White Matter Lesions Volume and Motor Performances in the Elderly
White Matter Lesions Volume and Motor Performances in the Elderly
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DOI：
10.1002/ana.21674
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发表时间：
2009-06-01
影响因子：
11.2
通讯作者：
Tzourio, Christophe
中科院分区：
文献类型：
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作者：
Soumare, Aicha;Elbaz, Alexis;Tzourio, Christophe
目的：研究运动功能与脑白质损伤体积(WML)之间的横断面和纵向相关性，以及这些损害的定位的影响。方法：在基线状态下，对法国三城研究中心第戎的1702名年龄在80岁及以下的受试者进行运动表现(最大步行速度、Tinetti步态和平衡分量表)评估。使用自动组织分割和定量病变大小的方法测量WMLs损伤的体积(总体积、脑室周围体积、深层体积)。结果：基线时，WMLs和Gt；=90百分位数0.50[1.45-1~55]m/S的受试者步行速度的平均值和95%可信区间(CI)均低于体积较小的受试者(1.56[1-55-1-58]m/S；p=0.004)。基线总体积超过90%百分位数的WML预测在随访期间步行速度下降(步行速度下降最大的优势比[95%CI]=2.3[1.3-4.1]，p=0.006)。此外，脑室周围白质瘤体积大但不深，与基线(p=0.005)和随时间推移(p=0.001)较慢的步行速度以及较低的Tinetti步态评分(p=0.001)相关。这些关联独立于包括认知在内的几个混杂因素，并且主要由脑室周围WML的体积来解释。这些发现支持了血管对老年人运动能力下降的贡献的假说。
Objectives: To investigate the cross-sectional and longitudinal associations between performance-based measures of motor function and volume of white matter lesions (WMLs), and to examine the influence of the localization of these lesions.Methods: At baseline, motor performances (maximum walking speed, Tinetti gait and balance subscales) were assessed in 1,702 subjects aged 80 years or younger from the Dijon (France), France center of the Three-City study. Volumes of WMLs lesions (total, periventricular, deep) were measured using an automated method of tissue segmentation and quantification of lesion size. At 8-year follow-up, walking speed was evaluated in 1,086 subjects.Results: At baseline, mean and 95% confidence interval (CI) walking speed was lower in subjects with total volumes of WMLs >= 90th percentile 0.50 [1.45-1-55] m/s) than in subjects with lower volumes (1.56 [1-55-1-58] m/s; p = 0.004). Baseline total volumes of WMLs above the 90th percentile predicted walking speed decline during follow-up (odds ratio [95% Cl] for having the greatest walking speed decline = 2.3 [1.3-4.1], p = 0.006). Moreover, high volumes of periventricular but not deep WMLs were associated with slower walking speed at baseline (p = 0.005) and over time (p = 0.001), and with lower Tinetti gait subscore (p = 0.02).Interpretation: Our study shows a cross-sectional and longitudinal association between high total volumes of WMLS, in particular volumes above the 90th percentile, and impaired mobility. These associations were independent of several confounders, including cognition, and were mainly accounted for by Volumes of periventricular WMLs. These findings support the hypothesis of a vascular contribution to motor decline in the elderly.