Effects of dichotic listening on gait domains of healthy older adults during dual-tasking: An exploratory observational study

Background - Identification of the cognitive mechanisms behind gait changes in aging is a prime endeavor in gerontology and geriatrics. For this reason, we have implemented a new dual-task paradigm where an auditory attentional task is performed during over-ground walking. Dichotic listening assesses spontaneous attention and voluntary attention directed to right and left-ear. The uniqueness of dichotic listening relies on its requirements that vary in difficulty and recruitment of resources from whole brain to one brain hemisphere. When used in dual-tasking, asymmetric effects on certain gait parameters have been reported. Objectives - The present study aims to acquire a more global understanding on how dichotic listening affects gait domains. Specifically, we aimed to understand how spontaneous vs lateralized auditory attention altered the Principal Component Analysis (PCA) structure of gait in healthy older adults. Methods - Seventy-eight healthy older adults (mean age: 71.1 years; 44 women and 34 men) underwent the Bergen dichotic listening test while walking. As this study only focuses on the effects of the cognitive task on gait, only dual-task costs for gait were calculated and entered into the PCA analyses. We explored the PCA structure for the effects on bilateral gait parameters (i.e., both limbs together) as well as on lateralized gait parameters (i.e, separate parameters by limb). We first established gait domains during single-task walking. Then, dual-task cost scores for gait were entered in a series of PCAs. Results - Results from the PCAs for bilateral gait parameters showed limited alterations on gait structure. In contrast, PCAs for lateralized data demonstrated modifications of the gait structure during dichotic listening. The PCAs corresponding for all dichotic listening conditions showed different factor solutions ranging between 4 and 6 factors that explained between 73.8% to 80% of the total variance. As a whole, all conditions had an impact on “pace”, “pace variability” and “base of support variability” domains. In the spontaneous attention condition, a six-factor solution explaining 78.3% of the variance showed asymmetrical disruptions on the PCA structure. When attention was focused to right-ear, a five-factor solution explaining 89% of the variance and similar to baseline was found. When attention was directed to left-ear, a four-factor solution explaining 73.8% of the variance was found with symmetrical impact on all factors. Conclusions - These findings demonstrate for the first time that specific facets of attentional control affects gait domains both symmetrically and asymmetrically in healthy older adults

Evaluation of error production in animal fluency and its relationship to frontal tracts in normal aging and mild Alzheimer's disease: A combined LDA and time-course analysis investigation

Semantic verbal fluency (VF), assessed by animal category, is a task widely used for early detection of dementia. A feature not regularly assessed is the occurrence of errors such as perseverations and intrusions. So far, no investigation has analyzed the how and when of error occurrence during semantic VF in aging populations, together with their possible neural correlates. The present study aims to address the issue using a combined methodology based on latent Dirichlet allocation (LDA) analysis for word classification together with a time-course analysis identifying exact time of errors’ occurrence. LDA is a modeling technique that discloses hidden semantic structures based on a given corpus of documents. We evaluated a sample of 66 participants divided into a healthy young group (n = 24), healthy older adult group (n = 23), and group of patients with mild Alzheimer’s disease (AD) (n = 19). We performed DTI analyses to evaluate the white matter integrity of three frontal tracts purportedly underlying error commission: anterior thalamic radiation, frontal aslant tract, and uncinate fasciculus. Contrasts of DTI metrics were performed on the older groups who were further classified into high-error rate and low-error rate subgroups. Results demonstrated a unique deployment of error commission in the patient group characterized by high incidence of intrusions in the first 15 s and higher rate of perseverations toward the end of the trial. Healthy groups predominantly showed very low incidence of perseverations. The DTI analyses revealed that the patients with AD committing high-error rate presented significantly more degenerated frontal tracts in the left hemisphere. Thus, our findings demonstrated that the appearance of intrusions, together with left hemisphere degeneration of frontal tracts, is a pathognomic trait of mild AD. Furthermore, our data suggest that the error commission of patients with AD arises from executive and working memory impairments related partly to deteriorated left frontal tracts

What does hand motor function tell us about our aging brain in association with WMH?

