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Ofori E, Delgado F, James DL, Wilken J, Hancock LM, Doniger GM, Gudesblatt M. Impact of distinct cognitive domains on gait variability in individuals with mild cognitive impairment and dementia. Exp Brain Res 2024; 242:1573-1581. [PMID: 38753043 DOI: 10.1007/s00221-024-06832-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 04/07/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Gait variability is a common feature in neurodegenerative diseases and has been linked to cognitive impairment. Despite this link, the influence of specific cognitive domains, such as memory, visual spatial skills, executive function, and verbal function on gait variability is not well-understood. OBJECTIVE To investigate the predictive value of these specific cognitive domains on gait variability in people with mild cognitive impairment (MCI) and dementia during preferred and dual task walking. METHOD One hundred and two participants with either MCI or dementia underwent a comprehensive cognitive assessment and completed preferred and dual-task walking trials on a pressure-sensing walkway. Gait variability was assessed using the PKMAS software. Lower extremity function was evaluated with a self-reported validated scale. RESULTS Our findings indicate that only visual spatial abilities had a moderate predictive value on gait variability [F (1, 78) = 17.30, p < 0.01, r = 0.43], both in preferred pace walking (70% direct effect) and dual-task walking (90% direct effect) (p's < 0.05). Additionally, lower extremity functional skills had a significant indirect effect (30%) on gait variability in preferred walking contexts. CONCLUSION For individuals diagnosed with MCI or dementia, increased gait variability may be driven by deficits in visual spatial processing. An increased understanding of the role of visual spatial processing in gait variability can aid in the assessment and management of individuals with MCI or dementia, potentially leading to targeted interventions to improve mobility and safety.
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Affiliation(s)
- Edward Ofori
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
| | - Ferdinand Delgado
- Department of Kinesiology, University of New Hampshire, Durham, NH, United States
| | - Dara L James
- Edson College of Nursing and Health Innovation, Arizona State, Phoenix, AZ, USA
| | - Jeffrey Wilken
- Department of Neurology, Georgetown University, Washington, DC, USA
- Washington Neuropsychology Research Group, Fairfax, VA, USA
| | - Laura M Hancock
- Neuropsychology, Cleveland Clinic, Cleveland, OH, United States
| | - Glen M Doniger
- Department of Clinical Research, NeuroTrax Corporation, Naples, FL, USA
- Neuropsychology, Cleveland Clinic, Cleveland, OH, United States
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Kim S, Wang SM, Kang DW, Um YH, Yoon HM, Lee S, Choe YS, Kim RE, Kim D, Lee CU, Lim HK. Development of a prediction model for cognitive impairment of sarcopenia using multimodal neuroimaging in non-demented older adults. Alzheimers Dement 2024. [PMID: 38889242 DOI: 10.1002/alz.14054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/05/2024] [Accepted: 05/16/2024] [Indexed: 06/20/2024]
Abstract
INTRODUCTION Despite prior research on the association between sarcopenia and cognitive impairment in the elderly, a comprehensive model that integrates various brain pathologies is still lacking. METHODS We used data from 528 non-demented older adults with or without sarcopenia in the Catholic Aging Brain Imaging (CABI) database, containing magnetic resonance imaging scans, positron emission tomography scans, and clinical data. We also measured three key components of sarcopenia: skeletal muscle index (SMI), hand grip strength (HGS), and the five times sit-to-stand test (5STS). RESULTS All components of sarcopenia were significantly correlated with global cognitive function, but cortical thickness and amyloid-beta (Aβ) retention had distinctive relationships with each measure. In the path model, brain atrophy resulting in cognitive impairment was mediated by Aβ retention for SMI and periventricular white matter hyperintensity for HGS, but directly affected by the 5STS. DISCUSSION Treatments targeting each sub-domain of sarcopenia should be considered to prevent cognitive decline. HIGHLIGHTS We identified distinct impacts of three sarcopenia measures on brain structure and Aβ. Muscle mass is mainly associated with Aβ and has an influence on the brain atrophy. Muscle strength linked with periventricular WMH and brain atrophy. Muscle function associated with cortical thinning in specific brain regions. Interventions on sarcopenia may be important to ease cognitive decline in the elderly.
