Loss of Neural Automaticity Contributes to Slower Walking in COPD Patients

S Ahmed Hassan; Leandro Viçosa Bonetti; Karina Tamy Kasawara; Matthew B Stanbrook; Dmitry Rozenberg; W Darlene Reid

doi:10.3390/cells11101606

Loss of Neural Automaticity Contributes to Slower Walking in COPD Patients

Cells. 2022 May 11;11(10):1606. doi: 10.3390/cells11101606.

Authors

S Ahmed Hassan^{1

2}, Leandro Viçosa Bonetti^{3

4}, Karina Tamy Kasawara¹, Matthew B Stanbrook⁵, Dmitry Rozenberg^{5

6}, W Darlene Reid^{1

7

8}

Affiliations

¹ Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Ontario, ON M5G 1V7, Canada.
² Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, ON M5T 3M6, Canada.
³ Department of Physical Therapy, Universidade de Caxias do Sul, Caxias do Sul 95070-560, Rio Grande do Sul, Brazil.
⁴ Post-Graduation Program in Health Sciences, Universidade de Caxias do Sul, Caxias do Sul 95070-560, Rio Grande do Sul, Brazil.
⁵ Division of Respirology, Temerty Faculty of Medicine, University Health Network, Toronto, ON M5T 2S8, Canada.
⁶ Ajmera Transplant Program, Toronto General Hospital Research Institute, Toronto, ON M5G 2C4, Canada.
⁷ KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON M5G 2A2, Canada.
⁸ Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON M5B 1T8, Canada.

Abstract

The physical impairments (e.g., slower walking speed) in patients with chronic obstructive pulmonary disease (COPD) have been attributed to peripheral characteristics (e.g., muscle atrophy). However, cognitive impairment may compromise motor control including walking automaticity. The objective of this study was to investigate PFC neural activity, evaluated using changes in oxygenated hemoglobin (ΔO₂Hb), during preferred paced walking (PPW) in COPD patients and age-matched controls. The ΔO₂Hb from the left and right dorsolateral PFC was measured using functional near-infrared spectroscopy. Fifteen COPD patients (age: 71 ± 8) and twenty age-matched controls (69 ± 7 years) participated. Two-way mixed ANOVA demonstrated that O₂Hb in both groups decreased during PPW from the start (quintile 1; Q1) to the end (quintile 5; Q5) in the left dorsolateral and medial PFC. Q1 was comprised of the data during the first 20% of the task, while Q5 included data collected in the last 20% of the task duration. PPW duration ranged between 30.0 and 61.4 s in the control group and between 28.6 and 73.0 s in COPD patients. COPD patients demonstrated a higher O₂Hb in Q5 compared to the negative O₂Hb in controls in the right medial and dorsolateral PFC during PPW. PPW velocity was lower in COPD patients compared to controls (1.02 ± 0.22 vs. 1.22 ± 0.14 m/s, p = 0.005). Healthy older controls exhibited automaticity during walking unlike patients with COPD. The lesser decrease in O₂Hb in COPD patients may be attributed to increased executive demands or affect-related cues (e.g., pain or dyspnea) during walking.

Keywords: automaticity; chronic obstructive; gait; near-infrared; prefrontal cortex; pulmonary disease; spectroscopy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cognitive Dysfunction*
Humans
Middle Aged
Pain
Pulmonary Disease, Chronic Obstructive*
Walking / physiology

Grants and funding

This work was supported by the Research and Innovation Ontario [501683], Canada Foundation for Innovation [501682], Ontario Respiratory Care Society [503659] and the Department of Physical Therapy and Rehabilitation Sciences Institute [100771] at the University of Toronto. The funding agencies had no involvement in the content of this manuscript.