Oregon Health & Science University, Department of Neurology, Portland, OR, USA.
Universidade Estadual Paulista (UNESP), Instituto de Biociências, Campus Rio Claro, Brazil.
Maturitas. 2018 Jul;113:53-72. doi: 10.1016/j.maturitas.2018.04.011. Epub 2018 Apr 25.
An emerging body of literature has examined cortical activity during walking and balance tasks in older adults and in people with Parkinson's disease, specifically using functional near infrared spectroscopy (fNIRS) or electroencephalography (EEG). This review provides an overview of this developing area, and examines the disease-specific mechanisms underlying walking or balance deficits. Medline, PubMed, PsychInfo and Scopus databases were searched. Articles that described cortical activity during walking and balance tasks in older adults and in those with PD were screened by the reviewers. Thirty-seven full-text articles were included for review, following an initial yield of 566 studies. This review summarizes study findings, where increased cortical activity appears to be required for older adults and further for participants with PD to perform walking and balance tasks, but specific activation patterns vary with the demands of the particular task. Studies attributed cortical activation to compensatory mechanisms for underlying age- or PD-related deficits in automatic movement control. However, a lack of standardization within the reviewed studies was evident from the wide range of study protocols, instruments, regions of interest, outcomes and interpretation of outcomes that were reported. Unstandardized data collection, processing and reporting limited the clinical relevance and interpretation of study findings. Future work to standardize approaches to the measurement of cortical activity during walking and balance tasks in older adults and people with PD with fNIRS and EEG systems is needed, which will allow direct comparison of results and ensure robust data collection/reporting. Based on the reviewed articles we provide clinical and future research recommendations.
越来越多的文献研究了老年人和帕金森病患者在行走和平衡任务中的皮质活动，具体使用了功能近红外光谱 (fNIRS) 或脑电图 (EEG)。本综述提供了该新兴领域的概述，并探讨了导致行走或平衡障碍的特定疾病机制。检索了 Medline、PubMed、PsychInfo 和 Scopus 数据库。由审稿人筛选出描述老年人和 PD 患者行走和平衡任务期间皮质活动的文章。在最初的 566 项研究中，有 37 篇全文文章被纳入综述。本综述总结了研究结果，表明皮质活动的增加对于老年人以及进一步对于 PD 参与者执行行走和平衡任务是必需的，但特定的激活模式因特定任务的要求而异。研究将皮质激活归因于自动运动控制中与年龄或 PD 相关的潜在缺陷的补偿机制。然而，从报告的研究方案、仪器、感兴趣区域、结果和结果解释的广泛差异中可以明显看出，综述中的研究缺乏标准化。未标准化的数据收集、处理和报告限制了研究结果的临床相关性和解释。未来需要标准化使用 fNIRS 和 EEG 系统测量老年人和 PD 患者行走和平衡任务期间皮质活动的方法，这将允许直接比较结果并确保稳健的数据收集/报告。基于综述文章，我们提供了临床和未来研究建议。