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Affiliation(s)
- Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Han Min Yoon
- Department of Rehabilitation, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Soyoung Lee
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Yeong Sim Choe
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Regina Ey Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Donghyeon Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- CMC Institute for Basic Medical Science, the Catholic Medical Center of The Catholic University of Korea, Seoul, Republic of Korea
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Zhang X, Lu H, Fan M, Tian W, Cui M, Jiang Y, Suo C, Zhang T, Xu K, Wang Y, Chen X. Mobility-related brain regions linking carotid intima-media thickness to specific gait performances in old age. BMC Geriatr 2024; 24:303. [PMID: 38561655 PMCID: PMC10983675 DOI: 10.1186/s12877-024-04918-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Gait disturbance is common in older adults with vascular diseases. However, how carotid atherosclerosis affects gait remains poorly understood. The objectives were to investigate the associations between carotid intima-media thickness and specific gait performances and explore the potential role of brain structure in mediating these associations. METHODS A cross-sectional analysis of data from the Taizhou Imaging Study was conducted, including 707 individuals who underwent both gait and carotid ultrasound examinations. Gait assessments include the Timed-Up-and-Go test, the Tinetti test, and quantitative gait assessment using a wearable device. Quantitative parameters were summarized into independent gait domains with factor analysis. Magnetic resonance images were obtained on a 3.0-Tesla scanner, and the volumes of fifteen brain regions related to motor function (primary motor, sensorimotor), visuospatial attention (inferior posterior parietal lobules, superior posterior parietal lobules), executive control function (dorsolateral prefrontal cortex, anterior cingulate), memory (hippocampus, entorhinal cortex), motor imagery (precuneus, parahippocampus, posterior cingulated cortex), and balance (basal ganglia: pallidum, putamen, caudate, thalamus) were computed using FreeSurfer and the Desikan-Killiany atlas. Mediation analysis was conducted with carotid intima-media thickness as the predictor and mobility-related brain regions as mediators. RESULTS Carotid intima-media thickness was found to be associated with the Timed-Up-and-Go performance (β = 0.129, p = 0.010) as well as gait performances related to pace (β=-0.213, p < 0.001) and symmetry (β = 0.096, p = 0.045). Besides, gait performances were correlated with mobility-related brain regions responsible for motor, visuospatial attention, executive control, memory, and balance (all FDR < 0.05). Notably, significant regions differed depending on the gait outcomes measured. The primary motor (41.9%), sensorimotor (29.3%), visuospatial attention (inferior posterior parietal lobules, superior posterior parietal lobules) (13.8%), entorhinal cortex (36.4%), and motor imagery (precuneus, parahippocampus, posterior cingulated cortex) (27.3%) mediated the association between increased carotid intima-media thickness and poorer Timed-Up-and-Go performance. For the pace domain, the primary motor (37.5%), sensorimotor (25.8%), visuospatial attention (12.3%), entorhinal cortex (20.7%), motor imagery (24.9%), and balance (basal ganglia: pallidum, putamen, caudate, thalamus) (11.6%) acted as mediators. CONCLUSIONS Carotid intima-media thickness is associated with gait performances, and mobility-related brain volume mediates these associations. Moreover, the distribution of brain regions regulating mobility varies in the different gait domains. Our study adds value in exploring the underlying mechanisms of gait disturbance in the aging population.
