老年人在认知-平衡双任务下的皮质激活特征

doi:10.3969/j.issn.1006-9771.2023.10.010

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (10): 1189-1194.doi: 10.3969/j.issn.1006-9771.2023.10.010

老年人在认知-平衡双任务下的皮质激活特征

阚超杰¹^,², 郭川¹^,³, 朱仕哲¹, 眭有昕¹, 王庆雷¹, 庄任², 耿阿燕¹, 王彤¹^,³()

1.南京医科大学康复医学院，江苏南京市 210000
2.常州市德安医院，江苏常州市 213000
3.南京医科大学第一附属医院，江苏南京市 210000

收稿日期:2023-07-03 修回日期:2023-09-11 出版日期:2023-10-25 发布日期:2023-11-16
通讯作者: 王彤(1961-)，女，博士，教授、主任医师，博士研究生导师。E-mail： wangtong60621@163.com
作者简介:阚超杰(1994-)，男，汉族，江苏常州市人，硕士研究生，康复治疗师，主要研究方向：神经康复。
基金资助:
国家重点研发计划项目(2018YFC2001600);国家重点研发计划项目(2018YFC2001603);常州市卫健委青年人才科技项目(QN202244)

Characteristics of cortical activation in older adults under cognition-balance dual tasks

KAN Chaojie¹^,², GUO Chuan¹^,³, ZHU Shizhe¹, SUI Youxin¹, WANG Qinglei¹, ZHUANG Ren², GENG Ayan¹, WANG Tong¹^,³()

1. School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu 210000, China
2. Changzhou De'an Hospital, Changzhou, Jiangsu 213000, China
3. The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, China

Received:2023-07-03 Revised:2023-09-11 Published:2023-10-25 Online:2023-11-16
Contact: WANG Tong, E-mail: wangtong60621@163.com
Supported by:
National Key Research and Development Program(2018YFC2001600);National Key Research and Development Program(2018YFC2001603);Changzhou Health Commission Young Talent Science and Technology Project(QN202244)

摘要/Abstract

摘要：

目的探讨老年人在执行认知-平衡双任务时平衡能力和大脑皮质激活的特征。
方法 2023年1月至4月，不定向招募健康老年人20例，佩戴功能性近红外光谱采集帽，自然站于动静态平衡仪上，完成闭眼稳定平面站立(CF)、闭眼稳定平面站立同时进行计算任务(CFc)、睁眼不稳定平面站立(OS)、睁眼不稳定平面站立同时进行计算任务(OSc)、闭眼不稳定平面站立(CS)、闭眼不稳定平面站立同时进行计算任务(CSc) 6项任务，动静态平衡仪测量总稳定性指数;设双侧运动前区、感觉运动区和前额叶区为感兴趣区，计算皮质激活β值。
结果 CFc时总稳定性指数大于CF时(Z = -2.014, P < 0.05)，CSc时小于CS时(Z = -2.063, P < 0.05)。CFc时双侧各感兴趣区β值均大于CF时(|Z| > 2.464, |t| > 3.733, P < 0.05)，OSc时均大于OS时(|t| > 2.308, P < 0.05);CSc时右感觉运动区β值大于CS时(t = -2.912, P < 0.05)。CSc时计算正确次数显著小于CFc时和OSc时(|Z| > 3.643, P < 0.001)。
结论老年人双任务下平衡能力下降，大脑皮质激活增加。随着平衡任务难度提升，老年人在双任务下会优先保持姿势平衡，认知表现下降，可能与双任务下大脑皮质激活程度不能进一步增加有关。

关键词: 老年人, 平衡, 双任务, 皮质激活, 功能性近红外光谱技术

Abstract:

Objective To explore the characteristics of balance and cortical activation in older adults when performing cognition-balance dual tasks.
Methods From January to April, 2023, 20 healthy older adults were non-targeted recruited. They completed six tasks of close eyes & fixed platform (CF), close eyes & fixed platform & cognitive task (CFc), open eyes & sway-referenced platform (OS), open eyes & sway-referenced platform & cognitive task (OSc), close eyes & sway-referenced platform (CS), and close eyes & sway-referenced platform & cognitive task (CSc) on the Balance SD, wearing functional near-infrared spectroscopy caps. The overal stability index (OSI) was measured with Balance SD. The premotor cortex (PMC), sensorimotor cortex (SMC) and prefrontal cortex (PFC) were as regions of interest (ROIs), and the β values were calculated.
Results The OSI was more as CFc than as CF (Z = -2.014, P < 0.05), and was less as CSc than as CS (Z = -2.063, P < 0.05). The β values of bilateral ROIs were all more as CFc than as CF (|Z| > 2.464, |t| > 3.733, P < 0.05), and as OSc than as OS (|t| > 2.308, P < 0.05); the β value of the right SMC was more as CSc than as CS (t = -2.912, P < 0.05). The number of correct counts was less as CSc than as CFc and OSc (|Z| > 3.643, P < 0.001).
Conclusion Balance has been impaired under dual tasks for older adults, while activation of cerebral cortex increases. However, for more difficult balance task, older adults would preferentially maintain postural balance under dual tasks, while cognitive performance decreases, which may be the results from no more activation of cerebral cortex under dual tasks.

