White Matter Changes-Related Gait and Executive Function Deficits: Associations with Age and Parkinson's Disease

Abstract

Background: White matter changes (WMC) are a common finding among older adults and patients with Parkinson's disease (PD), and have been associated with, e.g., gait deficits and executive dysfunction. How the factors age and PD influence WMC-related deficits is, to our best knowledge, not investigated to date. We hypothesized that advanced age and presence of PD leads to WMC-related symptoms while practicing tasks with a low complexity level, and low age and absence of PD leads to WMC-related symptoms while practicing tasks with a high complexity level.Methods: Hundred and thirty-eight participants [65 young persons without PD (50–69 years, yPn), 22 young PD patients (50–69 years, yPD), 36 old persons without PD (70–89 years, oPn) and 15 old PD patients (70–89 years, oPD)] were included. Presence and severity of WMC were determined with the modified Fazekas score. Velocity of walking under single and dual tasking conditions and the Trail Making Test (TMT) were used as gait and executive function parameters. Correlations between presence and severity of WMC, and gait and executive function parameters were tested in yPn, yPD, oPn, and oPD using Spearman's rank correlation, and significance between groups was evaluated with Fisher's z-transformed correlation coefficient.Results: yPn and yPD, as well as oPn and oPD did not differ regarding demographic and clinical parameters. Severity of WMC was not significantly different between groups. yPn and yPD displayed significant correlations of WMC with executive function parameters at low levels of task complexity, oPn at intermediate, and oPD at high complexity levels.Conclusion: This study argues for a relevant association of age and PD-related brain pathology with WMC-related gait and executive function deficits.

Dual-task gait and white matter hyperintensities in Lewy body diseases: An exploratory analysis

“…Adding age to the model significantly increased the adjusted R 2 values for the whole model for all conditions, indicating age is an important factor that is associated with WMH and dual task gait ( Table 3 ). The literature parallels this finding showing DTC increases and overall cognitive ability decreases, while WMH burden increases, with age ( Murman, 2015 ; Sartor et al, 2017 ; Garnier-Crussard et al, 2020 ). Future studies should examine age-related imaging changes, such as brain atrophy and structural and functional connectivity.…”

Multi-modal neuroimaging of dual-task walking: Structural MRI and fNIRS analysis reveals prefrontal grey matter volume moderation of brain activation in older adults

“…As an exploratory aim, recognizing that the brain regions utilized during complex gait tasks is certainly not limited to the frontal cortex, we extended our LMM analyses to explore other brain regions which may be related to the (non-spatially localized) frontal brain activations seen with fNIRS. The regions identified in these analyses ( Supplementary Table 1) are not surprising as potentially related to gait function: for example, cerebral white matter is a surrogate measure of brain atrophy, caudate has been shown to be related to gait performance (Macfarlane et al, 2015), and fusiform and pre-cuneus gyri have been shown to be related to gait and visuo-spatial orientation (Malouin et al, 2003;Sartor et al, 2017).…”

Demographic and clinical variables as differentiating predictors of cognitive disorders in Parkinson’s disease

“…Advanced age, schooling, and clinical profile are some of the factors explored in studies of cognitive impairment in patients with PD [8][9][10][11] . However, the association between these variables and cognition, comparing groups of Brazilian elderly and nonelderly persons with PD, has yet to be performed.…”