The impact of cerebral small vessel disease burden and its imaging markers on gait, postural control, and cognition in Parkinson’s disease

Chen, Keke; Jin, Zhaohui; Fang, Jinping; Lin, Qi; Liu, Cui; Wang, Ruidan; Su, Yuan; Yan, None Hongjiao; Liu, Aixian; Xi, Jianing; Wen, Qiping; Fang, Boyan

doi:10.1007/s10072-022-06563-1

Cited by 6 publications

(4 citation statements)

References 59 publications

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“…In line with the previous study, our study also found that patients with CSVD had an impaired stride length. Similar to stride speed, researchers found decreased cadence in CSVD patients [15,[18][19][20]. Interestingly, a cross-sectional study with large samples showed that patients with CSVD had step length, step speed, swing time and stance time impaired and age was associated with step length, step speed, swing time and stance time [21].…”

Section: Discussionmentioning

confidence: 99%

Single- and dual-task gait parameters in determination of cerebral small vessel disease

He,

Huang,

et al. 2024

Preprint

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Background and objective: Gait disorder is one of the primary symptoms of cerebral small vessel disease (CSVD) and its potential diagnostic value was not known. We aimed to investigate the gait performance in CSVD and to determine the diagnostic value of gait parameters for CSVD under single-task and dual-task walking conditions. Methods: We prospectively recruited consecutive patients with CSVD from January 1, 2022 to August 31, 2023. A total of 129 CSVD patients and 71 healthy controls were enrolled. Direct gait parameters in the patient group and the control group were compared under single-task and dual-task conditions, controlling for covariates. Gait parameters were compared between the two groups, using the receiver operating characteristic curve. Results: Compared to controls, participants with CSVD had shorter stride length, slower stride speed, shorter cadence, longer stance time/phase, longer stride time, shorter swing phase, smaller average toe-off angle and smaller heel stride angle either in single-task walking test or in dual-task walking test (all P<0.05). Average heel strike angle could distinguish CSVD from healthy controls both in single-task (AUC = 0.858, P < 0.001, sensitivity, 83.1%; specificity, 76.7%) and dual-task walking tests (AUC = 0.865, P < 0.001, sensitivity, 91.5%; specificity, 70.5%) with moderate accuracy, independent of covariates. Conclusion: Gait patterns changed in patients with CSVD. Our findings suggest that average heel strike angle was one of the most valuable gait parameters of altered gait in CSVD and that could serve as a diagnostic marker of CSVD.

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Section: Discussionmentioning

confidence: 99%

Single- and dual-task gait parameters in determination of cerebral small vessel disease

He,

Huang,

et al. 2024

Preprint

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“…The presence and size of WMH increase with age even in apparently healthy individuals and can be larger in those with medical and neuropsychiatric disorders, for example, HIV infection and alcohol use disorder (AUD) [1,2], Alzheimer's disease [3], Parkinson's disease [4]; mild stroke [5][6][7][8], small cerebrovascular disease [9,10], depression [11].…”

Section: Introductionmentioning

confidence: 99%

“…A visually distinctive, neuroradiological marker of brain degradation is white matter hyperintense (WMH) signal occurring at the borders of the lateral ventricles and in deep white matter of cortical, cerebellar, and subcortical tissue. The presence and size of WMH increase with age even in apparently healthy individuals and can be larger in those with medical and neuropsychiatric disorders, for example, HIV infection and alcohol use disorder (AUD) [1,2], Alzheimer's disease [3], Parkinson's disease [4]; mild stroke [5–8], small cerebrovascular disease [9,10], depression [11]. Initial reports were skeptical about the functional ramifications of the ‘unidentified bright objects’, also known as UBOs [12], now called WMH, but dozens of reports have since noted variables that are common correlates of WMH number and size, implicating WMH as underlying functional declines in normal aging [13–19], age-related frailty [20], and numerous neuropsychiatric disorders.…”

Section: Introductionmentioning

confidence: 99%

Contributions of cerebral white matter hyperintensities, age, and pedal perception to postural sway in people with HIV

