A study on higher-order gait control and its dysfunction using neuroimaging technique

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The present study aimed at studying neural mechanisms of higher-order gait control and its abnormality, which may lead to gait disorders, by combining multiple non-invasive brain mapping techniques such as neuroimaging and electrophysiology. To begin with, a hypothetical neural mechanism of human gait control was proposed as a theoretical framework of following studies. This model was composed of two fundamental systems: basal ganglia-brainstem system and basal ganglia-thalamo-cortical system. In parallel to this theoretical development, effort was made for the methodological development to subserve the neuroimaging study of gait. These technical developments include the application of functional magnetic resonance imaging(fMRI) on cognitive, linguistic and motor behavior, diffusion tensor imaging(DTI), and simultaneous measurement of transcranial magnetic stimulation(TMS) -electromyography- fMRI. Moreover, the present study yielded two major achievements specific to the understanding … More of gait control. (1) To investigate the visuo-motor interaction in the gait control system, brain activity was investigated with functional magnetic resonance imaging while subjects watched a movie of another person's walking behavior from the third-person perspective or they imagined them walking under the visual environment mimicking visual experience of walking behavior from the first-person perspective. The results revealed that supplementary motor areas and premotor areas were active during both observation and imagination of gait. This study suggests that gait planning centers in the motor cortex are also involved in understanding of other persons' walking behavior. (2) Twenty patients with ischemic white matter changes were classified into 11 patients with gait disorder and 9 patients with normal walking behavior. Blood flow was measured while these patients were walking on a treadmill. The main results were underactivity in the right thalamus and supplementary motor areas in the gait disordered group. Understanding of human gait control system with neuroimaging will be important for the development of neuro-rehabilitation and brain-machine interface. Less