步态变异性与脑室特征之间的关联：一项脑图谱研究。
Association between gait variability and brain ventricle attributes: a brain mapping study.
作者信息
Annweiler Cedric, Montero-Odasso Manuel, Bartha Robert, Drozd John, Hachinski Vladimir, Beauchet Olivier
机构信息
Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, University Memory Clinic of Angers, UPRES EA 4638, University of Angers, UNAM, Angers, France; Department of Medicine, Division of Geriatric Medicine, Parkwood Hospital, St. Joseph's Health Care London, Gait and Brain Lab, Lawson Health Research Institute, University of Western Ontario, London, Ontario, Canada; Center for Functional and Metabolic Mapping, Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
Department of Medicine, Division of Geriatric Medicine, Parkwood Hospital, St. Joseph's Health Care London, Gait and Brain Lab, Lawson Health Research Institute, University of Western Ontario, London, Ontario, Canada.
出版信息
Exp Gerontol. 2014 Sep;57:256-63. doi: 10.1016/j.exger.2014.06.015. Epub 2014 Jun 24.
BACKGROUND
It remains unknown which brain regions are involved in the maintenance of gait dynamic stability in older adults, as characterized by a low stride time variability. Expansion of lateral cerebral ventricles is an indirect marker of adjacent brain tissue volume. The purpose of this study was to examine the association between stride time variability and the volume of sub-regions of the lateral cerebral ventricles among older community-dwellers.
METHODS
One-hundred-fifteen participants free of hydrocephalus from the GAIT study (mean, 70.4±4.4years; 43.5% female) were included in this analysis. Stride time variability was measured at self-selected pace with a 10m electronic portable walkway (GAITRite). Participants were separated into 3 groups based on tertiles of stride time variability (i.e., <2.0%; 2.0-2.8%; >2.8%). Brain ventricle sub-volumes were quantified from three-dimensional T1-weighted MRI using semi-automated software. Age, gender, Cumulative Illness Rating Scale for Geriatrics, Mini-Mental State Examination, Go-NoGo, brain vascular burden, 4-item Geriatric Depression Scale, psychoactive drugs, vision, proprioception, body mass index, muscular strength and gait velocity were used as covariates.
RESULTS
Participants with the highest (i.e., worst) tertile of stride time variability exhibited larger temporal horns than those with the lowest (P=0.030) and intermediate tertiles (P=0.028). They also had larger middle portions of ventricular bodies than those with the intermediate tertile (P=0.018). Larger temporal horns were associated with increase in stride time variability (adjusted β=0.86, P=0.005), specifically with the highest tertile of stride time variability (adjusted OR=2.45, P=0.044).
CONCLUSIONS
Higher stride time variability was associated with larger temporal horns in older community-dwellers. Addressing focal neuronal losses in temporal lobes may represent an important strategy to prevent gait instability.
背景
步幅时间变异性低是老年人步态动态稳定性的特征，目前尚不清楚哪些脑区参与了这种稳定性的维持。侧脑室扩大是相邻脑组织体积的间接标志。本研究的目的是探讨老年社区居民的步幅时间变异性与侧脑室各亚区体积之间的关联。
方法
本分析纳入了GAIT研究中的115名无脑积水参与者（平均年龄70.4±4.4岁；43.5%为女性）。使用10米电子便携式步道（GAITRite）以自选速度测量步幅时间变异性。参与者根据步幅时间变异性的三分位数分为3组（即<2.0%；2.0 - 2.8%；>2.8%）。使用半自动软件从三维T1加权磁共振成像中量化脑室亚体积。将年龄、性别、老年累积疾病评定量表、简易精神状态检查表、停止信号任务、脑血管负担、4项老年抑郁量表、精神活性药物、视力、本体感觉、体重指数、肌肉力量和步态速度用作协变量。
结果
步幅时间变异性最高（即最差）三分位数的参与者比最低三分位数的参与者（P = 0.030）和中间三分位数的参与者有更大的颞角（P = 0.028）。他们的脑室体中部也比中间三分位数的参与者更大（P = 0.018）。较大的颞角与步幅时间变异性增加相关（调整β = 0.86，P = 0.005），特别是与步幅时间变异性最高的三分位数相关（调整比值比 = 2.45，P = 0.044）。
结论
在老年社区居民中，较高的步幅时间变异性与较大的颞角相关。解决颞叶局部神经元丢失问题可能是预防步态不稳的重要策略。
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