Motor-cognitive Dual Task Research Articles

A Review of Recent Advances in Cognitive-Motor Dual-Tasking for Parkinson's Disease Rehabilitation.

Parkinson's disease is primarily characterized by the degeneration of motor neurons, leading to significant impairments in movement. Initially, physical therapy was predominantly employed to address these motor issues through targeted rehabilitation exercises. However, recent research has indicated that cognitive training can enhance the quality of life for patients with Parkinson's. Consequently, some researchers have posited that the simultaneous engagement in computer-assisted motor and cognitive dual-task (CADT) may yield superior therapeutic outcomes. A comprehensive literature search was performed across various databases, and studies were selected following PRISMA guidelines, focusing on CADT rehabilitation interventions. Dual-task training enhances Parkinson's disease (PD) rehabilitation by automating movements and minimizing secondary task interference. The inclusion of a sensor system provides real-time feedback to help patients make immediate adjustments during training. Furthermore, CADT promotes more vigorous participation and commitment to training exercises, especially those that are repetitive and can lead to patient boredom and demotivation. Virtual reality-tailored tasks, closely mirroring everyday challenges, facilitate more efficient patient adaptation post-rehabilitation. Although the current studies are limited by small sample sizes and low levels, CADT rehabilitation presents as a significant, effective, and potential strategy for PD.

Muscle endurance, neuromuscular fatigability, and cognitive control during prolonged dual-task in people with chronic obstructive pulmonary disease: a case–control study

Abstract Purpose Recent studies suggest that, compared to healthy individuals, people with chronic obstructive pulmonary disease (pwCOPD) present a reduced capacity to perform cognitive-motor dual-task (CMDT). However, these studies were focused on short-duration CMDT offering limited insight to prolonged CMDT inducing fatigue, which can be encountered in daily life. The present study aimed to explore the effect of adding a cognitive task during repeated muscle contractions on muscle endurance, neuromuscular fatigability, and cognitive control in pwCOPD compared to healthy participants. Methods Thirteen pwCOPD and thirteen age- and sex-matched healthy participants performed submaximal isometric contractions of the knee extensors until exhaustion in two experimental sessions: (1) without cognitive task and (2) with a concurrent working memory task (i.e., 1-back task). Neuromuscular fatigability (as well as central and peripheral components measured by peripheral magnetic stimulation), cognitive performance, and perceived muscle fatigue were assessed throughout the fatiguing tasks. Results Independently to the experimental condition, pwCOPD exhibited lower muscle endurance compared to healthy participants (p = 0.039), mainly explained by earlier peripheral fatigue and faster attainment of higher perceived muscle fatigue (p < 0.05). However, neither effect of cognitive task (p = 0.223) nor interaction effect (group × condition; p = 0.136) was revealed for muscle endurance. Interestingly, cognitive control was significantly reduced only in pwCOPD at the end of CMDT (p < 0.015), suggesting greater difficulty for patients with dual tasking under fatigue. Conclusion These findings provide novel insights into how and why fatigue develops in COPD in dual-task context, offering a rationale for including such tasks in rehabilitation programs.

Study of psychophysiological indicators of sensorimotor Integration in PTSD. Justification of the choice of targets for biofeedback

Post-traumatic stress disorder (PTSD) is an actual medico-social problem. The pathogenesis of PTSD closely relates to impairment of sensorimotor integration (SMI). The effectiveness of psychosomatic disorder therapy for PTSD rehabilitation can be improved by restoring normal sensorimotor integration. The review examines various autonomic, electro-physiological and postural markers of high sensory motor integration in highly skilled athletes and musicians, as well as impairment of these indices in persons with PTSD. We have established that the most accessible and informative indicators of SMI are: an increase in EEG power in the individually adjusted high-frequency alpha-band, a reduction in energy demands for posture control and a decrease in the electromyographic activity of redundant muscles, not involved in motor-cognitive dual task. In the future, it is planned to use these indicators to diagnose stress disorders and to develop sensorimotor integration recovery training in patients with PTSD.

