Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Sagol School of Neurosciences, Tel-Aviv University, Tel-Aviv, Israel.
Eur J Neurol. 2020 Mar;27(3):454-460. doi: 10.1111/ene.14119. Epub 2019 Nov 29.
Existing research studies have demonstrated a relationship between magnetic resonance imaging (MRI) neuroimaging measures and walking speed in people with multiple sclerosis (PwMS). However, to date there are no data as to the brain structures involved in gait coordination and control in PwMS. Therefore, the aim of our study was to investigate the association between walk ratio, an indicator of gait coordination, and related brain structures in PwMS.
A brain MRI was performed by a 3.0-T MR scanner in conjunction with a volumetric analysis based on three-dimensional T1-weighted images. Regions of interest were volumes of the hippocampus, amygdala, putamen, caudate, pallidum, thalamus, cerebellum and the corpus callosum regions. Walking speed and walk ratio, defined as step length divided by step rate, was measured whilst walking on an electronic walkway.
In all, 343 PwMS (41.1 ± 13.4 years, 69.1% female, median Expanded Disability Status Scale 2.5) were included in the study. A significant association was found between the left cerebellum volume and walk ratio after controlling for age, gender, total cranial volume and disability; R = 0.379, P = 0.002. A similar association was found between the right cerebellum volume and walk ratio, R = 0.364, P = 0.002. No correlations were observed between walk ratio and the thalamus, basal ganglia, hippocampus, amygdala and the corpus callosum volumes. No association was found between walking speed and all brain measures.
The walk ratio should be considered when evaluating and assessing PwMS presenting with ataxia. Furthermore, it is also hypothesized that a low walk ratio indicates a lower cerebellum volume in the MS population.
现有的研究表明，磁共振成像（MRI）神经影像学测量与多发性硬化症（MS）患者的步行速度之间存在关系。然而，迄今为止，尚无数据表明 MS 患者的步态协调和控制涉及哪些脑结构。因此，我们的研究目的是探讨 MS 患者步幅比（步态协调的指标）与相关脑结构之间的关系。
通过 3.0T 磁共振扫描仪进行脑 MRI 检查，并结合基于三维 T1 加权图像的容积分析。感兴趣区域为海马体、杏仁核、壳核、尾状核、苍白球、丘脑、小脑和胼胝体区域的体积。在电子步道上行走时，测量步行速度和步幅比（定义为步长除以步频）。
共纳入 343 名 MS 患者（41.1±13.4 岁，69.1%为女性，扩展残疾状况量表中位数 2.5）。在校正年龄、性别、总颅容积和残疾后，发现左小脑体积与步幅比之间存在显著相关性；R=0.379，P=0.002。右小脑体积与步幅比之间也存在类似的相关性，R=0.364，P=0.002。步幅比与丘脑、基底节、海马体、杏仁核和胼胝体体积之间无相关性。步幅比与所有脑测量值之间均无相关性。
在评估和评估表现出共济失调的 MS 患者时，应考虑步幅比。此外，还假设低步幅比表明 MS 人群的小脑体积较低。
