Login Register Cart 0
Generic placeholder image

Current Neurovascular Research

Editor-in-Chief

ISSN (Print): 1567-2026
ISSN (Online): 1875-5739

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

The Correlation Between Modified Total Cerebral Small Vessel Disease Score and Gait and Balance Disorder in Middle-aged to Older Adults

Author(s): Yutong Hou, Shuna Yang, Yue Li, Wei Qin, Lei Yang and Wenli Hu*

Volume 19, Issue 3, 2022

Published on: 28 October, 2022

Page: [358 - 366] Pages: 9

DOI: 10.2174/1567202619666220908113144

Price: $65

Abstract

Background and Aims: The aim of this study is to investigate the relationships between the original and modified total cerebral Small Vessel Disease (CSVD) score and gait and balance impairment using quantitative and semi-quantitative tests.

Methods: In our study, patients aged 45 to 85 consecutively recruited. CSVD manifestations were identified with brain Magnetic Resonance Imaging (MRI), and the original and modified CSVD scores were calculated based on the results. Gait and balance function were assessed using both gait parameters and clinical rating scales. The correlation between the original and modified total scores of the CSVD and gait and balance dysfunction was demonstrated.

Results: 224 patients were enrolled in the study. Gait and balance disorders were associated with both the original and modified CSVD scores. A significant association remained after adjusting for gender, height, age, hypertension, and other relevant risk factors. The binary logistic regression and chi-squared trend tests revealed that impairment of movement function significantly correlated with the modified CSVD score and that the dysfunction was significantly higher for patients with modified CSVD scores of 5-6 than those with scores of 1-2. In Receiver Operating Characteristic (ROC) analysis, modified CSVD scores were more accurate in predicting gait impairment than original CSVD scores.

Conclusion: We found both original and modified total CSVD scores to be related to gait and balance disorder, and the modified CSVD score was more accurate in identifying movement impairment and should be used as an effective tool in investigating CSVD and motor dysfunction.

Keywords: cerebral small vessel disease, modified CSVD score, gait, balance, motor disturbance