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Grants
- 2022ZD0211600 the Science and Technology Innovation 2030 Major Projects
- 2022ZD0211600 the Science and Technology Innovation 2030 Major Projects
- 2022ZD0211600 the Science and Technology Innovation 2030 Major Projects
- 2022ZD0211600 the Science and Technology Innovation 2030 Major Projects
- 2022ZD0211600 the Science and Technology Innovation 2030 Major Projects
- 2021YFC2500100 National Key Research and Development Program of China
- 2021YFC2500100 National Key Research and Development Program of China
- 2021YFC2500100 National Key Research and Development Program of China
- 2021YFC2500100 National Key Research and Development Program of China
- 2021YFC2500100 National Key Research and Development Program of China
- 2021YFC2500100 National Key Research and Development Program of China
- 2021YFC2500100 National Key Research and Development Program of China
- 23ZR1414000, 22ZR1405300 the Natural Science Foundation of Shanghai, China
- 23ZR1414000, 22ZR1405300 the Natural Science Foundation of Shanghai, China
- 23ZR1414000, 22ZR1405300 the Natural Science Foundation of Shanghai, China
- 23ZR1414000, 22ZR1405300 the Natural Science Foundation of Shanghai, China
- 23ZR1414000, 22ZR1405300 the Natural Science Foundation of Shanghai, China
- 23ZR1414000, 22ZR1405300 the Natural Science Foundation of Shanghai, China
- 22QA1404000 the Shanghai Rising-Star Program
- 22QA1404000 the Shanghai Rising-Star Program
- 22QA1404000 the Shanghai Rising-Star Program
- 22QA1404000 the Shanghai Rising-Star Program
- 22QA1404000 the Shanghai Rising-Star Program
- GWGZLXK-2023-02 Fudan School of Public Health-Jiading CDC key disciplines for the high-quality development of public health
- GWGZLXK-2023-02 Fudan School of Public Health-Jiading CDC key disciplines for the high-quality development of public health
- GWGZLXK-2023-02 Fudan School of Public Health-Jiading CDC key disciplines for the high-quality development of public health
- GWGZLXK-2023-02 Fudan School of Public Health-Jiading CDC key disciplines for the high-quality development of public health
- GWGZLXK-2023-02 Fudan School of Public Health-Jiading CDC key disciplines for the high-quality development of public health
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Affiliation(s)
- Xin Zhang
- School of Public Health, the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Heyang Lu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Min Fan
- Taixing Disease Control and Prevention Center, Taizhou, Jiangsu, China
| | - Weizhong Tian
- Taizhou People's Hospital Affiliated to Nantong University, Taizhou, Jiangsu, China
| | - Mei Cui
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yanfeng Jiang
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Chen Suo
- School of Public Health, the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Tiejun Zhang
- School of Public Health, the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Kelin Xu
- School of Public Health, the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
| | - Yingzhe Wang
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China.
| | - Xingdong Chen
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China.
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Li B, Gu Z, Wang W, Du B, Wu C, Li B, Wang T, Yin G, Gao X, Chen J, Bi X, Zhang H, Sun X. The associations between peripheral inflammatory and lipid parameters, white matter hyperintensity, and cognitive function in patients with non-disabling ischemic cerebrovascular events. BMC Neurol 2024; 24:86. [PMID: 38438839 PMCID: PMC10910845 DOI: 10.1186/s12883-024-03591-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/27/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The global prevalence of VCI has increased steadily in recent years, but diagnostic biomarkers for VCI in patients with non-disabling ischemic cerebrovascular incidents (NICE) remain indefinite. The primary objective of this research was to investigate the relationship between peripheral serological markers, white matter damage, and cognitive function in individuals with NICE. METHODS We collected clinical data, demographic information, and medical history from 257 patients with NICE. Using the MoCA upon admission, patients were categorized into either normal cognitive function (NCF) or VCI groups. Furthermore, they were classified as having mild white matter hyperintensity (mWMH) or severe WMH based on Fazekas scores. We then compared the levels of serological markers between the cognitive function groups and the WMH groups. RESULTS Among 257 patients with NICE, 165 were male and 92 were female. Lymphocyte count (OR = 0.448, P < 0.001) and LDL-C/HDL-C (OR = 0.725, P = 0.028) were protective factors for cognitive function in patients with NICE. The sWMH group had a higher age and inflammation markers but a lower MoCA score, and lymphocyte count than the mWMH group. In the mWMH group, lymphocyte count (AUC = 0.765, P < 0.001) and LDL-C/HDL-C (AUC = 0.740, P < 0.001) had an acceptable diagnostic value for the diagnosis of VCI. In the sWMH group, no significant differences were found in serological markers between the NCF and VCI groups. CONCLUSION Lymphocyte count, LDL-C/HDL-C were independent protective factors for cognitive function in patients with NICE; they can be used as potential biological markers to distinguish VCI in patients with NICE and are applicable to subgroups of patients with mWMH.
