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Effect of small vessel disease burden and lacunes on gait/posture impairment in Parkinson’s disease

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Abstract

Introduction

The comorbidity of cerebral small vessel disease (CSVD) may worsen gait impairment of Parkinson’s disease (PD). However, the evidence remains scarce and controversial, and the mechanism of their potential interaction remains largely unknown. The present study aimed to investigate the overall impact of quantity and location of CSVD on gait/posture function in PD.

Methods

This cross-sectional study included 315 consecutive eligible patients with PD from Beijing Tiantan Hospital from May 2016 to August 2018. Associations of gait/posture subscores with the burden score of CSVD and four CSVD imaging markers were assessed using multivariate linear regression models.

Results

Burden of CSVD was significantly associated with more severe gait/posture impairment in PD in the unadjusted model (β = 0.521, P = 0.011, 95% CI 0.118–0.923) and in the model adjusted for age, hypertension, ischemic stroke, low-density lipoprotein level, cholesterol level, and cognitive statues (β = 0.448, P = 0.047, 95% CI 0.006–0.891). The presence of lacunes, but not other CSVD markers, was significantly associated with higher gait/posture subscores after the adjustment (β = 0.492, P = 0.041, 95% CI 0.021–0.964), and the number of lacunes in the basal ganglia significantly correlated with the gait/posture subscores in patients with PD (P = 0.012, Spearman r = 0.161).

Conclusions

CSVD and lacunes in the basal ganglia may independently contribute to gait/posture dysfunction in PD. Promoting neurovascular health may preserve some gait/posture function of PD.

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Funding

The study was supported by grants from the National Natural Science Foundation of China (Nos. 81771367 and 81571226), the Ministry of Science and Technology of the People’s Republic of China (Nos. 2017YFC1310203 and 2016YFC1306501), and Beijing Municipal Science and Technology Commission (No. Z171100000117013).

Author information

Authors and Affiliations

  1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Huimin Chen, Meimei Zhang, Gengliang Liu, Xuemei Wang, Zhan Wang, Huizi Ma, Yuesong Pan, Yilong Wang & Tao Feng

  2. China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China

    Huimin Chen, Meimei Zhang, Gengliang Liu, Xuemei Wang, Zhan Wang, Huizi Ma, Yuesong Pan, Yilong Wang & Tao Feng

  3. Advanced Innovation Center for Human Brain Projection, Capital Medical University, Beijing, China

    Huimin Chen, Meimei Zhang, Gengliang Liu, Xuemei Wang, Zhan Wang, Huizi Ma, Yuesong Pan, Yilong Wang & Tao Feng

  4. Illinois Neurological Institute Stroke Network, Sisters of the Third Order of St Francis Healthcare System, University of Illinois College of Medicine, Peoria, USA

    David Wang

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  1. Huimin Chen
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Correspondence to Tao Feng.

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This study was approved by the Ethics Committee of the Beijing Tiantan Hospital and was performed in accordance with the Declaration of Helsinki. Informed consent was obtained either from the participants or their closest relatives.

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Chen, H., Zhang, M., Liu, G. et al. Effect of small vessel disease burden and lacunes on gait/posture impairment in Parkinson’s disease. Neurol Sci 41, 3617–3624 (2020). https://doi.org/10.1007/s10072-020-04452-z

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