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首页> 外文学位 >The brain mechanisms underlying walking in complex situations in healthy older adults and persons with parkinson's disease.
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The brain mechanisms underlying walking in complex situations in healthy older adults and persons with parkinson's disease.

机译：在健康的老年人和帕金森氏病患者中，复杂情况下行走的大脑机制。

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摘要

Introduction: The ability to walk safely and independently is a fundamental component of daily living activities. Walking while dual tasking and obstacle negotiation are two tasks that have been used to investigate walking in complex situations. Deficits in cognitive domains and sensory-motor processes associated with aging and neurodegeneration impair the ability to successfully assess the environment and react to it. These changes in the ability to walk are modulated via neural circuits. However, the actual neural circuits of the brain involved in the control of locomotion in different challenging situations are still poorly understood.;Results: Significant differences in brain activation were observed in the fMRI and fNIRS. Between groups comparison showed that persons with PD had a significantly higher activation in frontal, parietal, occipital, and cerebellum regions during usual walking compared to healthy older adults (p<0.048). Comparison between the walking tasks within each group revealed (1) increased activation during walking while negotiating obstacles in both groups (p<0.023) and (2) increased activation during walking while dual tasking only in healthy older adults (p<0.035). Correlations between brain activation and performance in motor-cognitive tests were found in both groups however, healthy older adults presented inverse correlation and persons with PD positive correlation.;Conclusions: These findings indicate that subjects with PD activate larger brain areas than healthy older adults even during usual walking. Perhaps, this increased activation is a compensatory strategy to enhance performance. The increased activation already during usual walking task may limit the ability to increase activation or recruit additional brain areas during the more complex walking tasks and may contribute to the high prevalence of falls and the dual tasking difficulty in persons with PD.;Methods: Two groups of subjects; 20 healthy older adults (mean age 69.7+/-1.3 yrs, 50% females) and 47 persons with PD (mean age 71.7+/-1.1 yrs, 32% females) were studied. The protocol included real and imagined walking while negotiating obstacles and dual tasking. Walking conditions were performed while being monitored with fNIRS and imagined walking were assessed in the MR scanner. A repeated measures design (condition x group) was conducted with two levels; within group and between groups.
机译：简介：安全独立行走的能力是日常生活活动的基本组成部分。同时执行双重任务和障碍物协商时的行走是用于调查复杂情况下行走的两个任务。与衰老和神经变性相关的认知领域和感觉运动过程的缺陷削弱了成功评估环境并对环境做出反应的能力。步行能力的这些变化是通过神经回路调节的。然而，在不同的挑战性情况下，参与运动控制的大脑的实际神经回路仍知之甚少。结果：在fMRI和fNIRS中观察到大脑激活的显着差异。两组之间的比较显示，与正常老年人相比，PD患者在正常行走过程中的额叶，顶叶，枕叶和小脑区域的活化明显更高（p <0.048）。每组步行任务之间的比较显示（1）在两组中协商障碍时步行过程中激活增加（p <0.023）和（2）仅在健康的成年人中双重任务时步行过程中激活增加（p <0.035）。两组均发现了大脑激活与运动认知测试中的表现之间的相关性，但是健康的老年人呈现出负相关，而PD呈正相关。结论：这些发现表明PD的受试者甚至比健康的老年人具有更大的大脑区域在平时走路时。也许，这种增加的激活是增强性能的补偿策略。通常的步行任务中已经增加的激活可能会限制在更复杂的步行任务中增加激活或招募更多大脑区域的能力，并且可能导致跌倒患病率高和PD患者的双重任务困难。主题研究了20名健康的老年人（平均年龄69.7 +/- 1.3岁，女性50％）和47例PD（平均年龄71.7 +/- 1.1岁，女性32％）。该协议包括在协商障碍物和双重任务时的真实行走和想象行走。在用fNIRS监控的同时执行步行条件，并在MR扫描仪中评估想象的步行情况。重复测量设计（条件x组）分为两个级别：组内和组之间。

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  • 作者

    Maidan, Inbal.;

  • 作者单位

    Rutgers The State University of New Jersey, School of Health Related Professions.;

  • 授予单位 Rutgers The State University of New Jersey, School of Health Related Professions.;
  • 学科 Medical imaging.;Physical therapy.;Aging.
  • 学位 Ph.D.
  • 年度 2015
  • 页码 205 p.
  • 总页数 205
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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