Positron emission tomography,45 SPECT,215 and near-infrared spectroscopy46 can be carried out in association with walking on a treadmill. Supine rest was compared to 30 minutes of treadmill walking after injection with a flu-orodeoxyglucose tracer and placing the subject back into the scanner. Cerebral activity for glucose increased bilaterally in the cerebellar ver-mis and the bilateral occipital cortex and para-median BA 3, 4, 6 (including the SMA), 40 and 43. This activity presumably reflects the inte gration of visual and somatosensory information with motor activity in the leg region for motor control during rather rhythmic stepping. In some studies, the anterior cingulate and prefrontal cortices are active, perhaps especially in relation to the rhythmic movement and attention needed for treadmill locomotion. When normal subjects imagine doing locomotive leg movements while supine, functional imaging reveals significant increases in activation in the SMA and leg region of the primary sensorimotor cortex bilaterally and in the cingulate gyrus and cerebellar vermis.46,216 A PET study of postural standing revealed significant activation of the vermis.217 Rehabilitation specialists will be able to apply PET, fMRI, and other functional imaging techniques to detect and promote the reorganization of cortical networks for walking.
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