Abstract
Background: Impaired gait and balance are associated with severity of leukoaraiosis. Evaluation of balance is based on neurological examination using Romberg's test with bipedal standing, assessment scale, and posturographic parameters. The goal of this study was to determine the relationship between static equilibrium and grades of white matter hyperintensities (WMHs) using static posturography as a quantitative technical method.Method: One hundred and eighteen (118) patients with lacunar infarct were recruited and assessed on MRI with Fazekas's grading scale into four groups. On admission, age, gender, height, weight, Berg Balance Scale (BBS), mini-mental state examination (MMSE), and static posturography parameters were recorded, and their correlations with WMHs were determined.Results: Age was significantly and positively correlated with severity of WMHs (r = 0.39, p < 0.05). WMH score was negatively correlated with BBS score (r = −0.65, p < 0.05) and MMSE score (r = −0.79, p < 0.05). There was a significant positive correlation between track length anteroposterior (AP, with eyes closed) and severity of WMHs (r = 0.70, p < 0.05). Partial correlation analysis and multiple logistic regression analysis indicated that track length AP with eyes closed, was a predictor for the severity of WMHs (p< 0.05).Conclusion: The severity of WHMs is associated with age, cognitive decline, and impairment in balance. Posturography parameter in track length in AP direction with eyes closed in relation to cognition and balance, may be a potential marker for disease progression in WMHs.
Highlights
Changes in cerebral white matter, called white matter hyperintensities (WMHs), which are seen in one-third of the ischemic stroke population, are risk factors for acute stroke [1]
The criteria used were: age above 18 years; patients diagnosed with lacunar stroke according to the TOAST criteria through magnetic resonance imaging (MRI), and patients who were referred with chief complaints about cognitive deficit and imbalance not directly related to the presence lacunar stroke
This study excluded patients in the following categories: [1] patients with contraindications to MRI; [2] patients with WMHs from other identified causes; [3] patients with hemorrhage, severe stroke, Alzheimer’s disease, Parkinson’s syndrome, paralysis, and aphasia; [4] patients with evidence of a cardiac embolic source or cerebral large vessel disease; [5] patients with orthopedic diseases, peripheral neuropathy and proprioceptive loss according to physical examination for the nervous system, MRI for spinal cord, and electromyography examination; [6] patients with benign positional vertigo, Meniere’s Disease and vestibular neuritis and other peripheral vertigo disease according to positioning test and the video head impulse test (Type 1085, GN/otometrics)
Summary
Changes in cerebral white matter, called white matter hyperintensities (WMHs), which are seen in one-third of the ischemic stroke population, are risk factors for acute stroke [1]. Static Posturography Relate to WMHs. In recent years, the relationship amongst white matter lesions and cognition, physical function and falls have been investigated, and is thought to result from chronic brain ischemia/small vessel disease [3,4,5,6]. It is necessary to evolve a useful method for assessment of neurofunction deficit in WMHs, in cognition and balance. Some clinical tests have been developed to determine the presence and severity of postural instability. Physiatrists have advocated the BBS as a useful tool for evaluation of the effectiveness of physical therapeutic interventions and for quantitative descriptions of function in clinical practice and research. The goal of this study was to determine the relationship between static equilibrium and grades of white matter hyperintensities (WMHs) using static posturography as a quantitative technical method
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