Van Etten Building, Bronx, NY, 10461, USA. .,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
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Motor Cortical Activation Assessment in Progressive Multiple Sclerosis Patients Enrolled in Gait Rehabilitation: A Secondary Analysis of the RAGTIME Trial Assisted by Functional Near-Infrared Spectroscopy. Diagnostics (Basel) 2021; 11:diagnostics11061068. [PMID: 34207923 PMCID: PMC8227480 DOI: 10.3390/diagnostics11061068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 01/16/2023] Open
Abstract
This study aimed to determine cortical activation responses to two different rehabilitative programs, as measured through functional near-infrared spectroscopy (fNIRS). As a secondary analysis of the RAGTIME trial, we studied 24 patients with progressive multiple sclerosis (MS) and severe disability who were randomized to a regimen of robot-assisted gait training (RAGT) or overground walking (OW). Cortical activation during a treadmill walking task, assessed through fNIRS recordings from the motor and premotor cortexes (M1/PM), was calculated as the area under the curve (AUC) of oxyhemoglobin for each hemisphere and the total area (Tot-OxyAUC). Gait speed, endurance, and balance were also measured, along with five healthy control subjects. At baseline, Tot-OxyAUC during walking was significantly increased in MS patients compared to healthy people and was significantly higher for those with more severe disabilities; it was also inversely correlated with physical performance. After rehabilitation, significant opposite variations in Tot-OxyAUC were observed, with activity levels being increased after OW and decreased after RAGT (+242,080 ± 361,902 and −157,031 ± 172,496 arbitrary units, respectively; p = 0.002), particularly in patients who were trained at a lower speed. Greater reductions in the cortical activation of the more affected hemisphere were significantly related to improvements in gait speed (r = −0.42) and endurance (r = −0.44). Cortical activation, assessed through fNIRS, highlighted the brain activity in response to the type and intensity of rehabilitation.
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