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Cai M, Jacob MA, Norris DG, de Leeuw FE, Tuladhar AM. Longitudinal relation between structural network efficiency, cognition, and gait in cerebral small vessel disease. J Gerontol A Biol Sci Med Sci 2021; 77:554-560. [PMID: 34459914 PMCID: PMC8893255 DOI: 10.1093/gerona/glab247] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background To investigate changes in gait performance over time and how these changes are associated with the decline in structural network efficiency and cognition in older patients with cerebral small vessel disease (SVD). Methods In a prospective, single-center cohort with 217 older participants with SVD, we performed 1.5T MRI scans, cognitive tests, and gait assessments evaluated by Timed UP and Go (TUG) test twice over 4 years. We reconstructed the white matter network for each subject based on diffusion tensor imaging tractography, followed by graph-theoretical analyses to compute the global efficiency. Conventional MRI markers for SVD, that is, white matter hyperintensity (WMH) volume, number of lacunes, and microbleeds, were assessed. Results Baseline global efficiency was not related to changes in gait performance, while decline in global efficiency over time was significantly associated with gait decline (ie, increase in TUG time), independent of conventional MRI markers for SVD. Neither baseline cognitive performance nor cognitive decline was associated with gait decline. Conclusions We found that disruption of the white matter structural network was associated with gait decline over time, while the effect of cognitive decline was not. This suggests that structural network disruption has an important role in explaining the pathophysiology of gait decline in older patients with SVD, independent of cognitive decline.
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Affiliation(s)
- Mengfei Cai
- Department of Neurology, Radboud University Medical Center; Donders Institute for Brain, Cognition, and Behaviour, Nijmegen; The Netherlands
| | - Mina A Jacob
- Department of Neurology, Radboud University Medical Center; Donders Institute for Brain, Cognition, and Behaviour, Nijmegen; The Netherlands
| | - David G Norris
- Center for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Radboud University Medical Center; Donders Institute for Brain, Cognition, and Behaviour, Nijmegen; The Netherlands
| | - Anil M Tuladhar
- Department of Neurology, Radboud University Medical Center; Donders Institute for Brain, Cognition, and Behaviour, Nijmegen; The Netherlands
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He L, de Souto Barreto P, Giudici KV, Gabelle A, Perus L, Mangin JF, Rolland Y, Vellas B. Five-Year Lower Extremity Function is Associated with White Matter Abnormality in Older Adults. J Am Geriatr Soc 2021; 69:995-1002. [PMID: 33417728 DOI: 10.1111/jgs.16989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To explore associations between changes of lower extremity function (LEF) parameters over a 5-year period and diffusion tensor imaging (DTI) parameters of white matter tracts among community-dwelling older adults. DESIGN A secondary analysis on image and physical function data collected from the Multidomain Alzheimer's Preventive Trial (MAPT). PARTICIPANTS 208 older adults (aged 75 ± 4 years, with spontaneous memory complaint or limited instrumental daily living activity or slow gait speed, 60% female) of the MAPT-magnetic resonance imaging (MRI) ancillary study. The time interval between a participant's enrolment and MRI scan was on average 110 ± 97 days. MEASUREMENTS Forty-eight white matter tracts (WMTs) were measured. LEF parameters (measured after the MRI scan) were assessed as the short physical performance battery (SPPB) score, gait speed, and chair stands time over a 5-year period. Mixed-effects models were performed to explore the associations between baseline DTI values and the progression of LEF parameters. Bonferroni correction was applied for multiple comparison correction. RESULTS The progression of LEF was associated with 35 baseline DTI parameters from 24 WMTs. Higher baseline DTI parameter values were related to more decreases in SPPB score and gait speed, and greater increases in chair stands time. Bilateral uncinate fasciculus was associated with all LEF parameters. Other WMTs in cingulum, cerebral and cerebellar peduncle, internal capsule, and corpus callosum also showed close connections with LEF changes. CONCLUSIONS Our findings show that DTI parameters of some WMTs are associated with the 5-year decline in LEF, suggesting that alterations in WMT integrity (evaluated by DTI parameters) might be used to explore potential causes of impaired mobility in older adults when no clear explanations can be found.
