Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Neuroimage. 2012 Jan 16;59(2):1478-84. doi: 10.1016/j.neuroimage.2011.08.005. Epub 2011 Aug 11.
Although gait disturbances are present in a substantial portion of patients with cerebral small vessel disease (SVD), their pathogenesis has not been clarified as they are not entirely explained by the white matter lesions (WMLs) and lacunar infarcts. The role of cortical thickness in these patients remains largely unknown. We aimed to assess the regions of cortical thickness associated with distinct gait parameters in patients with SVD, and whether these associations were dependent on WMLs and lacunar infarcts. MRI data were obtained from 415 subjects with SVD, aged between 50 and 85 years. We assessed cortical thickness using surface-based cortical thickness analysis, and gait performance using the GAITRite system. Cortical thickness of predominantly the orbitofrontal and ventrolateral prefrontal cortex, the inferior parietal lobe, cingulate areas and visual association cortices was positively related to stride length. Thickness of the primary and supplementary motor cortices and the cingulate cortex was positively related to cadence, while thickness of the orbitofrontal and ventrolateral prefrontal cortex, anterior cingulate cortex and especially the inferior parietal lobe and superior temporal gyrus was negatively related to stride width. The associations with stride length and width were partially explained by the subcortical WMLs and lacunar infarcts. Cortical thickness may therefore be important in gait disturbances in individuals with SVD, with different cortical patterns for specific gait parameters. We suggest that cortical atrophy is part of the disease processes in patients with SVD.
尽管脑小血管病（SVD）患者存在步态障碍，但由于其并非完全由脑白质病变（WML）和腔隙性梗死引起，因此其发病机制尚未阐明。皮质厚度在这些患者中的作用在很大程度上仍然未知。我们旨在评估与 SVD 患者不同步态参数相关的皮质厚度区域，以及这些关联是否依赖于 WML 和腔隙性梗死。从年龄在 50 至 85 岁的 415 名 SVD 患者中获得 MRI 数据。我们使用基于表面的皮质厚度分析评估皮质厚度，并使用 GAITRite 系统评估步态表现。额眶回和额下回皮质、顶下小叶、扣带回区域和视觉联合皮质的皮质厚度与步幅呈正相关。初级和辅助运动皮质以及扣带回的厚度与步频呈正相关，而额眶回和额下回皮质、前扣带回皮质，尤其是顶下小叶和颞上回的厚度与步宽呈负相关。与步幅和步宽的关联部分由皮质下 WML 和腔隙性梗死解释。因此，皮质厚度在 SVD 患者的步态障碍中可能很重要，不同的皮质模式与特定的步态参数相关。我们认为皮质萎缩是 SVD 患者疾病过程的一部分。
