首页|认知功能损伤对双任务站立影响的中枢机制:功能性近红外脑成像系统分析

认知功能损伤对双任务站立影响的中枢机制:功能性近红外脑成像系统分析

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背景:轻度认知障碍老年人由于认知功能下降,姿势控制能力下降,易发生跌倒.双任务范式由于更贴近日常生活,常被用于评估姿势控制能力,但以往对于轻度认知障碍老年人的认知与姿势控制双任务研究主要探讨姿势控制的外在表现特征,中枢神经机制的直接证据依然缺乏.目的:探讨轻度认知障碍老年人在执行站立姿势控制-空间工作记忆双任务时大脑躯体感觉运动皮质激活特征.方法:采用蒙特利尔认知量表(MoCA-B)筛选受试者,共纳入轻度认知障碍老年人16人、认知功能正常老年人17人,进行5种任务测试,分别为空间工作记忆(SIT)、双足平衡站立(SD)、Romberg 站立(SR)、双足平衡站立-空间工作记忆双任务(DD)、Romberg 站立-空间工作记忆双任务(DR);同时使用功能性近红外脑成像系统和三维测力台收集躯体感觉运动皮质(20个通道)的血液动力学、足底压力中心(COP)摆动轨迹数据.结果与结论:①在Romberg 站立、双足平衡站立-空间工作记忆双任务、Romberg 站立-空间工作记忆双任务下,轻度认知障碍老年人前后、内外方向足底压力中心位移均显著大于认知功能正常老年人(P<0.05);②在双足平衡站立-空间工作记忆双任务下,轻度认知障碍老年人15通道(右侧前运动皮质/辅助运动区)的氧合血红蛋白变化量值显著大于认知功能正常老年人(P<0.05);在Romberg 站立-空间工作记忆双任务下,轻度认知障碍老年人15,17通道(右侧前运动皮质/辅助运动区)的氧合血红蛋白变化量值均显著大于认知功能正常老年人(P<0.05);③在Romberg 站立-空间工作记忆双任务下,轻度认知障碍老年人内外方向足底压力中心位移与15通道的氧合血红蛋白变化量存在显著正相关(r=0.659,P<0.05),认知功能正常老年人内外方向足底压力中心位移与15通道的氧合血红蛋白变化量存在高度正相关(r=0.840,P<0.05).结果表明,与认知功能正常老年人相比,轻度认知障碍老年人在站立姿势控制-空间工作记忆双任务中站立姿势控制能力较弱,右侧前运动皮质与辅助运动区激活水平更高,更多的脑资源用于侧向姿势控制,可能是轻度认知障碍老年人认知衰退导致站立姿势控制能力变弱的大脑补偿机制.
Central nervous mechanisms underlying effects of cognitive impairment on dual-task stance:functional near-infrared spectroscopy analysis
BACKGROUND:Elderly people with mild cognitive impairment experience a decline in postural control ability due to cognitive function decline,making them more prone to falls.The dual-task paradigm,which more closely mirrors daily life,is often used to assess postural control ability.However,previous dual-task studies on cognition and postural control in elderly people with mild cognitive impairment have mainly focused on the external manifestations of postural control,with direct evidence of central nervous mechanisms still lacking.OBJECTIVE:To investigate the activation characteristics of the cerebral somatic sensorimotor cortex in the elderly people with mild cognitive impairment while performing the dual task of stance postural control and spatial working memory.METHODS:Participants were screened using the Montreal Cognitive Assessment,enrolling 16 elderly people with mild cognitive impairment and 17 healthy older people.They performed five task tests:spatial working memory,dual-feet balance stance,Romberg stance,dual task of dual-feet balance stance and spatial working memory,and dual task of Romberg stance and spatial working memory.Functional near-infrared spectroscopy and a three-dimentional force platform were used simultaneously to collect data on cerebral cortex(20 channels)hemodynamics and center of pressure swing trajectory.RESULTS AND CONCLUSION:In Romberg stance,dual task of dual-feet balance stance and spatial working memory,and dual task of Romberg stance and spatial working memory tasks,center of pressure displacements in anterior-posterior and medial-lateral directions were significantly greater in mild cognitive impairment elderly people than that in normal elder people(P<0.05).In dual task of dual-feet balance stance and spatial working memory task,ΔHbO2 at channel 15(right pre-motor cortex and supplementary motor area)was significantly greater in mild cognitive impairment elderly people than that in normal elder people(P<0.05).In dual task of Romberg stance and spatial working memory task,ΔHbO2 at channels 15 and 17(right pre-motor cortex and supplementary motor area)was significantly greater in the elderly people with mild cognitive impairment compared with the healthy older people(P<0.05).In dual task of Romberg stance and spatial working memory task,a significantly positive correlation in the elderly people with mild cognitive impairment(r=0.659,P<0.05)and a strong positive correlation in the healthy older people were observed between center of pressure displacement in medial-lateral direction and ΔHbO2 at channel 15(r=0.840,P<0.05).The results indicate that compared with the cognitively normal healthy older people,the elderly people with mild cognitive impairment showed weaker stance postural control capability during the dual task of stance postural control and spatial working memory,with higher activation levels in the right pre-motor cortex and supplementary motor area.The increased brain resource allocation for lateral postural control may represent the brain compensation mechanism in the elderly people with mild cognitive impairment due to cognitive decline leading to weakened stance postural control ability.

mild cognitive impairmentpostural controlspatial working memorypre-motor cortexsupplementary motor areafunctional near-infrared spectroscopy

董志文、于聪、陈岩、丁建军

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山东体育学院运动与健康学院,山东省 济南市 250102

山东体育学院国家足球学院国家篮球学院,山东省 日照市 275900

轻度认知障碍 姿势控制 空间工作记忆 前运动皮质 辅助运动区 功能性近红外光谱

2025

中国组织工程研究
中国康复医学会,《中国组织工程研究与临床康复》杂志社

中国组织工程研究

北大核心
影响因子:1.387
ISSN:2095-4344
年,卷(期):2025.29(17)