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Affiliation(s)
- Lingxiao He
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Philipe de Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,UMR INSERM 1027, University of Toulouse III, Toulouse, France.,Faculté de Médecine, University of Toulouse III, Toulouse, France
| | - Kelly Virecoulon Giudici
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Audrey Gabelle
- Memory Resources and Research Center, Montpellier University Hospital, Montpellier, France.,Inserm U1061, Montpellier, France.,University of Montpellier i-site MUSE, Montpellier, France
| | - Lisa Perus
- Memory Resources and Research Center, Montpellier University Hospital, Montpellier, France.,Inserm U1061, Montpellier, France.,University of Montpellier i-site MUSE, Montpellier, France
| | - Jean-François Mangin
- CATI Multicenter Neuroimaging Platform, Neurospin, CEA, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,UMR INSERM 1027, University of Toulouse III, Toulouse, France.,Faculté de Médecine, University of Toulouse III, Toulouse, France
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,UMR INSERM 1027, University of Toulouse III, Toulouse, France.,Faculté de Médecine, University of Toulouse III, Toulouse, France
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Maltais M, de Souto Barreto P, Perus L, Mangin JF, Grigis A, Chupin M, Bouyahia A, Gabelle A, Delrieux J, Rolland Y, Vellas B. Prospective Associations Between Diffusion Tensor Imaging Parameters and Frailty in Older Adults. J Am Geriatr Soc 2020; 68:1050-1055. [PMID: 31981370 DOI: 10.1111/jgs.16343] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/18/2019] [Accepted: 12/18/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cross-sectional associations have been found between frail individuals and worse white matter (WM) integrity. However, the prospective association between WM integrity and frailty is still unclear. Our objectives were to measure associations between WM integrity using diffusion tensor imaging (DTI) and the 5-year worsening of frailty in community-dwelling older adults. DESIGN Secondary analysis of the randomized controlled Multidomain Alzheimer Preventive Trial (MAPT). SETTING Thirteen memory centers in France and Monaco between 2008 and 2011. PARTICIPANTS Participants (mean age = 74.7 ± 3.9 years) with no dementia at baseline who had functional magnetic resonance imaging performed as part of the MAPT study (n = 227). MEASUREMENTS Fractional anisotropy and mean diffusivity (MD), axial diffusivity (AxD), and radial diffusivity (RD) were acquired for 10 different brain regions. Frailty was assessed by the Fried frailty phenotype (score from 0 to 5, higher is worse) at up to seven time points for 5 years. Mixed effect ordinal logistic regression model was used to assess the prospective association between DTI parameters (independent variables) and frailty (dependent variable). All the analyses were adjusted for age, sex, baseline total intracranial volume, and the presence of one of the following cardiovascular risk factors (hypertension, diabetes, and/or hypercholesterolemia). RESULTS A statistically significant association was found between the RD, AxD, and MD for different brain regions (anterior limb of internal capsule, external capsule, posterior corona radiata, posterior thalamic radiation, superior corona radiata, superior frontal occipital fasciculus, and superior longitudinal fasciculus) and worsening of frailty over 5 years after adjusting for multiple comparisons. CONCLUSIONS This is the first study to show that WM integrity is associated with frailty in older adults. The mechanisms related to these results require further investigation. J Am Geriatr Soc 68:1050-1055, 2020.
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Affiliation(s)
- Mathieu Maltais
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Philipe de Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,France Faculté de Médecine, Unités mixtes de recherche (UMR) Institut national de la santé et de la recherche médicale (INSERM) 1027, University of Toulouse III, Toulouse, France
| | - Lisa Perus
- Memory Resources and Research Center, Montpellier University Hospital, INSERM U1061, University of Montpellier i-Site Montpellier Université d'Excellence (MUSE), Montpellier, France
| | - Jean-François Mangin
- CATI Multicenter Neuroimaging Platform, Neurospin, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Paris Saclay University, Gif sur Yvette, France
| | - Antoine Grigis
- CATI Multicenter Neuroimaging Platform, Neurospin, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Paris Saclay University, Gif sur Yvette, France
| | - Marie Chupin
- CATI Multicenter Neuroimaging Platform, Neurospin, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Paris Saclay University, Gif sur Yvette, France
| | - Ali Bouyahia
- CATI Multicenter Neuroimaging Platform, Neurospin, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Paris Saclay University, Gif sur Yvette, France
| | - Audrey Gabelle
- Memory Resources and Research Center, Montpellier University Hospital, INSERM U1061, University of Montpellier i-Site Montpellier Université d'Excellence (MUSE), Montpellier, France
| | - Julien Delrieux
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,France Faculté de Médecine, Unités mixtes de recherche (UMR) Institut national de la santé et de la recherche médicale (INSERM) 1027, University of Toulouse III, Toulouse, France
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,France Faculté de Médecine, Unités mixtes de recherche (UMR) Institut national de la santé et de la recherche médicale (INSERM) 1027, University of Toulouse III, Toulouse, France
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Verwer JH, Reijmer YD, Koek HL, Biessels GJ. Reply to: Comment on Physical Performance in Memory Clinic Patients: The Potential Role of the White Matter Network. J Am Geriatr Soc 2019; 67:2666-2667. [PMID: 31520413 DOI: 10.1111/jgs.16160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 08/09/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Jurre H Verwer
- Department of Neurology, Neurosurgery, and Neuropsychology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Yael D Reijmer
- Department of Neurology, Neurosurgery, and Neuropsychology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Huiberdina L Koek
- Department of Geriatrics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Geert Jan Biessels
- Department of Neurology, Neurosurgery, and Neuropsychology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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