Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, IL, USA.
Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA.
Neurorehabil Neural Repair. 2024 Dec;38(11-12):795-807. doi: 10.1177/15459683241273411. Epub 2024 Aug 23.
Mobility and cognitive impairment are prevalent and co-occurring in older adults with multiple sclerosis (OAMS), yet there is limited research concerning the role of disability status in the cognitive control of gait among OAMS.
We investigated the levels of prefrontal cortex (PFC) activation, using oxygenated hemoglobin (HbO), during cognitively-demanding tasks in OAMS with lower and higher disability using functional near-infrared spectroscopy (fNIRS) to: (1) identify PFC activation differences in single task walk and cognitively-demanding tasks in OAMS with different levels of disability; and (2) evaluate if disability may moderate practice-related changes in neural efficiency in OAMS.
We gathered data from OAMS with lower (n = 51, age = 65 ± 4 years) or higher disability (n = 48, age = 65 ± 5 years), using a cutoff of 3 or more, in the Patient Determined Disease Steps, for higher disability, under 3 different conditions (single-task walk, Single-Task-Alpha, and Dual-Task-Walk [DTW]) administered over 3 counterbalanced, repeated trials.
OAMS who had a lower disability level exhibited decreased PFC activation levels during Single-Task-Walk (STW) and larger increases in PFC activation levels, when going from STW to a cognitively-demanding task, such as a DTW, than those with higher disability. OAMS with a lower disability level exhibited greater declines in PFC activation levels with additional within session practice than those with a higher disability level.
These findings suggest that disability moderates brain adaptability to cognitively-demanding tasks and demonstrate the potential for fNIRS-derived outcome measures to complement neurorehabilitation outcomes.
移动能力和认知障碍在多发性硬化症（MS）老年患者中普遍存在且同时发生，但关于残疾状况在这些患者认知控制步态中的作用的研究有限。
我们使用功能近红外光谱（fNIRS）研究了低残疾和高残疾 MS 老年患者在执行认知要求任务时前额叶皮层（PFC）的氧合血红蛋白（HbO）激活水平，以：（1）确定不同残疾程度的 MS 老年患者在执行单任务行走和认知要求任务时的 PFC 激活差异；（2）评估残疾状况是否可能调节 MS 老年患者神经效率的与练习相关变化。
我们收集了低残疾（n = 51，年龄 = 65±4 岁）和高残疾（n = 48，年龄 = 65±5 岁）MS 老年患者的数据，使用患者确定疾病步骤的 3 分或更高的残疾评分作为高残疾标准，在 3 种不同条件（单任务行走、单任务阿尔法和双任务行走 [DTW]）下进行 3 次平衡重复试验。
与高残疾患者相比，低残疾患者在执行单任务行走（STW）时 PFC 激活水平较低，在从 STW 过渡到认知要求任务（如 DTW）时 PFC 激活水平增加更大。与高残疾患者相比，低残疾患者在额外的会话内练习时 PFC 激活水平下降更大。
这些发现表明残疾状况调节了大脑对认知要求任务的适应性，并表明 fNIRS 衍生的结果测量有潜力补充神经康复结果。
