White matter abnormalities in mobility-impaired older persons

Guttmann, Charles R.G.; Benson, Randall R.; Warfield, Simon K.; Wei, Xing‐Chang; Anderson, Mark; Hall, Charles B.; Abu-Hasaballah, Khamis; Mugler, John P.; Wolfson, Leslie

doi:10.1212/wnl.54.6.1277

Cited by 154 publications

(122 citation statements)

References 41 publications

(28 reference statements)

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“…6,16,42 Few cross-sectional studies reported a correlation between the extent of LA evaluated visually or with computation of LA volume and gait or motor deficit. 8,11,12,16 We failed to identify any correlation between the extent of LA and clinical scores of motor or cognitive deficit in our small cross-sectional study. This confirms that visual scales are not very sensitive to the clinical counterpart of LA.…”

Section: Discussioncontrasting

confidence: 55%

“…3,4 The possible correlation of LA with cognitive decline or motor deficit has been investigated using visual or computerized methods to assess the LA extent. [5][6][7][8][9][10][11][12][13][14][15][16] Diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are MR techniques sensitive to changes in the diffusion properties of water protons in terms of apparent diffusion coefficient (ADC), mean diffusivity (MD), or fractional anisotropy (FA). Previous studies using region of interest measurements have demonstrated that MD and FA in patients with LA are altered not only in the areas exhibiting signal intensity changes in T2-weighted images but also in the normal-appearing white matter.…”

mentioning

confidence: 99%

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Whole-Brain Histogram and Voxel-Based Analyses of Diffusion Tensor Imaging in Patients with Leukoaraiosis: Correlation with Motor and Cognitive Impairment

Nave¹,

Foresti²,

Pratesi³

et al. 2007

American Journal of Neuroradiology

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BACKGROUND AND PURPOSE:Cerebral white matter changes, termed leukoaraiosis (LA), appearing as areas of increased signal intensity in T2-weighted MR images, are common in elderly subjects, but the possible correlation of LA with cognitive or motor deficit has not been established. We hypothesized that histogram and voxel-based analyses of whole-brain mean diffusivity (MD) and fractional anisotropy (FA) maps calculated from diffusion tensor imaging (DTI) could be more sensitive tools than visual scales to investigate the clinical correlates of LA.

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Section: Discussioncontrasting

confidence: 55%

mentioning

confidence: 99%

Whole-Brain Histogram and Voxel-Based Analyses of Diffusion Tensor Imaging in Patients with Leukoaraiosis: Correlation with Motor and Cognitive Impairment

Nave¹,

Foresti²,

Pratesi³

et al. 2007

American Journal of Neuroradiology

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“…To our knowledge, this has not been previously demonstrated. Nevertheless, it does concur with observations that show covert white matter lesions are associated with impaired mobility (Guttmann et al 2000;Benson et al 2002).…”

Section: Discussionsupporting

confidence: 90%

Structural neural correlates of impaired mobility and subsequent decline in executive functions: a 12-month prospective study

Hsu

Best

Chiu

et al. 2016

Experimental Gerontology

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Impaired mobility, such as falls, may be an early biomarker of subsequent cognitive decline and is associated with subclinical alterations in both brain structure and function. In this 12-month prospective study, we examined whether there are volumetric differences in gray matter and subcortical regions, as well as cerebral white matter, between older fallers and non-fallers. In addition, we assessed whether these baseline volumetric differences are associated with changes in cognitive function over 12 months. A total of 66 community-dwelling older adults were recruited and categorized by their falls status. Magnetic resonance imaging occurred at baseline and participants' physical and cognitive performances were assessed at baseline and 12-months. At baseline, fallers showed significantly lower volumes in gray matter, subcortical regions, and cerebral white matter compared with non-fallers. Notably, fallers had significantly lower left lateral orbitofrontal white matter volume. Moreover, lower left lateral orbitofrontal white matter volume at baseline was associated with greater decline in set-shifting performance over 12 months. Our data suggest that falls may indicate subclinical alterations in regional brain volume that are associated with subsequent decline in executive functions.

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“…Using this approach, significant correlations have been noted between neuroimaging-derived measures of white matter integrity and ventricle size with aspects of body sway (Tell et al, 1998;Guttmann et al, 2000;Starr et al, 2003;Sullivan et al, 2009). For example, with respect to aging, Sullivan et al (2009) recently showed that sulcal/ventricular enlargement and increased white matter hyperintensities predicted increased body sway during stand- ing.…”

Section: Discussionmentioning

confidence: 99%

Brain Activity during Ankle Proprioceptive Stimulation Predicts Balance Performance in Young and Older Adults

Goble¹,

Coxon²,

Impe³

et al. 2011

J. Neurosci.

176

124

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Proprioceptive information from the foot/ankle provides important information regarding body sway for balance control, especially in situations where visual information is degraded or absent. Given known increases in catastrophic injury due to falls with older age, understanding the neural basis of proprioceptive processing for balance control is particularly important for older adults. In the present study, we linked neural activity in response to stimulation of key foot proprioceptors (i.e., muscle spindles) with balance ability across the lifespan. Twenty young and 20 older human adults underwent proprioceptive mapping; foot tendon vibration was compared with vibration of a nearby bone in an fMRI environment to determine regions of the brain that were active in response to muscle spindle stimulation. Several body sway metrics were also calculated for the same participants on an eyes-closed balance task. Based on regression analyses, multiple clusters of voxels were identified showing a significant relationship between muscle spindle stimulation-induced neural activity and maximum center of pressure excursion in the anterior-posterior direction. In this case, increased activation was associated with greater balance performance in parietal, frontal, and insular cortical areas, as well as structures within the basal ganglia. These correlated regions were age-and foot-stimulation side-independent and largely localized to right-sided areas of the brain thought to be involved in monitoring stimulus-driven shifts of attention. These findings support the notion that, beyond fundamental peripheral reflex mechanisms, central processing of proprioceptive signals from the foot is critical for balance control.

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White matter abnormalities in mobility-impaired older persons

Cited by 154 publications

References 41 publications

Whole-Brain Histogram and Voxel-Based Analyses of Diffusion Tensor Imaging in Patients with Leukoaraiosis: Correlation with Motor and Cognitive Impairment

Whole-Brain Histogram and Voxel-Based Analyses of Diffusion Tensor Imaging in Patients with Leukoaraiosis: Correlation with Motor and Cognitive Impairment

Structural neural correlates of impaired mobility and subsequent decline in executive functions: a 12-month prospective study

Brain Activity during Ankle Proprioceptive Stimulation Predicts Balance Performance in Young and Older Adults

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