Impact of White Matter Hyperintensity and Age on Gait Parameters in Patients With Cerebral Small Vessel Disease

• Published in: Journal of the American Medical Directors Association Vol. 24; no. 5; pp. 672 - 678
• Main Authors: Jiang, Mingzhu, Wu, Shan, Zhang, Yunyun, Li, Yan, Lin, Bo, Pan, Qi, Tian, Shufen, Ni, Ruihan, Liu, Qi, Zhu, Yingwu
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2023
• Subjects: Aged; Artificial Intelligence; cerebral small vessel disease; Cerebral Small Vessel Diseases - diagnostic imaging; Cross-Sectional Studies; Fazekas scale; Female; Gait; gait parameters; geriatric population; Humans; Magnetic Resonance Imaging; Male; Middle Aged; White Matter - diagnostic imaging; Fazekas scale; cerebral small vessel disease; gait parameters; geriatric population
• ISSN: 1525-8610; 1538-9375
• DOI: 10.1016/j.jamda.2022.12.001

This study aimed to investigate the effect of white matter hyperintensity (WMH), a common cerebral small vessel disease (CSVD) imaging marker, and age on gait parameters in middle-aged and geriatric populations.
Cross-sectional study.
A total of 1076 participants (62.9% female; age 61.0 ± 9.3 years), who visited the neurology clinic or obtained a physical check-up from the Affiliated Hospital of Guizhou Medical University. In total, 883 patients with WMH and 193 healthy controls were included in this study.
The Fazekas scores of patients with CSVD were used to assess the burden of WMH. Based on the Fazekas scores, all participants were divided into 4 groups: 553 patients with Fazekas I, 257 patients with Fazekas II, 73 patients with Fazekas III, and 193 controls. Gait parameters, including step speed, frequency, length, width, stance time, and swing time, were quantitatively assessed using a vision-based artificial intelligence gait analyzer (SAIL system). The relationships among the Fazekas scores, age, and gait parameters were analyzed.
Step speed, step length, step width, stance time, and swing time were significantly different among the 4 groups. Furthermore, Fazekas scores and age were both associated with gait parameters, including step speed, step length, stance time, and swing time. The Fazekas scores were associated with step width, whereas age was not. Age was associated with step frequency, whereas Fazekas scores were not.
Fazekas score and age are useful for evaluating gait parameters in patients with CSVD. Emerging WMH (such as Fazekas Ⅰ) could be a clinical warning sign of gait disturbance in a geriatric population.