Neurology 2000;54:1277-1283
© 2000 American Academy of Neurology
Articles
White matter abnormalities in mobility-impaired older persons
C. R. G. Guttmann, MD,
R. Benson, MD,
S. K. Warfield, PhD,
X. Wei, MD,
M. C. Anderson, MS,
C. B. Hall, PhD,
K. Abu-Hasaballah, PhD,
J. P. Mugler, III, PhD and
L. Wolfson, MD
From the Department of Radiology (Drs. Guttmann, Warfield, and Wei, and M.C. Anderson), Brigham & Women’s Hospital, Harvard Medical School, Boston, MA; the Departments of Neurology (Drs. Benson, Hall, Abu-Hasaballah, and Wolfson), and Community Medicine and Health Care (Dr. Hall), University of Connecticut Health Center; the Department of Statistics (Dr. Hall), University of Connecticut, Storrs, CT; and Departments of Radiology and Biomedical Engineering (Dr. Mugler), University of Virginia Health Sciences Center, Charlottesville, VA.
Address correspondence and reprint requests to Dr. Charles R.G. Guttmann, Department of Radiology, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA 02115; e-mail: guttmann{at}bwh.harvard.edu
OBJECTIVE: To investigate the relationship between white matter abnormalities and impairment of gait and balance in older persons.
METHODS: Quantitative MRI was used to evaluate the brain tissue compartments of 28 older individuals separated into normal and impaired groups on the basis of mobility performance testing using the Short Physical Performance Battery. In addition, individuals were tested on six indices of gait and balance. For imaging data, segmentation of intracranial volume into four tissue classes was performed using template-driven segmentation, in which signal-intensity–based statistical tissue classification is refined using a digital brain atlas as anatomic template.
RESULTS: Both decreased white matter volume, which was age-related, and increased white matter signal abnormalities, which were not age-related, were observed in the mobility-impaired group compared with the control subjects. The average volume of white matter signal abnormalities for impaired individuals was nearly double that of control subjects.
CONCLUSIONS: This cross-sectional study suggests that decreased white matter volume is age-related, whereas increased white matter signal abnormalities are most likely to occur as a result of disease. Both of these changes are independently associated with impaired mobility in older persons and therefore likely to be additive factors of motor disability.
Key words: Aging—Brain—Gait—Balance—White matter—MRI—Image processing.
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