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痴迷但我忘了原因:轻度认知障碍老年跌倒者的功能连接中断。

Head over heels but I forget why: Disruptive functional connectivity in older adult fallers with mild cognitive impairment.

机构信息

Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.

Faculty of Medicine, McGill University, Montreal, QC, Canada; Centre of Excellence on Aging and Chronic Diseases of McGill University Health Network, Montreal, QC, Canada.

出版信息

Behav Brain Res. 2019 Dec 30;376:112104. doi: 10.1016/j.bbr.2019.112104. Epub 2019 Jul 17.

Abstract

UNLABELLED

Disrupted functional connectivity has been highlighted as a neural mechanism by which impaired cognitive function and mobility co-exist in older adults with mild cognitive impairment (MCI). The objective of this study was to determine the independent and combined effects of MCI and faller status on functional connectivity of three functional networks: default mode network (DMN), fronto-parietal network (FPN) and sensorimotor network (SMN) between 4 groups of older adults: 1) Healthy; 2) MCI without Falls; 3) Fallers without MCI; and 4) Fallers with MCI.

METHODS

Sixty-six adults aged 70-80 years old were included. Cognition was assessed using: 1) cognitive dual task; 2) Stroop Colour-Word Test; 3) Trail Making Tests (TMT); and 4) Digit Symbol Substitution Test (DSST). Postural sway was assessed with eyes opened and standing on the floor. Functional connectivity was measured using fMRI while performing a finger-tapping task.

RESULTS

Differences in DMN-SMN connectivity were found for Fallers with MCI vs Fallers without MCI (p = .001). Fallers with MCI had significantly greater postural sway than the other groups. Both DMN-SMN connectivity (p = .03) and postural sway (p = .001) increased in a significantly linear fashion from Fallers without MCI, to MCI without Falls, to Fallers with MCI. Participants with MCI performed significantly worse on the DSST (p = .003) and TMT (p = .007) than those without MCI.

CONCLUSION

Aberrant DMN-SMN connectivity may underlie reduced postural stability. Having both impaired cognition and mobility is associated with a greater level of disruptive DMN-SMN connectivity and increased postural sway than singular impairment.

摘要

目的

本研究旨在确定轻度认知障碍(MCI)和跌倒者状态对 4 组老年人三个功能网络(默认模式网络[DMN]、额顶网络[FPN]和感觉运动网络[SMN])功能连接的独立和综合影响:1)健康;2)无跌倒的 MCI;3)无 MCI 的跌倒者;和 4)MCI 和跌倒者。

方法

纳入 66 名 70-80 岁的成年人。使用 1)认知双重任务;2)Stroop 颜色-单词测试;3)Trail Making Tests(TMT);和 4)数字符号替代测试(DSST)评估认知。使用 fMRI 在睁眼和站立在地板上时评估姿势摆动。使用 fMRI 在执行手指敲击任务时测量功能连接。

结果

与无 MCI 的跌倒者相比,MCI 和跌倒者的 DMN-SMN 连接存在差异(p=0.001)。MCI 和跌倒者的姿势摆动明显大于其他组。DMN-SMN 连接(p=0.03)和姿势摆动(p=0.001)均呈显著线性增加,从无 MCI 的跌倒者、无 MCI 的 MCI 到 MCI 和跌倒者。MCI 参与者在 DSST(p=0.003)和 TMT(p=0.007)上的表现明显差于无 MCI 参与者。

结论

异常的 DMN-SMN 连接可能是姿势稳定性降低的基础。认知和运动功能同时受损与更严重的 DMN-SMN 连接中断和姿势摆动增加有关,而不是单一的损伤。

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