The effect of diabetes on prefrontal cortex activation patterns during active walking in older adults

Holtzer, Roee; George, Claudene J.; İzzetoğlu, Meltem; Wang, Cuiling

doi:10.1016/j.bandc.2018.03.002

Cited by 26 publications

(41 citation statements)

References 63 publications

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“…Also in participants from the CCMA study, higher levels of self-perceived stress and fatigue were associated with attenuation of brain activation patterns (lower increase in O 2 Hb levels from ST to DT walking) (Holtzer et al, 2017a,b). Participants with diabetes from the same study showed lower PFC activation during DT, compared to non-diabetics (Holtzer et al, 2018a), while obese cognitively healthy older adults from a different study showed higher activation, especially during a precision walking task, compared to non-obese counterparts (Osofundiya et al, 2016). When combining fNIRS with cerebral microstructural white matter integrity assessment, using MRI with Diffusion Tensor Imaging (DTI), altered white matter integrity was associated to higher O 2 Hb levels during DT walk compared to normal walk in the CCMA study (Lucas et al, 2018).…”

Section: Association Between Activation and Clinical Variablesmentioning

confidence: 83%

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Functional Near-Infrared Spectroscopy to Study Cerebral Hemodynamics in Older Adults During Cognitive and Motor Tasks: A Review

Udina

Avtzi

Durdurán

et al. 2020

Front. Aging Neurosci.

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The integrity of the frontal areas of the brain, specifically the prefrontal cortex, are critical to preserve cognition and mobility in late life. Prefrontal cortex regions are involved in executive functions and gait control and have been related to the performance of dual-tasks. Dual-task performance assessment may help identify older adults at risk of negative health outcomes. As an alternative to neuroimaging techniques that do not allow assessment during actual motion, functional Near-Infrared Spectroscopy (fNIRS) is a non-invasive technique that can assess neural activation through the measurement of cortical oxygenated and deoxygenated hemoglobin levels, while the person is performing a motor task in a natural environment as well as during cognitive tasks. The aim of this review was to describe the use of fNIRS to study frontal lobe hemodynamics during cognitive, motor and dual-tasks in older adults. From the 46 included publications, 20 studies used only cognitive tasks, three studies used motor tasks and 23 used dual-tasks. Our findings suggest that fNIRS detects changes in frontal activation in older adults (cognitively healthy and mild cognitive impairment), especially while performing cognitive and dual-tasks. In both the comparison between older and younger adults, and in people with different neurological conditions, compared to healthier controls, the prefrontal cortex seems to experience a higher activation, which could be interpreted in the context of proposed neural inefficiency and limited capacity models. Further research is needed to establish standardized fNIRS protocols, study the cerebral hemodynamic in different neurological and systemic conditions that might influence cortical activation and explore its role in predicting incident health outcomes such as dementia.

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Section: Association Between Activation and Clinical Variablesmentioning

confidence: 83%

“…O 2 Hb increase was highest in the post-stroke group, followed by older and young adults. * Holtzer (Brain Cogn., 2018), USA (Holtzer et al, 2018a) N = 315 Healthy old (76.8 ± 6.7). Prefrontal.…”

Section: Hawkinsmentioning

confidence: 99%

Functional Near-Infrared Spectroscopy to Study Cerebral Hemodynamics in Older Adults During Cognitive and Motor Tasks: A Review

Udina

Avtzi

Durdurán

et al. 2020

Front. Aging Neurosci.

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“…We used HbO 2 and not Hb as a surrogate for neural activity in the PFC because the former is more reliable and sensitive to gait-related changes in brain activation patterns [46,47]. We administered proximal 10-s baselines immediately before each experimental condition to quantify relative changes in HbO 2 for each task [19,20,22,23,48]. A central "hub" computer with E-Prime 2.0 software synchronized the acquisition of Gait and fNIRS events [19][20][21][22][23][24].…”

Section: Preprocessing and Hemodynamic Signal Extractionmentioning

confidence: 99%

“…In recent years, functional Near-Infrared Spectroscopy (fNIRS) has been used to investigate changes in the hemodynamic response during active walking in humans (for reviews, see [17,18]). Specifically, studies revealed that, in older adults, fNIRS-derived Oxygenated Hemoglobin (HbO 2 ) in the Prefrontal Cortex (PFC) was increased in Dual-Task-Walk (DTW) compared to Single-Task-Walk (STW) conditions due to the greater attention and executive demands imposed by DTW [19][20][21][22][23]. Moreover, repeated training trials during one experimental session resulted in improved behavioral performance and brain efficiency, the latter operationalized using fNIRS-derived HbO 2 , in DTW but not STW conditions [24].…”

Section: Introductionmentioning

confidence: 99%

Mild Cognitive Impairments Attenuate Prefrontal Cortex Activations during Walking in Older Adults

