Longitudinal Relation Between Structural Network Efficiency, Cognition, and Gait in Cerebral Small Vessel Disease

Area of Science:

• Neurology
• Neuroimaging
• Geriatrics

Background:

• Cerebral small vessel disease (SVD) affects older adults, potentially impacting gait and cognition.
• Understanding the relationship between SVD, structural brain networks, and gait decline is crucial.

Purpose of the Study:

• To investigate gait performance changes over time in older SVD patients.
• To determine associations between declining structural network efficiency, cognition, and gait changes.

Main Methods:

• Prospective cohort study of 217 older SVD patients followed for 4 years.
• Assessed gait using Timed UP and Go (TUG) test, cognitive function, and white matter networks via diffusion tensor imaging (DTI).
• Analyzed global network efficiency and conventional SVD MRI markers (WMH, lacunes, microbleeds).

Main Results:

• Decline in white matter network global efficiency over time correlated significantly with gait decline (increased TUG time).
• This association was independent of conventional SVD MRI markers.
• Neither baseline cognition nor cognitive decline was linked to gait decline.

Conclusions:

• Structural white matter network disruption, not cognitive decline, is associated with gait decline in older SVD patients.
• This highlights the role of structural network integrity in the pathophysiology of gait impairment in SVD.