{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:27:57Z","timestamp":1790832477760,"version":"4.1.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:00:00Z","timestamp":1683244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study examined prefrontal cortex (PFC) activation during dual-task seated stepping and walking performed by subacute stroke patients with hemiplegia and evaluated the relationship between PFC activation, frontal lobe functions, and dual-task interference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with functional ambulation category (FAC) scores \u2264 2 comprised the seated stepping task group. Those with FAC scores &amp;gt; 2 comprised the walking task group. There were 11 patients in the seated stepping task group (mean age, 65.3\u00b112.2 years; age range, 55-73.5 years; 7 male and 4 female patients; time since stroke onset, 45.7\u00b19.9 days) and 11 patients in the walking task group (mean age, 65.6\u00b115.2 years; age range, 49.5-74.5 years; 7 male and 4 female patients; time since stroke onset, 57.5\u00b118.3 days). Both groups completed the Frontal Assessment Battery (FAB). The seated stepping task group performed the following three tasks: cognitive task (CT), normal seated stepping (NSS), and dual-task seated stepping (DTSS). The walking task group completed the following tasks: CT, normal walking (NW), and dual-task walking (DTW). The CT was a letter fluency task; this letter fluency task was simultaneously performed during seated stepping (DTSS) and walking (DTW). Changes in the oxygenated hemoglobin (O\n                      <jats:sub>2<\/jats:sub>\n                      Hb) concentration and deoxygenated hemoglobin concentration during the tasks were measured using near-infrared spectroscopy (Pocket NIRS HM; Dynasense Inc., Japan). The number of steps, walking speed, and percentage of correct responses to the CT were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results showed that DTSS activated the PFC significantly more than performing a single task and that NSS was associated with a significantly higher difference in the hemoglobin concentration when compared to that associated with the CT, which was a single task. In the walking task group, PFC activation was significantly higher during DTW, NW, and CT (in that order), and O\n                      <jats:sub>2<\/jats:sub>\n                      Hb concentrations were significantly higher in the contralesional hemisphere than in the ipsilesional hemisphere during all tasks. Associations between PFC activation, FAB scores, and dual-task interference in the seated task group indicated significant positive correlations between FAB scores and cognitive performance with dual-task interference.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DTSS may be an effective means of activating the PFC of patients with difficulty walking.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnins.2023.1169744","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:49:24Z","timestamp":1683247764000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Prefrontal activation during dual-task seated stepping and walking performed by subacute stroke patients with hemiplegia"],"prefix":"10.3389","volume":"17","author":[{"given":"Shinnosuke","family":"Nosaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Imada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Saita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Okamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1177\/1545968315613864","article-title":"Prefrontal cortex activation while walking under dual-task conditions in stroke: a multimodal imaging study","volume":"30","author":"Al-Yahya","year":"2016","journal-title":"Neurorehabilit. Neural Repair."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1394","DOI":"10.1006\/nimg.2002.1280","article-title":"Aging gracefully: compensatory brain activity in high-performing older adults","volume":"17","author":"Cabeza","year":"2002","journal-title":"NeuroImage"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1007\/s40520-013-0119-5","article-title":"Brain activation during dual-task walking and executive function among older adults with mild cognitive impairment: a fNIRS study","volume":"25","author":"Doi","year":"2013","journal-title":"Aging Clin. Exper. Res."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1621","DOI":"10.1212\/WNL.55.11.1621","article-title":"The FAB\u2014a frontal assessment battery at bedside","volume":"55","author":"Dubois","year":"2000","journal-title":"Neurology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/S0531-5565(02)00160-2","article-title":"The neurobiology of memory changes in normal aging","volume":"38","author":"Erickson","year":"2003","journal-title":"Exper. Gerontol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1038\/nrn2497","article-title":"Human volition: towards a neuroscience of will","volume":"9","author":"Haggard","year":"2008","journal-title":"Nat. Rev. Neurosci."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.humov.2018.03.010","article-title":"Prefrontal over-activation during walking in people with mobility deficits: interpretation and functional implications","volume":"59","author":"Hawkins","year":"2018","journal-title":"Hum. Move. Sci."