Exploring cortical activation patterns during linear vs. curvilinear walking in people with multiple sclerosis using...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Multiple Sclerosis (MS) is a chronic central nervous system disease causing inflammation, demyelination, and axon loss.
• Mobility impairment, particularly in walking ability, is a key symptom affecting quality of life in people with MS (PwMS).
• As MS progresses, walking difficulties often necessitate walking aids, impacting daily mobility.

Purpose of the Study:

• To investigate cortical activation patterns during walking in PwMS using walking aids via functional Near-Infrared Spectroscopy (fNIRS).
• To compare neural activation during linear versus curvilinear walking, reflecting real-world mobility demands.
• To identify specific brain regions involved in gait control for PwMS with moderate disability.

Main Methods:

• Nineteen PwMS with an Expanded Disability Status Scale (EDSS) score of 6 participated.
• Functional Near-Infrared Spectroscopy (fNIRS) was used to measure cortical activity during 30-second walking trials.
• Participants walked along linear and curvilinear paths while using their prescribed walking aids.

Main Results:

• Walking, both linear and curvilinear, elicited widespread cortical activation in PwMS, including prefrontal, sensorimotor, and parietal regions.
• Curvilinear walking showed significantly higher activation in specific Brodmann Areas (BA10, BA8, BA6) compared to linear walking.
• Increased activation in prefrontal and premotor areas during curvilinear walking suggests greater cognitive and motor control demands.

Conclusions:

• Cortical activation patterns during walking in PwMS using aids are extensive and involve multiple brain regions.
• Challenging gait maneuvers, like curvilinear walking, require enhanced recruitment of prefrontal and premotor cortical areas.
• Gait rehabilitation programs for PwMS should integrate both linear and curvilinear walking exercises to better prepare patients for real-world mobility.