Abstract

Gait disturbances in the elderly are disabling and a major public health issue but are poorly understood. In this multimodal MR imaging study, we used 2 voxel-based analysis methods to assess the voxelwise relationship of magnetization transfer ratio and white matter hyperintensity location with gait velocity in older adults. We assessed 230 community-dwelling participants of the Austrian Stroke Prevention Family Study. Every participant underwent 3T MR imaging, including magnetization transfer imaging. Voxel-based magnetization transfer ratio-symptom mapping correlated the white matter magnetization transfer ratio of each voxel with gait velocity. To assess a possible relationship between white matter hyperintensity location and gait velocity, we applied voxel-based lesion-symptom mapping. We found a significant association between the magnetization transfer ratio within the forceps minor and gait velocity (β = 0.134; 95% CI, 0.011-0.258; P = .033), independent of demographics, general physical performance, vascular risk factors, and brain volume. White matter hyperintensities did not significantly change this association. Our study provides new evidence for the importance of magnetization transfer ratio changes in gait disturbances at an older age, particularly in the forceps minor. The histopathologic basis of these findings is yet to be determined.

Highlights

  • BACKGROUND AND PURPOSEGait disturbances in the elderly are disabling and a major public health issue but are poorly understood

  • We found a significant association between the magnetization transfer ratio within the forceps minor and gait velocity (␤ ϭ 0.134; 95% CI, 0.011– 0.258; P ϭ .033), independent of demographics, general physical performance, vascular risk factors, and brain volume

  • Gait abnormalities in older adults are common.[1,2]. They are associated with falls[3,4] and represent a serious public health issue.[1,5]

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Summary

Methods

We assessed 230 community-dwelling participants of the Austrian Stroke Prevention Family Study. Voxel-based magnetization transfer ratio–symptom mapping correlated the white matter magnetization transfer ratio of each voxel with gait velocity. To assess a possible relationship between white matter hyperintensity location and gait velocity, we applied voxel-based lesion-symptom mapping. Study Subjects The study sample is drawn from the Austrian Stroke Prevention Family Study, a prospective single-center community-based study designed to assess the cerebral effects of vascular risk factors in the healthy elderly population of the City of Graz, Austria. None of the study participants had a history or MR imaging findings suggestive of normal pressure hydrocephalus. A total of 381 individuals from 169 families were included in the study. We focused on age-related decline in gait velocity and included all 230 subjects 60 years of age and older in the current analysis

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