Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle Upon Tyne, UK.
Geriatric Medicine, Northumbria Healthcare Trust, UK.
Neurosci Biobehav Rev. 2019 May;100:344-369. doi: 10.1016/j.neubiorev.2018.12.017. Epub 2018 Dec 13.
Gait is complex, described by diverse characteristics underpinned by widespread central nervous system networks including motor and cognitive functions. Despite this, neural substrates of discrete gait characteristics are poorly understood, limiting understanding of gait impairment in ageing and disease. This structured review aims to map gait characteristics, defined from a pre-specified model reflecting independent gait domains, to brain imaging parameters in older adults. Fifty-two studies of 38,029 yielded were reviewed. Studies showed inconsistent approaches when mapping gait assessment to neural substrates, limiting conclusions. Gait impairments typically associated with brain deterioration, specifically grey matter atrophy and white matter integrity loss. Gait velocity, a global measure of gait control, was most frequently associated with these imaging markers within frontal and basal ganglia regions, and its decline predicted from white matter volume and integrity measurements. Fewer studies assessed additional gait measures or functional imaging parameters. Future studies mapping regional neuroanatomical and functional correlates of gait are needed, including those which take a multi-process network perspective to better understand mobility in health and disease.
步态复杂，由广泛的中枢神经系统网络支撑的多种特征描述，包括运动和认知功能。尽管如此，离散步态特征的神经基础仍知之甚少，这限制了对衰老和疾病中步态障碍的理解。本结构化综述旨在将步态特征（根据反映独立步态域的预设模型定义）映射到老年人的脑影像参数。综述了 52 项研究，涉及 38029 名参与者。研究表明，将步态评估映射到神经基质的方法不一致，限制了结论的得出。步态障碍通常与大脑恶化有关，特别是灰质萎缩和白质完整性丧失。步态速度是步态控制的一个整体衡量指标，在额叶和基底神经节区域内与这些影像学标志物最相关，其下降可以从白质体积和完整性测量中预测。较少的研究评估了其他步态测量或功能影像学参数。需要进行更多的研究来映射步态的区域神经解剖和功能相关性，包括采用多过程网络视角的研究，以更好地理解健康和疾病中的移动能力。
