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Prefrontal Cortex Activation During Dual Task With Increasing Cognitive Load in Subacute Stroke Patients: A Pilot
Eric Hermand1, Bertrand Tapie1,2, Olivier Dupuy3
1Laboratoire HAVAE, EA6310, Université de Limoges, Limoges, France.
Frontiers in Aging Neuroscience
|July 18, 2019
Summary
Stroke patients struggle with dual tasks, showing no increased brain activity with higher cognitive loads during walking. Cognitive function declined with increased cognitive demand, indicating limited brain resources post-stroke.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Cognitive Science
Background:
- Stroke survivors often experience difficulties with dual tasks (DT), performing cognitive tasks while walking.
- Prefrontal cortex (PFC) activity increases during DT compared to single tasks (ST) in stroke patients.
- The impact of increasing cognitive load on PFC activity during DT in subacute stroke is not well understood.
Purpose of the Study:
- To investigate the effects of N-back tasks (low and high cognitive load) on cerebral activity, gait, and cognitive performance in subacute stroke patients.
- To explore the relationship between cognitive load, PFC activity, and dual-task performance in early stroke recovery.
Main Methods:
- Eleven subacute stroke patients underwent functional near-infrared spectroscopy (fNIRS) to measure PFC activity (ΔO2Hb, ΔHHb).
- Participants performed single-task walking (STwalk) and dual-task conditions combining walking with verbal 1-back (low load) and 2-back (high load) tasks.
- Gait parameters (speed, stride variability) and cognitive performance (accuracy) were recorded.
Main Results:
- Increased PFC oxyhemoglobin (ΔO2Hb) was observed during walking but did not further increase with cognitive loads in dual tasks.
- Walking speed decreased significantly with both low and high cognitive loads in dual tasks compared to single-task walking.
- Cognitive performance was impaired by walking and further reduced by higher cognitive load, with no difference between low and high loads in dual-task walking.
Conclusions:
- A 'ceiling' effect in PFC activity during walking in subacute stroke patients limits additional cognitive resource allocation for simultaneous cognitive tasks.
- Cognitive performance, not motor performance, declined with increased cognitive load during dual-task walking in the early recovery phase.
- These findings suggest limited neural resources for dual-tasking in subacute stroke, impacting cognitive function more than gait parameters.
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