Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
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A Systematic Review of Cortical Excitability during Dual-Task in Post-Stroke Patients

  • Soyi Jung (Department of physical therapy, Uijeongbu eulji university hospital) ;
  • Chang-Sik An (Department of Physical Therapy, College of Health Science, Eulji University)
  • Received : 2024.06.02
  • Accepted : 2024.06.27
  • Published : 2024.06.30
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Abstract

Objective: Stroke is a leading cause of disability worldwide, often leaving survivors with significant cognitive and motor impairments. Dual-task (DT), which involves performing cognitive and motor tasks simultaneously, can influence brain activation patterns and functional recovery in stroke patients. Design: A systematic review Methods: Following PRISMA guidelines, databases including MEDLINE, CINAHL, Embase, and Web of Science were searched for studies assessing cortical activation via functional near-infrared spectroscopy (fNIRS) during DT performance in stroke patients. Studies were selected based on predefined eligibility criteria, focusing on changes in hemodynamic responses and their correlation with task performance. Results: Eight studies met the inclusion criteria. Findings indicate that DT leads to increased activation in the prefrontal cortex (PFC), premotor cortex (PMC), and posterior parietal cortex (PPC), suggesting an integrated cortical response to managing concurrent cognitive and motor demands. However, increased activation did not consistently translate to improved functional outcomes, highlighting the complex relationship between brain activation and rehabilitation success. Conclusions: DT interventions may enhance cortical activation and neuroplasticity in post-stroke patients, but the relationship between increased brain activity and functional recovery remains complex and requires further investigation. Tailored DT programs that consider individual neurophysiological and functional capacities are recommended to optimize rehabilitation outcomes.

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References

  1. Saini V, Guada L, Yavagal DR. Global Epidemiology of Stroke and Access to Acute Ischemic Stroke Interventions. Neurology. 2021;97:S6-S16.
  2. Barker-Collo S, Feigin V, Parag V, Lawes C, Senior H. Auckland stroke outcomes study: part 2: cognition and functional outcomes 5 years poststroke. Neurology. 2010;75:1608-16.
  3. Grotta JC, Albers GW, Broderick JP, Kasner SE, Lo EH, Sacco RL, et al. Stroke: pathophysiology, diagnosis, and management. 7th ed. Philadelphia, USA: Elsevier Inc.; 2021.
  4. Al-Yahya E, Dawes H, Smith L, Dennis A, Howells K, Cockburn J. Cognitive motor interference while walking: a systematic review and metaanalysis. Neurosci Biobehav Rev. 2011;35:715-28.
  5. Plummer P, Eskes G, Wallace S, Giuffrida C, Fraas M, Campbell G, et al. Cognitive-motor interference during functional mobility after stroke: state of the science and implications for future research. Arch Phys Med Rehabil. 2013;94:2565-74. e6.
  6. Filiatrault J, Arsenault AB, Dutil E, Bourbonnais D. Motor function and activities of daily living assessments: a study of three tests for persons with hemiplegia. Am J Occup Ther. 1991;45:806-10.
  7. Abernethy B. Dual-task methodology and motor skills research: some applications and methodological constraints. J Hum Mov Stud. 1988;14:101-32.
  8. Tsang CSL, Pang MYC. Association of subsequent falls with evidence of dual-task interference while walking in community-dwelling individuals after stroke. Clin Rehabil. 2020;34:971-80.
  9. Bishnoi A, Holtzer R, Hernandez ME. Brain activation changes while walking in adults with and without neurological disease: systematic review and meta-analysis of functional near-infrared spectroscopy studies. Brain Sci. 2021;11:291.
  10. Wagshul ME, Lucas M, Ye K, Izzetoglu M, Holtzer R. Multi-modal neuroimaging of dual-task walking: Structural MRI and fNIRS analysis reveals prefrontal grey matter volume moderation of brain activation in older adults. Neuroimage. 2019;189:745-54.
  11. Mirelman A, Maidan I, Bernad-Elazari H, Nieuwhof F, Reelick M, Giladi N, et al. Increased frontal brain activation during walking while dual tasking: an fNIRS study in healthy young adults. J Neuroeng Rehabil. 2014;11:1-7.
