Neuroscience Research Australia, University of New South Wales, New South Wales, Australia.
School of Public Health and Community and Medicine, University of New South Wales, New South Wales, Australia.
Neurorehabil Neural Repair. 2020 Dec;34(12):1088-1098. doi: 10.1177/1545968320969943. Epub 2020 Nov 6.
People with Parkinson's disease (PD) have difficulties generating quick and accurate steps in anticipation of and/or in response to environmental hazards. However, neural mechanisms underlying performance in cognitively demanding stepping tasks are unclear.
This study compared activation patterns in cognitive and motor cortical regions using functional near-infrared spectroscopy (fNIRS) between people with PD and age-matched healthy older adults (HOA) during stepping tasks.
Fifty-two people with PD and 95 HOA performed a simple choice stepping reaction time test (CSRT) and 2 cognitively demanding stepping tests (inhibitory CSRT [iCSRT] and Stroop stepping test [SST]) on a computerized step mat. Cortical activation in the dorsolateral prefrontal cortex (DLPFC), Broca's area, supplementary motor area (SMA), and premotor cortex (PMC) were recorded using fNIRS. Stepping performance and cortical activity were contrasted between groups and between the CSRT and the iCSRT and SST.
The PD group performed worse than the HOA in all 3 stepping tests. A consistent pattern of interactions indicated differential hemodynamic responses between the groups. Compared with the CSRT, the PD group exhibited reduced DLPFC activity in the iCSRT and reduced SMA and PMC activity in the SST. The HOA exhibited increased DLPFC, SMA, and PMC activity when performing the SST in comparison with the CSRT task.
In contrast to the HOA, the PD group demonstrated reduced cortical activity in the DLPFC, SMA, and PMC during the more complex stepping tasks requiring inhibitory control. This may reflect subcortical and/or multiple pathway damage with subsequent deficient use of cognitive and motor resources.
帕金森病（PD）患者在预测和/或应对环境危险时，难以快速准确地迈出步伐。然而，认知要求高的跨步任务中表现的神经机制尚不清楚。
本研究通过功能近红外光谱（fNIRS）比较 PD 患者和年龄匹配的健康老年人（HOA）在执行跨步任务时认知和运动皮质区域的激活模式。
52 名 PD 患者和 95 名 HOA 在计算机化的踏步垫上进行了简单选择踏步反应时间测试（CSRT）和 2 项认知要求高的踏步测试（抑制性 CSRT [iCSRT]和斯特鲁普踏步测试 [SST]）。使用 fNIRS 记录背外侧前额叶皮质（DLPFC）、布罗卡区、辅助运动区（SMA）和运动前皮质（PMC）的皮质激活。比较组间和 CSRT 与 iCSRT 和 SST 之间的踏步表现和皮质活动。
PD 组在所有 3 项踏步测试中的表现均差于 HOA 组。一致的相互作用模式表明两组之间存在不同的血液动力学反应。与 CSRT 相比，PD 组在 iCSRT 中 DLPFC 活动减少，在 SST 中 SMA 和 PMC 活动减少。与 CSRT 任务相比，HOA 组在执行 SST 时表现出 DLPFC、SMA 和 PMC 活动增加。
与 HOA 组相比，PD 组在需要抑制控制的更复杂的踏步任务中，DLPFC、SMA 和 PMC 的皮质活动减少。这可能反映了皮质下和/或多途径损伤，随后导致认知和运动资源的使用不足。
