White matter lesions volume and motor performances in the elderly
Ann Neurol.. 2009-06-01; 65(6): 706-715
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1. Ann Neurol. 2009 Jun;65(6):706-15. doi: 10.1002/ana.21674.
White matter lesions volume and motor performances in the elderly.
Soumaré A(1), Elbaz A, Zhu Y, Maillard P, Crivello F, Tavernier B, Dufouil C,
Mazoyer B, Tzourio C.
(1)Inserm U708, Neuroepidemiology, Hôpital de la Salpêtrière, 47 Bvd de
l’Hôpital, Paris, France.
OBJECTIVES: To investigate the cross-sectional and longitudinal associations
between performance-based measures of motor function and volume of white matter
lesions (WMLs), and to examine the influence of the localization of these
METHODS: At baseline, motor performances (maximum walking speed, Tinetti gait and
balance subscales) were assessed in 1,702 subjects aged 80 years or younger from
the Dijon (France), France center of the Three-City study. Volumes of WMLs
lesions (total, periventricular, deep) were measured using an automated method of
tissue segmentation and quantification of lesion size. At 8-year follow-up,
walking speed was evaluated in 1,086 subjects.
RESULTS: At baseline, mean and 95% confidence interval (CI) walking speed was
lower in subjects with total volumes of WMLs >or=90th percentile (1.50
[1.45-1.55] m/s) than in subjects with lower volumes (1.56 [1.55-1.58] m/s; p =
0.004). Baseline total volumes of WMLs above the 90th percentile predicted
walking speed decline during follow-up (odds ratio [95% CI] for having the
greatest walking speed decline = 2.3 [1.3-4.1], p = 0.006). Moreover, high
volumes of periventricular but not deep WMLs were associated with slower walking
speed at baseline (p = 0.005) and over time (p = 0.001), and with lower Tinetti
gait subscore (p = 0.02).
INTERPRETATION: Our study shows a cross-sectional and longitudinal association
between high total volumes of WMLs, in particular volumes above the 90th
percentile, and impaired mobility. These associations were independent of several
confounders, including cognition, and were mainly accounted for by volumes of
periventricular WMLs. These findings support the hypothesis of a vascular
contribution to motor decline in the elderly.
PMID: 19557865 [Indexed for MEDLINE]