  12. Mehagnoul-Schipper DJ, van der Kallen BFW, Colier WNJM, van der Sluijs MC, van Erning LJTO, Thijssen HOM, et al. Simultaneous measurements of cerebral oxygenation changes during brain activation by near-infrared spectroscopy and functional magnetic resonance imaging in healthy young and elderly subjects. Hum Brain Mapp. 2002;16:14-23.
  13. Csipo T, Mukli P, Lipecz A, Tarantini S, Bahadli D, Abdulhussein O, et al. Assessment of age-related decline of neurovascular coupling responses by functional near-infrared spectroscopy (fNIRS) in humans. Geroscience. 2019;41:495-509.
  14. Pinti P, Tachtsidis I, Hamilton A, Hirsch J, Aichelburg C, Gilbert S, et al. The present and future use of functional near-infrared spectroscopy (fNIRS) for cognitive neuroscience. Ann N Y Acad Sci. 2020;1464:5-29.
  15. Huo C, Xu G, Li W, Xie H, Zhang T, Liu Y, et al. A review on functional near-infrared spectroscopy and application in stroke rehabilitation. Med Nov Technol Devices. 2021;11:100064.
  16. Obrig H. NIRS in clinical neurology a - 'promising' tool? Neuroimage. 2014;85:535-46.
  17. Yucel MA, Selb JJ, Huppert TJ, Franceschini MA, Boas DA. Functional near infrared spectroscopy: enabling routine functional brain imaging. Curr Opin Biomed Eng. 2017;4:78-86.
  18. Chen Y, Cao Z, Mao M, Sun W, Song Q, Mao D. Increased cortical activation and enhanced functional connectivity in the prefrontal cortex ensure dynamic postural balance during dual-task obstacle negotiation in the older adults: A fNIRS study. Brain Cogn. 2022;163:105904.
  19. Lu C-F, Liu Y-C, Yang Y-R, Wu Y-T, Wang R-Y. Maintaining gait performance by cortical activation during dual-task interference: a functional near-infrared spectroscopy study. PLoS One. 2015;10:e0129390.
  20. Maidan I, Nieuwhof F, Bernad-Elazari H, Reelick MF, Bloem BR, Giladi N, et al. The Role of the Frontal Lobe in Complex Walking Among Patients With Parkinson's Disease and Healthy Older Adults:An fNIRS Study. Neurorehabil Neural Repair. 2016;30:963-71.
  21. Meester D, Al-Yahya E, Dawes H, Martin-Fagg P, Pinon C. Associations between prefrontal cortex activation and H-reflex modulation during dual task gait. fnhum. 2014;8:78.
  22. Mirelman A, Maidan I, Bernad-Elazari H, Shustack S, Giladi N, Hausdorff JM. Effects of aging on prefrontal brain activation during challenging walking conditions. Brain Cogn. 2017;115:41-6.
  23. Pelicioni PH, Tijsma M, Lord SR, Menant J. Prefrontal cortical activation measured by fNIRS during walking: effects of age, disease and secondary task. PeerJ. 2019;7:e6833.
  24. Suzuki M, Miyai I, Ono T, Oda I, Konishi I, Kochiyama T, et al. Prefrontal and premotor cortices are involved in adapting walking and running speed on the treadmill: an optical imaging study. Neuroimage. 2004;23:1020-6.
  25. Lim SB, Peters S, Yang C-l, Boyd LA, Liu-Ambrose T, Eng JJ. Frontal, sensorimotor, and posterior parietal regions are involved in dual-task walking after stroke. Front Neurol. 2022;13:904145.
  26. Ding Q, Ou Z, Yao S, Wu C, Chen J, Shen J, et al. Cortical activation and brain network efficiency during dual tasks: an fNIRS study. Neuroimage. 2024:120545.
  27. Chatterjee SA, Fox EJ, Daly JJ, Rose DK, Wu SS, Christou EA, et al. Interpreting prefrontal recruitment during walking after stroke: influence of individual differences in mobility and cognitive function. Front Hum Neurosci. 2019;13:194.
