Hou Yutong, Yang Shuna, Li Yue, Qin Wei, Yang Lei, Hu Wenli
Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2022 Oct 26;13:993979. doi: 10.3389/fneur.2022.993979. eCollection 2022.
Gait disturbances are common in the elderly and can lead to the loss of functional independence and even death. Enlarged perivascular space (EPVS) and motor performance may be related, but only few studies have explored this relationship. The aim of our study was to investigate the effects of both the severity and location of EPVS on movement disorders.
Two hundred and six participants aged between 45 and 85 years old with complete magnetic resonance imaging (MRI) data were included in our analysis. EPVS were divided into basal ganglia (BG) and centrum semiovale (CSO), and their grades were measured. Gait was assessed quantitatively using a 4-m walkway and TUG test as well as semi-quantitatively using the Tinetti and SPPB tests. The function of upper extremities was evaluated by 10-repeat pronation-supination, 10-repeat finger-tapping, and 10-repeat opening and closing of the hands.
Both high-grade EPVS, whether in BG and CSO, were independently correlated with gait parameters, the TUG time, Tinetti, and SPPB tests. The EPVS located in BG had a significant association with 10-repeat finger-tapping time (β = 0.231, = 0.025) and a similar association was also observed between CSO-EPVS and 10-repeat pronation-supination time (β = 0.228, = 0.014).
Our results indicated that EPVS was associated with gait disturbances, and a further investigation found that EPVS has an association with upper extremities disorder. EPVS should be considered as a potential target for delaying gait and upper extremities damage since CSVD can be prevented to some extent.
步态障碍在老年人中很常见，可导致功能独立性丧失甚至死亡。血管周围间隙扩大（EPVS）与运动功能可能有关，但仅有少数研究探讨过这种关系。我们研究的目的是调查EPVS的严重程度和位置对运动障碍的影响。
纳入206名年龄在45至85岁之间且有完整磁共振成像（MRI）数据的参与者进行分析。将EPVS分为基底节（BG）和半卵圆中心（CSO），并对其分级进行测量。使用4米步行道和定时起立步行测试（TUG）对步态进行定量评估，并使用Tinetti和简短体能状况量表（SPPB）测试进行半定量评估。通过10次重复的旋前-旋后、10次重复的手指敲击以及10次重复的手部开合动作来评估上肢功能。
无论在BG还是CSO中，高级别EPVS均与步态参数、TUG时间、Tinetti和SPPB测试独立相关。位于BG的EPVS与10次重复手指敲击时间有显著关联（β = 0.231，P = 0.025），在CSO-EPVS与10次重复旋前-旋后时间之间也观察到类似关联（β = 0.228，P = 0.014）。
我们的结果表明，EPVS与步态障碍有关，进一步研究发现EPVS与上肢功能障碍有关。由于脑小血管病（CSVD）在一定程度上可以预防，因此应将EPVS视为延缓步态和上肢损伤的潜在靶点。
