Targeted tDCS Mitigates Dual-Task Costs to Gait and Balance in Older Adults.
Ann Neurol
; 90(3): 428-439, 2021 09.
Article
in En
| MEDLINE
| ID: mdl-34216034
ABSTRACT
OBJECTIVE:
Among older adults, the ability to stand or walk while performing cognitive tasks (ie, dual-tasking) requires coordinated activation of several brain networks. In this multicenter, double-blinded, randomized, and sham-controlled study, we examined the effects of modulating the excitability of the left dorsolateral prefrontal cortex (L-DLPFC) and the primary sensorimotor cortex (SM1) on dual-task performance "costs" to standing and walking.METHODS:
Fifty-seven older adults without overt illness or disease completed 4 separate study visits during which they received 20 minutes of transcranial direct current stimulation (tDCS) optimized to facilitate the excitability of the L-DLPFC and SM1 simultaneously, or each region separately, or neither region (sham). Before and immediately after stimulation, participants completed a dual-task paradigm in which they were asked to stand and walk with and without concurrent performance of a serial-subtraction task.RESULTS:
tDCS simultaneously targeting the L-DLPFC and SM1, as well as tDCS targeting the L-DLPFC alone, mitigated dual-task costs to standing and walking to a greater extent than tDCS targeting SM1 alone or sham (p < 0.02). Blinding efficacy was excellent and participant subjective belief in the type of stimulation received (real or sham) did not contribute to the observed functional benefits of tDCS.INTERPRETATION:
These results demonstrate that in older adults, dual-task decrements may be amenable to change and implicate L-DPFC excitability as a modifiable component of the control system that enables dual-task standing and walking. tDCS may be used to improve resilience and the ability of older results to walk and stand under challenging conditions, potentially enhancing everyday functioning and reducing fall risks. ANN NEUROL 2021;90428-439.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psychomotor Performance
/
Aging
/
Prefrontal Cortex
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Postural Balance
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Transcranial Direct Current Stimulation
/
Gait
Type of study:
Clinical_trials
/
Health_economic_evaluation
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
En
Journal:
Ann Neurol
Year:
2021
Type:
Article
Affiliation country:
Morocco