Background - White matter hyperintensities (WMH) are a common cerebral finding in older people. WMH are usually asymptomatic, but excessive WMH are associated with cognitive decline and dementia. WMH are also among the neurological findings most consistently associated with declining motor performance in healthy ageing. Aims - To determine if WMH load is associated with simple and complex motor movements in dominant and non-dominant hands in cognitively intact older subjects. Methods - Hand motor performance was assessed with the Purdue Pegboard and Finger-tapping tests on 44 healthy right-handed participants, mean age 70.9 years (range 59–84 years). Participants also underwent magnetic resonance (MR) imaging, which were used to quantify WMH volume. The effect of WMH on the motor parameters was assessed via mediation analyses. Results - WMH load increased significantly with age, while the motor scores decreased significantly with age. WMH load mediated only the relationship between age and left-hand pegboard scores. Discussion - WMH mediated only the more complex Purdue Pegboard task for the non-dominant hand. This is likely because complex movements in the non-dominant hand recruit a larger cerebral network, which is more vulnerable to WMH. Conclusions - Complex hand movements in the non-dominant hand are mediated by WMH. Subtle loss of motor movements of non-dominant hand might predict future excessive white matter atrophy

Evaluation of error production in animal fluency and its relationship to frontal tracts in normal aging and mild Alzheimer's disease: A combined LDA and time-course analysis investigation

Semantic verbal fluency (VF), assessed by animal category, is a task widely used for early detection of dementia. A feature not regularly assessed is the occurrence of errors such as perseverations and intrusions. So far, no investigation has analyzed the how and when of error occurrence during semantic VF in aging populations, together with their possible neural correlates. The present study aims to address the issue using a combined methodology based on latent Dirichlet allocation (LDA) analysis for word classification together with a time-course analysis identifying exact time of errors’ occurrence. LDA is a modeling technique that discloses hidden semantic structures based on a given corpus of documents. We evaluated a sample of 66 participants divided into a healthy young group (n = 24), healthy older adult group (n = 23), and group of patients with mild Alzheimer’s disease (AD) (n = 19). We performed DTI analyses to evaluate the white matter integrity of three frontal tracts purportedly underlying error commission: anterior thalamic radiation, frontal aslant tract, and uncinate fasciculus. Contrasts of DTI metrics were performed on the older groups who were further classified into high-error rate and low-error rate subgroups. Results demonstrated a unique deployment of error commission in the patient group characterized by high incidence of intrusions in the first 15 s and higher rate of perseverations toward the end of the trial. Healthy groups predominantly showed very low incidence of perseverations. The DTI analyses revealed that the patients with AD committing high-error rate presented significantly more degenerated frontal tracts in the left hemisphere. Thus, our findings demonstrated that the appearance of intrusions, together with left hemisphere degeneration of frontal tracts, is a pathognomic trait of mild AD. Furthermore, our data suggest that the error commission of patients with AD arises from executive and working memory impairments related partly to deteriorated left frontal tracts

Higher cognitive reserve is associated with better working memory performance and working-memory-related p300 modulation

This study aims to examine how two levels of cognitive reserve, as evidenced by reading syntactic skill, modify performance and neural activity in a two-load-level (high vs. low) working memory (WM) task. Two groups of participants with different reading skills, high and low, were obtained from clustering analysis. We collected the P300 event-related potential component during the performance of the WM Sternberg task. The high reading performance (HRP) group showed a higher percentage of correct answers than the low reading performance (LRP) group in the negative probes of the WM task, which were probe stimuli not included in the memory set presented immediately before. Both groups showed P300 amplitude modulations, that is, larger WM-related P300 amplitudes for low than for high WM loads. Following the behavioral results, the HRP group displayed smaller WM-related amplitude modulations than the LRP group in the negative probes. The findings together suggest that higher levels of reading skill are associated with improved neural efficiency, which reflects in a better working memory performance

