The brain map of gait variability in aging, cognitive impairment and dementia—A systematic review

Tian, Qu; Chastan, Nathalie; Bair, Woei-Nan; Resnick, Susan M.; Ferrucci, Luigi; Studenski, Stephanie A.

doi:10.1016/j.neubiorev.2017.01.020

Cited by 124 publications

(124 citation statements)

References 60 publications

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“…For example, subclinical brain vascular abnormalities, measured on brain MRIs as infarcts and white matter hyperintensities, were reported to associate with greater variability of spatial gait parameters (step length) (Rosano et al 2007). In older adults, gait variability is thought to be associated with areas important for sensorimotor integration, coordination (Tian et al 2017), and memory and executive function (Rosso et al 2014). In the present study, there was a discernible trend for increased gait variability after induction of neurovascular uncoupling.…”

Section: Discussionsupporting

confidence: 51%

Pharmacologically induced impairment of neurovascular coupling responses alters gait coordination in mice

et al. 2017

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There is correlative evidence that impaired cerebral blood flow (CBF) regulation, in addition to promoting cognitive impairment, is also associated with alterations in gait and development of falls in elderly people. CBF is adjusted to neuronal activity via neurovascular coupling (NVC) and this mechanism becomes progressively impaired with age. To establish a direct cause-andeffect relationship between impaired NVC and gait abnormalities, we induced neurovascular uncoupling pharmacologically in young C57BL/6 mice by inhibiting the synthesis of vasodilator mediators involved in NVC. Treatment of mice with the epoxygenase inhibitor MSPPOH, the NO synthase inhibitor L-NAME, and the COX inhibitor indomethacin significantly decreased NVC mimicking the aging phenotype. Pharmacologically induced neurovascular uncoupling significantly decreased the dynamic gait parameter duty cycle, altered footfall patterns, and significantly increased phase dispersion, indicating impaired interlimb coordination. Impaired NVC also tended to increase gait variability. Thus, selective experimental disruption of NVC causes subclinical gait abnormalities, supporting the importance of CBF in both cognitive function and gait regulation.

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Section: Discussionsupporting

confidence: 51%

Pharmacologically induced impairment of neurovascular coupling responses alters gait coordination in mice

et al. 2017

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“…(Cremers et al, 2012) In addition, decreased ACC integrity has been associated with increased gait variability among older adults. (Tian et al, 2017) Further, electroencephalographic recording over the SFG/ACC region during treadmill gait in healthy young adults has shown that this region is rhythmically active in synchrony with the gait cycle. (Gwin et al, 2011, Knaepen et al, 2015) This activity is the most pronounced during trailing limb push off and leading limb initial contact, similar to the gait-related activation pattern of the sensorimotor cortex.…”

Section: Discussionmentioning

confidence: 99%

Resting‐state functional connectivity of subcortical locomotor centers explains variance in walking capacity

Boyne

Maloney

DiFrancesco

et al. 2018

Human Brain Mapping

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Walking capacity influences the quality of life and disability in normal aging and neurological disease, but the neural correlates remain unclear and subcortical locomotor regions identified in animals have been more challenging to assess in humans. Here we test whether resting-state functional MRI connectivity (rsFC) of midbrain and cerebellar locomotor regions (MLR and CLR) is associated with walking capacity among healthy adults. Using phenotypic and MRI data from the Nathan Kline Institute Rockland Sample (n =119, age 18-85), the association between walking capacity (6-min walk test distance) and rsFC was calculated from subcortical locomotor regions to 81 other gait-related regions of interest across the brain. Additional analyses assessed the independence and specificity of the results. Walking capacity was associated with higher rsFC between the MLR and superior frontal gyrus adjacent to the anterior cingulate cortex, higher rsFC between the MLR and paravermal cerebellum, and lower rsFC between the CLR and primary motor cortex foot area. These rsFC correlates were more strongly associated with walking capacity than phenotypic variables such as age, and together explained 25% of the variance in walking capacity. Results were specific to locomotor regions compared with the other brain regions. The rsFC of locomotor centers correlates with walking capacity among healthy adults. These locomotion-related biomarkers may prove useful in future work aimed at helping patients with reduced walking capacity.

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“…Recent studies have attempted to elucidate the neural correlates of these age‐related deviations from normal gait . For instance, gait variability has been associated with several volumetric neuroimaging markers, including larger temporal horns, smaller middle portion of ventricular bodies, reduced total brain volume, lower hippocampus and anterior cortex volume, and lower microstructural integrity in normal‐appearing white matter and in white matter lesions . Additionally, white matter hyperintensities, brain infarcts, and brain atrophy have also been found to predict increases in step length variability and decreases in gait speed and stride length .…”

Section: The Act Of Walking In Normal Agingmentioning

confidence: 99%

“…Evidence shows an overlap between areas responsible for multisensory and higher order cognitive processing (e.g., executive functions) and those involved in sensorimotor integration and motor control (Fig. ) . Specifically, frontal and parietal areas (e.g., PFC, primary motor cortex, and superior parietal cortex) are involved in multisensory processing, executive functions, and complex motor behavior .…”

Section: Exploiting the Benefits Of Multisensory Processing For Succementioning

confidence: 99%

“Walking” through the sensory, cognitive, and temporal degradations of healthy aging

Paraskevoudi

Balcı

Vatakis

2018

Annals of the New York Academy of Sciences

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As we age, there is a wide range of changes in motor, sensory, cognitive, and temporal processing due to alterations in the functioning of the central nervous and musculoskeletal systems. Specifically, aging is associated with degradations in gait; altered processing of the individual sensory systems; modifications in executive control, memory, and attention; and changes in temporal processing. These age-related alterations are often inter-related and have been suggested to result from shared neural substrates. Additionally, the overlap between these brain areas and those controlling walking raises the possibility of facilitating performance in several tasks by introducing protocols that can efficiently target all four domains. Attempts to counteract these negative effects of normal aging have been focusing on research to prevent falls and/or enhance cognitive processes, while ignoring the potential multisensory benefits accompanying old age. Research shows that the aging brain tends to increasingly rely on multisensory integration to compensate for degradations in individual sensory systems and for altered neural functioning. This review covers the age-related changes in the above-mentioned domains and the potential to exploit the benefits associated with multisensory integration in aging so as to improve one's mobility and enhance sensory, cognitive, and temporal processing.

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The brain map of gait variability in aging, cognitive impairment and dementia—A systematic review

Cited by 124 publications

References 60 publications

Pharmacologically induced impairment of neurovascular coupling responses alters gait coordination in mice

Pharmacologically induced impairment of neurovascular coupling responses alters gait coordination in mice

Resting‐state functional connectivity of subcortical locomotor centers explains variance in walking capacity

“Walking” through the sensory, cognitive, and temporal degradations of healthy aging

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