Hemodynamics of the Frontopolar and Dorsolateral Pre-Frontal Cortex in People with Multiple Sclerosis During Walking, Cognitive Subtraction, and Cognitive-Motor Dual-Task

Introduction Higher cortical activity has been observed in people with multiple sclerosis (pwMS) during walking and dual-tasking. However, further studies in overground walking and considering pre-frontal cortex (PFC) sub-areas are necessary. Objectives To investigate PFC activity during a cognitive-motor dual-task (DT) and its single component tasks, in combination with behavioral outcomes in pwMS. Methods Fifteen pwMS (EDSS 3.5 [2-5.5], 42 ± 11 years) and 16 healthy controls (HC, 45.2 ± 13.2 years) performed 3 conditions: single motor-walking (SWT), single cognitive – subtracting sevens (SCT), and a DT. Meters walked and the number of correct answers were obtained from which, respectively, the motor (mDTC) and cognitive (cDTC) DT costs were calculated. A functional Near-Infrared Spectroscopy covering the frontopolar and dorsolateral PFC (DLPFC) areas was used to concentration of relative oxyhemoglobin (ΔHbO2) and deoxyhemoglobin (ΔHHb) in the PFC. A repeated 2-way ANOVA (group × conditions) was used to compare ΔHbO2/ΔHHb and behavioral outcomes. Results PwMS walked shorter distances (P < .002) and answered fewer correct numbers (P < .03) than HC in all conditions, while cDTC and mDTC were similar between groups. PwMS presented higher ΔHbO2 in the frontopolar area than HC in the SWT (P < .001). HC increased ΔHbO2 in frontopolar during the SCT (P < .029) and DT (P < .037) compared with the SWT. Conclusion Higher frontopolar activity in pwMS compared to HC in the SWT suggests reduced gait automaticity. Furthermore, it seems that only HC increased neural activity in the frontopolar in the SCT and DT, which might suggest a limit of cognitive resources to respond to DT in pwMS.

Scalp Acupuncture Synchronizing Dual Task Gait for Enhancing Prefrontal Cortex Response.

Studies have shown that motor-cognitive dual task can greatly improve motor/cognitive function. However, the therapeutic effect of motor-cognitive dual task is still limited. How to improve dual-task performance is the key to solving this problem. Scalp acupuncture is a non-drug intervention method of traditional Chinese medicine to treat brain-derived diseases by acupuncturing the corresponding projection area of cerebral cortex function on the scalp. Studies have shown that scalp acupuncture helps improve neuronal damage and cognitive dysfunction and plays a neuroprotective function in central nervous system diseases. However, no relevant studies have discussed the synergistic gain effect of motor-cognitive dual task and scalp acupuncture. Therefore, this protocol aims to demonstrate the standardized operation of scalp acupuncture synchronizing motor-cognitive dual task and motor-cognitive dual task and compares the differences between these two tasks in healthy subjects through a randomized cross-over trial. This protocol initially revealed the possible influence mechanism of scalp acupuncture synchronizing motor-cognitive dual task on cognitive performance, gait control, and cortical brain function, which can provide new ideas and a theoretical basis for clinical exploration of new and effective non-drug treatment of integrated Chinese and Western medicine.

Adding a sustained attention task to a physically demanding cycling exercise exacerbates neuromuscular fatigue and impairs cognitive performance in both normoxia and hypoxia.

Both cognitive motor dual-tasks (CMDT) protocols and hypoxic environments have been associated with significant impairments in cognitive and physical performance. We aimed to determine the effects of hypoxia on cognitive performance and neuromuscular fatigue during a highly physically demanding CMDT. Fifteen young adults completed a first session involving a cognitive task (CTLCOG) followed by cycling exercise (CTLEX) in normoxia. After that, they randomly participated in CMDT sessions in normoxia (DTNOR) and hypoxia (DTHYP). The physical exercise consisted of 20min cycling at a "hard" perceived effort, and the cognitive task consisted of 15min sustained attention to response time task (SART). Concurrent psycho-physiological measurements included: quadriceps neuromuscular fatigue (peripheral/central components from femoral nerve electrostimulation), prefrontal cortex (PFC) oxygenation by near-infrared spectroscopy, and perception of effort. SART performance significantly decreased in DTNOR (-15.7 ± 15.6%, P < 0.01) and DTHYP (-26.2 ± 16.0%, P < 0.01) compared to CTLCOG (-1.0 ± 17.7%, P = 0.61). Peripheral fatigue similarly increased across conditions, whereas the ability of the central nervous system to activate the working muscles was impaired similarly in DTNOR (-6.1 ± 5.9%, P < 0.001) and DTHYP (-5.4 ± 7.3%, P < 0.001) compared to CTLEX (-1.1 ± 0.2%, P = 0.52). Exercise-induced perception of effort was higher in DTHYP vs. DTNOR and in DTNOR vs. CTLEX. This was correlated with cognitive impairments in both normoxia and hypoxia. PFC deoxygenation was more pronounced in DTHYP compared to DTNOR and CTLEX. In conclusion, performing a sustained attention task together with physically challenging cycling exercise promotes central neuromuscular fatigue and impairs cognitive accuracy; the latter is particularly noticeable when the CMDT is performed in hypoxia.

