Postural and Gait Disturbance Correlated with Decreased Frontal Cerebral Blood Flow in Alzheimer Disease

Nakamura, Tomoya; Meguro, Kenichi; Yamazaki, Hideki; Okuzumi, H; Tanaka, Arisa; Horikawa, A; Yamaguchi, Keiji; Katsuyama, Narumi; Nakano, Masato; Arai, Hidenori; Sasaki, H

doi:10.1097/00002093-199709000-00005

Cited by 78 publications

(65 citation statements)

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“…The statistically significant correlations between SH load in frontal and basal ganglion regions and stride length in the AD group suggests that vascular pathology in these regions may be associated with dynamic stability of gait in AD as well. These results are in keeping with studies that report correlations between gait impairment in AD and Parkinson's disease with impaired cerebral blood flow in the frontal regions on SPECT [17] . SH are associated with decreased metabolism in the frontal regions involving both normal and cognitively impaired individuals [16] , which could explain the association between decrement in gait velocity and stride length and SH in these regions in this study.…”

Section: Discussionsupporting

confidence: 91%

“…SH is also associated with hypoperfusion in the frontal regions [16] , which in turn is related to gait impairment [17] , suggesting that frontal regions can impact gait in mild AD. The regions involved in gait control include the frontal lobes and basal ganglia [18][19][20] , and SH in these regions can influence gait by interrupting brain circuitry [21] and signal processing [22] and disrupting long-loop reflexes [23] .…”

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confidence: 99%

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Gait and Subcortical Hyperintensities in Mild Alzheimer’s Disease and Aging

Nadkarni¹,

McIlroy²,

Mawji³

et al. 2009

Dement Geriatr Cogn Disord

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Background/Aims: The relationship between subcortical hyperintensities (SH) on brain MRI and gait parameters in aging and Alzheimer’s disease (AD) is unclear. This study compared gait in 42 mild AD patients to 22 normal controls (NC) based on their SH severity and correlated them to SH burden in these groups. Methods: Gait velocity, stride length, cadence and step width were captured on an automated walkway. Severity of SH on MRI was visually scored, which was used to dichotomize the AD and NC groups into high and low SH severity subgroups. Correlations between gait parameters and total and regional distribution of SH were explored. Results: Compared to both AD subgroups and the NC subgroup with high SH severity, the NC subgroup with low SH severity had a significantly faster velocity (127 cm/s). Overall SH severity correlated significantly with stride length and velocity in the AD (r = –0.4, p = 0.01) and NC (r = –0.4, p = 0.02) groups, respectively, specifically with SH severity in the frontal and basal ganglion regions. Conclusion: SH burden may have a relatively stronger association with slower gait velocity in NC than in patients with mild AD. The fronto-subcortical SH load may influence gait in AD and aging.

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Section: Discussionsupporting

confidence: 91%

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confidence: 99%

Gait and Subcortical Hyperintensities in Mild Alzheimer’s Disease and Aging

Nadkarni¹,

McIlroy²,

Mawji³

et al. 2009

Dement Geriatr Cogn Disord

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“…Therefore, it is possible that falls in severely demented patients can be explained alternatively. In our previous study, postural and gait disturbances in severe stages of dementia were associated with a reduced cerebral blood flow in the frontal lobe (14). A second limitation of the present study is the difficulty in verifying the fall history because AD patients may not adequately remember each fall or caregivers may not be aware of every fall event.…”

Section: Discussionmentioning

confidence: 72%

Risk of Falls in Alzheimer's Disease: A Prospective Study

et al. 2005

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ObjectiveFalls are common in patients with Alzheimer's disease (AD). Identification of the potential risk factors and developing preventive strategies for falls will have a significant impact in maintaining the quality of life in AD.Patients Clinical follow-up of 124 (74.1±6.1 years, range 62-88) mild to moderate AD patients in an outpatient memory clinic.Methods Postural sway, cognitive function, use of neuroleptics, severity of periventricular and deep white matter lesions, and the presence or absence of silent brain infarctions on magnetic resonance imaging were assessed at baseline.

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“…These include central nervous system function as seen with maturation and with aging. and as demonstrated by alterations in Parkinson's disease, Huntington's disease as well as in Alzheimer's disease (Nakamura et al, 1997;Nakamura et al, 1996;Sheridan, Solomont, Kowall, & Hausdorff, 2003). Gait variability has been related to cardiovascular function and associated with heart rate variability.…”

Section: Contributing Factorsmentioning

confidence: 99%

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Hausdorff

2007

Human Movement Science

712

594

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Until recently, quantitative studies of walking have typically focused on properties of a typical or average stride, ignoring the stride-to-stride fluctuations and considering these fluctuations to be noise. Work over the past two decades has demonstrated, however, that the alleged noise actually conveys important information. The magnitude of the stride-to-stride fluctuations and their changes over time during a walk -gait dynamics -may be useful in understanding the physiology of gait, in quantifying age-related and pathologic alterations in the locomotor control system, and in augmenting objective measurement of mobility and functional status Indeed, alterations in gait dynamics may help to determine disease severity, medication utility, and fall risk, and to objectively document improvements in response to therapeutic interventions, above and beyond what can be gleaned from measures based on the average, typical stride. This review discusses support for the idea that gait dynamics has meaning and may be useful in providing insight into the neural control of locomtion and for enhancing functional assessment of aging, chronic disease, and their impact on mobility.

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Postural and Gait Disturbance Correlated with Decreased Frontal Cerebral Blood Flow in Alzheimer Disease

Cited by 78 publications

References 0 publications

Gait and Subcortical Hyperintensities in Mild Alzheimer’s Disease and Aging

Gait and Subcortical Hyperintensities in Mild Alzheimer’s Disease and Aging

Risk of Falls in Alzheimer's Disease: A Prospective Study

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

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