Association of Dual-Task Gait Cost and White Matter Hyperintensity Burden Poststroke: Results From the ONDRI.
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Pieruccini-Faria Frederico, Cornish Benjamin, Binns Malcolm, Fraser Julia, Haddad Seyyed M H, Sunderland Kelly, Ramirez Joel, Beaton Derek, Kwan Donna, Dilliott Allison A, Scott Christopher, Sarquis-Adamson Yanina, Black Alanna, Van Ooteghem Karen, Casaubon Leanne, Dowlatshahi Dar, Hassan Ayman, Mandzia Jennifer, Sahlas Demetrios, Saposnik Gustavo, Tan Brian, Hegele Robert, Bulman Dennis, Ghani Mahdi, Robinson John, Rogaeva Ekaterina, Farhan Sali, Symons Sean, Nanayakkara Nuwan, Arnott Stephen R, Berezuk Courtney, Holmes Melissa, Adamo Sabrina, Ozzoude Miracle, Zamyadi Mojdeh, Lou Wendy, Sujanthan Sujeevini, Bartha Robert, Black Sandra E, Swartz Richard H, McIlroy William, Montero-Odasso Manuel
Аннотация
METHODS: This is a cohort study with a total of 123 older (69 ± 7 years of age) participants with history of stroke were included from the Ontario Neurodegenerative Disease Research Initiative. Participants were clinically assessed and had gait performance assessed under single- and dual-task conditions. Structural neuroimaging data were analyzed to measure both, white matter hyperintensity (WMH) and normal appearing volumes. Percentage of WMH volume in frontal, parietal, occipital, and temporal lobes as well as subcortical hyperintensities in basal ganglia + thalamus were the main outcomes. Multivariate models investigated associations between DTC and hyperintensity volumes, adjusted for age, sex, years of education, global cognition, vascular risk factors, APOE4 genotype, residual sensorimotor symptoms from previous stroke and brain volume.
RESULTS: There was a significant positive global linear association between DTC and hyperintensity burden (adjusted Wilks' λ = .87, P = .01). Amongst all WMH volumes, hyperintensity burden from basal ganglia + thalamus provided the most significant contribution to the global association (adjusted β = .008, η2 = .03; P = .04), independently of brain atrophy.
CONCLUSIONS: In poststroke, increased DTC may be an indicator of larger white matter damages, specifically in subcortical regions, which can potentially affect the overall cognitive processing and decrease gait automaticity by increasing the cortical control over patients' locomotion.