Key words: older adults, balance, dual task, cortical activation, functional near-infrared spectroscopy

中图分类号:

R592

阚超杰, 郭川, 朱仕哲, 眭有昕, 王庆雷, 庄任, 耿阿燕, 王彤. 老年人在认知-平衡双任务下的皮质激活特征[J]. 《中国康复理论与实践》, 2023, 29(10): 1189-1194.

KAN Chaojie, GUO Chuan, ZHU Shizhe, SUI Youxin, WANG Qinglei, ZHUANG Ren, GENG Ayan, WANG Tong. Characteristics of cortical activation in older adults under cognition-balance dual tasks[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(10): 1189-1194.

图/表 4

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任务	OSI	Z值	P值
CF	1.500 (1.025, 2.700)	-2.014	0.044
CFc	2.050 (1.300, 3.550)	-2.014	0.044
OS	1.300 (1.100, 1.900)	-0.545	0.586
OSc	1.450 (1.000, 1.975)	-0.545	0.586
CS	2.000 (1.650, 4.000)	-2.063	0.039
CSc	1.800 (1.425, 2.275)	-2.063	0.039

ROI	任务	β值	t/Z值	P值^a	ROI	任务	β值	t/Z值	P值^a
RSMC	CF CFc	0.018 (-0.007, 0.065) 0.044 (0.020, 0.107)	-2.464	0.014	LSMC	OS OSc	0.009±0.072 0.080±0.069	-3.554	0.006
RPMC	CF CFc	0.007±0.039 0.055±0.063	-4.688	< 0.001	LPMC	OS OSc	-0.002±0.050 0.062±0.084	-2.769	0.015
RPFC	CF CFc	0.010 (-0.031, 0.029) 0.058 (0.016, 0.125)	-3.733	< 0.001	LPFC	OS OSc	-0.021 (-0.039, 0.075) 0.090 (0.029, 0.136)	-2.800	0.009
LSMC	CF CFc	0.013±0.045 0.067±0.065	-4.966	< 0.001	RSMC	CS CSc	0.025 (-0.016, 0.065) 0.083 (0.052, 0.129)	-2.912	0.022
LPMC	CF CFc	0.004 (-0.016, 0.037) 0.053 (0.028, 0.104)	-3.808	< 0.001	RPMC	CS CSc	0.019 (0.004, 0.053) 0.085 (0.036, 0.103)	-2.315	0.062
LPFC	CF CFc	0.015±0.065 0.078±0.078	-5.043	< 0.001	RPFC	CS CSc	0.036 (-0.002, 0.092) 0.049 (0.029, 0.088)	-0.672	0.602
RSMC	OS OSc	0.010±0.077 0.082±0.102	-3.078	0.009	LSMC	CS CSc	0.025 (0.005, 0.086) 0.079 (0.026, 0.123)	-1.755	0.159
RPMC	OS OSc	0.005±0.061 0.066±0.075	-4.382	0.002	LPMC	CS CSc	0.044±.0.061 0.067±0.068	-1.283	0.322
RPFC	OS OSc	0.008±0.067 0.046±0.071	-2.308	0.032	LPFC	CS CSc	0.053 (0.013, 0.147) 0.074 (0.048, 0.105)	-0.149	0.881

任务	计算正确次数	Z值	P值
CFc OSc	4.000 (3.000, 6.750) 4.000 (3.000, 6.500)	-0.518	0.604
CFc CSc	4.000 (3.000, 6.750) 2.000 (1.000, 3.000)	-3.643	< 0.001
OSc CSc	4.000 (3.000, 6.500) 2.000 (1.000, 3.000)	-3.855	< 0.001

老年人在认知-平衡双任务下的皮质激活特征

Characteristics of cortical activation in older adults under cognition-balance dual tasks

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