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• Clinical Article •
A study of white matter lesions in older people with fall risk using diffusion tensor imaging
SHEN Hui-cong  LI Zheng-ran  CHANG Tian-jing  ZHANG Ning  WANG Chun-xue  MA Jun 

DOI:10.12015/issn.1674-8034.2016.06.005.


[Abstract] Objective: To analyze the diffusion tensor imaging (DTI) and clinical characteristic of the aged who had white matter lesions with fall risks, quantify the fall risk index and provide a basis for fall precautions.Materials and Methods: People aged more than 60 years old with brain white matter lesions from Beijing Tiantan Hospital, Capital Medical University, were included in study, according to the Tinetti Balance and Gait Analysis, 15 patients were divided into experimental group (Tinetti<25) and 29 contrast group (Tinetti≥25). The significantly different white matter fiber tracts were identified by Tract Based Spatial Statistics (TBSS) and were also made correlation analysis with MoCA, MMSE, Tinetti Gait Analysis, Tinetti Balance Analysis and TUGT.Results: There was statistic significance in the score of MMSE (t=2.806, P=0.008) and MoCA (t=2.890, P=0.006) between two groups with white matter lesions. In subjects with risk of falls, the mean FA of whole brain was lower than that of contrast group (t=2.862, P=0.007), and was positively correlated with MMSE (r=0.533, P=0.041) and MoCA (r=0.642, P=0.010). Significantly abnormal FA clusters (representing loss of WM integrity) of patients with risk of falls were seen in the right fasciculus uncinatus, genu, body and splenium of corpus callosum, both anterior corona radiate, right superior corona radiate, right superior longitudinal fasciculus and left cingulate gyrus. The mean FA of corpus callosum-genu, right superior corona radiate, body of corpus callosum, splenium of corpus callosum, right superior longitudinal fasciculus and left cingulate gyrus were positively correlated with MoCA scores in those with risk of falls(P<0.05). The mean FA of right fasciculus uncinatus (r=0.562, P=0.029) was positively correlated with Tinetti Balance Analysis. The mean FA of right fasciculus uncinatus (r=0.572, P=0.026), body of corpus callosum (r=0.538, P=0.038), splenium of corpus callosum (r=0.580, P=0.023) and left cingulate gyrus (r=0.520, P=0.047) were positively correlated with Tinetti Gait Analysis. The mean FA of body of corpus callosum (r=-0.582, P=0.023) and left cingulate gyrus (r=-0.538, P=0.039) were negatively correlated with TUGT.Conclusion: In subjects with risk of falls, the mean FA of whole brain and some white matter fiber tracts decreased, these differences were correlated with cognition, balance and gait. Therefore, DTI can identify the structural changes in brain of those with risk of falls and quantify the fall risk index.
[Keywords] Aged；Leukoencephalopathies；Accidental falls；Diffusion tensor imaging

SHEN Hui-cong Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China

LI Zheng-ran Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China

CHANG Tian-jing Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China

ZHANG Ning Department of Neuropsychological and Clinical Psychology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing 100050, China

WANG Chun-xue Department of Neuropsychological and Clinical Psychology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing 100050, China

MA Jun* Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China

*Correspondence to: Ma J, E-mail: dr_ma@sina.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of Beijing Natural Science Foundation No. 7092027 supported by Beijing Municipal Science & Technology Commission NO. Z151100003915117
Received  2016-04-20
Accepted  2016-05-18
DOI: 10.12015/issn.1674-8034.2016.06.005
DOI:10.12015/issn.1674-8034.2016.06.005.

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