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Article Dans Une Revue Frontiers in Neurology Année : 2020

Functional status is associated with prefrontal cortex activation in gait in subacute stroke patients

Résumé

The increasing of cerebral oxygenation, more precisely the overactivation of the prefrontal cortex (PFC), reflects cortical control of gait in stroke disease. Studies about the relationship between brain activation and the functional status in stroke patients remain scarce. The aim of this study is to compare brain activation, gait parameters and cognitive performances in single and dual tasks according to the functional status in subacute stroke patients. Twenty-one subacute stroke patients were divided in two groups according to Barthel Index ('Low Barthel' and 'High Barthel') and performed randomly ordered walking, cognitive task (n-back task) and dual tasks (walking + n-back task). We assessed gait performances (speed, variability) using an electronic walkway system and cerebral oxygenation (∆O 2 Hb) by functional near infrared spectroscopy. Patients with better functional status ('High Barthel') showed a lower PFC activation (∆O 2 Hb) and better gait in walking in single and dual-tasks compared to 'Low Barthel' patients who exhibited decreased gait performances despite a higher PFC activation, especially in the unaffected side (P<0.001). PFC overactivation in less functional subacute stroke patients may be due to the loss of stepping automaticity. Our results suggest that it would be interesting to propose rehabilitation programs focused on walking, especially for patients with low functional capacity.
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Dates et versions

hal-03187520 , version 1 (01-04-2021)

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Eric Hermand, Maxence Compagnat, Olivier Dupuy, Jean-Yves Salle, Jean-Christophe Daviet, et al.. Functional status is associated with prefrontal cortex activation in gait in subacute stroke patients. Frontiers in Neurology, 2020, 11, pp.559227. ⟨10.3389/fneur.2020.559227⟩. ⟨hal-03187520⟩
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