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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.

[1]
Lamb SE, Jorstad-Stein EC, Hauer K, et al. Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. J Am Geriatr Soc, 2005, 53(9): 1618-1622.
[2]
Tinetti ME, Williams CS. Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med, 1997, 337(18): 1279-1284.
[3]
周白瑜，石婧，于普林. 北京市社区老年人跌倒情况及其后果的相关因素研究. 中华流行病学杂志, 2013, 34(8): 778-781.
[4]
Renfro MO, Fehrer S. Multifactorial screening for fall risk in community-dwelling older adults in the primary care office: development of the fall risk assessment & screening tool. J Geriatr Phys Ther, 2011, 34(4): 174-183.
[5]
Murray ME, Senjem ML, Petersen RC, et al. Functional impact of white matter hyperintensities in cognitively normal elderly subjects. Arch Neurol, 2010, 67(11): 1379-1385.
[6]
Bruijn SM, Van Impe A, Duysens J, et al. White matter microstructural organization and gait stability in older adults. Front Aging Neurosci, 2014(6): 104.
[7]
Morley JE. White matter lesions (leukoaraiosis): a major cause of falls. J Am Med Dir Assoc, 2015, 16(6): 441-443.
[8]
Koo BB, Bergethon P, Qiu WQ, et al. Clinical prediction of fall risk and white matter abnormalities: a diffusion tensor imaging study. Arch Neurol, 2012, 69(6): 733-738.
[9]
戴建平，沈慧聪，李少武. 磁共振脉冲序列在中枢神经系统中的应用（二). 磁共振成像, 2010, 1(4): 305-310.
[10]
Wardlaw JM, Smith EE, Biessels GJ, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol, 2013, 12(8): 822-838.
[11]
Madden DJ, Bennett IJ, Burzynska A, et al. Diffusion tensor imaging of cerebral white matter integrity in cognitive aging. Biochim Biophys Acta, 2012, 1822(3): 386-400.
[12]
Srikanth V, Beare R, Blizzard L, et al. Cerebral white matter lesions, gait, and the risk of incident falls: a prospective population-based study. Stroke, 2009, 40(1): 175-180.
[13]
张舒校，王建平，苗勤, 等. 脑白质疏松症患者分级与跌倒风险的相关性研究. 中华神经医学杂志, 2013, 12(8): 794-796.
[14]
杨烁慧，詹松华，陆方, 等. 基于DTI技术的急性中风患者缺血脑白质纤维束的扩散性与神经功能恢复的相关性研究. 磁共振成像, 2015, 6(10): 727-733.
[15]
苟辉亮，黎胜强，覃颖, 等. 精神分裂症患者脑白质纤维扩散张量成像测量方法研究. 磁共振成像, 2016, 7(3): 161-166.
[16]
Salo R, Nordahl TE, Buonocore MH, et al. Cognitive control and white matter callosal microstructure in methamphetamine-dependent subjects: a diffusion tensor imaging study. Biol Psychiatry, 2009, 65(2): 122-128.
[17]
Amboni M, Barone P, Hausdorff JM. Cognitive contributions to gait and falls: evidence and implications. Mov Disord, 2013, 28(11): 1520-1533.
[18]
王海燕，赵斌，王光彬. 磁共振扩散张量成像在显示正常人脑白质纤维中的应用. 中国医学影像技术, 2006, 22(9): 1325-1329.
[19]
李亚迪，董海波，谢国民, 等. 基于纤维束空间统计分析多参数DTI在遗忘型轻度认知障碍的应用. 放射学实践, 2012, 27(6): 598-602.
[20]
Greicius MD, Krasnow B, Reiss AL, et al. Functional connectivity in the resting brain: a network analysis of the default mode hypothesis. Proc Natl Acad Sci U S A, 2003, 100(1): 253-258.
[21]
Kreisel SH, Blahak C, Bazner H, et al. Deterioration of gait and balance over time: the effects of age-related white matter change-the LADIS study. Cerebrovasc Dis, 2013, 35(6): 544-553.
[22]
Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas, 2013, 75(1): 51-61.
[23]
李真，盛净，马绍骏. 老年人跌倒相关危险因素的研究进展.老年医学与保健, 2015, 21(2): 121-123.
[24]
Wrisley DM, Kumar NA. Functional gait assessment: concurrent, discriminative, and predictive validity in community-dwelling older adults. Phys Ther, 2010, 90(5): 761-773.
[25]
Koerte I, Pelavin P, Kirmess B, et al. Anisotropy of transcallosal motor fibres indicates functional impairment in children with periventricular leukomalacia. Dev Med Child Neurol, 2011, 53(2): 179-186.
[26]
Moscufo N, Guttmann CR, Meier D, et al. Brain regional lesion burden and impaired mobility in the elderly. Neurobiol Aging, 2011, 32(4): 646-654.
[27]
Inzitari D, Pracucci G, Poggesi A, et al. Changes in white matter as determinant of global functional decline in older independent outpatients: three year follow-up of LADIS (leukoaraiosis and disability) study cohort. BMJ, 2009, 339: b2477.

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