Abstract

Objective: To investigate the correlation between cerebral small vessel disease (CSVD) burden and motor performance of lower and upper extremities in community-dwelling populations.Methods: We performed a cross-sectional analysis on 770 participants enrolled in the Shunyi study, which is a population-based cohort study. CSVD burden, including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), perivascular spaces (PVS), and brain atrophy were measured using 3T magnetic resonance imaging. All participants underwent quantitative motor assessment of lower and upper extremities, which included 3-m walking speed, 5-repeat chair-stand time, 10-repeat pronation–supination time, and 10-repeat finger-tapping time. Data on demographic characteristics, vascular risk factors, and cognitive functions were collected. General linear model analysis was performed to identify potential correlations between motor performance measures and imaging markers of CSVD after controlling for confounding factors.Results: For motor performance of the lower extremities, WMH was negatively associated with gait speed (standardized β = -0.092, p = 0.022) and positively associated with chair-stand time (standardized β = 0.153, p < 0.0001, surviving FDR correction). For motor performance of the upper extremities, pronation–supination time was positively associated with WMH (standardized β = 0.155, p < 0.0001, surviving FDR correction) and negatively with brain parenchymal fraction (BPF; standardized β = -0.125, p = 0.011, surviving FDR correction). Only BPF was found to be negatively associated with finger-tapping time (standardized β = -0.123, p = 0.012). However, lacunes, CMBs, or PVS were not found to be associated with motor performance of lower or upper extremities in multivariable analysis.Conclusion: Our findings suggest that cerebral microstructural changes related to CSVD may affect motor performance of both lower and upper extremities. WMH and brain atrophy are most strongly associated with motor function deterioration in community-dwelling populations.

Highlights

  • IntroductionCerebral small vessel disease (CSVD), which is characterized by neuroimaging changes, including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), perivascular spaces (PVS), and brain atrophy, may accelerate age-related motor deterioration (Wardlaw et al, 2013)

  • Motor impairments become more prevalent with advancing age (Lord et al, 2016)

  • We aimed to investigate the contribution of Cerebral small vessel disease (CSVD) burden to motor changes in the lower and upper extremities, and to provide new insights on the importance of prevention and interventions for motor impairment in elderly individuals with CSVD burden

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Summary

Introduction

Cerebral small vessel disease (CSVD), which is characterized by neuroimaging changes, including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), perivascular spaces (PVS), and brain atrophy, may accelerate age-related motor deterioration (Wardlaw et al, 2013). The contribution of CSVD to motor performance of lower extremities has been widely accepted, while the importance of each imaging marker remains controversial. Due to their lower impact on daily activities, upper extremity functions have been under-investigated when compared to walking impairment. Motor performance of the upper extremities has not yet been well-studied in relation to CSVD burden

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