背景:路易体痴呆(DLB)是认知行为障碍的原因,也是步态障碍的原因。后者被认为与帕金森病有关,但是这些疾病的神经基础并不清楚,尤其是在早期阶段。这项研究的目的是通过容积磁共振成像来研究DLB患者步态障碍的神经元基础。与健康老年人对照和阿尔茨海默病患者相比。
方法:具有运动评估的临床检查,包括10米步行速度,单腿平衡和定时向上和去测试,对84例DLB患者进行了全面的神经心理学评估和3D脑磁共振成像,39名阿尔茨海默病患者和22名健康老年人对照。我们使用统计参数映射12进行单样本t检验,以研究每个步态评分与灰质体积之间的相关性(P≤0.05,校正为家庭误差)。
结果:我们发现DLB患者的步行速度与尾状核灰质减少之间存在相关性(P<0.05,经家庭误差校正),前扣带皮质,中扣带皮质,海马,辅助电机区域,右小脑皮质和左顶叶盖层。我们发现与TimedUp和Go测试和单腿平衡没有相关性。
结论:步态障碍是由某些经典区域如小脑和辅助运动区支撑的。我们的结果表明,DLB受试者的自愿步态可能存在动机和情感成分,以扣带皮质为支撑,空间方向组件,以海马为基础,提示大脑处理速度和帕金森病的参与,由尾状核支撑。
背景:研究方案已在ClinicalTrials.gov上注册。(NCT01876459),2013年6月12日。
BACKGROUND: Dementia with Lewy Bodies (DLB) is responsible for cognitive-behavioural disorders but also for gait disorders. The latter are thought to be related to parkinsonism, but the neural bases of these disorders are not well known, especially in the early stages. The aim of this study was to investigate by volumetric Magnetic Resonance Imaging the neuronal basis of gait disorders in DLB patients, compared to Healthy Elderly Controls and Alzheimer\'s Disease patients.
METHODS: Clinical examination with motor assessment including 10-meter walking speed, one-leg balance and Timed Up and Go test, a comprehensive neuropsychological evaluation and 3D brain Magnetic Resonance Imaging were performed on 84 DLB patients, 39 Alzheimer\'s Disease patients and 22 Healthy Elderly Controls. We used Statistical Parametric Mapping 12 to perform a one-sample t-test to investigate the correlation between each gait score and gray matter volume (P ≤ 0.05 corrected for family-wise error).
RESULTS: We found a correlation for DLB patients between walking speed and gray matter decrease (P < 0.05, corrected for family-wise error) in caudate nuclei, anterior cingulate cortex, mid-cingulate cortex, hippocampi, supplementary motor area, right cerebellar cortex and left parietal operculum. We found no correlation with Timed Up and Go test and one-leg balance.
CONCLUSIONS: Gait disorders are underpinned by certain classical regions such as the cerebellum and the supplementary motor area. Our results suggest there may be a motivational and emotional component of voluntary gait in DLB subjects, underpinned by the cingulate cortex, a spatial orientation component, underpinned by hippocampi and suggest the involvement of brain processing speed and parkinsonism, underpinned by the caudate nuclei.
BACKGROUND: The study protocol has been registered on ClinicalTrials.gov. (NCT01876459) on June 12, 2013.