Authors: Kaitlyn Bigner BS1, Jenna Calvelage BS1, Sarah Doren BS1, Katie Preston

BS1, Daniel Carl PhD1, Pierce Boyne PT, DPT, PhD, NCS1
1
University of Cincinnati, Cincinnati, OH, USA
Title: Identifying the Neural Signature of Motivation for Exercise
Purpose/Hypothesis: Motivation is likely a key contributor to rehabilitation engagement
& outcomes, exercise adherence and community participation. Yet, it is difficult to
measure, as current methods rely on subjective questionnaires, and the neural basis of
motivation for physical activity remains poorly understood. Understanding the neural
underpinnings of motivation could lead to more objective measurement, which may be
useful for guiding future intervention development and delivery. Recent correlational
research has suggested a possible role for superior frontal gyrus medial area 9
(SFG9m) in motivation for physical activity. The purpose of this study was to determine
brain regions that are upregulated by additional extrinsic motivation during locomotor
exercise, with a focus on SFG9m.
Number of Subjects: Thirteen healthy adults, 24.9±3.6 years old (mean ± SD).
Materials and Methods: Participants performed a single-visit walking experiment,
which included 20 trials of maximal speed overground walking (20 feet x 4 per trial, with
20 seconds of standing rest between trials). Half of the trials were randomized to
include additional extrinsic motivation (lap timer, tracked best lap time and verbal
encouragement). Oxygenated hemoglobin (HbO) response was measured with
wearable near infrared spectroscopy from specific brain regions, including: SFG9m,
primary motor cortex lower limb region (M1-LL), supplemental motor area (SMA), dorsal
premotor cortex (PMd), anterior prefrontal cortex (aPFC) and dorsolateral prefrontal
cortex (DLPFC). Mixed effects models compared responses between trial types and
brain regions.
Results: During extra motivation trials, participants walked faster (2.67±0.28 vs.
2.40±0.24 m/s; p=0.0001) and had slightly higher heart rates (92±5 vs. 90±6 %max;
p=0.0005). Compared with standard trials, extra motivation trials had significantly
greater brain activation in all regions tested: SFG9m (+1108 uM HbO; p<0.0001), M1-LL
(+631; p<0.0001), SMA (+313; p=0.03), PMd (+82; p=0.007), aPFC (+320; p<0.0001)
and DLPFC (+425; p=0.0007). SFG9m response was significantly greater than all other
regions except M1-LL (p=0.07), which had later activation onset.
Conclusions: Widespread brain regions seem to be upregulated by extrinsic
motivation, and especially SFG9m. This could explain the positive effects of
motivational feedback on gait outcomes observed in prior stroke rehabilitation research.
To our knowledge, this is the first experimental study indicating that SFG9m may play
an important role in motivation for physical activity.
Clinical Relevance: These findings provide a potential biologic basis for the benefits of
additional extrinsic motivation, elicited with clinically-feasible methods during locomotor
exercise. Future clinical studies could build on this information to develop prognostic
biomarkers, identify novel brain stimulation targets to improve motivation (e.g. SFG9m),
or select potential candidates for targeted behavioral intervention to supplement
physical rehabilitation.
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