Slow gait in MCI is associated with ventricular enlargement: results from the Gait and Brain Study

Journal of Neural Transmission - Tập 120 - Trang 1083-1092 - 2012
C. Annweiler1,2,3,4,5,6, O. Beauchet3,4, R. Bartha5, M. Montero-Odasso1,2,6
1Division of Geriatric Medicine, Department of Medicine, Parkwood Hospital, St. Joseph’s Health Care London, London, Canada
2Gait and Brain Lab, Lawson Health Research Institute, University of Western Ontario, London, Canada
3Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, Angers, France
4University Memory Clinic of Angers; UPRES EA 4638, University of Angers, UNAM, Angers, France
5Department of Medical Biophysics, Center for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
6Division of Geriatric Medicine, Gait and Brain Lab, Parkwood Hospital, London, Canada

Tóm tắt

Slow gait is ubiquitous among older adults and predicts cognitive decline and progression to dementia. Age-related structural brain changes could be responsible for abnormal gait. The purpose of this study was to determine whether brain lateral ventricle volume, a measure of brain atrophy, was associated with gait velocity among older adults with mild cognitive impairment (MCI), while considering the effects of age and brain vascular burden. Twenty community-dwellers with MCI, free of hydrocephalus, aged 76 years (69/80) [median (25th/75th percentile)] (35 % female) from the ‘Gait and Brain Study’ were included in this analysis. Quantitative gait performance was measured while steady-state walking at self-selected pace with a 6-m electronic portable walkway (GAITRite). Brain ventricle volume was quantified using semi-automated software from three-dimensional T1-weighted magnetic resonance imaging. Age, white matter hyperintensity burden and Mini-Mental State Examination score were used as potential confounders. Median gait velocity was 118.7 cm/s (104.4/131.3). Median brain ventricle volume was 39.9 mL (30.0/46.6) with the left ventricle being slightly larger than the right (P = 0.052). Brain ventricle volume was inversely associated with gait velocity (adjusted β = −0.63, P = 0.046). Volume of both the ventricular main bodies and the temporal horns correlated inversely with gait velocity (respectively, P = 0.009, P = 0.008). Left ventricle volume correlated with decreased gait velocity (P = 0.002) while right ventricle did not (P = 0.068). Slower gait velocity was associated with larger brain ventricle volume in our sample of people with MCI independent of age, cerebrovascular burden and cognitive worsening. This result may help elucidate the trajectories of cognitive and gait declines in people with MCI.

