Baseline Cerebral Small Vessel Disease Is Not Associated with Gait Decline After Five Years

Mov Disord Clin Pract. 2016 Nov 16;4(3):374-382. doi: 10.1002/mdc3.12435. eCollection May-Jun 2017.


Background: Cerebral small vessel disease (SVD) is cross-sectionally associated with gait disturbances, however, the relation between baseline SVD and gait decline over time is uncertain. Furthermore, diffusion tensor imaging (DTI) studies on gait decline are currently lacking.

Objective: To investigate the association between baseline imaging SVD markers and gait decline.

Methods: In 2006, 310 participants from the RUN DMC cohort, a prospective cohort with older adults aged 50-85 years with SVD, were included. Gait variables were assessed using a computerized walkway during baseline and follow-up. Linear and logistic regression analyses were used to investigate the relation between imaging measures and gait decline and incident gait impairment (speed ≤ 1.0 m/s). Tract-based spatial statistics (TBSS) was used to identify possible differences in DTI measures of white matter tracts between participants with and without incident gait impairment.

Results: Mean age was 63.3 years (SD: 8.4) and mean follow-up duration 5.4 years (SD: 0.2). No significant associations between imaging measures and gait decline were found. TBSS analysis revealed no significant differences in DTI measures between participants with and without incident gait impairment after additional adjustment for SVD. In sub-analyses, a high total WMH volume (OR: 2.8 for highest quartile, 95% CI: 1.1-7.1) and high infratentorial WMH volume (OR: 1.8 per SD increase, 95% CI: 1.1-2.9) were associated with an increased 5-year risk of gait impairment, although this was not significant after correction for multiple testing.

Conclusion: Baseline imaging SVD markers were not associated with gait decline or incident gait impairment after 5 years. Future studies should investigate if SVD progression is related to gait deterioration.

Keywords: cerebral small vessel disease; diffusion tensor imaging; gait; magnetic resonance imaging.