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Motor Dual-Tasks for Gait Analysis and Evaluation in Post-Stroke Patients
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Ventricular dilation: association with gait and cognition.

Walter M Palm1, Jane S Saczynski, J van der Grond

  • 1Department of Radiology, Leiden University Medical Center, The Netherlands.

Annals of Neurology
|October 23, 2009
PubMed
Summary

Increased ventricular dilation relative to sulcal cerebrospinal fluid (CSF) volume is linked to gait and cognitive impairments in older adults without stroke. This finding highlights a potential imaging biomarker for neurological decline.

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Area of Science:

  • Neurology
  • Neuroimaging
  • Geriatrics

Background:

  • Normal pressure hydrocephalus presents with gait, cognitive, and urinary issues, often linked to enlarged ventricles.
  • Investigating ventricular dilation relative to sulcal cerebrospinal fluid (CSF) volume offers insights into neurological changes in aging populations.

Purpose of the Study:

  • To examine the relationship between ventricular volume and sulcal CSF volume.
  • To determine the association of disproportionate ventricular dilation with gait, cognitive, and urinary function in a stroke-free elderly cohort.

Main Methods:

  • Analysis of 858 elderly participants from the Age, Gene/Environment Susceptibility-Reykjavik Study.
  • Assessment of gait speed, cognitive function (processing speed, memory, executive function), and bladder function.
  • Magnetic resonance imaging (MRI) for semiautomated segmentation of CSF volumes and assessment of white matter hyperintensity (WMH).
  • Calculation of ventricular volume divided by sulcal CSF volume (VV/SV) ratio.

Main Results:

  • A disproportionate increase in ventricular volume relative to sulcal CSF volume (highest VV/SV quartile) was associated with gait impairment (OR, 1.9) and cognitive impairment (OR, 1.8).
  • No significant association was found between the VV/SV ratio and bladder dysfunction.
  • These associations were independent of white matter hyperintensity (WMH) volume.

Conclusions:

  • Ventricular dilation, relative to sulcal CSF spaces, is associated with increased prevalence and severity of gait and cognitive impairments in the general elderly population without a history of stroke.
  • The VV/SV ratio may serve as a potential imaging marker for age-related neurological decline, distinct from WMH burden.