Abstract
Background: Walking in the “real world” involves motor and cognitive processes. In relation to this, declines in both motor function and cognition contribute to age-related gait dysfunction. Transcranial direct current stimulation (tDCS) and treadmill walking (STW) have potential to improve gait, particularly during dual-task walking (DTW); walking whilst performing a cognitive task. Our aims were to analyze effects of combined anodal tDCS + STW intervention on cortical activity and gait during DTW.Methods: Twenty-three young adults (YA) and 21 older adults (OA) were randomly allocated to active or sham tDCS stimulation groups. Participants performed 5-min of mixed treadmill walking (alternating 30 s bouts of STW and DTW) before and after a 20-min intervention of active or sham tDCS + STW. Anodal electrodes were placed over the left prefrontal cortex (PFC) and the vertex (Cz) using 9 cm2 electrodes at 0.6 mA. Cortical activity of the PFC, primary motor cortex (M1), premotor cortex (PMC), and supplementary motor area (SMA) bilaterally were recorded using a functional near-infrared spectroscopy (fNIRS) system. Oxygenated hemoglobin (HbO2) levels were analyzed as indicators of cortical activity. An accelerometer measured gait parameters. We calculated the difference between DTW and STW for HbO2 and gait parameters. We applied linear mixed effects models which included age group (YA vs. OA), stimulation condition (sham vs. active), and time (pre- vs. post-intervention) as fixed effects. Treadmill belt speed was a covariate. Partial correlation tests were also performed.Results: A main effect of age group was observed. OA displayed higher activity bilaterally in the PFC and M1, unilaterally in the right PMC and higher gait variability than YA. M1 activity decreased in both YA and OA following active tDCS + STW. There was no overall effect of tDCS + STW on PFC activity or gait parameters. However, negative correlations were observed between changes in left PFC and stride length variability following active tDCS + STW intervention.Conclusion: Increased activity in multiple cortical areas during DTW in OA may act as a compensatory mechanism. Reduction in M1 activity following active tDCS + STW with no observed gait changes suggests improved neural efficiency.
Highlights
Walking ability is a sensitive indicator of health status in older adults (OA) (Studenski et al, 2011; Morris et al, 2016)
The two-way ANOVA revealed a main effect of age group for body mass [F(1,38) = 27.37, p = 0.045, η2p = 0.113], preferred treadmill speed [F(1,38) = 27.37, p < 0.001, η2p = 0.419] and the Adverse Effects of Transcranial direct current stimulation (tDCS) Questionnaire [F(1,38) = 16.05, Frontiers in Aging Neuroscience | www.frontiersin.org
In this study we investigated the effects of combined anodal tDCS applied over M1 and prefrontal cortex (PFC), and treadmill walking on cortical activity and gait parameters in young adults (YA) and OA
Summary
Walking ability is a sensitive indicator of health status in older adults (OA) (Studenski et al, 2011; Morris et al, 2016). Age-related gait changes linked with increased falls risk include reduced gait speed and step length, and increased gait variability in comparison to young adults (YA) (Hausdorff et al, 2001; Verghese et al, 2009; Sawa et al, 2014; Aboutorabi et al, 2016). These gait parameters have been associated with deficits in cognitive parameters such as executive function and attention in OA and are a potential indicator of cognitive impairment (Yogev-Seligmann et al, 2008; Morris et al, 2016). Our aims were to analyze effects of combined anodal tDCS + STW intervention on cortical activity and gait during DTW
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