İzzetoğlu

2020

Brain Sciences

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The presence of Mild Cognitive Impairments (MCI) is associated with worse gait performance. However, the effect of MCI on cortical control of gait, as assessed during active walking, is unknown. We hypothesized that MCI would be associated with attenuated activations and limited improvement in efficiency in the Prefrontal cortex (PFC) under cognitively-demanding walking conditions. Functional Near-Infrared Spectroscopy (fNIRS) was used to assess Oxygenated Hemoglobin (HbO2) in the PFC during Single-Task-Walk (STW), cognitive interference (Alpha) and Dual-Task-Walk (DTW) conditions. Three repeated trials in each experimental condition were administered. Healthy control (n = 71; mean age = 76.82 ± 6.21 years; %female = 50.7) and MCI (n = 11; mean age = 78.27 ± 4.31 years; %female = 45.5) participants were included. The increase in HbO2 from STW to DTW was attenuated among MCI participants compared to controls (estimate = 0.505; p = 0.001). Whereas, among controls, HbO2 increased from Alpha to DTW, the opposite was observed among MCI participants (estimate = 0.903; p < 0.001). In DTW, the decline in HbO2 from trial 1 to 2 was attenuated in MCI participants compared to controls (estimate = 0.397; p = 0.008). Moreover, whereas HbO2 declined from trial 1 to 3 among controls, MCI participants showed the opposite trend (estimate = 0.946; p < 0.001). MCI was associated with attenuated brain activation patterns and compromised ability to improve PFC efficiency during dual-task walking.

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“…Third, the walking function might reflect metabolism in the brain. Holtzer and colleagues suggested that elderly patients with diabetes mellitus exhibit altered frontal lobe function during walking and are at a risk of falling [41]. Fourth, it is possible that hypoglycemia caused by sulphonylurea and insulin is linked to abnormalities in brain metabolism and a reduced walking speed.…”

Section: Why Is Reduced Walking Speed Associated With Mci?mentioning

confidence: 99%

Walking Speed is the Sole Determinant Criterion of Sarcopenia of Mild Cognitive Impairment in Japanese Elderly Patients with Type 2 Diabetes Mellitus

Machii

Kudo

Saito

et al. 2020

JCM

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Diabetes mellitus is a risk factor for mild cognitive impairment (MCI) and dementia. However, how the clinical characteristics of MCI patients with type 2 diabetes mellitus are linked to sarcopenia and/or its criteria remain to be elucidated. Japanese patients with type 2 diabetes mellitus were categorized into the MCI group for MoCA-J (the Japanese version of the Montreal cognitive assessment) score <26, and into the non-MCI group for MoCA-J ≥26. Sarcopenia was defined by a low skeletal mass index along with low muscle strength (handgrip strength) or low physical performance (walking speed <1.0 m/s). Univariate and multivariate-adjusted odds ratio models were used to determine the independent contributors for MoCA-J <26. Among 438 participants, 221 (50.5%) and 217 (49.5%) comprised the non-MCI and MCI groups, respectively. In the MCI group, age (61 ± 12 vs. 71 ± 10 years, p < 0.01) and duration of diabetes mellitus (14 ± 9 vs. 17 ± 9 years, p < 0.01) were higher than those in the non-MCI group. Patients in the MCI group exhibited lower hand grip strength, walking speed, and skeletal mass index, but higher prevalence of sarcopenia. Only walking speed (rather than muscle loss or muscle weakness) was found to be an independent determinant of MCI after adjusting for multiple factors, such as age, gender, body mass index (BMI), duration of diabetes mellitus, hypertension, dyslipidemia, smoking, drinking, estimated glomerular filtration rate (eGFR), HbA1c, and history of coronary heart diseases and stroke. In subgroup analysis, a group consisting of male patients aged ≥65 years, with BMI <25, showed a significant OR for walking speed. This study showed that slow walking speed is a sole determinant criterion of sarcopenia of MCI in patients with type 2 diabetes mellitus. It was suggested that walking speed is an important factor in the prediction and prevention of MCI development in patients with diabetes mellitus.

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The effect of diabetes on prefrontal cortex activation patterns during active walking in older adults

Cited by 26 publications

References 63 publications

Functional Near-Infrared Spectroscopy to Study Cerebral Hemodynamics in Older Adults During Cognitive and Motor Tasks: A Review

Functional Near-Infrared Spectroscopy to Study Cerebral Hemodynamics in Older Adults During Cognitive and Motor Tasks: A Review

Mild Cognitive Impairments Attenuate Prefrontal Cortex Activations during Walking in Older Adults

Walking Speed is the Sole Determinant Criterion of Sarcopenia of Mild Cognitive Impairment in Japanese Elderly Patients with Type 2 Diabetes Mellitus

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