Tài liệu tham khảo

Accomazzi V, Lazarowich R, Barlow CJ, Davey B, inventors, Cedara Software Corp, assignee (2005) Image region segmentation system and method. US Patent Application 20050031202 Alexander NB (1996) Gait disorders in older adults. J Am Geriatr Soc 44:434–451 American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC Annweiler C, Beauchet O, Celle S, Roche F, Annweiler T, Allali G, Bartha R, Montero-Odasso M, On behalf of the WALK Team (Working group Angers-London for Knowledge) (2012a) Contribution of brain imaging to the understanding of gait disorders in Alzheimer’s disease: a systematic review. Am J Alzheimers Dis Other Demen 27:371–380 Annweiler C, Montero-Odasso M (2012) Vascular burden as a substrate for higher-level gait disorders in older adults. A review of brain mapping literature. Panminerva Med 54:189–204 Annweiler C, Montero-Odasso M, Bartha R, Beauchet O, Bowman GL, Silbert L, Dodge H, Quinn J, Kaye J (2012b) Nutrient biomarker patterns, cognitive function, and MRI measures of brain aging. Neurology 78:1281–1282 Baloh RW, Ying SH, Jacobson KM (2003) A longitudinal study of gait and balance dysfunction in normal older people. Arch Neurol 60:835–839 Barberger-Gateau P, Fabrigoule C, Helmer C, Rouch I, Dartigues JF (1999) Functional impairment in instrumental activities of daily living: an early clinical sign of dementia? J Am Geriatr Soc 47:456–462 Beauchet O, Berrut G (2006) Gait and dual-task: definition, interest, and perspectives in the elderly. Psychol Neuropsychiatr Vieil 4:215–225 Beauchet O, Allali G, Berrut G, Hommet C, Dubost V, Assal F (2008) Gait analysis in demented subjects: interests and perspectives. Neuropsychiatr Dis Treat 4:155–160 Beauchet O, Allali G, Thiery S, Gautier J, Fantino B, Annweiler C (2011a) Association between high variability of gait speed and mild cognitive impairment: a cross-sectional pilot study. J Am Geriatr Soc 59:1973–1974 Beauchet O, Freiberger E, Annweiler C, Kressig RW, Herrmann FR, Allali G (2011b) Test–retest reliability of stride time variability while dual tasking in healthy and demented adults with frontotemporal degeneration. J Neuroeng Rehabil 8:37 Burns JM, Johnson DK, Watts A, Swerdlow RH, Brooks WM (2010) Reduced lean mass in early Alzheimer disease and its association with brain atrophy. Arch Neurol 67:428–433 Camicioli R, Howieson D, Oken B, Sexton G, Kaye J (1998) Motor slowing precedes cognitive impairment in the oldest old. Neurology 50:1496–1498 Camicioli R, Moore MM, Sexton G, Howieson DB, Kaye JA (1999) Age-related brain changes associated with motor function in healthy older people. J Am Geriatr Soc 47:330–334 Carmichael OT, Kuller LH, Lopez OL, Thompson PM, Dutton RA, Lu A, Lee SE, Lee JY, Aizenstein HJ, Meltzer CC, Liu Y, Toga AW, Becker JT (2007) Ventricular volume and dementia progression in the cardiovascular health study. Neurobiol Aging 28:389–397 Colcombe SJ, Erickson KI, Raz N, Webb AG, Cohen NJ, McAuley E, Kramer AF (2003) Aerobic fitness reduces brain tissue loss in aging humans. J Gerontol A Biol Sci Med Sci 58:176–180 Colcombe SJ, Erickson KI, Scalf PE, Kim JS, Prakash R, McAuley E, Elavsky S, Marquez DX, Hu L, Kramer AF (2006) Aerobic exercise training increases brain volume in aging humans. J Gerontol A Biol Sci Med Sci 61:1166–1170 Corballis MC (1991) Left brain, right brain. Science 251:575–576 Cummings JL (2009) Defining and labeling disease-modifying treatments for Alzheimer’s disease. Alzheimers Dement 5:406–418 de Laat KF, Tuladhar AM, van Norden AG, Norris DG, Zwiers MP, de Leeuw FE (2011) Loss of white matter integrity is associated with gait disorders in cerebral small vessel disease. Brain 134:73–83 Dubois B, Albert ML (2004) Amnestic MCI or prodromal Alzheimer’s disease? Lancet Neurol 3:246–248 Eggermont L, Swaab D, Luiten P, Scherder E (2006) Exercise, cognition and Alzheimer’s disease: more is not necessarily better. Neurosci Biobehav Rev 30:562–575 Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198 Gottlieb J (2007) From thought to action: the parietal cortex as a bridge between perception, action, and cognition. Neuron 53:9–16 Guo X, Steen B, Matousek M, Andreasson LA, Larsson L, Palsson S, Su V, Skoog I (2001) A population-based study on brain atrophy and motor performance in elderly women. J Gerontol A Biol Sci Med Sci 56:M633–M637 Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, Studenski S, Berkman LF, Wallace RB (2000) Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 55:M221–M231 Heuninckx S, Wenderoth N, Debaere F, Peeters R, Swinnen SP (2005) Neural basis of aging: the penetration of cognition into action control. J Neurosci 25:6787–6967 Hoops S, Nazem S, Siderowf AD, Duda JE, Xie SX, Stern MB, Weintraub D (2009) Validity of the MoCA and MMSE in the detection of MCI and dementia in Parkinson disease. Neurology 73:1738–1745 Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL (1982) A new clinical scale for the staging of dementia. Br J Psychiatry 140:566–572 Kressig RW, Beauchet O, European GAITRite Network Group (2006) Guidelines for clinical applications of spatio-temporal gait analysis in older adults. Aging Clin Exp Res 18:174–176 Kuller LH, Shemanski L, Manolio T, Haan M, Fried L, Bryan N, Burke GL, Tracy R, Bhadelia R (1998) Relationship between ApoE, MRI findings, and cognitive function in the Cardiovascular Health Study. Stroke 29:388–398 Kuo HK, Leveille