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患有运动性认知风险综合征的脑小血管病患者在单任务和双任务行走过程中的临床特征

The clinical characteristics of cerebral small vessel disease patients with motoric cognitive risk syndrome during single- and dual-task walking.

作者信息

Xie Hongyang, Zhang Nan, Xia Cuiqiao, Ding Yu, Zhao Hongyi, Huang Yonghua

机构信息

Department of Neurology, Chinese PLA General Hospital, Beijing, China.

Department of Neurology, Number 984 Hospital of the PLA, Beijing, China.

出版信息

Heliyon. 2024 Apr 30;10(9):e30007. doi: 10.1016/j.heliyon.2024.e30007. eCollection 2024 May 15.

Abstract

OBJECTIVE

We aimed to (1) identify neuroimaging biomarkers of distinguishing motoric cognitive risk syndrome (MCRS) risk among older Chinese adults with cerebral small vessel disease (CSVD) and (2) detect differences in gait parameters and neuroimaging biomarkers between CSVD individual with and without MCRS, especially during dual-task walking (DTW).

METHODS

We enrolled 126 inpatients with CSVD who were divided into two groups according to MCRS status. Data on basic parameters, variability, asymmetry, and coordination were collected during single-task walking (STW) and DTW. Neuroimaging features (white matter hyperintensities, lacunes, and microbleeds) and total disease burden were calculated. Analysis of variance and logistic regression analyses were applied to assess the role of STW, DTW, and neuroimaging biomarkers in MCRS.

RESULTS

In total, 126 consecutive inpatients with CSVD were included (84 and 42 patients were classified as MCRS-negative and MCRS-positive, respectively). The MCRS-positive group showed poorer performance for nearly all gait parameters compared with the MCRS-negative group during cognitive DTW. Meanwhile, all gait parameters except asymmetry were assessed in participants with MCRS for significant deterioration during cognitive DTW compared with that during STW. However, only basic parameters differed between STW and cognitive DTW in participants without MCRS. A significant independent association between total CSVD scores and MCRS was also detected.

CONCLUSIONS

For CSVD patients, with higher total CSVD burden rather than any single neuroimaging marker, was linked to a greater risk of MCRS. In addition, CSVD individuals with MCRS had higher variability and phase coordination index (PCI), especially in cognitive DTW. Thus, they should concentrate more on their gait variability or coordination and reduce secondary task loads while walking in daily life, especially in cognitive secondary tasks.

摘要

目的

我们旨在(1)识别中国老年脑小血管病(CSVD)患者中区分运动认知风险综合征(MCRS)风险的神经影像学生物标志物,以及(2)检测有和无MCRS的CSVD个体之间的步态参数和神经影像学生物标志物差异,尤其是在双任务步行(DTW)期间。

方法

我们纳入了126例CSVD住院患者,根据MCRS状态将其分为两组。在单任务步行(STW)和DTW期间收集基本参数、变异性、不对称性和协调性数据。计算神经影像特征(白质高信号、腔隙和微出血)和总疾病负担。应用方差分析和逻辑回归分析来评估STW、DTW和神经影像学生物标志物在MCRS中的作用。

结果

总共纳入了126例连续的CSVD住院患者(分别有84例和42例患者被分类为MCRS阴性和MCRS阳性)。在认知DTW期间,MCRS阳性组与MCRS阴性组相比,几乎所有步态参数的表现都更差。同时,与STW期间相比,在认知DTW期间,对MCRS参与者的所有步态参数(不对称性除外)进行评估,发现有显著恶化。然而,在无MCRS的参与者中,STW和认知DTW之间仅基本参数存在差异。还检测到总CSVD评分与MCRS之间存在显著的独立关联。

结论

对于CSVD患者,总CSVD负担较高而非任何单一神经影像标志物,与MCRS风险较高相关。此外,患有MCRS的CSVD个体具有更高的变异性和相位协调指数(PCI),尤其是在认知DTW中。因此,他们在日常生活中行走时,尤其是在认知次要任务中,应更多地关注步态变异性或协调性,并减少次要任务负荷。

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