Objectives

To investigate cerebellar lobule atrophy patterns in elderly fallers (EFs) and their association with gait and cognitive performance.

Background

Cognitive impairments, gait, and balance deficits are major risk factors for falls in older adults, however, their neural fingerprints remain poorly understood. Recent evidence from neuroimaging studies highlight the role of the cerebellum in both sensorimotor and cognitive networks, suggesting that it may contribute to fall risk.

Methods

Fourteen EFs (mean age ± SD = 78 ± 1.5 yrs.) and 20 healthy controls (HCs) (mean age ± SD = 69.6 ± 1.3 yrs.) underwent a 3 T MRI scan obtaining 3D T1-weighted images, cognitive, and gait assessments. Cerebellar lobule segmentation was performed, and the obtained cerebellar lobules volumes were adjusted for intracranial volume (ICV). The relationship between lobules volumes, gait, and cognitive performance scores was assessed using hierarchical multiple linear regression adjusted for age and gender.

Results

EFs exhibited lower cerebellar volumes in the posterior cerebellum, lobules V, VI, VIIB, VIIIA, VIIIB, and Crus II, and significantly higher volumes in the anterior cerebellum and lobule IV (p = 0.018 and p = 0.046) compared to HCs. In EFs, lobule V, VI, VIIB, VIIIA, VIIIB, and anterior cerebellum volumes were found to be independent predictors of usual walking (UW) gait speed, dual-task (DT) gait speed, mini Best, MOCA, CTTa, and CTTb (p < 0.05).

Conclusions

The observed patterns of cerebellar lobule atrophy and their associations with motor and cognitive performance scores suggest that cerebellar atrophy contributes to the pathophysiology of fall risk in EFs.

中文翻译：

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步态和认知异常与老年跌倒者的局部小脑萎缩有关——一项初步研究

目标

研究老年跌倒者 (EF) 的小脑小叶萎缩模式及其与步态和认知能力的关系。

背景

认知障碍、步态和平衡缺陷是老年人跌倒的主要危险因素，然而，他们的神经指纹仍然知之甚少。最近来自神经影像学研究的证据强调了小脑在感觉运动和认知网络中的作用，表明它可能有助于跌倒风险。

方法

14 名 EF（平均年龄 ± SD = 78 ± 1.5 岁）和 20 名健康对照（HC）（平均年龄 ± SD = 69.6 ± 1.3 岁）进行了 3 T MRI 扫描，获得了 3D T1 加权图像、认知和步态评估。进行小脑小叶分割，并根据颅内体积（ICV）调整获得的小脑小叶体积。使用针对年龄和性别调整的分层多元线性回归评估小叶体积、步态和认知表现评分之间的关​​系。

结果

与 HC 相比，EF 在小脑后部、小叶 V、VI、VIIB、VIIIA、VIIIB 和 Crus II 中表现出较低的小脑体积，而在小脑前部和小叶 IV 中的体积显着较高（p = 0.018 和p = 0.046）。在 EF 中，小叶 V、VI、VIIB、VIIIA、VIIIB 和小脑前体积被发现是正常步行 (UW) 步态速度、双任务 (DT) 步态速度、迷你最佳、MOCA、CTTa 和CTTb ( p < 0.05)。

结论

观察到的小脑小叶萎缩模式及其与运动和认知能力评分的关联表明小脑萎缩有助于 EF 跌倒风险的病理生理学。