Diffusion tensor imaging and gait in elderly persons with cerebral small vessel disease

Karlijn F de Laat, Anouk G W van Norden, Rob A R Gons, Lucas J B van Oudheusden, Inge W M van Uden, David G Norris, Marcel P Zwiers, Frank-Erik de Leeuw

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND AND PURPOSE: Although cerebral small vessel disease, including white matter lesions (WML) and lacunar infarcts, is associated with gait disturbances, not all individuals with small vessel disease have these disturbances. Identical-appearing WML on MRI could reflect different degrees of microstructural integrity. Moreover, conventional MRI does not assess the integrity of normal-appearing white matter (NAWM). We therefore investigated the relation between white matter integrity assessed by diffusion tensor imaging in WML, NAWM, several regions of interest, and gait.

METHODS: A total of 484 nondemented elderly persons between 50 and 85 years old with cerebral small vessel disease were included in this analysis and underwent MRI and diffusion tensor imaging scanning. Mean diffusivity and fractional anisotropy within WML, NAWM, and regions of interest were related to quantitative and semiquantitative gait parameters.

RESULTS: Mean diffusivity in the WML was inversely related with gait (velocity β=-0.15; P=0.002). For the fractional anisotropy, this relation was less evident. The same was found in the NAWM (velocity β=-0.21; P<0.001) and for some parameters also after additional adjustment for WML and lacunar infarcts.

CONCLUSIONS: This study indicates that integrity of both WML and NAWM, beyond the detection limit of conventional MRI, is associated with gait disturbances.

Original languageEnglish
Pages (from-to)373-9
Number of pages7
JournalStroke
Volume42
Issue number2
DOIs
Publication statusPublished - Feb 2011

Cite this

de Laat, K. F., van Norden, A. G. W., Gons, R. A. R., van Oudheusden, L. J. B., van Uden, I. W. M., Norris, D. G., ... de Leeuw, F-E. (2011). Diffusion tensor imaging and gait in elderly persons with cerebral small vessel disease. Stroke, 42(2), 373-9. https://doi.org/10.1161/STROKEAHA.110.596502
de Laat, Karlijn F ; van Norden, Anouk G W ; Gons, Rob A R ; van Oudheusden, Lucas J B ; van Uden, Inge W M ; Norris, David G ; Zwiers, Marcel P ; de Leeuw, Frank-Erik. / Diffusion tensor imaging and gait in elderly persons with cerebral small vessel disease. In: Stroke. 2011 ; Vol. 42, No. 2. pp. 373-9.
@article{14dd4b3512e4478b8167721ba2290b07,
title = "Diffusion tensor imaging and gait in elderly persons with cerebral small vessel disease",
abstract = "BACKGROUND AND PURPOSE: Although cerebral small vessel disease, including white matter lesions (WML) and lacunar infarcts, is associated with gait disturbances, not all individuals with small vessel disease have these disturbances. Identical-appearing WML on MRI could reflect different degrees of microstructural integrity. Moreover, conventional MRI does not assess the integrity of normal-appearing white matter (NAWM). We therefore investigated the relation between white matter integrity assessed by diffusion tensor imaging in WML, NAWM, several regions of interest, and gait.METHODS: A total of 484 nondemented elderly persons between 50 and 85 years old with cerebral small vessel disease were included in this analysis and underwent MRI and diffusion tensor imaging scanning. Mean diffusivity and fractional anisotropy within WML, NAWM, and regions of interest were related to quantitative and semiquantitative gait parameters.RESULTS: Mean diffusivity in the WML was inversely related with gait (velocity β=-0.15; P=0.002). For the fractional anisotropy, this relation was less evident. The same was found in the NAWM (velocity β=-0.21; P<0.001) and for some parameters also after additional adjustment for WML and lacunar infarcts.CONCLUSIONS: This study indicates that integrity of both WML and NAWM, beyond the detection limit of conventional MRI, is associated with gait disturbances.",
keywords = "Age Factors, Aged, Aged, 80 and over, Cerebral Arteries/pathology, Cerebrovascular Disorders/complications, Cohort Studies, Diffusion Tensor Imaging/methods, Female, Gait/physiology, Gait Disorders, Neurologic/diagnosis, Humans, Longitudinal Studies, Male, Microvessels/pathology, Middle Aged",
author = "{de Laat}, {Karlijn F} and {van Norden}, {Anouk G W} and Gons, {Rob A R} and {van Oudheusden}, {Lucas J B} and {van Uden}, {Inge W M} and Norris, {David G} and Zwiers, {Marcel P} and {de Leeuw}, Frank-Erik",
year = "2011",
month = "2",
doi = "10.1161/STROKEAHA.110.596502",
language = "English",
volume = "42",
pages = "373--9",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

de Laat, KF, van Norden, AGW, Gons, RAR, van Oudheusden, LJB, van Uden, IWM, Norris, DG, Zwiers, MP & de Leeuw, F-E 2011, 'Diffusion tensor imaging and gait in elderly persons with cerebral small vessel disease' Stroke, vol. 42, no. 2, pp. 373-9. https://doi.org/10.1161/STROKEAHA.110.596502