Regional brain activity and neural network changes in cognitive-motor dual-task interference: A functional near-infrared spectroscopy study

Previous neuroimaging studies have reported dual-task interference (DTi) and deterioration of task performance in a cognitive-motor dual task (DT) compared to that in a single task (ST). Greater frontoparietal activity is a neural signature of DTi; nonetheless, the underlying mechanism of cortical network in DTi still remains unclear. This study aimed to investigate the regional brain activity and neural network changes during DTi induced by highly demanding cognitive-motor DT. Thirty-four right-handed healthy young adults performed the spiral-drawing task. They underwent a paced auditory serial addition test (PASAT) simultaneously or independently while their cortical activity was measured using functional near-infrared spectroscopy. Motor performance was determined using the balanced integration score (BIS), a balanced index of drawing speed and precision. The cognitive task of the PASAT was administered with two difficulty levels defined by 1 s (PASAT-1 s) and 2 s (PASAT-2 s) intervals, allowing for the serial addition of numbers. Cognitive performance was determined using the percentage of correct responses. These motor and cognitive performances were significantly reduced during DT, which combined a drawing and a cognitive task at either difficulty level, compared to those in the corresponding ST conditions. The DT conditions were also characterized by significantly increased activity in the right dorsolateral prefrontal cortex (DLPFC) compared to that in the ST conditions. Multivariate Granger causality (GC) analysis of cortical activity in the selected frontoparietal regions of interest further revealed selective top-down causal connectivity from the right DLPFC to the right inferior parietal cortex during DTs. Furthermore, changes in the frontoparietal GC connectivity strength between the PASAT-2 s DT and ST conditions significantly correlated negatively with changes in the percentage of correct responses. Therefore, DTi can occur even in cognitively proficient young adults, and the right DLPFC and frontoparietal network being crucial neural mechanisms underlying DTi. These findings provide new insights into DTi and its underlying neural mechanisms and have implications for the clinical utility of cognitive-motor DTs applied to clinical populations with cognitive decline, such as those with psychiatric and brain disorders.

Cognitive interference of respiratory versus limb muscle dual tasking in healthy adults.

Inspiratory threshold loading (ITL) and associated dyspnoea have been shown to interfere with cognition during cognitive-motor dual tasking. However, ITL has not been compared with another rhythmic muscle activity, such as lower limb pedalling. While ITL has been shown to interfere with cognition, the mechanism of the prefrontal cortex (PFC) during ITL or other rhythmical muscle dual tasking, has not been elucidated. Given the cognitive interference that arises during ITL, we hypothesise that ITL cognitive-motor dual tasking will result in greater cognitive decrements and increased PFC activity compared with the pedalling cognitive-motor dual task. 30 healthy participants (16 females; median age 23 (interquartile range 23-24) years) were recruited. They performed five 3-min tasks in a single visit in a random order: single tasks were ITL, pedalling and Stroop task and dual tasks were ITL-Stroop and pedalling-Stroop. Participant's PFC activity was assessed bilaterally using functional near-infrared spectroscopy throughout each task. Single- and dual-task cognitive performance was evaluated by measuring Stroop task reaction time and accuracy. Dyspnoea and rating of perceived exertion were evaluated at the end of each task. ITL-Stroop resulted in greater impairments in reaction time (p<0.001), accuracy (p<0.01) and increased medial/dorsolateral PFC activity (p≤0.006) than pedalling-Stroop. ITL-Stroop elicited greater Borg dyspnoea and rating of perceived exertion than pedalling-Stroop (p<0.001), despite pedalling-Stroop having a greater heart rate response (p<0.001). The heightened cognitive decrements, perceptual response and PFC activity suggest that inspiratory muscle loading and its accompanied dyspnoea results in greater cognitive interference than rhythmic pedalling.

