Analysis of clinical and imaging characteristics of patients with freezing of gait in cerebral small vessel disease
Ning Su1, He-Jiao Mao1, Jiang-xia Zhang1, Wen-Cheng Zhu2, Fei Han1, Ming Yao1, Li-Xin Zhou1, Jun Ni1, Xiang-Min Fan2, Feng Tian2, Yi-Cheng Zhu1
1Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China, 2State Key Laboratory of Computer Science, Institute of Software, Chinese Academy of Sciences, Beijing 100190, China
Objective:
This study aims to study the clinical and imaging characteristics of patients with freeing of gait (FOG) in Cerebral small vessel disease (CSVD).
Background:
FOG is prevalent in Parkinson’s disease in those with severe gait disorders. However, little is known about vascular FOG in patients with CSVD.
Design/Methods:
The current study is a case-control study. Symptomatic CSVD patients were recruited. Patients with FOG (CSVD-FOG) and without FOG (CSVD-no-FOG) were categorized into two groups. The differences of clinical and imaging characteristics in these two groups were studied.
Results:
In 444 symptomatic CSVD patients with gait testing records, 24 were CSVD-FOG. 72 CSVD-no-FOG patients were matched according to age and sex. Prevalence of vascular risk factors including hypertension, diabetes mellitus, and hyperlipidemia were not significantly different between two groups. In CSVD-FOG groups, 83.3% were claimed about gait disorder, and had a higher percentage of urinary disorders and impaired cognitive functions compared with CSVD-no-FOG. Patients with apathy were not different between two groups. In assessing quantitative gait parameters, CSVD-FOG patients had slower gait speed, shorter gait stride and gait length, lower gait height and wider gait width. For CSVD imaging burdens, the CSVD-FOG had similar white matter hyperintensity burden with CSVD-no-FOT. However, CSVD-FOG had higher prevalence of silent brain infarction (SBI) and cerebral microbleeds (CMBs) in location of whiter matter and brain stem.
Conclusions:
CSVD-FOG patients had severe clinical symptoms of gait disorder, cognitive impairment and urinary problems, as well as higher imaging burdens of SBI and CMBs in whiter matter and brain stem.