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Affiliation(s)
- Binghan Li
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Zhengsheng Gu
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Weisen Wang
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Bingying Du
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Chenghao Wu
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Bin Li
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Tianren Wang
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ge Yin
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Xin Gao
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jingjing Chen
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Xiaoying Bi
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Hailing Zhang
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China.
| | - Xu Sun
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China.
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Chin KS, Holper S, Loveland P, Churilov L, Yassi N, Watson R. Prevalence of cerebral microbleeds in Alzheimer's disease, dementia with Lewy bodies and Parkinson's disease dementia: A systematic review and meta-analysis. Neurobiol Aging 2024; 134:74-83. [PMID: 38006706 DOI: 10.1016/j.neurobiolaging.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/27/2023]
Abstract
Cerebral microbleeds (CMB) are often associated with vascular risk factors and/or cerebral amyloid angiopathy and are frequently identified in people with dementia. The present study therefore aimed to estimate the pooled prevalence and associations of CMB in Alzheimer's disease (AD), dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), using meta-analytic methods. Sixty-five MRI studies were included after a systematic search on major electronic databases. We found that the prevalence of CMB was comparable across the three dementia subtypes (31-36%) and was highly influenced by the MRI techniques used. CMB in AD were associated with a history of hypertension and amyloid-β burden. In contrast, CMB in DLB, despite being predominantly lobar, were associated with hypertension, but not amyloid-β burden. These findings suggest that the underlying pathophysiology of CMB in DLB might differ from that of AD. There was substantially larger number of AD studies identified and more studies evaluating CMB in Lewy body dementias are warranted.
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Affiliation(s)
- Kai Sin Chin
- Department of Medicine - The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia; Department of Aged Care, The Royal Melbourne Hospital, Parkville, Australia; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.
| | - Sarah Holper
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Departments of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Paula Loveland
- Department of Aged Care, The Royal Melbourne Hospital, Parkville, Australia; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Leonid Churilov
- Department of Medicine - The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Nawaf Yassi
- Department of Medicine - The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Departments of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Rosie Watson
- Department of Medicine - The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia; Department of Aged Care, The Royal Melbourne Hospital, Parkville, Australia; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
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Weng X, Liu S, Li M, Zhang Y, Zhu J, Liu C, Hu H. White matter hyperintensities: a possible link between sarcopenia and cognitive impairment in patients with mild to moderate Alzheimer's disease. Eur Geriatr Med 2023; 14:1037-1047. [PMID: 37330930 DOI: 10.1007/s41999-023-00818-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/29/2023] [Indexed: 06/20/2023]
Abstract
PURPOSE Alzheimer's disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD. METHODS 57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using 3D-slicer software. RESULTS AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed. CONCLUSION WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.
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Affiliation(s)
- Xiaofen Weng
- Department of Neurology, The Second Affiliated Hospital of Soochow University, 1055 San Xiang Road, Suzhou, 215004, Jiangsu, China
- Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China
| | - Shanwen Liu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, 1055 San Xiang Road, Suzhou, 215004, Jiangsu, China
| | - Meng Li
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yingchun Zhang
- Department of Ultrasonography, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jiangtao Zhu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Chunfeng Liu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, 1055 San Xiang Road, Suzhou, 215004, Jiangsu, China
| | - Hua Hu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, 1055 San Xiang Road, Suzhou, 215004, Jiangsu, China.
