Frontal, Sensorimotor, and Posterior Parietal Regions Are Involved in Dual-Task Walking After Stroke

Shannon B Lim; Sue Peters; Chieh-Ling Yang; Lara A Boyd; Teresa Liu-Ambrose; Janice J Eng

doi:10.3389/fneur.2022.904145

Frontal, Sensorimotor, and Posterior Parietal Regions Are Involved in Dual-Task Walking After Stroke

Front Neurol. 2022 Jun 22:13:904145. doi: 10.3389/fneur.2022.904145. eCollection 2022.

Authors

Shannon B Lim^{1

2}, Sue Peters^{1

2

3}, Chieh-Ling Yang^{1

2

4

5}, Lara A Boyd^{1

6}, Teresa Liu-Ambrose^{1

6

7}, Janice J Eng^{1

2

7}

Affiliations

¹ Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
² Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, BC, Canada.
³ School of Physical Therapy, Western University, London, ON, Canada.
⁴ Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan.
⁵ Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan.
⁶ The David Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
⁷ Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.

Abstract

Background: Walking within the community requires the ability to walk while simultaneously completing other tasks. After a stroke, completing an additional task while walking is significantly impaired, and it is unclear how the functional activity of the brain may impact this.

Methods: Twenty individual in the chronic stage post-stroke participated in this study. Functional near-infrared spectroscopy (fNIRS) was used to measure prefrontal, pre-motor, sensorimotor, and posterior parietal cortices during walking and walking while completing secondary verbal tasks of varying difficulty. Changes in brain activity during these tasks were measured and relationships were accessed between brain activation changes and cognitive or motor abilities.

Results: Significantly larger activations were found for prefrontal, pre-motor, and posterior parietal cortices during dual-task walking. Increasing dual-task walking challenge did not result in an increase in brain activation in these regions. Higher general cognition related to lower increases in activation during the easier dual-task. With the harder dual-task, a trend was also found for higher activation and less motor impairment.

Conclusions: This is the first study to show that executive function, motor preparation/planning, and sensorimotor integration areas are all important for dual-task walking post-stroke. A lack of further brain activation increase with increasing challenge suggests a point at which a trade-off between brain activation and performance occurs. Further research is needed to determine if training would result in further increases in brain activity or improved performance.

Keywords: dual-task; functional near-infrared spectroscopy; gait; posterior parietal cortex (PPC); pre-motor cortex (PMC); prefrontal cortex (PFC); sensorimotor cortex (SMC); stroke.