步长变异性较高表明老年人选定区域的灰质完整性较低。
Higher step length variability indicates lower gray matter integrity of selected regions in older adults.
作者信息
Rosso Andrea L, Olson Hunt Megan J, Yang Mei, Brach Jennifer S, Harris Tamara B, Newman Anne B, Satterfield Suzanne, Studenski Stephanie A, Yaffe Kristine, Aizenstein Howard J, Rosano Caterina
机构信息
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA.
Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA.
出版信息
Gait Posture. 2014;40(1):225-30. doi: 10.1016/j.gaitpost.2014.03.192. Epub 2014 Apr 12.
Step length variability (SLV) increases with age in those without overt neurologic disease, is higher in neurologic patients, is associated with falls, and predicts dementia. Whether higher SLV in older adults without neurologic disease indicates presence of neurologic abnormalities is unknown. Our objective was to identify whether SLV in older adults without overt disease is associated with findings from multimodal neuroimaging. A well-characterized cohort of 265 adults (79-90 years) was concurrently assessed by gait mat, magnetic resonance imaging with diffusion tensor, and neurological exam. Linear regression models adjusted for gait speed, demographic, health, and functional covariates assessed associations of MRI measures (gray matter volume, white matter hyperintensity volume, mean diffusivity, fractional anisotropy) with SLV. Regional distribution of associations was assessed by sparse partial least squares analyses. Higher SLV (mean: 8.4, SD: 3.3) was significantly associated with older age, slower gait speed, and poorer executive function and also with lower gray matter integrity measured by mean diffusivity (standardized beta=0.16; p=0.02). Associations between SLV and gray matter integrity were strongest for the hippocampus and anterior cingulate gyrus (both β=0.18) as compared to other regions. Associations of SLV with other neuroimaging markers were not significant. Lower integrity of normal-appearing gray matter may underlie higher SLV in older adults. Our results highlighted the hippocampus and anterior cingulate gyrus, regions involved in memory and executive function. These findings support previous research indicating a role for cognitive function in motor control. Higher SLV may indicate focal neuropathology in those without diagnosed neurologic disease.
在没有明显神经系统疾病的人群中,步长变异性(SLV)随年龄增长而增加,在神经系统疾病患者中更高,与跌倒相关,并可预测痴呆症。在没有神经系统疾病的老年人中,较高的SLV是否表明存在神经学异常尚不清楚。我们的目的是确定没有明显疾病的老年人的SLV是否与多模态神经影像学检查结果相关。对265名成年人(79 - 90岁)组成的特征明确的队列同时进行了步态垫、扩散张量磁共振成像和神经学检查。针对步态速度、人口统计学、健康状况和功能协变量进行调整的线性回归模型评估了MRI测量指标(灰质体积、白质高信号体积、平均扩散率、各向异性分数)与SLV之间的关联。通过稀疏偏最小二乘分析评估关联的区域分布。较高的SLV(平均值:8.4,标准差:3.3)与年龄较大、步态速度较慢、执行功能较差显著相关,也与通过平均扩散率测量的较低灰质完整性相关(标准化β = 0.16;p = 0.02)。与其他区域相比,SLV与灰质完整性之间的关联在海马体和前扣带回最强(两者β = 0.18)。SLV与其他神经影像学标志物之间的关联不显著。外观正常的灰质较低的完整性可能是老年人较高SLV的基础。我们的结果突出了海马体和前扣带回,这两个区域参与记忆和执行功能。这些发现支持了先前的研究,表明认知功能在运动控制中发挥作用。在未诊断出神经系统疾病的人群中,较高的SLV可能表明存在局灶性神经病理学。