Basal ganglia and brainstem located cerebral microbleeds contribute to gait impairment
Hejiao Mao1, Ning Su1, Jiangxia Zhang1, Wencheng Zhu2, Hao Zhang2, Xiangmin Fan2, Fei Han1, Jun Ni1, Lixin Zhou1, Ming Yao1, Feng Tian2, Yicheng Zhu1
1Peking Union Medical College Hospital, 2Chinese Academy of Sciences
Objective:
To investigate the relationship of quantitative gait parameters with MRI imaging markers in patients of cerebral small vessel disease (CSVD).
Background:
Gait disorder is one of the most typical symptoms in cerebral small vessel disease (CSVD) patients, while the mechanism behind is still not completely clarified. Previous studies found that white matter hyperintensity (WMH), especially in the frontal lobe, was associated with gait disturbance in CSVD patients. The basal ganglia and brainstem are also frequent sites of small-vessel lesions, such as lacunae and microbleeds. These two parts are also closely related to the regulation of gait and motor function. However, few study has compared that lacune or CMB, small cavitating ischemic infarcts or deposition of hemosiderin, which has a greater impact on gait function.
Design/Methods:
Clinical data, MRI scanning, and quantitative gait tests were performed on 127 symptomatic CSVD patients. CMBs and lacunar infarcts in regards to anatomical locations and burdens were measured. The correlation between CSVD imaging markers and gait parameters was evaluated using general linear model (GLM) analysis.
Results:
Presence of CMBs was significantly associated with speed (β = -0.144, p = 0.0288), stride length (β = -0.088, p = 0.0302), and right step length (β = -0.052, p = 0.0133). Presence of CMBs in basal ganglia was significantly associated with speed, stride length, and step length. Presence of CMBs in brainstem was significantly associated with all the gait parameters including speed, stride length, step length, height, and width. Presence of CMBs in cerebellum was significantly associated with speed. However, having lacunes was not associated with worse gait performances.Basal ganglia and brainstem located CMBs are determinants of impacts of MRI markers on gait impairment in symptomatic CSVD patients.
Conclusions:
Basal ganglia and brainstem located CMBs are determinants of impacts of MRI markers on gait impairment in symptomatic CSVD patients.