Diffusion tensor imaging and gait in elderly persons with cerebral small vessel disease. / de Laat, Karlijn F; van Norden, Anouk G W; Gons, Rob A R; van Oudheusden, Lucas J B; van Uden, Inge W M; Norris, David G; Zwiers, Marcel P; de Leeuw, Frank-Erik.

In: Stroke, Vol. 42, No. 2, 02.2011, p. 373-9.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Diffusion tensor imaging and gait in elderly persons with cerebral small vessel disease

AU - de Laat, Karlijn F

AU - van Norden, Anouk G W

AU - Gons, Rob A R

AU - van Oudheusden, Lucas J B

AU - van Uden, Inge W M

AU - Norris, David G

AU - Zwiers, Marcel P

AU - de Leeuw, Frank-Erik

PY - 2011/2

Y1 - 2011/2

N2 - BACKGROUND AND PURPOSE: Although cerebral small vessel disease, including white matter lesions (WML) and lacunar infarcts, is associated with gait disturbances, not all individuals with small vessel disease have these disturbances. Identical-appearing WML on MRI could reflect different degrees of microstructural integrity. Moreover, conventional MRI does not assess the integrity of normal-appearing white matter (NAWM). We therefore investigated the relation between white matter integrity assessed by diffusion tensor imaging in WML, NAWM, several regions of interest, and gait.METHODS: A total of 484 nondemented elderly persons between 50 and 85 years old with cerebral small vessel disease were included in this analysis and underwent MRI and diffusion tensor imaging scanning. Mean diffusivity and fractional anisotropy within WML, NAWM, and regions of interest were related to quantitative and semiquantitative gait parameters.RESULTS: Mean diffusivity in the WML was inversely related with gait (velocity β=-0.15; P=0.002). For the fractional anisotropy, this relation was less evident. The same was found in the NAWM (velocity β=-0.21; P<0.001) and for some parameters also after additional adjustment for WML and lacunar infarcts.CONCLUSIONS: This study indicates that integrity of both WML and NAWM, beyond the detection limit of conventional MRI, is associated with gait disturbances.

AB - BACKGROUND AND PURPOSE: Although cerebral small vessel disease, including white matter lesions (WML) and lacunar infarcts, is associated with gait disturbances, not all individuals with small vessel disease have these disturbances. Identical-appearing WML on MRI could reflect different degrees of microstructural integrity. Moreover, conventional MRI does not assess the integrity of normal-appearing white matter (NAWM). We therefore investigated the relation between white matter integrity assessed by diffusion tensor imaging in WML, NAWM, several regions of interest, and gait.METHODS: A total of 484 nondemented elderly persons between 50 and 85 years old with cerebral small vessel disease were included in this analysis and underwent MRI and diffusion tensor imaging scanning. Mean diffusivity and fractional anisotropy within WML, NAWM, and regions of interest were related to quantitative and semiquantitative gait parameters.RESULTS: Mean diffusivity in the WML was inversely related with gait (velocity β=-0.15; P=0.002). For the fractional anisotropy, this relation was less evident. The same was found in the NAWM (velocity β=-0.21; P<0.001) and for some parameters also after additional adjustment for WML and lacunar infarcts.CONCLUSIONS: This study indicates that integrity of both WML and NAWM, beyond the detection limit of conventional MRI, is associated with gait disturbances.

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Cerebral Arteries/pathology

KW - Cerebrovascular Disorders/complications

KW - Cohort Studies

KW - Diffusion Tensor Imaging/methods

KW - Female

KW - Gait/physiology

KW - Gait Disorders, Neurologic/diagnosis

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Microvessels/pathology

KW - Middle Aged

U2 - 10.1161/STROKEAHA.110.596502

DO - 10.1161/STROKEAHA.110.596502

M3 - Article

VL - 42

SP - 373

EP - 379

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 2

ER -