Central imaging based on near-infrared functional imaging technology can be useful to plan management in patients with chronic lateral ankle instability

BackgroundNear infrared brain functional imaging (FNIRS) has been used for the evaluation of brain functional areas, the imaging differences of central activation of cognitive-motor dual tasks between patients with chronic lateral ankle instability (CLAI) and healthy population remain unclear. This study aimed to evaluated the role of central imaging based on FNIRS technology on the plan management in patients with CLAI, to provide insights to the clinical treatment of CLAI.MethodsCLAI patients treated in our hospital from January 1, 2021 to June 31, 2022 were selected. Both CLAI patients and health controls were intervened with simple task and cognitive-motor dual task under sitting and walking conditions, and the changes of oxygenated hemoglobin concentration in bilateral prefrontal cortex (PFC), premotor cortex (PMC) and auxiliary motor area (SMA) were collected and compared.ResultsA total of 23 participants were enrolled. There were significant differences in the fNIRS ΔHbO2 of barefoot subtractive walking PFC-R and barefoot subtractive walking SMA-R between experimental and control group (all P < 0.05). There was no significant difference in ΔHbO2 between the experimental group and the control group in other states (P > 0.05). There was no significant difference in ΔHbO2 between the experimental group and the control group in each state of the brain PMC region.ConclusionAdaptive alterations may occur within the relevant brain functional regions of individuals with CLAI. The differential activation observed between the PFC and the SMA could represent a compensatory mechanism emerging from proprioceptive afferent disruptions following an initial ankle sprain.

Effects of Cognitive-Motor and Motor-Motor Dual Tasks on Gait Performance in Older Adults with Sarcopenia.

With the advent of global aging, the health of the older population has become a critical public health challenge. The purpose of this study was to investigate the effect of dual-tasking on gait performance in patients with sarcopenia. Thirty participants with sarcopenia (age: 70.73 ± 4.12 yr, MMSE score: 26.90 ± 3.00), including 14 males and 16 females, were selected according to the diagnostic criteria of the Asian Working Group on Sarcopenia. All participants were instructed to perform the gait test in three modes: single task (ST), cognitive-motor dual task (CMDT), and motor-motor dual task (MMDT). Statistical analyses were performed using one-way ANOVA to evaluate the effects of different task types on gait parameters of the participants. (1) Compared with ST walking, gait frequency, step length, and step speed decreased, and the gait cycle and double-support phase increased in patients with sarcopenia during dual-task walking (p < 0.05); (2) Compared with ST walking, gait variability indices such as stride frequency, stride length, and support period significantly increased in patients with sarcopenia during dual-task walking (p < 0.05). The increased difficulty in postural control caused by dual-task interference may reduce the safety of motor strategies in patients with sarcopenia and increase the risk of falls. Future studies should focus on the effects of exercise interventions on multitasking patterns in people with sarcopenia to promote balance function in these populations.

From Control to Chaos: Visual-Cognitive Progression During Recovery from ACL Reconstruction.

BACKGROUND: Anterior cruciate ligament tear is a serious knee injury with implications for central nervous system (CNS) plasticity. To perform simple knee movements, people with a history of ACL reconstruction (ACL-R) engage cross-modal brain regions and when challenged with cognitive-motor dual-tasks, physical performance deteriorates. Therefore, people with ACL-R may increase visual-cognitive neural processes for motor control. CLINICAL QUESTION: What components of CNS plasticity should the rehabilitation practitioner target with interventions, and how can practitioners augment rehabilitation exercises to target injury associated plasticity? KEY RESULTS: This clinical commentary (1) describes the neurophysiological foundation for visual-cognitive compensation after ACL-R, (2) provides a theoretical rationale for implementing visual-cognitive challenges throughout the return to sport (RTS) continuum, and (3) presents a framework for implementing visual-cognitive challenges from the acute phases of rehabilitation. The 'Visual-Cognitive Control Chaos Continuum (VC-CCC) framework consists of five training difficulties that progress visual-cognitive challenges from high control to high chaos, to better represent the demands of sport. CLINICAL APPLICATION: The VC-CCC framework augments traditional rehabilitation so that each exercise can progress to increase difficulty and promote sensorimotor and visual-cognitive adaptation after ACL-R.