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Du H, Zheng J, Li X, Dong Y, Cheng Y, Liu C, Hu J, Chen X. The correlation between medial pattern of intracranial arterial calcification and white matter hyperintensities. Atherosclerosis 2023; 381:117247. [PMID: 37634296 DOI: 10.1016/j.atherosclerosis.2023.117247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND AND AIMS Despite reported correlations between intracranial arterial calcification (IAC) and white matter hyperintensities (WMH), little is known about the relationship between IAC pattern and WMH. By differentiating intimal and medial IAC, we aimed to investigate the relationship between IAC pattern and WMH. METHODS Consecutive acute stroke patients were included. IAC pattern was categorized as intimal or medial on plain brain CT. The number of cerebral arteries involved by IAC for each patient was recorded. IAC severity was defined as focal or diffuse. On brain MRI, the burden of WMH was visually graded and classified as absent mild, moderate and severe. Multiple logistic regression was performed to examine the relationship between IAC and WMH. RESULTS Among 265 patients, intimal IAC was detected in 54.7% patients and medial IAC in 48.5% patients. Diffuse IAC was present in 27.9% patients, all of which were medial. WMH was found in 75.5% patients, including 39.6% patients with mild WMH, 26.0% with moderate WMH, and 9.8% with severe WMH. The severity of medial IAC was correlated with WMH occurrence (p < 0.001). Chi-square linear trend suggested the number of arteries involved by medial IAC (p < 0.001) and the severity of medial IAC (p < 0.001) were correlated with WMH burden. Multiple ordinal logistic regression demonstrated a positive correlation of WMH burden with the number of arteries involved by medial IAC (p < 0.001) and the severity of medial IAC (p < 0.001). CONCLUSIONS Medial IAC was correlated with WMH. The dose-effect relationship between medial IAC and WMH suggests underlying shared mechanisms of intracranial large artery disease and small vessel disease.
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Affiliation(s)
- Heng Du
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region of China
| | - Jianrong Zheng
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xuelong Li
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region of China
| | - Yanjing Dong
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region of China
| | - Yajing Cheng
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Cong Liu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Jun Hu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China.
| | - Xiangyan Chen
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region of China.
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Lindh-Rengifo M, Jonasson SB, Ullén S, Palmqvist S, van Westen D, Stomrud E, Mattsson-Carlgren N, Nilsson MH, Hansson O. Effects of Brain Pathologies on Spatiotemporal Gait Parameters in Patients with Mild Cognitive Impairment. J Alzheimers Dis 2023; 96:161-171. [PMID: 37742636 PMCID: PMC10657715 DOI: 10.3233/jad-221303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Impaired gait can precede dementia. The associations between gait parameters and brain pathologies are therefore of interest. OBJECTIVE To explore how different brain pathologies (i.e., vascular and Alzheimer's) are associated with specific gait parameters from various gait components in persons with mild cognitive impairment (MCI), who have an increased risk of developing dementia. METHODS This cross-sectional study included 96 patients with MCI (mean 72, ±7.5 years; 52% women). Gait was evaluated by using an electronic walkway, GAITRite®. Four gait parameters (step velocity variability; step length; step time; stance time asymmetry) were used as dependent variables in multivariable linear regression analyses. Independent variables included Alzheimer's disease pathologies (amyloid-β and tau) by using PET imaging and white matter hyperintensities (WMH) by using MRI. Covariates included age, sex, comorbidities (and intracranial volume in analyses that includedWMH). RESULTS Increased tau-PET (Braak I-IV region of interest [ROI]) was associated with step velocity variability (standardized regression coefficient, β= 0.383, p < 0.001) and step length (β= 0.336, p < 0.001), which remained significant when using different Braak ROIs (I-II, III-IV, V-VI). The associations remained significant when adjusting for WMH (p < 0.001). When also controlling for gait speed, tau was no longer significantly (p = 0.168) associated with an increased step length. No significant associations between gait and Aβ-PET load or WMH were identified. CONCLUSIONS The results indicate that one should pay specific attention to assess step velocity variability when targeting single task gait in patients with MCI. Future studies should address additional gait variability measures and dual tasking in larger cohorts.