Sullivan,

Zahr,

Zhao

et al. 2024

Aids

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Objective: With aging, people living with HIV (PLWH) have diminishing postural stability that increases liability for falls. Factors and neuromechanisms contributing to instability are incompletely known. Brain white matter abnormalities seen as hyperintense (WMH) signals have been considered to underlie instability in normal aging and PLWH. We questioned whether sway-WMH relations endured after accounting for potentially relevant demographic, physiological, and HIV-related variables. Design: Mixed cross-sectional/longitudinal data acquired over 15 years in 141 PLWH and 102 age-range matched controls, 25–80 years old. Methods: Multimodal structural MRI data were quantified for 7 total and regional WMH volumes. Static posturography acquired with a force platform measured sway path length separately with eyes closed and eyes open. Statistical analyses used multiple regression with mixed modeling to test contributions from non-MRI and non-path data on sway path-WMH relations. Results: In simple correlations, longer sway paths were associated with larger WMH volumes in PWLH and controls. When demographic, physiological, and HIV-related variables were entered into multiple regressions, the sway-WMH relations under both vision conditions in the controls were attenuated when accounting for age and 2-point pedal discrimination. Although the sway-WMH relations in PLWH were influenced by age, 2-point pedal discrimination, and years with HIV infection, the sway-WMH relations endured for 5 of the 7 regions in the eyes-open condition. Conclusions: The constellation of age-related increasing instability while standing, degradation of brain white matter integrity, and peripheral pedal neuropathy is indicative of advancing fraility and liability for falls as people age with HIV infection.

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“…Furthermore, the association between WMHs and cognitive performance, motor function and core clinical features in LBD has also provided mixed results. Greater WMH burden is associated with worse cognitive performance, executive functioning, language and information processing [15, 16], and CMBs are positively correlated with the severity of motor and emotional impairments [17]. Few studies have investigated the association of WMHs with clinical features of DLB.…”

Section: Introductionmentioning

confidence: 99%

White matter hyperintensities in cognitive impairment with Lewy body disease: a multicentre study

Gan

Shi

Liu

et al. 2023

Euro J of Neurology

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Background and purposeWhite matter hyperintensities (WMHs) are associated with cognitive deficits and worse clinical outcomes in dementia, but rare studies have been carried out of cognitive impairment in Lewy body disease (CI‐LB) patients. The objective was to investigate the associations between WMHs and clinical manifestations in patients with CI‐LB.MethodsIn this retrospective multicentre cohort study, 929 patients (486 with dementia with Lewy bodies [DLB], 262 with Parkinson's disease dementia [PDD], 74 with mild cognitive impairment [MCI] with Lewy bodies [MCI‐LB] and 107 with Parkinson's disease with MCI [PD‐MCI]) were analysed from 22 memory clinics between January 2018 and June 2022. Demographic and clinical data were collected by reviewing medical records. WMHs were semi‐quantified according to the Fazekas method. Associations between WMHs and clinical manifestations were investigated by multivariate linear or logistic regression models.ResultsDementia with Lewy bodies patients had the highest Fazekas scores compared with PDD, MCI‐LB and PD‐MCI. Multivariable regressions showed the Fazekas score was positively associated with the scores of Unified Parkinson's Disease Rating Scale Part III (p = 0.001), Hoehn−Yahn stage (p = 0.004) and total Neuropsychiatric Inventory (p = 0.001) in MCI‐LB and PD‐MCI patients. In patients with DLB and PDD, Fazekas scores were associated with the absence of rapid eye movement sleep behaviour disorder (p = 0.041) and scores of Unified Parkinson's Disease Rating Scale Part III (p < 0.001), Hoehn−Yahn stage (p < 0.001) and the Montreal Cognitive Assessment (p = 0.014).ConclusionWhite matter hyperintensity burden of DLB was higher than for PDD, MCI‐LB and PD‐MCI. The greater WMH burden was significantly associated with poorer cognitive performance, worse motor function and more severe neuropsychiatric symptoms in CI‐LB.

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The impact of cerebral small vessel disease burden and its imaging markers on gait, postural control, and cognition in Parkinson’s disease

Cited by 6 publications

References 59 publications

Single- and dual-task gait parameters in determination of cerebral small vessel disease

Single- and dual-task gait parameters in determination of cerebral small vessel disease

Contributions of cerebral white matter hyperintensities, age, and pedal perception to postural sway in people with HIV

White matter hyperintensities in cognitive impairment with Lewy body disease: a multicentre study

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