Roee Holtzer1, Noah Epstein2, Jeannette R Mahoney3, Meltem Izzetoglu4, Helena M Blumen5. 1. Department of Neurology, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York. Ferkauf Graduate School of Psychology of Yeshiva University, Bronx, New York. roee.holtzer@einstein.yu.edu. 2. Ferkauf Graduate School of Psychology of Yeshiva University, Bronx, New York. 3. Department of Neurology, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York. 4. Drexel University School of Biomedical Engineering, Philadelphia, Pennsylvania. 5. Department of Medicine, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York.
Abstract
BACKGROUND: The relationship between mobility and cognition in aging is well established, but the relationship between mobility and the structure and function of the aging brain is relatively unknown. This, in part, is attributed to the technological limitations of most neuroimaging procedures, which require the individual to be immobile or in a supine position. Herein, we provide a targeted review of neuroimaging studies of mobility in aging to promote (i) a better understanding of this relationship, (ii) future research in this area, and (iii) development of applications for improving mobility. METHODS: A systematic search of peer-reviewed studies was performed using PubMed. Search terms included (i) aging, older adults, or elderly; (ii) gait, walking, balance, or mobility; and (iii) magnetic resonance imaging, voxel-based morphometry, fluid-attenuated inversion recovery, diffusion tensor imaging, positron emission tomography, functional magnetic resonance imaging, electroencephalography, event-related potential, and functional near-infrared spectroscopy. RESULTS: Poor mobility outcomes were reliably associated with reduced gray and white matter volume. Fewer studies examined the relationship between changes in task-related brain activation and mobility performance. Extant findings, however, showed that activation patterns in the cerebellum, basal ganglia, parietal and frontal cortices were related to mobility. Increased involvement of the prefrontal cortex was evident in both imagined walking conditions and conditions where the cognitive demands of locomotion were increased. CONCLUSIONS: Cortical control of gait in aging is bilateral, widespread, and dependent on the integrity of both gray and white matter.
BACKGROUND: The relationship between mobility and cognition in aging is well established, but the relationship between mobility and the structure and function of the aging brain is relatively unknown. This, in part, is attributed to the technological limitations of most neuroimaging procedures, which require the individual to be immobile or in a supine position. Herein, we provide a targeted review of neuroimaging studies of mobility in aging to promote (i) a better understanding of this relationship, (ii) future research in this area, and (iii) development of applications for improving mobility. METHODS: A systematic search of peer-reviewed studies was performed using PubMed. Search terms included (i) aging, older adults, or elderly; (ii) gait, walking, balance, or mobility; and (iii) magnetic resonance imaging, voxel-based morphometry, fluid-attenuated inversion recovery, diffusion tensor imaging, positron emission tomography, functional magnetic resonance imaging, electroencephalography, event-related potential, and functional near-infrared spectroscopy. RESULTS: Poor mobility outcomes were reliably associated with reduced gray and white matter volume. Fewer studies examined the relationship between changes in task-related brain activation and mobility performance. Extant findings, however, showed that activation patterns in the cerebellum, basal ganglia, parietal and frontal cortices were related to mobility. Increased involvement of the prefrontal cortex was evident in both imagined walking conditions and conditions where the cognitive demands of locomotion were increased. CONCLUSIONS: Cortical control of gait in aging is bilateral, widespread, and dependent on the integrity of both gray and white matter.
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