Attentional Distractions Do Not Influence Lumbar Spine Local Dynamic Stability during Repetitive Flexion-Extension Movements

The association between low back pain and lumbar spine local dynamic stability (LDS) appears to be modulated by if and how someone catastrophizes about pain, suggesting that the cognitive perceptions of pain may influence an individual’s ability to control lumbar spine motion. Previous work also demonstrates that directing cognitive resources and attentional focus can influence movement performance. Therefore, we aimed to examine whether distracting attentional focus would influence lumbar spine LDS during repetitive flexion-extension movements. Sixteen participants performed repetitive spine flexion-extension movements under two baseline conditions (pre- and post-), and while attentional focus was distracted by either an external sensory stimulus or a cognitive-motor dual-task, both targeted at the hands. Lumbar spine LDS was examined over 30 continuous movement repetitions using maximum Lyapunov exponents. In comparison to both Baseline and Post-Baseline trials, the perceived mental workload was significantly elevated during the cognitive-motor dual-task trial but not the external sensory stimulus trial. The only statistically significant effect on LDS occurred in the Post-Baseline trial, where LDS was higher than in the cognitive-motor dual-task. In combination with previous work, these findings suggest that distracting attentional focus during repetitive lumbar spine flexion-extension movements does not have a negative influence on lumbar spine LDS.

Global Cognition, Gender, and Level of Education Predict Dual-Task Gait Speed Variability Metrics in Older Adults

Introduction: The purpose of this study was to determine if demographic variables and measures of cognitive function, functional mobility, self-reported balance self-efficacy, and self-reported physical activity can predict gait speed variability during single-task walking (STGSCV), during cognitive-motor dual-tasking (DTGSCV), and dual-task effect on gait speed variability (DTEGSCV) in older adults. Methods: In 62 older adults, demographics were recorded and cognitive function (including the Montreal Cognitive Assessment, MoCA), functional mobility, balance self-efficacy (Activities-specific Balance Confidence Scale, ABC), and self-reported physical activity (Physical Activity Scale for the Elderly, PASE) were assessed. Three linear regression models were used to determine whether the functional mobility tests, PASE score, ABC score, and tests of cognitive function predicted gait speed variability outcomes (STGSCV, DTGSCV, DTEGSCV), with demographics included as covariates. Results: MoCA score (p = 0.003), gender (p = 0.040), and years of education (p = 0.010) significantly predicted DTGSCV (R2 = 0.297, p = 0.002). MoCA score (p = 0.008) and years of education (p < 0.001) also significantly predicted DTEGSCV. Despite a significant regression model (R2 = 0.316, p = 0.001), there were no significant individual predictors of STGSCV. Conclusion: Older adults with lower cognitive function scores, according to the MoCA, and higher levels of education demonstrate larger gait speed variability during dual-tasking and may be at increased risk of real-world mobility issues or falling.

Post-Stroke Functional Changes: In-Depth Analysis of Clinical Tests and Motor-Cognitive Dual-Tasking Using Wearable Sensors.

Clinical tests like Timed Up and Go (TUG) facilitate the assessment of post-stroke mobility, but they lack detailed measures. In this study, 21 stroke survivors and 20 control participants underwent TUG, sit-to-stand (STS), and the 10 Meter Walk Test (10MWT). Tests incorporated single tasks (STs) and motor-cognitive dual-task (DTs) involving reverse counting from 200 in decrements of 10. Eight wearable motion sensors were placed on feet, shanks, thighs, sacrum, and sternum to record kinematic data. These data were analyzed to investigate the effects of stroke and DT conditions on the extracted features across segmented portions of the tests. The findings showed that stroke survivors (SS) took 23% longer for total TUG (p < 0.001), with 31% longer turn time (p = 0.035). TUG time increased by 20% (p < 0.001) from STs to DTs. In DTs, turning time increased by 31% (p = 0.005). Specifically, SS showed 20% lower trunk angular velocity in sit-to-stand (p = 0.003), 21% longer 10-Meter Walk time (p = 0.010), and 18% slower gait speed (p = 0.012). As expected, turning was especially challenging and worsened with divided attention. The outcomes of our study demonstrate the benefits of instrumented clinical tests and DTs in effectively identifying motor deficits post-stroke across sitting, standing, walking, and turning activities, thereby indicating that quantitative motion analysis can optimize rehabilitation procedures.

