| Part Ⅰ:White matter hyperintensities and gait and balance dysfunctionObjective: Through the study of evaluating the gait and balance function of patients with white matter hyperintensity and healthy adults,objective to investigate the correlation between WMH and gait and balance dysfunction,and analyze the characteristics of gait and balance dysfunction in patients with WMH,so as to provide clues and basis for quick and simple diagnosis of WMH,and provide data support for predicting falls,reducing disability and improving patients’ quality of life Objective to provide more intuitive and effective fall prevention and control for WMH patients with gait and balance dysfunction.Method:Firstly,94 inpatients and outpatients with WMH in the Department of Neurology,Affiliated Hospital of Inner Mongolia Medical University from November 2019 to February 2021 were selected as the case group,and 60 healthy adults matched with the case group in age,gender and other general indicators,and not suffering from CSVD confirmed by magnetic resonance imaging(MRI)were selected as the control group.Secondly,WMH patients were divided into periventricular white matter hyperintensities(PWMHs)group and deep white matter hyperintensities(DWMHs)group according to different parts of the lesions,and were divided into three grades according to the severity of the lesions.All patients underwent clinical consultation,systemic physical examination of nervous system and MRI examination,including T1 weighted imaging,T2 weighted imaging,diffusion weighted imaging(DWI),fluid attenuated inversion recovery,The gait and balance function were evaluated by three scales: timed standing and walking test,short physical performance battery and Tinetti balance and gait scale.Spss25.0 statistical software package was used for statistical analysis.Results:(1)A total of 154 subjects were included in this study,including 94 cases(61.0%)in the case group and 60 cases(39.0%)in the control group.54 cases were PWMHs group(57.4%),40 cases were DWMHs group(42.6%).(2)Compared with the control group,the total score of the case group was significantly higher than that of the control group,and the total score of SPPB and Tinetti balance and gait scale was lower than that of the control group(P < 0.01).The scores of tandem station,repeated standing,walking speed,elbow nudge,eye closure and step length in the case group were significantly lower than those in the control group(P < 0.01).(3)The motor dysfunction caused by different parts of WMH has its own characteristics.The instant standing balance,step continuity and path score of PWMHs group were lower than those of DWMHs group,and the difference was statistically significant(P <0.05).There was no significant difference between PWMHs group and DWMHs group in timed standing and walking test,SPPB and total score of Tinetti(P > 0.05).(4)The more severe WMH was,the more severe the influence on motor function was.The total score of pwmhs of grade 3 was higher than that of grade 1 and grade 2,and the total score of SPPB and Tinetti balance and gait scale was significantly lower than that of the other two groups(P< 0.01).The scores of tandem station,walking speed and repeated standing of grade 3PWMHs were significantly lower than those of the other two groups(P < 0.01).The total score of DWMHs of grade 3 was higher than that of grade 1 and 2,and the total score of SPPB and Tinetti balance and gait scale was significantly lower than that of the other two groups(P < 0.01).The scores of half tandem station,walking speed and elbow nudge of grade3 DWMHs were lower than those of the other two groups(P < 0.01).Conclusion:WMH can lead to motor dysfunction.PWMHs has a significant effect on gait and balance function.The more severe WMH is,the more obvious gait and balance dysfunction is.Part Ⅱ:Cerebral microbleeds and gait and balance dysfunctionObjective:Through the study of cerebral microbleeds(CMB),we found that there was no significant difference between the two groups,Objective to investigate the correlation between CMB and gait and balance dysfunction,and analyze the characteristics of gait and balance dysfunction in patients with CMB,so as to provide clues and basis for clinical diagnosis of CMB patients quickly and easily,and provide data support for predicting falls,reducing disability and improving patients’ quality of life Objective to carry out more intuitive and effective fall prevention and control for CMB patients with gait and balance dysfunction.Method:Firstly,46 inpatients and outpatients with CMB in the Department of Neurology,Affiliated Hospital of Inner Mongolia Medical University from November 2019 to February 2021 were selected as the case group,and 60 healthy adults matched with the case group in age,gender and other general indicators,and not suffering from csvd confirmed by magnetic resonance imaging(MRI)were selected as the control group.Secondly,CMB patients were divided into frontal lobe group,other cerebral lobes group,basal ganglia group and infratentorial group according to different parts of lesions.All patients underwent clinical consultation,systematic physical examination of nervous system and MRI examination,including T1 weighted imaging,T2 weighted imaging,diffusion weighted imaging(DWI),susceptibility weighted imaging(SWI),fluid attenuated inversion recovery,The gait and balance function were evaluated by three scales: timed standing and walking test,short physical performance battery and Tinetti balance and gait scale.Spss25.0 statistical software package was used for statistical analysis.Results:(1)A total of 106 subjects were included in this study,including 46 cases(43.4%)in the case group and 60 cases(56.6%)in the control group.14 cases were frontal lobe group(30.4%),10 cases were other lobe group(21.7%),12 cases were basal ganglia group(26.1%),10 cases were infratentorial group(21.7%).(2)Compared with the control group,the total score of timed standing and walking test in the case group was higher than that in the control group,and the total score of SPPB and Tinetti balance and gait scale in the case group were lower than those in the control group,the difference was statistically significant(P < 0.01).The scores of balance test and walking speed in the case group were significantly lower than those in the control group(P < 0.01).(3)There was no statistical significance in the total score of the three scales in different parts(P >0.05).The scores of standing balance,eyes closed,360 degree turn and sitting balance in the basal ganglia group were significantly lower than those in the other three groups(P <0.05).Conclusion:CMB can lead to motor dysfunction.Different parts of CMB have different effects on gait and balance function. |
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