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Background  Experimental designs using surrogate gait-like movements, such as in functional magnetic resonance imaging (MRI), cannot fully capture the cortical activation associated with overground gait. Overground gait in a robotic exoskeleton may be an ideal tool to generate controlled sensorimotor stimulation of gait conditions like ‘active’ (i.e. user moves with the device) and ‘passive’ (i.e. user is moved by the device) gait. To truly understand these neural mechanisms, functional near-infrared spectroscopy (fNIRS) would yield greater ecological validity. Thus, the aim of this experiment was to use fNIRS to delineate brain activation differences between ‘ Active’  and ‘ Passive’  overground gait in a robotic exoskeleton.    Methods  Fourteen healthy adults performed 10 walking trials in a robotic exoskeleton for  Passive  and  Active  conditions, with fNIRS over bilateral frontal and parietal lobes, and electromyography (EMG) over bilateral thigh muscles. Digitization of optode locations and individual T1 MRI scans were used to demarcate the brain regions fNIRS recorded from.    Results  Increased oxyhemoglobin in the right frontal cortex was found for  Passive  compared with  Active  conditions. For deoxyhemoglobin, increased activation during  Passive  was found in the left frontal cortex and bilateral parietal cortices compared with  Active ; one channel in the left parietal cortex decreased during  Active  when compared with  Passive . Normalized EMG mean amplitude was higher in the  Active  compared with  Passive  conditions for all four muscles ( p  ≤ 0.044), confirming participants produced the conditions asked of them.    Conclusions  The parietal cortex is active during passive robotic exoskeleton gait, a novel finding as research to date has not recorded posterior to the primary somatosensory cortex. Increased activation of the parietal cortex may be related to the planning of limb coordination while maintaining postural control. Future neurorehabilitation research could use fNIRS to examine whether exoskeletal gait training can increase gait-related brain activation with individuals unable to walk independently.

Passive, yet not inactive: robotic exoskeleton walking increases cortical activation dependent on task