Prefrontal cortex activation during a dual task in patients with stroke

Gait Posture. 2018 Jan;59:193-198. doi: 10.1016/j.gaitpost.2017.09.032. Epub 2017 Oct 16.


Dual tasks destabilize task performance as they involve competing demands for cognitive and physical resources. Several studies have reported that dual-task walking activates the prefrontal cortex (PFC), and recent studies have indicated a relationship between PFC and dual-task deterioration in healthy subjects. However, PFC activity during dual-task walking in stroke patients remains unclear. We investigated the association between PFC activity and dual-task interference on physical and cognitive performance in stroke patients. This study included 14 stroke patients and 14 healthy subjects who performed a calculation task while walking at a comfortable pace on the floor. PFC activity was assessed using wearable near-infrared spectroscopy. The calculation task and trunk linear accelerations were evaluated as measures of cognitive and physical performance. The dual-task deterioration on both physical and cognitive performance of stroke patients was significantly higher than in healthy subjects. PFC activation during dual-task walking was significantly lower in stroke patients. Although right PFC activation was negatively correlated with dual-task deterioration on physical performance in stroke patients, left PFC activation was negatively correlated with the dual-task cost on cognitive performance in healthy subjects. Thus, during dual-task walking, PFC activation might prioritize physical demands in stroke patients, but might prioritize cognitive demands in healthy subjects.

Keywords: Dual task; Gait stability; Near-infrared spectroscopy; Prioritization; Stroke.

MeSH terms

  • Adult
  • Aged
  • Attention / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multitasking Behavior / physiology*
  • Prefrontal Cortex / physiopathology*
  • Problem Solving / physiology*
  • Spectroscopy, Near-Infrared
  • Stroke / physiopathology*
  • Walking / physiology*
  • Walking Speed / physiology