Structural brain correlates of neuropsychomotor performance in older adults with early cognitive decline

This letter critically evaluates the study by Yue et al investigating the association between gray matter volume (GMV) and cognitive/motor function in amnestic mild cognitive impairment (aMCI). Yue et al utilized voxel-based morphometry (VBM) and comprehensive functional assessments, finding significant GMV reductions in aMCI patients compared to controls, notably in temporal, parietal, occipital, and frontal regions. These structural changes correlated significantly with lower cognitive scores (mini-metal state examination, cambridge cognitive examination-Chinese version, activities of daily living) and impaired gait parameters (timed up and go test, dual task timed up and go test, speed). While strengths include the use of VBM and combined cognitive-motor assessment, the study's cross-sectional design precludes causal inferences. The reliance on laboratory-based gait analysis may also limit ecological validity. The findings support the potential role of GMV as an aMCI biomarker and highlight the concept of shared neural substrates for cognitive and motor control. Future longitudinal, multi-modal imaging, and mechanistic studies are crucial to confirm causality, understand underlying pathways, and guide the development of integrated interventions for aMCI.