Diffusion tensor imaging, white matter lesions, the corpus callosum, and gait in the elderly.
Diffusion tensor imaging, white matter lesions, the corpus callosum, and gait in the elderly.
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DOI：
10.1161/strokeaha.109.564765
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发表时间：
2009-12
期刊：
影响因子：
8.3
通讯作者：
Bergethon P
中科院分区：
文献类型：
--
作者：
Bhadelia RA;Price LL;Tedesco KL;Scott T;Qiu WQ;Patz S;Folstein M;Rosenberg I;Caplan LR;Bergethon P
步态障碍在老年人中很常见，特别是那些中风和常规脑MRI上的白色高信号（WMH）的老年人。弥散张量成像（DTI）对白色物质损伤比常规MRI更敏感。DTI测量和步态之间的关系尚未进行过评估。我们的目的是调查之间的关系，白色物质的完整性胼胝体所确定的DTI和定量措施的步态在老年人。一个社区居住的老年人队列的173名参与者进行了神经和神经心理学检查和脑MRI。采用Tinetti步态评分（0-12分）、平衡评分（0-16分）和总评分（0-28分）测量步态功能。DTI评价胼胝体压部和胼胝体背侧的各向异性分数。常规MRI用于评估脑梗死和WMH体积。步态异常的参与者在胼胝体的前角有较低的各向异性分数，但压部没有。多元回归分析显示，这些异常与所有三个Tinetti评分之间存在独立相关性（p <0.001）。在分析中加入MRI梗死和WMH体积后，这种关联仍然显著。步态功能的定量测量和DTI结果之间的独立关联表明，胼胝体前部的白色物质完整性是老年人步态的重要标志。脑和脊髓中白色物质束的DTI分析可以提高对步态障碍的病理生理学的认识，并有助于临床干预的目标。
Gait impairment is common in the elderly, especially those with stroke and white matter hyperintensities (WMH) on conventional brain MRI. Diffusion Tensor Imaging (DTI) is more sensitive to white matter damage than conventional MRI. The relationship between DTI measures and gait has not been previously evaluated. Our purpose was to investigate the relationship between the integrity of white matter in the corpus callosum as determined by DTI and quantitative measures of gait in the elderly. One hundred seventy-three participants of a community-dwelling elderly cohort had neurological and neuropsychological examinations and brain MRI. Gait function was measured by Tinetti gait (0-12), balance (0-16) and total (0-28) scores. DTI assessed Fractional Anisotropy in the genu and splenium of the corpus callosum. Conventional MRI was used to evaluate for brain infarcts and WMH volume. Participants with abnormal gait had low fractional anisotropy in the genu of the corpus callosum but not the splenium. Multiple regressions analyses showed an independent association between these genu abnormalities and all three Tinetti scores (p <0.001). This association remained significant after adding MRI infarcts and WMH volume to the analysis. The independent association between quantitative measures of gait function and DTI findings shows that white matter integrity in the genu of corpus callosum is an important marker of gait in the elderly. DTI analyses of white matter tracts in brain and spinal cord may improve knowledge about the pathophysiology of gait impairment and help target clinical interventions.