Functional neural correlates of reduced physiological falls risk
Tóm tắt
It is currently unclear whether the function of brain regions associated with executive cognitive processing are independently associated with reduced physiological falls risk. If these are related, it would suggest that the development of interventions targeted at improving executive neurocognitive function would be an effective new approach for reducing physiological falls risk in seniors. We performed a secondary analysis of 73 community-dwelling senior women aged 65 to 75 years old who participated in a 12-month randomized controlled trial of resistance training. Functional MRI data were acquired while participants performed a modified Eriksen Flanker Task - a task of selective attention and conflict resolution. Brain volumes were obtained using MRI. Falls risk was assessed using the Physiological Profile Assessment (PPA). After accounting for baseline age, experimental group, baseline PPA score, and total baseline white matter brain volume, baseline activation in the left frontal orbital cortex extending towards the insula was negatively associated with reduced physiological falls risk over the 12-month period. In contrast, baseline activation in the paracingulate gyrus extending towards the anterior cingulate gyrus was positively associated with reduced physiological falls risk. Baseline activation levels of brain regions underlying response inhibition and selective attention were independently associated with reduced physiological falls risk. This suggests that falls prevention strategies may be facilitated by incorporating intervention components - such as aerobic exercise - that are specifically designed to induce neurocognitive plasticity. ClinicalTrials.gov Identifier:
NCT00426881
Tài liệu tham khảo
Murray C, Lopez A: Global and regional descriptive epidemiology of disability: incidence, prevalence, health expectancies, and years lived with disability. The global burden of disease. Edited by: Murray C, Lopez A. 1996, Boston: The Harvard School of Public Health, 201-246.
Tinetti ME, Speechley M, Ginter SF: Risk factors for falls among elderly persons living in the community. The New England journal of medicine. 1988, 319: 1701-1707. 10.1056/NEJM198812293192604.
Lord S, Clark R, Webster I: Physiological factors associated with falls in an elderly population. Journal of American Geriatrics Society. 1991, 39: 1194-1200.
Lord S, Ward J, Williams P, Anstey K: Physiological factors associated with falls in older community-dwelling women. Journal of American Geriatrics Society. 1994, 42: 1110-1117.
Lundin-Olsson L, Nyberg L, Gustafson Y: "Stops walking when talking" as a predictor of falls in elderly people. Lancet. 1997, 349: 617-
Anstey KJ, von Sanden C, Luszcz MA: An 8-year prospective study of the relationship between cognitive performance and falling in very old adults. J Am Geriatr Soc. 2006, 54: 1169-1176. 10.1111/j.1532-5415.2006.00813.x.
Liu-Ambrose T, Ahamed Y, Graf P, Feldman F, Robinovitch SN: Older fallers with poor working memory overestimate their postural limits. Archives of physical medicine and rehabilitation. 2008, 89: 1335-1340. 10.1016/j.apmr.2007.11.052.
Liu-Ambrose TY, Ashe MC, Graf P, Beattie BL, Khan KM: Increased risk of falling in older community-dwelling women with mild cognitive impairment. Phys Ther. 2008, 88: 1482-1491. 10.2522/ptj.20080117.
Lord S, Fitzpatrick R: Choice stepping reaction time: A composite measure of fall risk in older people. Journal of gerontology. 2001, 10: M627-632.
Holtzer R, Friedman R, Lipton RB, Katz M, Xue X, Verghese J: The relationship between specific cognitive functions and falls in aging. Neuropsychology. 2007, 21: 540-548.
Persad CC, Giordani B, Chen HC, Ashton-Miller JA, Alexander NB, Wilson CS, Berent S, Guire K, Schultz AB: Neuropsychological predictors of complex obstacle avoidance in healthy older adults. J Gerontol B Psychol Sci Soc Sci. 1995, 50: P272-277.
Thal DR, Del Tredici K, Braak H: Neurodegeneration in normal brain aging and disease. Sci Aging Knowledge Environ. 2004, 2004: pe26-10.1126/sageke.2004.23.pe26.
Briley DP, Wasay M, Sergent S, Thomas S: Cerebral white matter changes (leukoaraiosis), stroke, and gait disturbance. J Am Geriatr Soc. 1997, 45: 1434-1438.
