Impact of small vessel disease in the brain on gait and balance
Open accessAbstract
Gait and balance impairment is highly prevalent in older people. We aimed to assess whether and how single markers of small vessel disease (SVD) or a combination thereof explain gait and balance function in the elderly. We analysed 678 community-dwelling healthy subjects from the Lothian Birth Cohort 1936 at the age of 71-74 years who had undergone comprehensive risk factor assessment, gait and balance assessment as well as brain MRI. We investigated the impact of individual SVD markers (white matter hyperintensity - WMH, microbleeds, lacunes, enlarged perivascular spaces, brain atrophy) as seen on structural brain MRI and of a global SVD score on the patients' performance. A regression model revealed that age, sex, and hypertension significantly explained gait speed. Among SVD markers white matter hyperintensity (WMH) score or volume were additional significant and independent predictors of gait speed in the regression model. A similar association was seen with the global SVD score. Our study confirms a negative impact of SVD-related morphologic brain changes on gait speed in addition to age, sex and hypertension independent from brain atrophy. The presence of WMH seems to be the major driving force for SVD on gait impairment in healthy elderly subjects.
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Neurodegenerative disorders that affect posture and gait such as Parkinson's disease, cerebellar degeneration, including the downbeat nystagmus syndrome, and small vessel white matter disease may manifest with dizziness or unsteadiness when standing or walking before motor signs can be detected on physical examination.
“Neurodegenerative disorders that affect posture and gait such as Parkinson’s disease, cerebellar degeneration [61], including the downbeat nystagmus syndrome [89], and small vessel white matter disease [2, 16, 66] may manifest with dizziness or unsteadiness when standing or walking before motor signs can be detected on physical examination.”
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- Authors
- Pinter, D., Ritchie, S. J., Doubal, F., Gattringer, T., Morris, Z., Bastin, M. E., del C. Valdés Hernández, M., Royle, N. A., Corley, J., Muñoz Maniega, S., Pattie, A., Dickie, D. A., Staals, J., Gow, A. J., Starr, J. M., Deary, I. J., Enzinger, C., Fazekas, F., & Wardlaw, J.
- Affiliations
- Medical University of Graz (AT)
- University of Edinburgh (GB)
- Maastricht University Medical Centre (NL)
- Heriot-Watt University (GB)
- Alzheimer Scotland (GB)
- Corresponding author
- Wardlaw, Joanna
- ORCID
- Venue
- Scientific Reports
- Published
- 2017-01-30
- Volume
- 7
- Issue
- 1
- Pages
- 41637-41637
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC5278543
- OpenAlex
- W2582661451
- Cited by
- 130
- References
- 41
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 16 · 2023: 9 · 2022: 17 · 2021: 22 · 2020: 12 · 2019: 19 · 2018: 10 · 2017: 6
- FWCI
- 8.87
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- Scottish Funding Council
- Age UK (LBC1936)
- University of Edinburgh
- Austrian Science Fund (T690)
- Centre for Cognitive Ageing and Cognitive Epidemiology
- Directorate for Biological Sciences
- Medical Research Council (MR/K026992/1, MR/M013111/1, MR/N003403/1, LBC1936)
- Biotechnology and Biological Sciences Research Council (LBC1936)
- Topics
- Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- cerebral small vessel disease, walking speed, balance, white matter hyperintensities, microbleeds, lacunes, perivascular spaces, brain atrophy, older adults, hypertension, brain MRI markers
- MeSH terms
- Aged, Brain, Postural Balance, Female, Gait, Humans, Magnetic Resonance Imaging, Male, Cerebral Small Vessel Diseases
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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