Journal - Neurology

Abstract :

OBJECTIVE: To investigate the relationship between white matterabnormalities and impairment of gait and balance in older persons. METHODS: Quantitative MRI was used to evaluate the brain tissuecompartments of 28 older individuals separated into normal andimpaired groups on the basis of mobility performance testingusing the Short Physical Performance Battery. In addition, individualswere tested on six indices of gait and balance. For imagingdata, segmentation of intracranial volume into four tissue classeswas performed using template-driven segmentation, in which signal-intensity–basedstatistical tissue classification is refined using a digitalbrain atlas as anatomic template. RESULTS: Both decreased white matter volume, which was age-related,and increased white matter signal abnormalities, which werenot age-related, were observed in the mobility-impaired groupcompared with the control subjects. The average volume of whitematter signal abnormalities for impaired individuals was nearlydouble that of control subjects. CONCLUSIONS: This cross-sectional study suggests that decreasedwhite matter volume is age-related, whereas increased whitematter signal abnormalities are most likely to occur as a resultof disease. Both of these changes are independently associatedwith impaired mobility in older persons and therefore likelyto be additive factors of motor disability.