Abstract
Gait disturbances are important clinical features of cerebral small vessel disease (CSVD) that increase the risk of falls and disability. Brain structural alterations and gait disturbances in CSVD patients have been well demonstrated. However, intrinsic resting cerebral function patterns in CSVD patients with gait disorders remain largely unknown. Fifty-eight CSVD patients were enrolled in our studies and categorized into the gait disorder group (CSVD-GD, n = 29) and no-gait disorder group (CSVD-NGD, n = 29) based on a gait examination. Gait was quantitatively assessed with the Timed Up and Go test and the intelligent device for energy expenditure and activity (IDEEA). Functional MRI and fractional amplitude of low-frequency fluctuation (fALFF) analyses were employed to explore local intrinsic neural oscillation alterations. Functional connectivity based on fALFF results was calculated to detect the potential changes in remote connectivity. Compared with the CSVD-NGD group, the CSVD-GD group showed decreased fALFF in regions mainly located in the sensorimotor network and frontoparietal network, such as the left supplementary motor area (SMA.L) and the left superior parietal gyrus, and increased fALFF in the right inferior frontal gyrus (orbital part), the left caudate, and the left precuneus. Moreover, the CSVD-GD patients exhibited lower connectivity between the SMA.L and temporal lobe, which was related to gait speed. The fALFF value of the SMA.L was associated with cadence. This study highlights the regional and network interaction abnormalities of the SMA in CSVD patients with gait disturbances. These findings could provide further insight into the neural mechanisms of gait disturbances in CSVD.
Highlights
Gait disturbances are quite common in elderly adults and are associated with an increased risk of falls, disability, and mortality (van der Holst et al, 2016)
The fractional amplitude of low-frequency fluctuation (fALFF) of SPL.L was negatively correlated with Timed Up and Go (TUG) (r = −0.504, p < 0.001) (Figure 5C), positively associated with both gait speed (r = 0.361, p = 0.005) (Figure 5D) and cadence (r = 0.474, p < 0.001) (Figure 5E)
The altered fALFF value in other regions was negatively correlated with TUG [PoCG.R (r = −0.414, p = 0.001); IFG.R, orbital part (r = −0.333, p = 0.011), Pcu.L (r = −0.522, p < 0.001), CAU.L (r = −0.276, p = 0.036)] (p < 0.05, cluster-level false discovery rate (FDR) corrected)
Summary
Gait disturbances are quite common in elderly adults and are associated with an increased risk of falls, disability, and mortality (van der Holst et al, 2016). Functional Activity of CSVD With Gait Disorder attention in recent years (Kwon et al, 2019; Navarro-Peternella et al, 2019); research on the influence of central nervous system factors is still limited. An extensive body of evidence has focused on the contributing role of cerebral small vessel disease (CSVD) on gait impairments in elderly individuals (Pinter et al, 2017; Loos et al, 2018; van der Holst et al, 2018). Cognition impairment is the most striking symptom of CSVD that attracts much attention from patients. Subcortical syndromes, such as gait disorders, tend to be neglected because of their insidious onset. A better understanding of the characteristics of gait disturbances and exploring the potential pathophysiological mechanisms of gait disorders in CSVD are critical scientific endeavors that will eventually help to achieve further advances in the therapy of gait disorders
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
