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Potential conflict of interest: The authors report no conflicts of interest.
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Original Article
White matter lesions volume and motor performances in the elderly†
Article first published online: 23 MAR 2009
DOI: 10.1002/ana.21674
Copyright © 2009 American Neurological Association
Additional Information
How to Cite
Soumaré, A., Elbaz, A., Zhu, Y., Maillard, P., Crivello, F., Tavernier, B., Dufouil, C., Mazoyer, B. and Tzourio, C. (2009), White matter lesions volume and motor performances in the elderly. Annals of Neurology, 65: 706–715. doi: 10.1002/ana.21674
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Publication History
- Issue published online: 25 JUN 2009
- Article first published online: 23 MAR 2009
- Accepted manuscript online: 23 MAR 2009 12:00AM EST
- Manuscript Accepted: 13 FEB 2009
- Manuscript Revised: 12 FEB 2009
- Manuscript Received: 22 MAY 2008
Funded by
- Fondation pour la Recherche Médicale
- Caisse Nationale Maladie des Travailleurs Salariés
- Direction Générale de la Santé
- Haute Autorité de la Santé
- Institut National de Prévention et d'Education pour la Santé
- Conseils Régionaux of Bourgogne
- Fondation de France
- Ministry of Research-INSERM Program “Cohortes et collections de données biologiques,” Mutuelle Générale de l'Education Nationale
- Institut de la Longévité
- Conseil Général de la Côte d'or
- PhD scholarship from the Fondation pour la Recherche Médicale
- French Chinese Foundation for Science and Applications
- China Scholarship Council
- Association de Recherche en Neurologie Vasculaire
- Abstract
- Article
- References
- Cited By
Abstract
Objectives
To investigate the cross-sectional and longitudinal associations between performance-based measures of motor function and volume of white matter lesions (WMLs), and to examine the influence of the localization of these lesions.
Methods
At baseline, motor performances (maximum walking speed, Tinetti gait and balance subscales) were assessed in 1,702 subjects aged 80 years or younger from the Dijon (France), France center of the Three-City study. Volumes of WMLs lesions (total, periventricular, deep) were measured using an automated method of tissue segmentation and quantification of lesion size. At 8-year follow-up, walking speed was evaluated in 1,086 subjects.
Results
At baseline, mean and 95% confidence interval (CI) walking speed was lower in subjects with total volumes of WMLs ≥90th percentile (1.50 [1.45–1.55] m/s) than in subjects with lower volumes (1.56 [1.55–1.58] m/s; p = 0.004). Baseline total volumes of WMLs above the 90th percentile predicted walking speed decline during follow-up (odds ratio [95% CI] for having the greatest walking speed decline = 2.3 [1.3–4.1], p = 0.006). Moreover, high volumes of periventricular but not deep WMLs were associated with slower walking speed at baseline (p = 0.005) and over time (p = 0.001), and with lower Tinetti gait subscore (p = 0.02).
Interpretation
Our study shows a cross-sectional and longitudinal association between high total volumes of WMLs, in particular volumes above the 90th percentile, and impaired mobility. These associations were independent of several confounders, including cognition, and were mainly accounted for by volumes of periventricular WMLs. These findings support the hypothesis of a vascular contribution to motor decline in the elderly. Ann Neurol 2009;65:706–715