Al-Yahya Emad, Johansen-Berg Heidi, Kischka Udo, Zarei Mojtaba, Cockburn Janet, Dawes Helen
The University of Jordan, Amman, Jordan Oxford Brookes University, Oxford, UK
University of Oxford, Oxford, UK.
Neurorehabil Neural Repair. 2016 Jul;30(6):591-9. doi: 10.1177/1545968315613864. Epub 2015 Oct 21.
Background Walking while performing another task (eg, talking) is challenging for many stroke survivors, yet its neural basis are not fully understood. Objective To investigate prefrontal cortex activation and its relationship to gait measures while walking under single-task (ST) and dual-task (DT) conditions (ie, walking while simultaneously performing a cognitive task) in stroke survivors. Methods We acquired near-infrared spectroscopy (NIRS) data from the prefrontal cortex during treadmill walking in ST and DT conditions in chronic stroke survivors and healthy controls. We also acquired functional magnetic resonance imaging (fMRI) and NIRS during simulated walking under these conditions. Results NIRS revealed increased oxygenated hemoglobin concentration in DT-walking compared with ST-walking for both groups. For simulated walking, NIRS showed a significant effect of group and group × task, being greater on both occasions, in stroke survivors. A greater increase in brain activation observed from ST to DT walking/ simulated walking was related to a greater change in motor performance in stroke survivors. fMRI revealed increased activity during DT relative to ST conditions in stroke patients in areas including the inferior temporal gyri, superior frontal gyri and cingulate gyri bilaterally, and the right precentral gyrus. The DT-related increase in fMRI activity correlated with DT-related change in behavior in stroke participants in the bilateral inferior temporal gyrus, left cingulate gyrus, and left frontal pole. Conclusion Our results provide novel evidence that enhanced brain activity changes relate to dual task motor decrements.
背景:对于许多中风幸存者来说,在执行另一项任务(如说话)时行走具有挑战性,但其神经基础尚未完全明确。目的:研究中风幸存者在单任务(ST)和双任务(DT)条件下(即同时执行认知任务时行走)行走时前额叶皮层的激活情况及其与步态测量的关系。方法:我们在慢性中风幸存者和健康对照者在跑步机上行走的ST和DT条件下,从前额叶皮层获取近红外光谱(NIRS)数据。我们还在这些条件下模拟行走期间获取功能磁共振成像(fMRI)和NIRS数据。结果:两组中,与ST行走相比,NIRS显示DT行走时氧合血红蛋白浓度增加。对于模拟行走,NIRS显示出组和组×任务的显著影响,在中风幸存者中,两种情况下均更大。在中风幸存者中,从ST行走/模拟行走观察到的大脑激活增加幅度更大与运动表现的更大变化有关。fMRI显示,中风患者在DT条件下相对于ST条件,包括双侧颞下回、额上回和扣带回以及右侧中央前回等区域的活动增加。fMRI活动中与DT相关的增加与中风参与者双侧颞下回、左侧扣带回和左侧额极中与DT相关的行为变化相关。结论:我们的结果提供了新的证据,即增强的大脑活动变化与双任务运动能力下降有关。
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