« Previous Next »
[1]
Verghese J, LeValley A, Hall CB, Katz MJ, Ambrose AF, Lipton RB. Epidemiology of gait disorders in community-residing older adults. J Am Geriatr Soc 2006; 54(2): 255-61.
[http://dx.doi.org/10.1111/j.1532-5415.2005.00580.x] [PMID: 16460376]
[2]
Kim YJ, Kwon HK, Lee JM, et al. Gray and white matter changes linking cerebral small vessel disease to gait disturbances. Neurology 2016; 86(13): 1199-207.
[http://dx.doi.org/10.1212/WNL.0000000000002516] [PMID: 26935893]
[3]
Rosario BL, Rosso AL, Aizenstein HJ, et al. Cerebral white matter and slow gait: Contribution of hyperintensities and normal-appearing parenchyma. J Gerontol A Biol Sci Med Sci 2016; 71(7): 968-73.
[http://dx.doi.org/10.1093/gerona/glv224] [PMID: 26755683]
[4]
Stijntjes M, de Craen AJM, van der Grond J, Meskers CGM, Slagboom PE, Maier AB. Cerebral microbleeds and lacunar infarcts are associated with walking speed independent of cognitive performance in middle-aged to older adults. Gerontology 2016; 62(5): 500-7.
[http://dx.doi.org/10.1159/000444583] [PMID: 26974848]
[5]
Chiu WT, Chan L, Wu D, Ko TH, Chen DYT, Hong CT. Cerebral microbleeds are associated with postural instability and gait disturbance subtype in people with Parkinson’s Disease. Eur Neurol 2018; 80(5-6): 335-40.
[http://dx.doi.org/10.1159/000499378] [PMID: 30928974]
[6]
Shen DC, Wu SL, Shi YZ, Wang S, Zhang YM, Wang CX. The correlation between white matter hyperintensity and balance disorder and fall risk: An observational, prospective cohort study. Chronic Dis Transl Med 2016; 2(3): 173-80.
[PMID: 29063039]
[7]
Pinter D, Ritchie SJ, Doubal F, et al. Impact of small vessel disease in the brain on gait and balance. Sci Rep 2017; 7: 41637.
[http://dx.doi.org/10.1038/srep41637] [PMID: 28134332]
[8]
de Laat KF, van den Berg HAC, van Norden AGW, Gons RAR, Olde Rikkert MGM, de Leeuw FE. Microbleeds are independently related to gait disturbances in elderly individuals with cerebral small vessel disease. Stroke 2011; 42(2): 494-7.
[http://dx.doi.org/10.1161/STROKEAHA.110.596122] [PMID: 21164137]
[9]
Huijts M, Duits A, van Oostenbrugge RJ, Kroon AA, de Leeuw PW, Staals J. Accumulation of MRI markers of cerebral small vessel disease is associated with decreased cognitive function. A study in first-ever lacunar stroke and hypertensive patients. Front Aging Neurosci 2013; 5: 72.
[http://dx.doi.org/10.3389/fnagi.2013.00072] [PMID: 24223555]
[10]
Loos C, McHutchison C, Cvoro V, et al. The relation between total cerebral small vessel disease burden and gait impairment in patients with minor stroke. Int J Stroke 2018; 13(5): 518-24.
[http://dx.doi.org/10.1177/1747493017730780]
[11]
Song TJ, Kim J, Song D, et al. Total cerebral small-vessel disease score is associated with mortality during follow-up after acute ischemic stroke. J Clin Neurol 2017; 13(2): 187-95.
[http://dx.doi.org/10.3988/jcn.2017.13.2.187] [PMID: 28406586]
[12]
Chen H, Zhang M, Liu G, et al. Effect of small vessel disease burden and lacunes on gait/posture impairment in Parkinson’s disease. Neurol Sci 2020; 41(12): 3617-24.
[http://dx.doi.org/10.1007/s10072-020-04452-z] [PMID: 32458249]
[13]
Hatate J, Miwa K, Matsumoto M, et al. Association between cerebral small vessel diseases and mild parkinsonian signs in the elderly with vascular risk factors. Parkinsonism Relat Disord 2016; 26: 29-34.
[http://dx.doi.org/10.1016/j.parkreldis.2016.02.011] [PMID: 26949060]
[14]
Hou Y, Li Y, Yang S, Qin W, Yang L, Hu W. Gait impairment and upper extremity disturbance are associated with total magnetic resonance imaging cerebral small vessel disease burden. Front Aging Neurosci 2021; 13: 640844.
[http://dx.doi.org/10.3389/fnagi.2021.640844] [PMID: 34054501]
[15]
Zhi N, Zhang L, Wang Y, et al. Modified cerebral small vessel disease score is associated with vascular cognitive impairment after lacunar stroke. Aging (Albany NY) 2021; 13(7): 9510-21.
[http://dx.doi.org/10.18632/aging.202438] [PMID: 33535189]
[16]
Chen H, Pan Y, Zong L, et al. Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes. Stroke Vasc Neurol 2020; 5(2): 128-37.
[http://dx.doi.org/10.1136/svn-2019-000305] [PMID: 32606085]
[17]
Guralnik JM, Simonsick EM, Ferrucci L, et al. A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994; 49(2): M85-94.
[http://dx.doi.org/10.1093/geronj/49.2.M85] [PMID: 8126356]
[18]
de Laat KF, van Norden AGW, Gons RAR, et al. Gait in elderly with cerebral small vessel disease. Stroke 2010; 41(8): 1652-8.
[http://dx.doi.org/10.1161/STROKEAHA.110.583229] [PMID: 20576951]
[19]
Srikanth V, Phan TG, Chen J, Beare R, Stapleton JM, Reutens DC. The location of white matter lesions and gait-A voxel-based study. Ann Neurol 2010; 67(2): 265-9.
[http://dx.doi.org/10.1002/ana.21826] [PMID: 20225293]
[20]
de Laat KF, Tuladhar AM, van Norden AGW, Norris DG, Zwiers MP, de Leeuw FE. Loss of white matter integrity is associated with gait disorders in cerebral small vessel disease. Brain 2011; 134(1): 73-83.
[http://dx.doi.org/10.1093/brain/awq343] [PMID: 21156660]
[21]
de Laat KF, van Norden AGW, Gons RAR, et al. Diffusion tensor imaging and gait in elderly persons with cerebral small vessel disease. Stroke 2011; 42(2): 373-9.