The Effects of Various Cognitive Tasks Including Working Memory, Visuospatial, and Executive Function on Postural Control in Patients With Anterior Cruciate Ligament Injury.

Anterior cruciate ligament (ACL) rupture can impair balance performance, particularly during cognitive motor dual-tasks. This study aimed to determine the effects of various modalities of cognitive load (working memory, and visuospatial and executive function) on postural control parameters in individuals with ACL injury. Twenty-seven ACL-injured and 27 healthy participants were evaluated doing different cognitive tasks (silent backward counting, Benton's judgment of line orientation, and Stroop color-word test) while standing on a rigid surface or a foam. Each task was repeated three times and then averaged. Center of pressure variables used to measure postural performance included sway area and sway velocity in anterior-posterior and medial-lateral directions. Cognitive performance was also assessed by calculating errors and the score of cognitive tasks. A mixed model analysis of variance for center of pressure parameters indicated that patients had more sways than the healthy group. The interaction of group by postural difficulty by cognitive tasks was statistically significant for cognitive errors (p < .01), and patients with ACL injury indicated more cognitive errors compared to healthy controls while standing on the foam. The main effect of cognitive task was statistically significant for all postural parameters, representing reduced postural sways in both groups with all cognitive tasks. However, ACL-injured patients showed more cognitive errors in difficult postural conditions, suggesting that individuals with ACL injury may prioritize postural control over cognitive task accuracy and adopt the posture-first strategy to maintain balance under dual-task conditions.

Fall Risk Assessment in Stroke Survivors: A Machine Learning Model Using Detailed Motion Data from Common Clinical Tests and Motor-Cognitive Dual-Tasking.

Falls are common and dangerous for stroke survivors. Current fall risk assessment methods rely on subjective scales. Objective sensor-based methods could improve prediction accuracy. Develop machine learning models using inertial sensors to objectively classify fall risk in stroke survivors. Determine optimal sensor configurations and clinical test protocols. 21 stroke survivors performed balance, Timed Up and Go, 10 Meter Walk, and Sit-to-Stand tests with and without dual-tasking. A total of 8 motion sensors captured lower limb and trunk kinematics, and 92 spatiotemporal gait and clinical features were extracted. Supervised models-Support Vector Machine, Logistic Regression, and Random Forest-were implemented to classify high vs. low fall risk. Sensor setups and test combinations were evaluated. The Random Forest model achieved 91% accuracy using dual-task balance sway and Timed Up and Go walk time features. Single thorax sensor models performed similarly to multi-sensor models. Balance and Timed Up and Go best-predicted fall risk. Machine learning models using minimal inertial sensors during clinical assessments can accurately quantify fall risk in stroke survivors. Single thorax sensor setups are effective. Findings demonstrate a feasible objective fall screening approach to assist rehabilitation.

Effects of motor-cognitive dual task training on cognitive and motor performance in patients with dementia: A systematic review

Effects of motor-cognitive dual task training on cognitive and motor performance in patients with dementia: A systematic review

Neuromuscular assessment of force development, postural, and gait performance under cognitive-motor dual-tasking in healthy older adults and people with early Parkinson's disease: Study protocol for a cross-sectional Mobile Brain/Body Imaging (MoBI) study.

