Annweiler Cedric, Beauchet Olivier, Bartha Robert, Hachinski Vladimir, Montero-Odasso Manuel
Gait and Brain Lab, Lawson Health Research Institute, Parkwood Hospital, The University of Western Ontario, London, Ontario, Canada ; Division of Geriatric Medicine, University Hospital; Memory Clinic; UPRES EA 4638, University of Angers, Angers, France ; Robarts Research Institute, the University of Western Ontario, London, Ontario, Canada.
Division of Geriatric Medicine, University Hospital; Memory Clinic; UPRES EA 4638, University of Angers, Angers, France.
PLoS One. 2014 Jan 31;9(1):e87314. doi: 10.1371/journal.pone.0087314. eCollection 2014.
BACKGROUND: Vitamin D is involved in brain physiology and lower-extremity function. We investigated spectroscopy in a cohort of older adults to explore the hypothesis that lower vitamin D status was associated with impaired neuronal function in caudal primary motor cortex (cPMC) measured by proton magnetic resonance spectroscopic imaging. METHODS: Twenty Caucasian community-dwellers (mean±standard deviation, 74.6±6.2 years; 35.0% female) from the 'Gait and Brain Study' were included in this analysis. Ratio of N-acetyl-aspartate to creatine (NAA/Cr), a marker of neuronal function, was calculated in cPMC. Participants were categorized according to mean NAA/Cr. Lower vitamin D status was defined as serum 25-hydroxyvitamin D (25OHD) concentration <75 nmol/L. Age, gender, number of comorbidities, vascular risk, cognition, gait performance, vitamin D supplements, undernourishment, cPMC thickness, white matter hyperintensities grade, serum parathyroid hormone concentration, and season of evaluation were used as potential confounders. RESULTS: Compared to participants with high NAA/Cr (n = 11), those with low NAA/Cr (i.e., reduced neuronal function) had lower serum 25OHD concentration (P = 0.044) and more frequently lower vitamin D status (P = 0.038). Lower vitamin D status was cross-sectionally associated with a decrease in NAA/Cr after adjustment for clinical characteristics (β = -0.41, P = 0.047), neuroimaging measures (β = -0.47, P = 0.032) and serum measures (β = -0.45, P = 0.046). CONCLUSIONS: Lower vitamin D status was associated with reduced neuronal function in cPMC. These novel findings need to be replicated in larger and preferably longitudinal cohorts. They contribute to explain the pathophysiology of gait disorders in older adults with lower vitamin D status, and provide a scientific base for vitamin D replacement trials.
背景：维生素D参与大脑生理功能和下肢功能。我们在一组老年人中进行了光谱分析，以探讨维生素D水平较低与通过质子磁共振波谱成像测量的尾侧初级运动皮层（cPMC）神经元功能受损之间的关系这一假设。 方法：“步态与大脑研究”中的20名白种社区居民（平均±标准差，74.6±6.2岁；35.0%为女性）纳入本分析。计算cPMC中神经元功能标志物N-乙酰天门冬氨酸与肌酸的比值（NAA/Cr）。参与者根据平均NAA/Cr进行分类。维生素D水平较低定义为血清25-羟维生素D（25OHD）浓度<75 nmol/L。年龄、性别、合并症数量、血管风险、认知、步态表现、维生素D补充剂、营养不良、cPMC厚度、白质高信号分级、血清甲状旁腺激素浓度和评估季节用作潜在混杂因素。 结果：与NAA/Cr高的参与者（n = 11）相比，NAA/Cr低（即神经元功能降低）的参与者血清25OHD浓度较低（P = 0.044），维生素D水平较低的情况更常见（P = 0.038）。在调整临床特征（β = -0.41，P = 0.047）、神经影像学指标（β = -0.47，P = 0.032）和血清指标（β = -0.45，P = 0.046）后，维生素D水平较低与NAA/Cr降低呈横断面相关。 结论：维生素D水平较低与cPMC中神经元功能降低有关。这些新发现需要在更大且最好是纵向队列中进行重复验证。它们有助于解释维生素D水平较低的老年人步态障碍的病理生理学，并为维生素D替代试验提供科学依据。
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