Abstract
BackgroundSubcortical vascular cognitive impairment (SVCI) is a subtype of vascular cognitive impairment associated with extensive cerebral small vessel diseases (CSVDs) imaging biomarkers. The objectives of this work were to study the existence and patterns of gait and balance impairments in patients with SVCI due to CSVDs.MethodsThe study was conducted on 28 newly diagnosed SVCI patients and 22 healthy control subjects (HCS) submitted to the advanced activity of daily living scale (AADLs), Berg balance test (BBT), Montreal Cognitive Assessment Scale (MoCA), computerized dynamic posturography (CDP), vision-based 3-D skeletal data gait analysis, and brain MRI volumetric assessment.ResultsSVCI patients showed a significant decrease in AADLs as well as total cerebral white matter volume, total cerebral cortical volume, and mean cortical thickness which were proportional to the degree of cognitive impairment as measured by the MoCA score. Regarding CDP analysis, patients with SVCI revealed prolongation of cancelation time and spectral power for mid- and high frequencies in dynamic positions. In respect to gait analysis, there were significant decreases in mean stride length and mean cadence as well as increases in mean step width and left to right step length difference in the SVCI group compared to HCS while doing a single task. These variables get highly significant during the dual-task performance with a p value < 0.001 for each one.ConclusionPatients with SVCI suffer from gait and balance impairments that are proportional to the severity of their cognitive decline and greatly impair their ADLs.
Highlights
Vascular cognitive impairment (VCI) is an umbrella term that describes a group of disorders in which the vascular component is either a cause or a contributor to cognitive decline
The results showed a significant increase in the incidence of hypertension in the Subcortical vascular cognitive impairment (SVCI) group compared to healthy control subjects (HCS) with a p value of 0.006
In respect to Activity of daily livings (ADLs), there was a significant reduction in advanced activity of daily living scale (AADLs) in the SVCI group compared to HCS with a p value of 0.025
Summary
Vascular cognitive impairment (VCI) is an umbrella term that describes a group of disorders in which the vascular component is either a cause or a contributor to cognitive decline. It is the second most common cause of dementia after Alzheimer’s disease with a prevalence of 1-4% in those > 65 years [1]. Computerized motion analysis of SCVI patients revealed many abnormalities during the precognitive as well as the early phases of the disease which differ from physiological aging These gait biomechanical changes could be used as objective diagnostic and prognostic biomarkers of SVCI as well as better understanding the disrupted circuits involved in gait abnormalities [7].
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