White matter correlates of gait perturbations resulting from spontaneous and lateralized attention in healthy older adults: A dual-task study

To date the neural mechanisms behind gait perturbations caused by dual-task paradigms are still unknown. Therefore, the present study examined white matter correlates of gait perturbations caused by a dichotic listening task where spontaneous (free focus of attention) and lateralized attentional control (voluntary attention directed to right or left-ear) were tested. Fifty-nine right-handed, healthy older adults (59–88 years) were evaluated during single-task walking and three dual-task conditions. Dual-task costs were calculated for mean (DTCM) and coefficients of variation (DTCCoV) in gait speed, step length, stride length and step width. Volume, fractional anisotropy and mean diffusivity were estimated using global probabilistic tractography for the 18 major brain tracts and correlated with the DTCs. Data demonstrated that DTCs on gait speed and step length significantly correlated with white matter integrity and volume in various tracts. Perturbations on gait speed caused by spontaneous attention were related to frontal circuitry integrity including corpus callosum, while perturbations on gait speed and step length produced by voluntary lateralized attention were associated to tracts subserving visuomotor integration and frontal function

Effects of age and working memory load on syntactic processing: An event-related potential study

Cognitive changes in aging include working memory (WM) decline, which may hamper language comprehension. An increase in WM demands in older adults would probably provoke a poorer sentence processing performance in this age group. A way to increase the WM load is to separate two lexical units in an agreement relation (i.e., adjective and noun), in a given sentence. To test this hypothesis, event-related potentials (ERPs) were collected from Spanish speakers (30 older adults, mean age = 66.06 years old; and 30 young adults, mean age = 25.7 years old) who read sentences to detect grammatical errors. The sentences varied with regard to (1) the gender agreement of the noun and adjective, where the gender of the adjective either agreed or disagreed with the noun, and (2) the WM load (i.e., the number of words between the noun and adjective in the sentence). No significant behavioral differences between groups were observed in the accuracy of the response, but older adults showed longer reaction times regardless of WM load condition. Compared with young participants, older adults showed a different pattern of ERP components characterized by smaller amplitudes of LAN, P600a, and P600b effects when the WM load was increased. A smaller LAN effect probably reflects greater difficulties in processing the morpho-syntactic features of the sentence, while smaller P600a and P600b effects could be related to difficulties in recovering and mapping all sentence constituents. We concluded that the ERP pattern in older adults showed subtle problems in syntactic processing when the WM load was increased, which was not sufficient to affect response accuracy but was only observed to result in a longer reaction time

One-Year Follow-Up of Healthy Older Adults with Electroencephalographic Risk for Neurocognitive Disorder after Neurofeedback Training

Background: In healthy older adults, excess theta activity is an electroencephalographic (EEG) predictor of cognitive impairment. In a previous study, neurofeedback (NFB) treatment reinforcing reductions theta activity resulted in EEG reorganization and cognitive improvement. Objective: To explore the clinical applicability of this NFB treatment, the present study performed a 1-year follow-up to determine its lasting effects. Methods: Twenty seniors with excessive theta activity in their EEG were randomly assigned to the experimental or control group. The experimental group received an auditory reward when the theta absolute power (AP) was reduced. The control group received the reward randomly. Results: Both groups showed a significant decrease in theta activity at the training electrode. However, the EEG results showed that only the experimental group underwent global changes after treatment. These changes consisted of delta and theta decreases and beta increases. Although no changes were found in any group during the period between the posttreatment evaluation and follow-up, more pronounced theta decreases and beta increases were observed in the experimental group when the follow-up and pretreatment measures were compared. Executive functions showed a tendency to improve two months after treatment which became significant one year later. Conclusion: These results suggest that the EEG and behavioral benefits of this NFB treatment persist for at least one year, which adds up to the available evidence contributing to identifying factors that increase its efficacy level. The relevance of this study lies in its prophylactic features of addressing a clinically healthy population with EEG risk of cognitive decline