The prefrontal cortex hemodynamic responses to dual-task paradigms in older adults: A systematic review and meta-analysis

Kulvara Lapanan; Phunsuk Kantha; Gallayaporn Nantachai; Solaphat Hemrungrojn; Michael Maes

doi:10.1016/j.heliyon.2023.e17812

The prefrontal cortex hemodynamic responses to dual-task paradigms in older adults: A systematic review and meta-analysis

Heliyon. 2023 Jul 6;9(7):e17812. doi: 10.1016/j.heliyon.2023.e17812. eCollection 2023 Jul.

Authors

Kulvara Lapanan^{1

2}, Phunsuk Kantha^{3

4}, Gallayaporn Nantachai^{1

5}, Solaphat Hemrungrojn^{1

2}, Michael Maes^{1

2

6

7

8

9}

Affiliations

¹ Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
² Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
³ School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
⁴ Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand.
⁵ Somdet Phra Sangharaj Nyanasamvara Geriatric Hospital, Department of Medical Services, Ministry of Public Health, Chon Buri Province, Thailand.
⁶ Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
⁷ Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.
⁸ Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria.
⁹ Mental Health Center, University of Electronic Science and Technology of China, Chengdu 611731, China.

Abstract

Background: Functional near-infrared spectroscopy (fNIRS) is a method to measure cerebral hemodynamics. Determining the changes in prefrontal cortex (PFC) hemodynamics during dual-task paradigms is essential in explaining alterations in physical activities, especially in older adults.

Aims: To systematically review and meta-analyze the effects of dual-task paradigms on PFC hemodynamics in older adults.

Methods: The search was conducted in PubMed, Scopus, and Web of Science from inception until March 2023 to identify studies on the effects of dual-task paradigms on PFC hemodynamics. The meta-analysis included variables of cerebral hemodynamics, such as oxygenated hemoglobin (HbO₂) and deoxygenated hemoglobin (HbR). The heterogeneity of the included studies was determined using the I² statistic. Additionally, subgroup analysis was conducted to compare the effects of different types of cognitive tasks.

Results: A total of 37 studies were included in the systematic review, 25 studies comprising 2224 older adults were included in the meta-analysis. Our findings showed that inhibitory control and working memory tasks significantly increased HbO₂ in the PFC by 0.53 (p < 0.01, 95% CI = 0.37 to 0.70) and 0.13 (p < 0.01, 95% CI = 0.08 to 0.18) μmol/L, respectively. Overall, HbO₂ was significantly increased during dual-task paradigms by 0.36 μmol/L (P < 0.01, 95% CI = 0.27 to 0.45). Moreover, dual-task paradigms also decreased HbR in the PFC by 0.04 (P < 0.01, 95% CI = -0.07 to -0.01). Specifically, HbR decreased by 0.08 during inhibitory control tasks (p < 0.01, 95% CI = -0.13 to -0.02), but did not change during working memory tasks.

Conclusion: Cognitive tasks related to inhibitory control required greater cognitive demands, indicating higher pfc activation during dual-task paradigms in older adults. for clinical implications, the increase in pfc oxygenated hemoglobin and decrease in pfc deoxygenated hemoglobin may help explain why older adults are more likely to fall during daily activities.

Keywords: Cerebral hemodynamics; Cognition; Dual-task; Executive function; Older adults; Prefrontal cortex; fNIRS.

Publication types

Review