Related Experiment Video
Updated: May 23, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Silent infarcts and cerebral microbleeds modify the associations of white matter lesions with gait and postural
Philip Choi1, Mandy Ren, Thanh G Phan
1Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash University, Melbourne, Australia.
Background And Purpose:
Although cerebral white matter lesions (WMLs), silent infarcts (SIs), and microbleeds (MBs) are individually associated with poorer gait and balance, it is unknown if they interact. We studied the interactions of WML volume with SI and MB on gait and postural stability.
Methods:
Participants in a population-based study aged 60 to 86 years underwent brain MRI, computerized gait measurement, and a physiological profile assessment of postural stability. Segmentation procedures and standard rating methods were used to measure WML, SI, and MB. Linear regression was used to test interactions between lesions on gait and postural stability, adjusting for age, sex, and total intracranial volume.
Results:
There were 395 participants (mean age, 72 years; SD, 7.0). SIs were predominantly located in subcortical frontal white matter and in deep gray structures, and MBs were largely lobar. Participants with SI or MB had higher WML volumes than those without (P<0.001 and P=0.05, respectively). The presence of SI (P for interaction=0.01) or MB (P for interaction <0.01) magnified the adverse association of WML volume with gait. SI (P for interaction=0.02), but not MB, magnified the adverse association of WML volume with postural stability.
Conclusions:
Subclinical cerebrovascular lesions are adversely associated with gait and postural stability in older people in a cumulative fashion.
Insights
Subclinical cerebrovascular lesions, including white matter lesions (WMLs), silent infarcts (SIs), and microbleeds (MBs), cumulatively worsen gait and balance in older adults. The interaction of WMLs with SIs or MBs significantly impacts mobility.
Area of Science:
- Neurology
- Gerontology
- Vascular Biology
Background:
- Cerebral white matter lesions (WMLs), silent infarcts (SIs), and microbleeds (MBs) are known risk factors for gait and balance impairment.
- The cumulative and interactive effects of these cerebrovascular lesions on motor function remain understudied.
Purpose of the Study:
- To investigate the interaction between WML volume and the presence of SIs and MBs on gait and postural stability.
- To determine if these subclinical cerebrovascular lesions have a cumulative impact on motor function in older adults.
Main Methods:
- A population-based cohort of 395 adults aged 60-86 years underwent brain MRI, gait analysis, and postural stability assessment.
- WML volume, SIs, and MBs were quantified using MRI segmentation and rating methods.
- Linear regression models were employed to assess lesion interactions on gait and stability, adjusting for covariates.
Main Results:
- Participants with SIs or MBs exhibited higher WML volumes.
- The presence of SIs or MBs amplified the negative association between WML volume and gait performance.
- SIs, but not MBs, also magnified the adverse effect of WMLs on postural stability.
Conclusions:
- Subclinical cerebrovascular lesions, including WMLs, SIs, and MBs, exert a cumulative detrimental effect on gait and postural stability in older individuals.
- The combined presence of different types of cerebrovascular lesions exacerbates motor impairments more than individual lesions alone.
