Role of the prefrontal cortex in human balance control

Although recent studies have demonstrated cortical involvement in human balance control, there is insufficient information regarding the regions of the cerebral cortex that contribute to human balance control and their mechanism of action. Using a functional near-infrared spectroscopic system, we investigated perturbation-related cortical activation. External perturbations were provided with and without the preceding auditory warning signals 2 s before the perturbation. Statistical analysis by applying the general linear model showed significant activation in the prefrontal cortex, including the dorsolateral prefrontal cortex and frontal eye field after external perturbation, regardless of the preceding auditory warning signals. A time-line analysis revealed similar temporal profiles for prefrontal activation in 2 different conditions. Based on the contrast between the 2 conditions, we detected enhanced activation in the right posterior parietal cortex and supplementary motor area in the condition where the auditory warning signals were provided. We presumed that prefrontal involvement may be relevant to adequate allocation of visuospatial attention. Our results may facilitate the understanding of cortical mechanisms for balance control in humans and the underlying pathophysiology of falls.