http://journals.sagepub.com/doi/abs/10.1177/1545968317693304
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Vera Gramigna, PhD†, Giovanni Pellegrino, PhD†, Antonio Cerasa, PhD, Simone Cutini, PhD, Roberta Vasta, PhD, Giuseppe Olivadese, PhD, Iolanda Martino, PhD, Aldo Quattrone, PhD, MD
Abstract
Walking
is a complex motor behavior with a special relevance in clinical
neurology. Many neurological diseases, such as Parkinson’s disease and
stroke, are characterized by gait disorders whose neurofunctional
correlates are poorly investigated. Indeed, the analysis of real walking
with the standard neuroimaging techniques poses strong challenges, and
only a few studies on motor imagery or walking observation have been
performed so far. Functional near-infrared spectroscopy (fNIRS) is
becoming an important research tool to assess functional activity in
neurological populations or for special tasks, such as walking, because
it allows investigating brain hemodynamic activity in an ecological
setting, without strong immobility constraints. A systematic review
following PRISMA guidelines was conducted on the fNIRS-based examination
of gait disorders. Twelve of the initial yield of 489 articles have
been included in this review. The lesson learnt from these studies
suggest that oxy-hemoglobin levels within the prefrontal and premotor
cortices are more sensitive to compensation strategies reflecting
postural control and restoration of gait disorders. Although this field
of study is in its relative infancy, the evidence provided encourages
the translation of fNIRS in clinical practice, as it offers a unique
opportunity to explore in depth the activity of the cortical motor
system during real walking in neurological patients. We also discuss to
what extent fNIRS may be applied for assessing the effectiveness of
rehabilitation programs.
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