  28. Hawkins KA, Fox EJ, Daly JJ, Rose DK, Christou EA, McGuirk TE, et al. Prefrontal over-activation during walking in people with mobility deficits: Interpretation and functional implications. Hum Mov Sci. 2018;59:46-55.
  29. Gibson N, Williams M, Maitland C, McCunn R. A framework for progressing and regressing core training within athletic and general populations. Strength Cond J. 2017;39:45-50.
  30. Higgins JPT, Morgan RL, Rooney AA, Taylor KW, Thayer KA, Silva RA, et al. A tool to assess risk of bias in non-randomized follow-up studies of exposure effects (ROBINS-E). Environ Int. 2024;186:108602.
  31. Al-Yahya E, Johansen-Berg H, Kischka U, Zarei M, Cockburn J, Dawes H. Prefrontal Cortex Activation While Walking Under Dual-Task Conditions in Stroke: A Multimodal Imaging Study. Neurorehabil Neural Repair. 2016;30:591-9.
  32. Chatterjee SA, Fox EJ, Daly JJ, Rose DK, Wu SS, Christou EA, et al. Interpreting Prefrontal Recruitment During Walking After Stroke: Influence of Individual Differences in Mobility and Cognitive Function. Front Hum Neurosci. 2019;13:194.
  33. Compagnat M, Daviet JC, Hermand E, Billot M, Salle JY, Perrochon A. Impact of a dual task on the energy cost of walking in individuals with subacute phase stroke. Brain Inj. 2023;37:114-21.
  34. Hermand E, Compagnat M, Dupuy O, Salle JY, Daviet JC, Perrochon A. Functional Status Is Associated With Prefrontal Cortex Activation in Gait in Subacute Stroke Patients: A Functional Near-Infrared Spectroscopy Study. Front Neurol. 2020;11:559227.
  35. Lim SB, Peters S, Yang CL, Boyd LA, Liu-Ambrose T, Eng JJ. Frontal, Sensorimotor, and Posterior Parietal Regions Are Involved in Dual-Task Walking After Stroke. Front Neurol. 2022;13:904145.
  36. Liu YC, Yang YR, Tsai YA, Wang RY, Lu CF. Brain Activation and Gait Alteration During Cognitive and Motor Dual Task Walking in Stroke-A Functional Near-Infrared Spectroscopy Study. IEEE Trans Neural Syst Rehabil Eng. 2018;26:2416-23.
  37. Nosaka S, Imada K, Saita K, Okamura H. Prefrontal activation during dual-task seated stepping and walking performed by subacute stroke patients with hemiplegia. Front Neurosci. 2023;17:1169744.
  38. Sun R, Li X, Zhu Z, Li T, Zhao M, Mo L, et al. Effects of dual-task training in patients with post-stroke cognitive impairment: A randomized controlled trial. Front Neurol. 2022;13:1027104.
  39. Lee J, Dong S, Jeong J, Yoon B. Effects of transcranial direct current stimulation over the dorsolateral prefrontal cortex (PFC) on cognitive-motor dual control skills. Percept Mot Skills. 2020;127:803-22.
  40. Correa FI, Kunitake AI, Segheto W, Duarte de Oliveira M, Fregni F, Ferrari Correa JC. The effect of transcranial direct current stimulation associated with video game training on the postural balance of older women in the community: A blind, randomized, clinical trial. Physiother Res Int. 2024;29:e2046.
  41. Fettrow T, Hupfeld K, Tays G, Clark DJ, Reuter-Lorenz PA, Seidler RD. Brain activity during walking in older adults: Implications for compensatory versus dysfunctional accounts. Neurobiol Aging. 2021;105:349-64.
  42. Park DC, Smith ET. Facilitation of Cognition in Older Adults: Traditional and Non-Traditional Approaches to Inducing Change. Med Res Arch. 2022;10.
  43. Dexter M, Ossmy O. The effects of typical ageing on cognitive control: recent advances and future directions. Front Aging Neurosci. 2023;15.