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Affiliation(s)
- Magnus Lindh-Rengifo
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | | | - Susann Ullén
- Clinical Studies Sweden – Forum South, Skåne University Hospital, Lund, Sweden
| | - Sebastian Palmqvist
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Danielle van Westen
- Diagnostic Radiology, Clinical Sciences Lund, Lund University, Lund, Sweden
- Image and Function, Skåne University Hospital, Lund, Sweden
| | - Erik Stomrud
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
- Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - Maria H. Nilsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Oskar Hansson
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
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Nomoto M, Miyata K, Kohno Y. White matter hyperintensity predicts independent walking function at 6 months after stroke: A retrospective cohort study. NeuroRehabilitation 2023; 53:557-565. [PMID: 38143395 DOI: 10.3233/nre-230225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
BACKGROUND White matter hyperintensity (WMH) is reported to have a potential prevalence in healthy people and is a predictor of walking disability. However, WMH has not been adequately considered as a predictor of independent walking after stroke. OBJECTIVE To investigate the effects of WMH severity on walking function in patients with acute stroke. METHODS The retrospective cohort study included 422 patients with acute stroke. The WMH severity from magnetic resonance images was evaluated using the Fazekas scale. Age, type of stroke, Fazekas scale, Brunnstrom motor recovery stage, Motricity Index, and Mini-Mental State Examination were used as independent variables. Multivariable logistic regression analysis was conducted on the factors of independent walking at discharge and 6 months after onset, respectively. RESULTS Multivariable analysis revealed that the Fazekas scale is not a predictive factor of independent walking at discharge (odds ratio [OR] = 0.89, 95% confidence intervals [CI] = 0.65-1.22), but at 6 months (OR = 0.54, 95% CI = 0.34-0.86). CONCLUSION The WMH severity was a predictive factor of independent walking in patients with acute stroke after 6 months. WMH is a factor that should be considered to improve the accuracy of predicting long-term walking function in patients with stroke.
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Affiliation(s)
- Masahiro Nomoto
- Department of Rehabilitation, Nerima Hikarigaoka Hospital, Tokyo, Japan
- Graduate School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Kazuhiro Miyata
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Yutaka Kohno
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
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Jiang M, Wu S, Zhang Y, Li Y, Lin B, Pan Q, Tian S, Ni R, Liu Q, Zhu Y. Impact of White Matter Hyperintensity and Age on Gait Parameters in Patients With Cerebral Small Vessel Disease. J Am Med Dir Assoc 2022; 24:672-678. [PMID: 36592938 DOI: 10.1016/j.jamda.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES This study aimed to investigate the effect of white matter hyperintensity (WMH), a common cerebral small vessel disease (CSVD) imaging marker, and age on gait parameters in middle-aged and geriatric populations. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A total of 1076 participants (62.9% female; age 61.0 ± 9.3 years), who visited the neurology clinic or obtained a physical check-up from the Affiliated Hospital of Guizhou Medical University. In total, 883 patients with WMH and 193 healthy controls were included in this study. METHODS The Fazekas scores of patients with CSVD were used to assess the burden of WMH. Based on the Fazekas scores, all participants were divided into 4 groups: 553 patients with Fazekas I, 257 patients with Fazekas II, 73 patients with Fazekas III, and 193 controls. Gait parameters, including step speed, frequency, length, width, stance time, and swing time, were quantitatively assessed using a vision-based artificial intelligence gait analyzer (SAIL system). The relationships among the Fazekas scores, age, and gait parameters were analyzed. RESULTS Step speed, step length, step width, stance time, and swing time were significantly different among the 4 groups. Furthermore, Fazekas scores and age were both associated with gait parameters, including step speed, step length, stance time, and swing time. The Fazekas scores were associated with step width, whereas age was not. Age was associated with step frequency, whereas Fazekas scores were not. CONCLUSIONS AND IMPLICATIONS Fazekas score and age are useful for evaluating gait parameters in patients with CSVD. Emerging WMH (such as Fazekas Ⅰ) could be a clinical warning sign of gait disturbance in a geriatric population.
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Affiliation(s)
- Mingzhu Jiang
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Shan Wu
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China.
| | - Yunyun Zhang
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Yan Li
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Bo Lin
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Qi Pan
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Shufen Tian
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Ruihan Ni
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Qi Liu
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Yingwu Zhu
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
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Relationship between parental history of dementia, motor-cognitive and executive function performance in African American women. J Neurol Sci 2022; 439:120305. [DOI: 10.1016/j.jns.2022.120305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 04/19/2022] [Accepted: 05/28/2022] [Indexed: 11/23/2022]
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