Soumare A, Elbaz A, Zhu Y, Maillard P, Crivello F, Tavernier B, Dufouil C, Mazoyer B, Tzourio C: White matter lesions volume and motor performances in the elderly. Annals of neurology. 2009, 65: 706-715. 10.1002/ana.21674.
Masdeu JC, Wolfson L, Lantos G, Tobin JN, Grober E, Whipple R, Amerman P: Brain white-matter changes in the elderly prone to falling. Archives of neurology. 1989, 46: 1292-1296.
Baloh RW, Ying SH, Jacobson KM: A longitudinal study of gait and balance dysfunction in normal older people. Archives of neurology. 2003, 60: 835-839. 10.1001/archneur.60.6.835.
Rosano C, Aizenstein H, Brach J, Longenberger A, Studenski S, Newman AB: Special Article: Gait Measures Indicate Underlying Focal Gray Matter Atrophy in the Brain of Older Adults. J Gerontol A Biol Sci Med Sci. 2008, 63: 1380-1388.
Rosano C, Aizenstein HJ, Studenski S, Newman AB: A regions-of-interest volumetric analysis of mobility limitations in community-dwelling older adults. J Gerontol A Biol Sci Med Sci. 2007, 62: 1048-1055.
Colcombe SJ, Erickson KI, Scalf PE, Kim JS, Prakash R, McAuley E, Elavsky S, Marquez DX, Hu L, Kramer AF: Aerobic Exercise Training Increases Brain Volume in Aging Humans. J Gerontol A Biol Sci Med Sci. 2006, 61: 1166-1170.
Liu-Ambrose TY, Nagamatsu LS, Handy TC, Leghari A: Does impaired cerebellar function contribute to risk of falls in seniors? A pilot study using functional magnetic resonance imaging. J Am Geriatr Soc. 2008, 56: 2153-2155. 10.1111/j.1532-5415.2008.01984.x.
Liu-Ambrose T, Nagamatsu LS, Graf P, Beattie BL, Ashe MC, Handy TC: Resistance training and executive functions: a 12-month randomized controlled trial. Archives of internal medicine. 2010, 170: 170-178. 10.1001/archinternmed.2009.494.
Folstein MF, Folstein SE, McHugh PR: "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975, 12: 189-198. 10.1016/0022-3956(75)90026-6.
Yesavage JA: Geriatric Depression Scale. Psychopharmacol Bull. 1988, 24: 709-711.
Charlson ME, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of chronic diseases. 1987, 40: 373-383. 10.1016/0021-9681(87)90171-8.
Smith SM, Zhang Y, Jenkinson M, Chen J, Matthews PM, Federico A, De Stefano N: Accurate, robust, and automated longitudinal and cross-sectional brain change analysis. NeuroImage. 2002, 17: 479-489. 10.1006/nimg.2002.1040.
Smith SM, Jenkinson M, Woolrich MW, Beckmann CF, Behrens TEJ, Johansen-Berg H, Bannister PR, De Luca M, Drobnjak I, Flitney DE: Advances in functional and structural MR image analysis and implementation as FSL. NeuroImage. 2004, 23: S208-S219.
Smith SM: Fast robust automated brain extraction. Human brain mapping. 2002, 17: 143-155. 10.1002/hbm.10062.
Jenkinson M: Fast, automated, N-dimensional phase-unwrapping algorithm. Magn Reson Med. 2003, 49: 193-197. 10.1002/mrm.10354.
Jenkinson M, Smith S: A global optimisation method for robust affine registration of brain images. Medical image analysis. 2001, 5: 143-156. 10.1016/S1361-8415(01)00036-6.
Zhang Y, Brady M, Smith S: Segmentation of brain MR images through a hidden Markov random field model and the expectation maximization algorithm. IEEE Trans on Medical Imaging. 2001, 20: 45-57. 10.1109/42.906424.
Colcombe SJ, Kramer AF, Erickson KI, Scalf P, McAuley E, Cohen NJ, Webb A, Jerome GJ, Marquez DX, Elavsky S: Cardiovascular fitness, cortical plasticity, and aging. Proc Natl Acad Sci USA. 2004, 101: 3316-3321. 10.1073/pnas.0400266101.
Friston KJ, Ashburner J, Frith CD, Poline J-P, Heather JD: Spatial registration and normalization of images. Huamn Brain Mapp. 1995, 2: 165-189.
