帕金森病患者在认知和运动双重任务中的多区域脑激活和步态恶化。

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY
Yan-Ci Liu, Yea-Ru Yang, Nai-Chen Yeh, Pei-Hsin Ku, Chia-Feng Lu, Ray-Yau Wang
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引用次数: 1

摘要

背景与目的:在帕金森病患者(PD)中,先前的研究已经注意到双任务行走时步态性能恶化。然而,不同类型的双重任务对步态表现和大脑激活的影响尚不清楚。本研究的目的是探讨认知和运动双任务行走对PD患者多区域脑活动的影响。方法:招募28名PD患者,以自行选择的速度进行单步行走(SW)、边走边做认知任务(WCT)和边走边做运动任务(WMT)。步态表现包括步行速度、步幅长度、步幅时间、摆动周期、时空变异性和双任务成本(DTC)。使用功能近红外光谱测量行走过程中前额叶皮质(PFC)、运动前皮质(PMC)和辅助运动区(SMA)的脑激活情况。结果:在执行次要任务,尤其是认知任务时,行走能力下降。此外,在步行后期,与WMT和SW相比,WCT期间PMC和SMA的激活程度更高,持续时间更长。然而,与SW相比,在WMT期间,SMA和PMC没有表现出增加的激活。此外,在不同的步行任务中,步态表现与PMC和SMA活动呈负相关。讨论和结论:轻度至中度PD患者在双任务行走时表现出步态恶化,特别是在WCT期间。PD患者在进行认知双任务行走时,SMA和PMC进一步被激活。补充数字内容可在文本中获得。视频摘要可获得作者的更多见解(参见视频,补充数字内容1,可在:http://links.lww.com/JNPT/A383)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Multiarea Brain Activation and Gait Deterioration During a Cognitive and Motor Dual Task in Individuals With Parkinson Disease.

Background and purpose: In people with Parkinson disease (PD), gait performance deteriorating during dual-task walking has been noted in previous studies. However, the effects of different types of dual tasks on gait performance and brain activation are still unknown. The purpose of this study was to investigate cognitive and motor dual-task walking performance on multiarea brain activity in individuals with PD.

Methods: Twenty-eight participants with PD were recruited and performed single walking (SW), walking while performing a cognitive task (WCT), and walking while performing a motor task (WMT) at their self-selected speed. Gait performance including walking speed, stride length, stride time, swing cycle, temporal and spatial variability, and dual-task cost (DTC) was recorded. Brain activation of the prefrontal cortex (PFC), premotor cortex (PMC), and supplementary motor areas (SMA) were measured using functional near-infrared spectroscopy during walking.

Results: Walking performance deteriorated upon performing a secondary task, especially the cognitive task. Also, a higher and more sustained activation in the PMC and SMA during WCT, as compared with the WMT and SW, in the late phase of walking was found. During WMT, however, the SMA and PMC did not show increased activation compared with during SW. Moreover, gait performance was negatively correlated with PMC and SMA activity during different walking tasks.

Discussion and conclusions: Individuals with mild to moderate PD demonstrated gait deterioration during dual-task walking, especially during WCT. The SMA and PMC were further activated in individuals with PD when performing cognitive dual-task walking.Supplemental Digital Content is Available in the Text.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A383 ).

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来源期刊
Journal of Neurologic Physical Therapy
Journal of Neurologic Physical Therapy CLINICAL NEUROLOGY-REHABILITATION
CiteScore
5.70
自引率
2.60%
发文量
63
审稿时长
>12 weeks
期刊介绍: The Journal of Neurologic Physical Therapy (JNPT) is an indexed resource for dissemination of research-based evidence related to neurologic physical therapy intervention. High standards of quality are maintained through a rigorous, double-blinded, peer-review process and adherence to standards recommended by the International Committee of Medical Journal Editors. With an international editorial board made up of preeminent researchers and clinicians, JNPT publishes articles of global relevance for examination, evaluation, prognosis, intervention, and outcomes for individuals with movement deficits due to neurologic conditions. Through systematic reviews, research articles, case studies, and clinical perspectives, JNPT promotes the integration of evidence into theory, education, research, and practice of neurologic physical therapy, spanning the continuum from pathophysiology to societal participation.
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