The ageing brain: Cortical overactivation - How does it evolve?

There is overwhelming evidence for an age-related change in brain activity when performing motor and motor-cognitive tasks (i.e. dual-tasking). In general this research shows increased cortical activity, i.e. cortical overactivation, and, less evident, subcortical deactivation in the healthy brains of older compared to young adults. Furthermore brain network activity becomes less distinct and less segregated. Interestingly from a behavioural point of view some of these adaptations seem helpful, leading to better motor performances than in age-matched seniors, but others are related to inferior performance. Current theories try to explain these findings, therefore, either in favour of compensatory strategies or in terms of non-selective, inefficient (dedifferentiated) brain activation. However the limitation of current theories is that they are 'static', considering only one point in time instead of age-related progression of brain activity over time. In contrast this review article proposes a developmental process, from compensation to negative overcompensation to chronic maladaptive overcompensation, which leads to dedifferentiation and desegregation. In addition this article highlights that elderly subjects utilize motor control strategies, such as increased cortical activity, down-regulation of inhibitory processes and less-segregated and lateralized brain activation patterns, that are also commonly found in healthy young adults when task challenges increase. Thus many findings about differences in brain activation may result from the fact that although 'absolute task difficulty' remains the same, 'relative task difficulty' increases for the older subjects, forcing them to apply the above-mentioned neural activation strategies. This initially compensatory strategy can, however, turn into non-efficient brain activation over time.