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The impact of cerebral small vessel disease burden and its imaging markers on gait, postural control, and cognition in Parkinson’s disease

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Abstract

Objective

This study aimed to investigate how cerebral small vessel disease (CSVD) burden and its imaging markers are related to alterations in different gait parameters in Parkinson’s disease (PD) and whether they affect attention, information processing speed, and executive function when global mental status is relatively intact.

Methods

Sixty-five PD patients were divided into the low CSVD burden group (n = 43) and the high CSVD burden group (n = 22). All patients underwent brain magnetic resonance imaging scans, clinical scale evaluations, and neuropsychological tests, as well as quantitative evaluation of gait and postural control. Multivariable linear regression models were conducted to investigate associations between CSVD burden and PD symptoms.

Results

Between-group analysis showed that the high CSVD group had worse attention, executive dysfunction, information processing speed, gait, balance, and postural control than the low CSVD group. Regression analysis revealed that greater CSVD burden was associated with poor attention, impaired executive function, and slow gait speed; white matter hyperintensity was associated with slow gait speed, decreased cadence, increased stride time, and increased stance phase time; the presence of lacune was associated only with poor attention and impaired executive function; enlarged perivascular space in the basal ganglia was associated with gait speed.

Conclusions

CSVD burden may worsen gait, postural control, attention, and executive function in patients with PD, and different imaging markers play different roles. Early management of vascular risks and treatment of vascular diseases provide an alternate way to mitigate some motor and cognitive dysfunction in PD.

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Acknowledgements

We are grateful to all the patients and the medical staff of the Neurological Rehabilitation Center of Beijing Rehabilitation Hospital who contributed to this project.

Funding

This study was supported by the National Key R&D Program of China (No. 2018YFC0115405) for BF and the Science and Technology Development Fund of Beijing Rehabilitation Hospital, Capital Medical University (2019R-006 for ZJ; 2020–069 for BF; 2020–051 for HY).

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Authors and Affiliations

  1. Capital Medical University, Beijing, China

    Keke Chen

  2. Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China

    Zhaohui Jin, Jinping Fang, Lin Qi, Cui Liu, Ruidan Wang, Yuan Su, Hongjiao Yan, Aixian Liu, Jianing Xi & Boyan Fang

  3. Radiology Department, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China

    Qiping Wen

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Contributions

Author contributions included conception and study design (BF, JX, AL, ZJ, QW, and KC), data collection or acquisition (ZJ, JF, LQ, CL, RW, YS, HY, QW, and KC), statistical analysis (BF and KC), interpretation of results (BF and JX), drafting the manuscript work (KC and QW), revising the manuscript critically for important intellectual content (BF, JX, AL, and QW), and approval of final version to be published and agreement to be accountable for the integrity and accuracy of all aspects of the work (KC, ZJ, JF, LQ, CL, RW, YS, HY, AL, JX, QW, and BF).

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Correspondence to Qiping Wen or Boyan Fang.

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This study was performed in line with the principles of the Declaration of Helsinki and was approved by the Institutional Ethics Committee of Beijing Rehabilitation Hospital, Capital Medical University (approval No. 2021bkky-001).

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Informed consents were obtained from all participants and/or their legal guardian(s) prior to inclusion.

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Qiping Wen and Boyan Fang share last authorship.

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Chen, K., Jin, Z., Fang, J. et al. The impact of cerebral small vessel disease burden and its imaging markers on gait, postural control, and cognition in Parkinson’s disease. Neurol Sci 44, 1223–1233 (2023). https://doi.org/10.1007/s10072-022-06563-1

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