Friston KJ, Frith CD, Turner R, Frackowiak RS: Characterizing evoked hemodynamics with fMRI. NeuroImage. 1995, 2: 157-165. 10.1006/nimg.1995.1018.
Talairach J, Tournoux P: Co-planar Stereotaxic Atlas of the Human Brain. 1988, New York: Thieme Medical Publishers
Rosano C, Aizenstein HJ, Wu M, Newman AB, Becker JT, Lopez OL, Kuller LH: Focal atrophy and cerebrovascular disease increase dementia risk among cognitively normal older adults. J Neuroimaging. 2007, 17: 148-155. 10.1111/j.1552-6569.2007.00093.x.
Rosano C, Brach J, Longstreth WT, Newman AB: Quantitative measures of gait characteristics indicate prevalence of underlying subclinical structural brain abnormalities in high-functioning older adults. Neuroepidemiology. 2006, 26: 52-60. 10.1159/000089240.
Rosano C, Brach J, Studenski S, Longstreth WT, Newman AB: Gait variability is associated with subclinical brain vascular abnormalities in high-functioning older adults. Neuroepidemiology. 2007, 29: 193-200. 10.1159/000111582.
Rosano C, Newman AB, Katz R, Hirsch CH, Kuller LH: Association Between Lower Digit Symbol Substitution Test Score and Slower Gait and Greater Risk of Mortality and of Developing Incident Disability in Well-Functioning Older Adults. Journal of the American Geriatrics Society. 2008, 56: 1618-1625. 10.1111/j.1532-5415.2008.01856.x.
Rosano C, Simonsick EM, Harris TB, Kritchevsky SB, Brach J, Visser M, Yaffe K, Newman AB: Association between physical and cognitive function in healthy elderly: the health, aging and body composition study. Neuroepidemiology. 2005, 24: 8-14. 10.1159/000081043.
Carter CS, Braver TS, Barch DM, Botvinick MM, Noll D, Cohen JD: Anterior cingulate cortex, error detection, and the online monitoring of performance. Science. 1998, 280: 747-749. 10.1126/science.280.5364.747.
Casey BJ, Trainor RJ, Orendi JL, Schubert AB, Nystrom LE, Giedd JN, Castellanos FX, Haxby JV, Noll DC, Cohen JD: A developmental functional MRI study of prefrontal activation during performance of a Go-No-Go task. Journal of Cognitive Neuroscience. 1997, 9: 835-847. 10.1162/jocn.1997.9.6.835.
Haupt S, Axmacher N, Cohen MX, Elger CE, Fell J: Activation of the caudal anterior cingulate cortex due to task-related interference in an auditory stroop. Human Brain Mapping. 2009, 30: 3043-3056. 10.1002/hbm.20731.
Boehler CN, Appelbaum LG, Krebs RM, Hopf JM, Woldorff MG: Pinning down response inhibition in the brain - Conjunction analyses of the Stop-signal task. NeuroImage. 2010, 52: 1621-1632. 10.1016/j.neuroimage.2010.04.276.
Anstey KJ, Wood J, Kerr G, Caldwell H, Lord SR: Different cognitive profiles for single compared with recurrent fallers without dementia. Neuropsychology. 2009, 23: 500-508.
Botvinick MM: Conflict monitoring and decision making: Reconsiling two perspectives on anterior cingulate function. Cognitive, Affective, and Behavioural Neuroscience. 2007, 7: 356-366. 10.3758/CABN.7.4.356.
Resnick SM, Pham DL, Kraut MA, Zonderman AB, Davatzikos C: Longitudinal magnetic resonance imaging studies of older adults: A shrinking brain. The Journal of Neuroscience. 2003, 23: 3295-3301.
Robertson MC, Campbell AJ, Gardner MM, Devlin N: Preventing Injuries in Older People by Preventing Falls: A Meta-Analysis of Individual-Level Data. J Am Geriatr Soc. 2002, 50: 905-911. 10.1046/j.1532-5415.2002.50218.x.
Kramer AF, Hahn S, Gopher D: Task coordination and aging: explorations of executive control processes in the task switching paradigm. Acta Psychol (Amst). 1999, 101: 339-378. 10.1016/S0001-6918(99)00011-6.