Neuromuscular dysfunction is common in older adults and more pronounced in neurodegenerative diseases. In Parkinson's disease (PD), a complex set of factors often prevents the effective performance of activities of daily living that require intact and simultaneous performance of the motor and cognitive tasks. The cross-sectional study includes a multifactorial mixed-measure design. Between-subject factor grouping the sample will be Parkinson's Disease (early PD vs. healthy). The within-subject factors will be the task complexity (single- vs. dual-task) in each motor activity, i.e., overground walking, semi-tandem stance, and isometric knee extension, and a walking condition (wide vs. narrow lane) will be implemented for the overground walking activity only. To study dual-task (DT) effects, in each motor activity participants will be given a secondary cognitive task, i.e., a visual discrimination task for the overground walking, an attention task for the semi-tandem, and mental arithmetic for the isometric extension. Analyses of DT effects and underlying neuronal correlates will focus on both gait and cognitive performance where applicable. Based on an a priori sample size calculation, a total N = 42 older adults (55-75 years) will be recruited. Disease-specific changes such as laterality in motor unit behavior and cortical control of movement will be studied with high-density surface electromyography and electroencephalography during static and dynamic motor activities, together with whole-body kinematics. This study will be one of the first to holistically address early PD neurophysiological and neuromuscular patterns in an ecologically valid environment under cognitive-motor DT conditions of different complexities. The outcomes of the study aim to identify the biomarker for early PD either at the electrophysiological, muscular or kinematic level or in the communication between these systems. ClinicalTrials.Gov, NCT05477654. This study was approved by the Medical Ethical Committee (106/2021).

Using Cognitive-Motor Dual-Tasks and Functional Near-Infrared Spectroscopy to Characterize Older Adults with and without Subjective Cognitive Decline.

Subjective cognitive decline (SCD) refers to individuals who report persistent cognitive deficits but perform normally on neuropsychological tests. Performance may be facilitated by increased prefrontal cortex activation, known as neural compensation, and could be used to differentiate between older adults with and without SCD. This cross-sectional pilot study measured changes in the hemodynamic response (ΔHbO2) using functional near-infrared spectroscopy (fNIRS) as well as cognitive and motor performance during fine and gross motor dual-tasks in older adults with and without SCD. Twenty older adults over 60 years old with (n = 10) and without (n = 10) SCD were recruited. Two experiments were conducted using 1) gross motor walking and 2) fine motor finger tapping tasks that were paired with an n-back working memory task. Participants also completed neuropsychological assessments and questionnaires on everyday functioning. Repeated measures ANOVAs demonstrated slower response times during dual-task gait compared to the single task (p = 0.032) and in the non-SCD group, slower gait speed was also observed in the dual compared to single task (p = 0.044). Response times during dual-task finger tapping were slower than the single task (p = 0.049) and greater ΔHbO2 was observed overall in the SCD compared to non-SCD group (p = 0.002). Examining neural and performance outcomes revealed differences between SCD and non-SCD groups and single and dual-tasks. Greater brain activation during dual-task finger tapping may reflect neural compensation, which should be examined in a larger sample and longitudinally to better characterize SCD.

Neuromuscular assessment of force development, postural, and gait performance under cognitive-motor dual-tasking in healthy older adults and early Parkinson's disease patients: Study protocol for a cross-sectional Mobile Brain/Body Imaging (MoBI) study

Background: Neuromuscular dysfunction is common in older adults and more pronounced in neurodegenerative diseases. In Parkinson's disease (PD), a complex set of factors often prevents the effective performance of activities of daily living that require intact and simultaneous performance of the motor and cognitive tasks. Methods: The cross-sectional study includes a multifactorial mixed-measure design. Between-subject factor grouping the sample will be Parkinson’s Disease (early PD vs. healthy). The within-subject factors will be the task complexity (single- vs. dual-task) in each motor activity, i.e., overground walking, semi-tandem stance, and isometric knee extension, and a walking condition (wide vs. narrow lane) will be implemented for the overground walking activity only. To study dual-task (DT) effects, in each motor activity participants will be given a secondary cognitive task, i.e., a visual discrimination task for the overground walking, an attention task for the semi-tandem, and mental arithmetic for the isometric extension. Analyses of DT effects and underlying neuronal correlates will focus on both gait and cognitive performance where applicable. Based on an a priori sample size calculation, a total N = 42 older adults (55-75 years) will be recruited. Disease-specific changes such as laterality in motor unit behavior and cortical control of movement will be studied with high-density surface electromyography and electroencephalography during static and dynamic motor activities, together with whole-body kinematics. Discussion: This study will be one of the first to holistically address early PD neurophysiological and neuromuscular patterns in an ecologically valid environment under cognitive-motor DT conditions of different complexities. The outcomes of the study aim to identify the biomarker for early PD either at the electrophysiological, muscular or kinematic level or in the communication between these systems. Clinical Trial Registration: ClinicalTrials.Gov, NCT05477654. This study was approved by the Medical Ethical Committee (106/2021).