Diffusion tensor imaging, white matter lesions, the corpus callosum, and gait in the elderly

Refeeque A. Bhadelia, Lori Lyn Price, Kurtis L. Tedesco, Tammy Scott, Wei Qiao Qiu, Samuel Patz, Marshal Folstein, Irwin Rosenberg, Louis R. Caplan, Peter Bergethon

Research output: Contribution to journalArticle

Abstract

Background and Purpose-Gait impairment is common in the elderly, especially those with stroke and white matter hyperintensities on conventional brain MRI. Diffusion tensor imaging (DTI) is more sensitive to white matter damage than conventional MRI. The relationship between DTI measures and gait has not been previously evaluated. Our purpose was to investigate the relationship between the integrity of white matter in the corpus callosum as determined by DTI and quantitative measures of gait in the elderly. Methods-One hundred seventy-three participants of a community-dwelling elderly cohort had neurological and neuropsychological examinations and brain MRI. Gait function was measured by Tinetti gait (0 to 12), balance (0 to 16) and total (0 to 28) scores. DTI assessed fractional anisotropy in the genu and splenium of the corpus callosum. Conventional MRI was used to evaluate for brain infarcts and white matter hyperintensity volume. Results-Participants with abnormal gait had low fractional anisotropy in the genu of the corpus callosum but not the splenium. Multiple regressions analyses showed an independent association between these genu abnormalities and all 3 Tinetti scores (P<0.001). This association remained significant after adding MRI infarcts and white matter hyperintensity volume to the analysis. CONCLUSIONS-: The independent association between quantitative measures of gait function and DTI findings shows that white matter integrity in the genu of corpus callosum is an important marker of gait in the elderly. DTI analyses of white matter tracts in the brain and spinal cord may improve knowledge about the pathophysiology of gait impairment and help target clinical interventions.

Original languageEnglish (US)
Pages (from-to)3816-3820
Number of pages5
JournalStroke
Volume40
Issue number12
DOIs
StatePublished - Dec 2009

Keywords

  • Diffusion
  • Gait
  • MRI
  • Mobility

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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    Bhadelia, R. A., Price, L. L., Tedesco, K. L., Scott, T., Qiu, W. Q., Patz, S., Folstein, M., Rosenberg, I., Caplan, L. R., & Bergethon, P. (2009). Diffusion tensor imaging, white matter lesions, the corpus callosum, and gait in the elderly. Stroke, 40(12), 3816-3820. https://doi.org/10.1161/STROKEAHA.109.564765