Impact of small vessel disease in the brain on gait and balance

Daniela Pinter; Stuart J. Ritchie; Fergus Doubal; Thomas Gattringer; Zoe Morris; Mark E. Bastin; Maria del C. Valdes Hernandez; Natalie A. Royle; Janie Corley; Susana Munoz Maniega; Alison Pattie; David A. Dickie; Julie Staals; Alan J. Gow; John M. Starr; Ian J. Deary; Christian Enzinger; Franz Fazekas; Joanna Wardlaw

doi:10.1038/srep41637

Impact of small vessel disease in the brain on gait and balance

Daniela Pinter, Stuart J. Ritchie, Fergus Doubal, Thomas Gattringer, Zoe Morris, Mark E. Bastin, Maria del C. Valdes Hernandez, Natalie A. Royle, Janie Corley, Susana Munoz Maniega, Alison Pattie, David A. Dickie, Julie Staals, Alan J. Gow, John M. Starr, Ian J. Deary, Christian Enzinger, Franz Fazekas, Joanna Wardlaw^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

57 Citations (Web of Science)

Abstract

Gait and balance impairment is highly prevalent in older people. We aimed to assess whether and how single markers of small vessel disease (SVD) or a combination thereof explain gait and balance function in the elderly. We analysed 678 community-dwelling healthy subjects from the Lothian Birth Cohort 1936 at the age of 71-74 years who had undergone comprehensive risk factor assessment, gait and balance assessment as well as brain MRI. We investigated the impact of individual SVD markers (white matter hyperintensity-WMH, microbleeds, lacunes, enlarged perivascular spaces, brain atrophy) as seen on structural brain MRI and of a global SVD score on the patients' performance. A regression model revealed that age, sex, and hypertension significantly explained gait speed. Among SVD markers white matter hyperintensity (WMH) score or volume were additional significant and independent predictors of gait speed in the regression model. A similar association was seen with the global SVD score. Our study confirms a negative impact of SVD-related morphologic brain changes on gait speed in addition to age, sex and hypertension independent from brain atrophy. The presence of WMH seems to be the major driving force for SVD on gait impairment in healthy elderly subjects.

Original language	English
Article number	41637
Number of pages	8
Journal	Scientific Reports
Volume	7
DOIs	https://doi.org/10.1038/srep41637
Publication status	Published - 30 Jan 2017

Keywords

WHITE-MATTER HYPERINTENSITIES
BIRTH COHORT 1936
OLDER-PEOPLE
DIFFUSION TENSOR
LACUNAR STROKE
BLOOD-PRESSURE
FOLLOW-UP
MRI
DISORDERS
COGNITION

Access to Document

10.1038/srep41637

Cite this

Pinter, D., Ritchie, S. J., Doubal, F., Gattringer, T., Morris, Z., Bastin, M. E., Hernandez, M. D. C. V., Royle, N. A., Corley, J., Maniega, S. M., Pattie, A., Dickie, D. A., Staals, J., Gow, A. J., Starr, J. M., Deary, I. J., Enzinger, C., Fazekas, F., & Wardlaw, J. (2017). Impact of small vessel disease in the brain on gait and balance. Scientific Reports, 7, [41637]. https://doi.org/10.1038/srep41637

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abstract = "Gait and balance impairment is highly prevalent in older people. We aimed to assess whether and how single markers of small vessel disease (SVD) or a combination thereof explain gait and balance function in the elderly. We analysed 678 community-dwelling healthy subjects from the Lothian Birth Cohort 1936 at the age of 71-74 years who had undergone comprehensive risk factor assessment, gait and balance assessment as well as brain MRI. We investigated the impact of individual SVD markers (white matter hyperintensity-WMH, microbleeds, lacunes, enlarged perivascular spaces, brain atrophy) as seen on structural brain MRI and of a global SVD score on the patients' performance. A regression model revealed that age, sex, and hypertension significantly explained gait speed. Among SVD markers white matter hyperintensity (WMH) score or volume were additional significant and independent predictors of gait speed in the regression model. A similar association was seen with the global SVD score. Our study confirms a negative impact of SVD-related morphologic brain changes on gait speed in addition to age, sex and hypertension independent from brain atrophy. The presence of WMH seems to be the major driving force for SVD on gait impairment in healthy elderly subjects.",

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author = "Daniela Pinter and Ritchie, {Stuart J.} and Fergus Doubal and Thomas Gattringer and Zoe Morris and Bastin, {Mark E.} and Hernandez, {Maria del C. Valdes} and Royle, {Natalie A.} and Janie Corley and Maniega, {Susana Munoz} and Alison Pattie and Dickie, {David A.} and Julie Staals and Gow, {Alan J.} and Starr, {John M.} and Deary, {Ian J.} and Christian Enzinger and Franz Fazekas and Joanna Wardlaw",

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AU - Pinter, Daniela

AU - Ritchie, Stuart J.

AU - Doubal, Fergus

AU - Gattringer, Thomas

AU - Morris, Zoe

AU - Bastin, Mark E.

AU - Hernandez, Maria del C. Valdes

AU - Royle, Natalie A.

AU - Corley, Janie

AU - Maniega, Susana Munoz

AU - Pattie, Alison

AU - Dickie, David A.

AU - Staals, Julie

AU - Gow, Alan J.

AU - Starr, John M.

AU - Deary, Ian J.

AU - Enzinger, Christian

AU - Fazekas, Franz

AU - Wardlaw, Joanna

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N2 - Gait and balance impairment is highly prevalent in older people. We aimed to assess whether and how single markers of small vessel disease (SVD) or a combination thereof explain gait and balance function in the elderly. We analysed 678 community-dwelling healthy subjects from the Lothian Birth Cohort 1936 at the age of 71-74 years who had undergone comprehensive risk factor assessment, gait and balance assessment as well as brain MRI. We investigated the impact of individual SVD markers (white matter hyperintensity-WMH, microbleeds, lacunes, enlarged perivascular spaces, brain atrophy) as seen on structural brain MRI and of a global SVD score on the patients' performance. A regression model revealed that age, sex, and hypertension significantly explained gait speed. Among SVD markers white matter hyperintensity (WMH) score or volume were additional significant and independent predictors of gait speed in the regression model. A similar association was seen with the global SVD score. Our study confirms a negative impact of SVD-related morphologic brain changes on gait speed in addition to age, sex and hypertension independent from brain atrophy. The presence of WMH seems to be the major driving force for SVD on gait impairment in healthy elderly subjects.

AB - Gait and balance impairment is highly prevalent in older people. We aimed to assess whether and how single markers of small vessel disease (SVD) or a combination thereof explain gait and balance function in the elderly. We analysed 678 community-dwelling healthy subjects from the Lothian Birth Cohort 1936 at the age of 71-74 years who had undergone comprehensive risk factor assessment, gait and balance assessment as well as brain MRI. We investigated the impact of individual SVD markers (white matter hyperintensity-WMH, microbleeds, lacunes, enlarged perivascular spaces, brain atrophy) as seen on structural brain MRI and of a global SVD score on the patients' performance. A regression model revealed that age, sex, and hypertension significantly explained gait speed. Among SVD markers white matter hyperintensity (WMH) score or volume were additional significant and independent predictors of gait speed in the regression model. A similar association was seen with the global SVD score. Our study confirms a negative impact of SVD-related morphologic brain changes on gait speed in addition to age, sex and hypertension independent from brain atrophy. The presence of WMH seems to be the major driving force for SVD on gait impairment in healthy elderly subjects.

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KW - MRI

KW - DISORDERS

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