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Deep white matter hyperintensities, microstructural integrity and dual task walking in older people
Tabassom Ghanavati1, Myriam Sillevis Smitt2, Stephen R Lord2
1Department of Physiotherapy Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran.
Brain Imaging and Behavior
|January 4, 2018
Summary
This study reveals that white matter hyperintensities (WMHs) slow dual-task gait speed in older adults, a relationship partly explained by cognitive functions. Cerebellar and cingulate pathways are crucial for dual-task walking.
Area of Science:
- Neuroscience
- Gerontology
- Biomechanics
Background:
- Gait speed is a critical indicator of health and mobility in older adults.
- Dual-tasking (performing gait and a cognitive task simultaneously) significantly impacts gait speed.
- White matter hyperintensities (WMHs) and microstructural integrity are implicated in age-related cognitive and motor decline.
Purpose of the Study:
- To investigate the neural, physiological, and cognitive factors influencing gait speed in older adults under single and dual-task conditions.
- To explore the mediating role of cognitive functions in the relationship between WMHs and dual-task gait speed.
- To identify specific brain regions associated with gait performance during dual-tasking.
Main Methods:
- Sixty-two community-dwelling older adults (mean age 80.0 years) participated.
- Gait speed was measured using a 20-meter walk under single and dual-task (alphabet recitation) conditions.
- Assessments included sensorimotor function, cognitive function across five domains, WMHs, and white matter microstructural integrity (fractional anisotropy - FA).
Main Results:
- Global physiological and cognitive measures correlated with both single and dual-task gait speed.
- Deep WMHs were specifically associated with slower dual-task gait speed.
- Cognitive functions, particularly executive cognition, mediated the association between deep WMHs and dual-task gait speed (reducing it by 44%).
- Fractional anisotropy (FA) in the genu and splenium of the corpus callosum correlated with single-task gait speed.
- FA in the Superior Cerebellar Peduncle, splenium of the Corpus Callosum, and Cingulum correlated with dual-task gait speed.
Conclusions:
- Greater deep WMH volumes are linked to slower walking speed during dual-tasking in older adults.
- This relationship is partially explained by global and executive cognitive functions.
- Cerebellar and cingulate white matter integrity are important for dual-task walking, reflecting roles in motor control and attention, respectively.
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