Deans' stroke musings: Prefrontal Cortex Activation While Walking Under Dual-Task Conditions in Stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, June 3, 2016

Prefrontal Cortex Activation While Walking Under Dual-Task Conditions in Stroke

When I first got out of the hospital I could barely walk and talk at the same time. I had to look at the ground and where my feet were going, it took years to be able to look ahead while walking. Not sure what use this is going to be in your rehabilitation.
http://nnr.sagepub.com/content/30/6/591?etoc

A Multimodal Imaging Study

¹The University of Jordan, Amman, Jordan
²Oxford Brookes University, Oxford, UK
³University of Oxford, Oxford, UK
⁴Nuffield Orthopaedic Centre, Oxford, UK
⁵National Brain Mapping Centre, Shahid Beheshti University Medical and General Campus, Tehran, Iran

Emad Al-Yahya, PhD, Faculty of Rehabilitation Sciences, The University of Jordan, Amman 11942, Jordan. Email: e.alyahya@ju.edu.jo

Abstract

Background. Walking while performing another task (eg, talking) is challenging for many stroke survivors, yet its neural basis are not fully understood.

Objective. To investigate prefrontal cortex activation and its relationship to gait measures while walking under single-task (ST) and dual-task (DT) conditions (ie, walking while simultaneously performing a cognitive task) in stroke survivors.

Methods. We acquired near-infrared spectroscopy (NIRS) data from the prefrontal cortex during treadmill walking in ST and DT conditions in chronic stroke survivors and healthy controls. We also acquired functional magnetic resonance imaging (fMRI) and NIRS during simulated walking under these conditions.

Results. NIRS revealed increased oxygenated hemoglobin concentration in DT-walking compared with ST-walking for both groups. For simulated walking, NIRS showed a significant effect of group and group × task, being greater on both occasions, in stroke survivors. A greater increase in brain activation observed from ST to DT walking/ simulated walking was related to a greater change in motor performance in stroke survivors. fMRI revealed increased activity during DT relative to ST conditions in stroke patients in areas including the inferior temporal gyri, superior frontal gyri and cingulate gyri bilaterally, and the right precentral gyrus. The DT-related increase in fMRI activity correlated with DT-related change in behavior in stroke participants in the bilateral inferior temporal gyrus, left cingulate gyrus, and left frontal pole.

Conclusion. Our results provide novel evidence that enhanced brain activity changes relate to dual task motor decrements.