Mismatch of MRI White Matter Hyperintensities and Gait Function in Patients With Cerebral Small Vessel Disease

Author:

Wu Lingshan1ORCID,Wang Ziyue1,Zhou Xirui1,Kong Qianqian1,Zhang Yi1,Xu Shabei12,Huang Hao12,Luo Xiang12ORCID

Affiliation:

1. Department of Neurology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China

2. Hubei Key Laboratory of Neural Injury and Functional Reconstruction Huazhong University of Science and Technology Wuhan Hubei China

Abstract

BackgroundCerebral small vessel disease (CSVD) is closely related to gait disorders. Previous studies have found a negative correlation between the severity of MRI white matter hyperintensities (WMH) and gait speed. However, not every individual with WMH experiences a gait disorder.PurposeTo investigate the mechanisms underlying the mismatch between the severity of MRI WMH and gait impairment, in particular in subjects with severe WMH (Fazekas 3, scale 0–3) resulting from vascular disease.Study TypeCohort.Population54 subjects with severe WMH and gait disorder (WMH‐GD; 29 males) and 114 subjects with severe WMH with no gait disorder (WMH‐nGD; 60 males).Field Strength/Sequence3T/diffusion tensor imaging (DTI), and T1‐weighted, T2‐weighted, FLAIR, DWI, SWI.AssessmentTrace‐based spatial statistics analysis (TBSS) approach (fractional anisotropy, FA; mean diffusivity; radial diffusivity; axial diffusivity); Cognitive assessment; Conventional MRI markers of CSVD (WMH, enlarged perivascular spaces, lacunae, and cerebral microbleeds); Gait parameters (gait speed; cadence; stride length; gait cycle duration; step duration; time‐up‐and‐go test, TUG). Gait disorder was defined as a TUG time exceeding 12 sec.Statistical TestsThe t‐tests, Mann–Whitney U tests, Chi‐square tests, and partial correlation analysis (Pearson or Spearman) were used. P < 0.05 with threshold‐free cluster enhancement corrected was considered statistically significant for TBSS.ResultsAfter adjusting for age, sex, height, and other conventional MRI markers of CSVD, the WMH‐nGD group showed significantly decreased FA values in the corpus callosum, bilateral superior longitudinal fasciculus, left corona radiata, and left posterior thalamic radiation. There was a significant association between FA values and TUG time, gait speed, and stride length in multiple WM tracts, independent of other conventional CSVD markers.Data ConclusionThis study provides evidence for microstructural damage of specific fibers in WMH‐GD subjects compared to WMH‐nGD subjects. This may explain the mismatch between WMH and gait impairment in subjects with severe WMH.Level of Evidence1Technical EfficacyStage 3

Funder

National Natural Science Foundation of China

Publisher

Wiley

Subject

Radiology, Nuclear Medicine and imaging

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