Lapanan Kulvara, Kantha Phunsuk, Nantachai Gallayaporn, Hemrungrojn Solaphat, Maes Michael
Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Heliyon. 2023 Jul 6;9(7):e17812. doi: 10.1016/j.heliyon.2023.e17812. eCollection 2023 Jul.
Functional near-infrared spectroscopy (fNIRS) is a method to measure cerebral hemodynamics. Determining the changes in prefrontal cortex (PFC) hemodynamics during dual-task paradigms is essential in explaining alterations in physical activities, especially in older adults.
To systematically review and meta-analyze the effects of dual-task paradigms on PFC hemodynamics in older adults.
The search was conducted in PubMed, Scopus, and Web of Science from inception until March 2023 to identify studies on the effects of dual-task paradigms on PFC hemodynamics. The meta-analysis included variables of cerebral hemodynamics, such as oxygenated hemoglobin (HbO) and deoxygenated hemoglobin (HbR). The heterogeneity of the included studies was determined using the I statistic. Additionally, subgroup analysis was conducted to compare the effects of different types of cognitive tasks.
A total of 37 studies were included in the systematic review, 25 studies comprising 2224 older adults were included in the meta-analysis. Our findings showed that inhibitory control and working memory tasks significantly increased HbO in the PFC by 0.53 ( < 0.01, 95% CI = 0.37 to 0.70) and 0.13 ( < 0.01, 95% CI = 0.08 to 0.18) μmol/L, respectively. Overall, HbO was significantly increased during dual-task paradigms by 0.36 μmol/L ( < 0.01, 95% CI = 0.27 to 0.45). Moreover, dual-task paradigms also decreased HbR in the PFC by 0.04 ( < 0.01, 95% CI = -0.07 to -0.01). Specifically, HbR decreased by 0.08 during inhibitory control tasks ( < 0.01, 95% CI = -0.13 to -0.02), but did not change during working memory tasks.
Cognitive tasks related to inhibitory control required greater cognitive demands, indicating higher pfc activation during dual-task paradigms in older adults. for clinical implications, the increase in pfc oxygenated hemoglobin and decrease in pfc deoxygenated hemoglobin may help explain why older adults are more likely to fall during daily activities.
功能近红外光谱技术（fNIRS）是一种测量脑血流动力学的方法。确定双任务范式期间前额叶皮质（PFC）血流动力学的变化对于解释身体活动的改变至关重要，尤其是在老年人中。
系统评价和荟萃分析双任务范式对老年人PFC血流动力学的影响。
在PubMed、Scopus和Web of Science数据库中从建库至2023年3月进行检索，以识别关于双任务范式对PFC血流动力学影响的研究。荟萃分析纳入了脑血流动力学变量，如氧合血红蛋白（HbO）和脱氧血红蛋白（HbR）。使用I统计量确定纳入研究的异质性。此外，进行亚组分析以比较不同类型认知任务的影响。
系统评价共纳入37项研究，荟萃分析纳入25项研究，共2224名老年人。我们的研究结果表明，抑制控制任务和工作记忆任务分别使PFC中的HbO显著增加0.53（<0.01，95%CI=0.37至0.70）和0.13（<0.01，95%CI=0.08至0.18）μmol/L。总体而言，在双任务范式期间HbO显著增加0.36μmol/L（<0.01，95%CI=0.27至0.45）。此外，双任务范式还使PFC中的HbR降低0.04（<0.01，95%CI=-0.07至-0.01）。具体而言，在抑制控制任务期间HbR降低0.08（<0.01，95%CI=-0.13至-0.02），但在工作记忆任务期间没有变化。
与抑制控制相关的认知任务需要更高的认知需求，表明老年人在双任务范式期间PFC激活更高。对于临床意义而言，PFC氧合血红蛋白的增加和PFC脱氧血红蛋白的降低可能有助于解释为什么老年人在日常活动中更容易跌倒。