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"559227","DOI":"10.3389\/fneur.2020.559227","article-title":"Functional status is associated with prefrontal cortex activation in gait in subacute stroke patients: a functional near-infrared spectroscopy study","volume":"11","author":"Hermand","year":"2020","journal-title":"Front. Neurol."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"160","DOI":"10.3389\/fnagi.2019.00160","article-title":"Prefrontal cortex activation during dual task with increasing cognitive load in subacute stroke patients: a pilot study","volume":"11","author":"Hermand","year":"2019","journal-title":"Front. Aging Neurosci."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1093\/ptj\/64.1.35","article-title":"Clinical gait assessment in the neurologically impaired. Clinical gait assessment in the neurologically impaired","volume":"64","author":"Holden","year":"1984","journal-title":"Physical Ther."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1093\/gerona\/glr068","article-title":"fNIRS study of walking and walking while talking in young and old individuals","volume":"66","author":"Holtzer","year":"2011","journal-title":"J. Gerontol."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"292","DOI":"10.3389\/fnhum.2014.00292","article-title":"Cerebral functional imaging using near-infrared spectroscopy during repeated performances of motor rehabilitation tasks tested on healthy subjects","volume":"8","author":"Ishikuro","year":"2014","journal-title":"Front. Hum. Neurosci."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1093\/gerona\/60.3.380","article-title":"Reading aloud and arithmetic calculation improve frontal function of people with dementia","volume":"60","author":"Kawashima","year":"2005","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"904145","DOI":"10.3389\/fneur.2022.904145","article-title":"Frontal, sensorimotor, and posterior parietal regions are involved in dual-task walking after stroke","volume":"13","author":"Lim","year":"2022","journal-title":"Front. Neurol."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2416","DOI":"10.1109\/TNSRE.2018.2878045","article-title":"Brain activation and gait alteration during cognitive and motor dual task walking in stroke-a functional near-infrared spectroscopy study","volume":"26","author":"Liu","year":"2018","journal-title":"IEEE Trans. Neural Syst. Rehabil. 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Rehabil."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.bandc.2017.04.002","article-title":"Effects of aging on prefrontal brain activation during challenging walking conditions","volume":"115","author":"Mirelman","year":"2017","journal-title":"Brain Cogn."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1002\/ana.10274","article-title":"Premotor cortex is involved in restoration of gait in stroke","volume":"52","author":"Miyai","year":"2002","journal-title":"Ann. Neurol."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.gaitpost.2017.09.032","article-title":"Prefrontal cortex activation during a dual task in patients with stroke","volume":"59","author":"Mori","year":"2018","journal-title":"Gait Posture"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1111\/j.1440-1819.2007.01614.x","article-title":"Reliability and validity of the Japanese version of the frontal assessment battery in patients with the frontal variant of frontotemporal dementia","volume":"61","author":"Nakaaki","year":"2007","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1016\/j.neuron.2010.08.007","article-title":"Neuronal activity drives localized blood\u2013brain-barrier transport of serum insulin-like growth factor-I into the CNS","volume":"67","author":"Nishijima","year":"2010","journal-title":"Neuron"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1080\/13825585.2020.1866156","article-title":"Effects of cognitive dysfunction and dual task on gait speed and prefrontal cortex activation in community-dwelling older adults","volume":"29","author":"Nosaka","year":"2022","journal-title":"Aging Neuropsychol. Cogn."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/1471-2202-14-10","article-title":"Differences in dual-task performance and prefrontal cortex activation between younger and older adults","volume":"14","author":"Ohsugi","year":"2013","journal-title":"BMC Neurosci."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"34","DOI":"10.3389\/fnins.2020.00034","article-title":"Motor imagery training with neurofeedback from the frontal pole facilitated sensorimotor cortical activity and improved hand dexterity","volume":"14","author":"Ota","year":"2020","journal-title":"Front. Neurosci."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2990","DOI":"10.1161\/STROKEAHA.118.022157","article-title":"Dual-task exercise reduces cognitive-motor interference in walking and falls after stroke a randomized controlled study","volume":"49","author":"Pang","year":"2018","journal-title":"Stroke"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e6833","DOI":"10.7717\/peerj.6833","article-title":"Prefrontal cortical activation measured by fNIRS during walking: effects of age, disease and secondary task","volume":"7","author":"Pelicioni","year":"2019","journal-title":"PEERJ"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"2565","DOI":"10.1016\/j.apmr.2013.08.002","article-title":"Cognitive-motor interference during functional mobility after stroke: state of the science and implications for future research","volume":"94","author":"Plummer","year":"2013","journal-title":"Arch. Phys. Med. 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