基底节和脑干的脑微出血导致脑小血管病患者的步态障碍。

Basal Ganglia and Brainstem Located Cerebral Microbleeds Contributed to Gait Impairment in Patients with Cerebral Small Vessel Disease.

机构信息

Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

State Key Laboratory of Computer Science, Institute of Software, Chinese Academy of Sciences, Beijing, China.

出版信息

J Alzheimers Dis. 2023;94(3):1005-1012. doi: 10.3233/JAD-230005.

DOI:10.3233/JAD-230005

PMID:37355892

Abstract

BACKGROUND

The mechanism of gait disorder in patients with cerebral small vessel disease (CSVD) remains unclear. Limited studies have compared the effect of cerebral microbleeds (CMBs) and lacunes on gait disturbance in CSVD patients in different anatomical locations.

OBJECTIVE

To investigate the relationship of quantitative gait parameters with varied anatomically located MRI imaging markers in patients with CSVD.

METHODS

Quantitative gait tests were performed on 127 symptomatic CSVD patients all with diffuse distributed white matter hyperintensities (WMHs). CMBs and lacunes in regard to anatomical locations and burdens were measured. The correlation between CSVD imaging markers and gait parameters was evaluated using general linear model analysis.

RESULTS

Presence of CMBs was significantly associated with stride length (β= -0.098, p = 0.0272) and right step length (β= -0.054, p = 0.0206). Presence of CMBs in basal ganglia (BG) was significantly associated with stride length and step length. Presence of CMBs in brainstem was significantly associated with gait parameters including stride length, step length, step height, and step width. Presence of lacunes in brainstem was significantly associated with gait speed (β= -0.197, p = 0.0365). However, presence of lacunes in the other areas was not associated with worse gait performances.

CONCLUSION

BG and brain stem located CMBs contributed to gait impairment in symptomatic CSVD patients.

摘要

背景

脑小血管病（CSVD）患者步态障碍的机制尚不清楚。有限的研究比较了脑微出血（CMBs）和腔隙在不同解剖部位 CSVD 患者步态障碍中的作用。

目的

探讨 CSVD 患者定量步态参数与 MRI 影像学标志物在不同解剖部位的关系。

方法

对 127 例有弥漫性分布的脑白质高信号（WMHs）的症状性 CSVD 患者进行定量步态测试。测量 CMBs 和腔隙的解剖位置和负荷。使用一般线性模型分析评估 CSVD 影像学标志物与步态参数之间的相关性。

结果

CMBs 的存在与步幅（β= -0.098，p= 0.0272）和右侧步幅（β= -0.054，p= 0.0206）显著相关。基底节（BG）CMBs 的存在与步幅和步长显著相关。脑干部位 CMBs 的存在与步幅、步长、步高和步宽等步态参数显著相关。脑干部位腔隙的存在与步态速度显著相关（β= -0.197，p= 0.0365）。然而，其他部位腔隙的存在与较差的步态表现无关。