[http://dx.doi.org/10.1161/STROKEAHA.110.596502] [PMID: 21193751]
[22]
Ryberg C, Rostrup E, Paulson OB, et al. Corpus callosum atrophy as a predictor of age-related cognitive and motor impairment: A 3-year follow-up of the LADIS study cohort. J Neurol Sci 2011; 307(1-2): 100-5.
[http://dx.doi.org/10.1016/j.jns.2011.05.002] [PMID: 21621224]
[23]
de Laat KF, Reid AT, Grim DC, et al. Cortical thickness is associated with gait disturbances in cerebral small vessel disease. Neuroimage 2012; 59(2): 1478-84.
[http://dx.doi.org/10.1016/j.neuroimage.2011.08.005] [PMID: 21854857]
[24]
Dumurgier J, Crivello F, Mazoyer B, et al. MRI atrophy of the caudate nucleus and slower walking speed in the elderly. Neuroimage 2012; 60(2): 871-8.
[http://dx.doi.org/10.1016/j.neuroimage.2012.01.102] [PMID: 22305950]
[25]
Smith EE, O’Donnell M, Dagenais G, et al. Early cerebral small vessel disease and brain volume, cognition, and gait. Ann Neurol 2015; 77(2): 251-61.
[http://dx.doi.org/10.1002/ana.24320] [PMID: 25428654]
[26]
Nadkarni NK, Boudreau RM, Studenski SA, et al. Slow gait, white matter characteristics, and prior 10-year interleukin-6 levels in older adults. Neurology 2016; 87(19): 1993-9.
[http://dx.doi.org/10.1212/WNL.0000000000003304] [PMID: 27733566]
[27]
Su N, Zhai FF, Zhou LX, et al. Cerebral small vessel disease burden is associated with motor performance of lower and upper extremities in community-dwelling populations. Front Aging Neurosci 2017; 9: 313.
[http://dx.doi.org/10.3389/fnagi.2017.00313] [PMID: 29021757]
[28]
Su N, Liang X, Zhai FF, et al. The consequence of cerebral small vessel disease: Linking brain atrophy to motor impairment in the elderly. Hum Brain Mapp 2018; 39(11): 4452-61.
[http://dx.doi.org/10.1002/hbm.24284] [PMID: 29956412]
[29]
van der Holst HM, Tuladhar AM, Zerbi V, et al. White matter changes and gait decline in cerebral small vessel disease. Neuroimage Clin 2018; 17: 731-8.
[http://dx.doi.org/10.1016/j.nicl.2017.12.007] [PMID: 29270357]
[30]
Zhou X, Zhang C, Li L, et al. Altered brain function in cerebral small vessel disease patients with gait disorders: A resting-state functional MRI study. Front Aging Neurosci 2020; 12: 234.
[http://dx.doi.org/10.3389/fnagi.2020.00234] [PMID: 33110408]
[31]
Wan Y, Hu W, Gan J, et al. Exploring the association between Cerebral small‐vessel diseases and motor symptoms in Parkinson’s disease. Brain Behav 2019; 9(4): e01219.
[http://dx.doi.org/10.1002/brb3.1219] [PMID: 30815987]
[32]
Shin NY, Park YW, Yoo SW, et al. Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD. NPJ Parkinsons Dis 2021; 7(1): 69.
[http://dx.doi.org/10.1038/s41531-021-00214-6] [PMID: 34376695]
[33]
Chen H, Wan H, Zhang M, et al. Cerebral small vessel disease may worsen motor function, cognition, and mood in Parkinson’s disease. Parkinsonism Relat Disord 2021; 83: 86-92.
[http://dx.doi.org/10.1016/j.parkreldis.2020.12.025] [PMID: 33493785]
[34]
Li P, Wang Y, Jiang Y, et al. Cerebral small vessel disease is associated with gait disturbance among community-dwelling elderly individuals: the Taizhou imaging study. Aging (Albany NY) 2020; 12(3): 2814-24.
[http://dx.doi.org/10.18632/aging.102779] [PMID: 32045885]
[35]
Köpke S, Meyer G. The Tinetti test. Z Gerontol Geriatr 2006; 39(4): 288-91.
[http://dx.doi.org/10.1007/s00391-006-0398-y] [PMID: 16900448]
[36]
Lauretani F, Ticinesi A, Gionti L, et al. Short-Physical Performance Battery (SPPB) score is associated with falls in older outpatients. Aging Clin Exp Res 2019; 31(10): 1435-42.
[http://dx.doi.org/10.1007/s40520-018-1082-y] [PMID: 30515724]
[37]
Rivolta MW, Aktaruzzaman M, Rizzo G, et al. Evaluation of the Tinetti score and fall risk assessment via accelerometry-based movement analysis. Artif Intell Med 2019; 95: 38-47.
[http://dx.doi.org/10.1016/j.artmed.2018.08.005] [PMID: 30195985]
[38]
Lee SY, Choo PL, Pang BWJ, et al. SPPB reference values and performance in assessing sarcopenia in community-dwelling Singaporeans – Yishun study. BMC Geriatr 2021; 21(1): 213.
[http://dx.doi.org/10.1186/s12877-021-02147-4] [PMID: 33781211]
[39]
Verwer JH, Biessels GJ, Heinen R, Exalto LG, Emmelot-Vonk MH, Koek HL. Occurrence of impaired physical performance in memory clinic patients with cerebral small vessel disease. Alzheimer Dis Assoc Disord 2018; 32(3): 214-9.
[http://dx.doi.org/10.1097/WAD.0000000000000233] [PMID: 29240562]
[40]
Tabara Y, Okada Y, Ohara M, et al. Association of postural instability with asymptomatic cerebrovascular damage and cognitive decline: The Japan Shimanami health promoting program study. Stroke 2015; 46(1): 16-22.
[http://dx.doi.org/10.1161/STROKEAHA.114.006704] [PMID: 25523051]
[41]
Lau KK, Li L, Schulz U, et al. Total small vessel disease score and risk of recurrent stroke. Neurology 2017; 88(24): 2260-7.
[http://dx.doi.org/10.1212/WNL.0000000000004042] [PMID: 28515266]
[42]
Xu T, Feng Y, Wu W, et al. The predictive values of different small vessel disease scores on clinical outcomes in mild ICH patients. J Atheroscler Thromb 2021; 28(9): 997-1008.
[http://dx.doi.org/10.5551/jat.61267] [PMID: 33551444]

Rights & Permissions Print Cite
Article Metrics
5
© 2024 Bentham Science Publishers | Privacy Policy