Hou Yutong, Li Yue, Yang Shuna, Qin Wei, Yang Lei, Hu Wenli
Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Front Aging Neurosci. 2021 May 12;13:640844. doi: 10.3389/fnagi.2021.640844. eCollection 2021.
Cerebral small vessel disease (cSVD)-including white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), lacunes, and enlarged perivascular spaces (EPVS)-is related to gait impairment. However, the association between the total magnetic resonance imaging (MRI) cSVD burden and gait and upper extremity function remains insufficiently investigated. This study aimed to assess the correlation between the total MRI cSVD burden score and gait impairment as well as upper extremity impairment. A total of 224 participants underwent MRI scans, and the presence of lacunes, WMHs, CMBs, and EPVS was evaluated and recorded as a total MRI cSVD burden score (range 0-4). Gait was assessed by 4-m walkway, Tinetti, Timed Up and Go (TUG), and Short Physical Performance Battery (SPPB) tests. Upper extremity function was assessed by 10-repeat hand pronation-supination time, 10-repeat finger-tapping time, and 10-repeat hand opening and closing time. The mean age of the 224 participants was 60.6 ± 10.5 years, and 64.3% were men. Independent of age, sex, height, and vascular risk factors, multivariable linear regression analyses showed that a higher total MRI cSVD burden score was related to a shorter stride length, wider step width, higher cadence, and poorer performance on the Tinetti, TUG, and SPPB tests and upper extremity tests (all < 0.05). Total MRI cSVD burden was associated with gait impairment and upper extremity disturbances, suggesting that total MRI cSVD burden might contribute to motor function decline. Longitudinal studies are required to determine whether there is a causal relationship between total MRI cSVD burden and motor function decline.
脑小血管病（cSVD）——包括白质高信号（WMH）、脑微出血（CMB）、腔隙性梗死和血管周围间隙增宽（EPVS）——与步态障碍有关。然而，磁共振成像（MRI）cSVD总负担与步态及上肢功能之间的关联仍未得到充分研究。本研究旨在评估MRI cSVD总负担评分与步态障碍以及上肢功能障碍之间的相关性。共有224名参与者接受了MRI扫描，评估并记录腔隙性梗死、WMH、CMB和EPVS的存在情况，作为MRI cSVD总负担评分（范围为0 - 4）。通过4米步行道、Tinetti量表、定时起立行走测试（TUG）和简短体能状况量表（SPPB）测试评估步态。通过10次重复的手部旋前 - 旋后时间、10次重复的手指敲击时间和10次重复的手部开合时间评估上肢功能。224名参与者的平均年龄为60.6±10.5岁，男性占64.3%。在不考虑年龄、性别、身高和血管危险因素的情况下，多变量线性回归分析显示，较高的MRI cSVD总负担评分与较短的步幅、较宽的步宽、较高的步频以及在Tinetti量表、TUG测试和SPPB测试以及上肢测试中较差的表现相关（均P<0.05）。MRI cSVD总负担与步态障碍和上肢功能障碍相关，表明MRI cSVD总负担可能导致运动功能下降。需要进行纵向研究以确定MRI cSVD总负担与运动功能下降之间是否存在因果关系。
