Basal Ganglia and Brainstem Located Cerebral Microbleeds Contributed to Gait Impairment in Patients with Cerebral Small Vessel Disease

Article type: Research Article

Authors: Mao, He-Jiao^a | Zhang, Jiang-Xia^a | Zhu, Wen-Cheng^b | Zhang, Hao^b | Fan, Xiang-Min^b | Han, Fei^a | Ni, Jun^a | Zhou, Li-Xin^a | Yao, Ming^a | Tian, Feng^b | Su, Ning^{a; 1; *} | Zhu, Yi-Cheng^{a; 1; *}

Affiliations: [a] Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China | [b] State Key Laboratory of Computer Science, Institute of Software, Chinese Academy of Sciences, Beijing, China

Correspondence: [*] Correspondence to: Ning Su and Yi-Cheng Zhu, Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Beijing 100730, China. Tel.: +86 10 69156380; Fax: +86 10 69156380; E-mails: suning343@163.com (Ning Su) and zhuych910@163.com (Yi-Cheng Zhu).

Note: [1] These authors contributed equally to this work.

Abstract: Background:The mechanism of gait disorder in patients with cerebral small vessel disease (CSVD) remains unclear. Limited studies have compared the effect of cerebral microbleeds (CMBs) and lacunes on gait disturbance in CSVD patients in different anatomical locations. Objective:To investigate the relationship of quantitative gait parameters with varied anatomically located MRI imaging markers in patients with CSVD. Methods:Quantitative gait tests were performed on 127 symptomatic CSVD patients all with diffuse distributed white matter hyperintensities (WMHs). CMBs and lacunes in regard to anatomical locations and burdens were measured. The correlation between CSVD imaging markers and gait parameters was evaluated using general linear model analysis. Results:Presence of CMBs was significantly associated with stride length (β= –0.098, p = 0.0272) and right step length (β= –0.054, p = 0.0206). Presence of CMBs in basal ganglia (BG) was significantly associated with stride length and step length. Presence of CMBs in brainstem was significantly associated with gait parameters including stride length, step length, step height, and step width. Presence of lacunes in brainstem was significantly associated with gait speed (β= –0.197, p = 0.0365). However, presence of lacunes in the other areas was not associated with worse gait performances. Conclusion:BG and brain stem located CMBs contributed to gait impairment in symptomatic CSVD patients.

Keywords: Basal ganglia, brainstem, cerebral microbleeds, cerebral small vessel disease, quantitative gait parameters

DOI: 10.3233/JAD-230005

Journal: Journal of Alzheimer's Disease, vol. 94, no. 3, pp. 1005-1012, 2023