Association of Dual-Task Gait Cost and White Matter Hyperintensity Burden Poststroke: Results From the ONDRI

Author:

Pieruccini-Faria Frederico1ORCID,Cornish Benjamin2,Binns Malcolm3,Fraser Julia2,Haddad Seyyed M. H.4,Sunderland Kelly3,Ramirez Joel5,Beaton Derek6,Kwan Donna7,Dilliott Allison A.8,Scott Christopher5,Sarquis-Adamson Yanina1,Black Alanna1,Van Ooteghem Karen2,Casaubon Leanne9,Dowlatshahi Dar10,Hassan Ayman11,Mandzia Jennifer12,Sahlas Demetrios13,Saposnik Gustavo14,Tan Brian3,Hegele Robert4,Bulman Dennis10,Ghani Mahdi15,Robinson John4,Rogaeva Ekaterina15,Farhan Sali16,Symons Sean5,Nanayakkara Nuwan4,Arnott Stephen R.3,Berezuk Courtney5,Holmes Melissa5,Adamo Sabrina5,Ozzoude Miracle5,Zamyadi Mojdeh3,Lou Wendy17,Sujanthan Sujeevini18,Bartha Robert4,Black Sandra E.9ORCID,Swartz Richard H.5,McIlroy William2,Montero-Odasso Manuel19

Affiliation:

1. Gait and Brain Lab, St. Joseph’s Hospital, Parkwood Institute, Lawson Health Research Institute, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

2. Neuroscience, Mobility and Balance Lab (NiMBaL), Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada

3. Rotman Research Institute, Baycrest Centre, Toronto, ON, Cananda; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

4. Department of Medicine, Robarts Research Institute, Schulich of Medicine and Dentistry, Western University, London, Ontario, Canada

5. Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada

6. Data Science & Advanced Analytics, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada

7. Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada

8. Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Robarts Research Institute, Western University, London, ON, Canada

9. Department of Medicine, Sunnybrook HSC, University of Toronto; Dr. Sandra Black Centre for Brain Resilience and Recovery; Hurvitz Brain Sciences Research Program Director, Sunnybrook Research Institute; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery Sunnybrook Health Sciences Centre, Toronto, ON, Canada

10. Department of Medicine, University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, ON, Canada

11. Thunder Bay Regional Research Institute, Northern Ontario School of Medicine, Thunder Bay, ON, Canada

12. Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, and London Health Sciences Center, London, ON, Canada

13. Division of Neurology, Department of Medicine, McMaster University, Hamilton, ON, Canada

14. St. Michaels Hospital, University of Toronto, Toronto, ON, Canada

15. Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada

16. Department of Neurology and Neurosurgery, Department of Human Genetics, The Montreal Neurological Institute, McGill University, Montreal, QC, Canada

17. Dalla Lana School of Public Health; University of Toronto, Toronto, ON, Canada

18. Department of Ophthalmology and Visual Sciences, Research Institute of the McGill University Health Center, Montreal, QC, Canada

19. Department of Medicine (Geriatrics) and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

Abstract

Background Acute change in gait speed while performing a mental task [dual-task gait cost (DTC)], and hyperintensity magnetic resonance imaging signals in white matter are both important disability predictors in older individuals with history of stroke (poststroke). It is still unclear, however, whether DTC is associated with overall hyperintensity volume from specific major brain regions in poststroke. Methods This is a cohort study with a total of 123 older (69 ± 7 years of age) participants with history of stroke were included from the Ontario Neurodegenerative Disease Research Initiative. Participants were clinically assessed and had gait performance assessed under single- and dual-task conditions. Structural neuroimaging data were analyzed to measure both, white matter hyperintensity (WMH) and normal appearing volumes. Percentage of WMH volume in frontal, parietal, occipital, and temporal lobes as well as subcortical hyperintensities in basal ganglia + thalamus were the main outcomes. Multivariate models investigated associations between DTC and hyperintensity volumes, adjusted for age, sex, years of education, global cognition, vascular risk factors, APOE4 genotype, residual sensorimotor symptoms from previous stroke and brain volume. Results There was a significant positive global linear association between DTC and hyperintensity burden (adjusted Wilks’ λ = .87, P = .01). Amongst all WMH volumes, hyperintensity burden from basal ganglia + thalamus provided the most significant contribution to the global association (adjusted β = .008, η2 = .03; P = .04), independently of brain atrophy. Conclusions In poststroke, increased DTC may be an indicator of larger white matter damages, specifically in subcortical regions, which can potentially affect the overall cognitive processing and decrease gait automaticity by increasing the cortical control over patients’ locomotion.

Funder

Ontario Brain Institute

Publisher

SAGE Publications

Subject

General Medicine

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