SG, Yu YH, Milberg WP (2007) Cognitive function, habitual gait speed, and late-life disability in the National Health and Nutrition Examination Survey (NHANES) 1999–2002. Gerontology 53:102–110 Longstreth WT Jr, Arnold AM, Manolio TA, Burke GL, Bryan N, Jungreis CA, O’Leary D, Enright PL, Fried L (2000) Clinical correlates of ventricular and sulcal size on cranial magnetic resonance imaging of 3,301 elderly people: the Cardiovascular Health Study. Neuroepidemiology 19:30–42 Machin D, Campbell M, Fayers P, Pinol A (1997) Sample size tables for clinical studies, 2nd edn. Blackwell Science, Oxford Manolio TA, Kronmal RA, Burke GL, Poirier V, O’Leary DH, Gardin JM, Fried LP, Steinberg EP, Bryan RN, for the Cardiovascular Health Study Collaborative Research Group (1994) Magnetic resonance abnormalities and cardiovascular disease in older adults: the Cardiovascular Health Study. Stroke 25:318–327 Montero-Odasso M, Schapira M, Varela C, Pitteri C, Soriano ER, Kaplan R, Camera LA, Mayorga LM (2004) Gait velocity in senior people. An easy test for detecting mobility impairment in community elderly. J Nutr Health Aging 8:340–343 Montero-Odasso M, Schapira M, Soriano ER, Varela M, Kaplan R, Camera LA, Mayorga LM (2005) Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. J Gerontol A Biol Sci Med Sci 60:1304–1309 Montero-Odasso M, Casas A, Hansen KT, Bilski P, Gutmanis I, Wells JL, Borrie MJ (2009) Quantitative gait analysis under dual-task in older people with mild cognitive impairment: a reliability study. J Neuroeng Rehabil 6:35 Montero-Odasso M, Muir SW, Speechley M (2012) Dual-task complexity affects gait in people with mild cognitive impairment: the interplay between gait variability, dual tasking, and risk of falls. Arch Phys Med Rehabil 93:293–299 Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H (2005) The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53:695–699 Nestor SM, Rupsingh R, Borrie M, Smith M, Accomazzi V, Wells JL, Fogarty J, Bartha R, Alzheimer’s Disease Neuroimaging Initiative (2008) Ventricular enlargement as a possible measure of Alzheimer’s disease progression validated using the Alzheimer’s disease neuroimaging initiative database. Brain 131:2443–2454 Perera S, Mody SH, Woodman RC, Studenski SA (2006) Meaningful change and responsiveness in common physical performance measures in older adults. J Am Geriatr Soc 54:743–749 Rosano C, Kuller LH, Chung H, Arnold AM, Longstreth WT Jr, Newman AB (2005a) Subclinical brain magnetic resonance imaging abnormalities predict physical functional decline in high-functioning older adults. J Am Geriatr Soc 53:649–654 Rosano C, Simonsick EM, Harris TB, Kritchevsky SB, Brach J, Visser M, Yaffe K, Newman AB (2005b) Association between physical and cognitive function in healthy elderly: the Health, Aging and Body Composition study. Neuroepidemiology 24:8–14 Rosano C, Brach J, Longstreth WT Jr, Newman AB (2006) Quantitative measures of gait characteristics indicate prevalence of underlying subclinical structural brain abnormalities in high-functioning older adults. Neuroepidemiology 26:52–60 Rosano C, Aizenstein H, Brach J, Longenberger A, Studenski S, Newman AB (2008) Special article: gait measures indicate underlying focal gray matter atrophy in the brain of older adults. J Gerontol A Biol Sci Med Sci 63:1380–1388 Sacco K, Cauda F, Cerliani L, Mate D, Duca S, Geminiani GC (2006) Motor imagery of walking following training in locomotor attention. The effet of “the tango lesson”. Neuroimage 32:1441–1449 Schott JM, Bartlett JW, Barnes J, Leung KK, Ourselin S, Fox NC, Alzheimer’s Disease Neuroimaging Initiative investigators (2010) Reduced sample sizes for atrophy outcomes in Alzheimer’s disease trials: baseline adjustment. Neurobiol Aging 31:1452–1462 Smith CD, Snowdon D, Markesbery WR (2000) Periventricular white matter hyperintensities on MRI: correlation with neuropathological findings. J Neuroimaging 10:13–16 Studenski S, Perera S, Wallace D, Chandler JM, Duncan PW, Rooney E, Fox M, Guralnik JM (2003) Physical performance measures in the clinical setting. J Am Geriatr Soc 51:314–322 Takata Y, Ansai T, Soh I, Kimura Y, Yoshitake Y, Sonoki K, Awano S, Kagiyama S, Yoshida A, Nakamichi I, Hamasaki T, Torisu T, Toyoshima K, Takehara T (2008) Physical fitness and cognitive function in an 85-year-old community-dwelling population. Gerontology 54:354–360 Turner B, Ramli N, Blumhardt LD, Jaspan T (2001) Ventricular enlargement in multiple sclerosis: a comparison of three-dimensional and linear MRI estimates. Neuroradiology 43:608–614 Verghese J, Lipton RB, Hall CB, Kuslansky G, Katz MJ, Buschke H (2002) Abnormality of gait as a predictor of non-Alzheimer’s dementia. N Engl J Med 347:1761–1768 Verghese J, Wang C, Lipton RB, Holtzer R, Xue X (2007) Quantitative gait dysfunction and risk of cognitive decline and dementia. J Neurol Neurosurg Psychiatry 78:929–935 Waite LM, Grayson DA, Piguet O, Creasey H, Bennett HP, Broe GA (2005) Gait slowing as a predictor of incident dementia: 6-year longitudinal data from the Sydney Older Persons Study. J Neurol Sci 229–230:89–93 Yogev-Seligmann G, Hausdorff JM, Giladi N (2008) The role of executive function and attention in gait. Mov Disord 23:329–342 Zimmerman ME, Lipton RB, Pan JW, Hetherington HP, Verghese J (2009) MRI- and MRS-derived hippocampal correlates of quantitative locomotor function in older adults. Brain Res 1291:73–81