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Prefrontal over-activation during walking in people with mobility deficits: Interpretation and functional implications.

作者信息

Hawkins Kelly A, Fox Emily J, Daly Janis J, Rose Dorian K, Christou Evangelos A, McGuirk Theresa E, Otzel Dana M, Butera Katie A, Chatterjee Sudeshna A, Clark David J

机构信息

Department of Physical Therapy, University of Florida, PO Box 100154, Gainesville, FL 32610, USA.

Department of Physical Therapy, University of Florida, PO Box 100154, Gainesville, FL 32610, USA; Brooks Rehabilitation, 3901 University Blvd S, Jacksonville, FL 32216, USA.

出版信息

Hum Mov Sci. 2018 Jun;59:46-55. doi: 10.1016/j.humov.2018.03.010. Epub 2018 Mar 29.


DOI:10.1016/j.humov.2018.03.010
PMID:29604488
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5988641/
Abstract

BACKGROUND: Control of walking by the central nervous system includes contributions from executive control mechanisms, such as attention and motor planning resources. Executive control of walking can be estimated objectively by recording prefrontal cortical activity using functional near infrared spectroscopy (fNIRS). OBJECTIVE: The primary objective of this study was to investigate group differences in prefrontal/executive control of walking among young adults, older adults, and adults post-stroke. Also assessed was the extent to which walking-related prefrontal activity fits existing cognitive frameworks of prefrontal over-activation. METHODS: Participants included 24 adults post-stroke with moderate to severe walking deficits, 15 older adults with mild gait deficits, and 9 young healthy adults. Executive control of walking was quantified as oxygenated hemoglobin concentration in the prefrontal cortex measured by fNIRS. Three walking tasks were assessed: typical walking, walking over obstacles, and walking while performing a verbal fluency task. Walking performance was assessed by walking speed. RESULTS: There was a significant effect of group for prefrontal activity (p < 0.001) during typical and obstacles walking tasks, with young adults exhibiting the lowest level of prefrontal activity, followed by older adults, and then adults post-stroke. In young adults the prefrontal activity during typical walking was much lower than for the verbal fluency dual-task, suggesting substantial remaining prefrontal resources during typical walking. However, in older and post-stroke adults these remaining resources were significantly less (p < 0.01). Cumulatively, these results are consistent with prefrontal over-activation in the older and stroke groups, which was accompanied by a steeper drop in walking speed as task complexity increased to include obstacles (p < 0.05). CONCLUSIONS: There is a heightened use of prefrontal/executive control resources in older adults and post-stroke adults during walking. The level of prefrontal resource utilization, particularly during complex walking tasks like obstacle crossing, may approach the ceiling of available resources for people who have walking deficits. Prior cognitive research has revealed that prefrontal over-activation combined with limited prefrontal resources can lead to poor cognitive performance. The present study suggests a similar situation influences walking performance. Future research should further investigate the extent to which prefrontal over-activation during walking is linked to adverse mobility outcomes.

摘要

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本文引用的文献

[1]
Neural correlates of obstacle negotiation in older adults: An fNIRS study.

Gait Posture. 2017-10

[2]
Effects of aging on prefrontal brain activation during challenging walking conditions.

Brain Cogn. 2017-7

[3]
Functional brain imaging of walking while talking - An fNIRS study.

Neuroscience. 2017-2-20

[4]
Brain activation changes during locomotion in middle-aged to older adults with multiple sclerosis.

J Neurol Sci. 2016-11-15

[5]
Walking while Performing Working Memory Tasks Changes the Prefrontal Cortex Hemodynamic Activations and Gait Kinematics.

Front Behav Neurosci. 2016-5-18

[6]
The Role of the Frontal Lobe in Complex Walking Among Patients With Parkinson's Disease and Healthy Older Adults: An fNIRS Study.

Neurorehabil Neural Repair. 2016-11

[7]
Altered brain activation in complex walking conditions in patients with Parkinson's disease.

Parkinsonism Relat Disord. 2016-4

[8]
Automaticity of walking: functional significance, mechanisms, measurement and rehabilitation strategies.

Front Hum Neurosci. 2015-5-5

[9]
Online fronto-cortical control of simple and attention-demanding locomotion in humans.

Neuroimage. 2015-5-15

[10]
Walking adaptability after a stroke and its assessment in clinical settings.

Stroke Res Treat. 2014

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