Study On The Correlation Between Gait And Balance Disorders With White Matter Hyperintensities In Patients Of Cerebral Small Vessel Disease

Objective:To explore the correlation between gait and balance disorders in patients with cerebral small vessel disease(CSVD)and white matter hyperintensities(WMH)in different burdens and locations,as well as the relationship between risk factors of cerebrovascular disease and white matter hyperintensities.Methods:84 patients with WMH admitted to the Department of Neurology,the First Affiliated Hospital of Bengbu Medical College from June 2021 to June 2022 were included in the study.All patients were examined with cranial MRI.According to the Fazekas scale,PWMH(Persistent white matter hyperintensities,PWMH)and DWMH(Deep white matter hyperintensities,DWMH)were independently scored.According to the severity of WMH,they were divided into low burden group(1-2 points),medium burden group(3-4 points)High burden group(5-6 points).According to the location of WMH,they were divided into PWMH group and DWMH group.The general clinical data such as age,sex,hypertension,diabetes,smoking history,drinking history,etc.of all subjects were collected,and the independent risk factors of WMH were analyzed using the multifactor ordered logistic regression model.The gait and balance function were comprehensively evaluated by measuring step length,step width,pace,and the Tinetti Balance and Gait Scale.Pearson correlation was used to analyze the correlation between PWMH scores and DWMH scores and the results of gait and balance function evaluations.Results:1.There was no significant difference in gender,diabetes,smoking history and drinking history among WMH low,medium and high burden groups(P>0.05),but there were significant differences in age and hypertension(P<0.05).Multivariate sequential logistic regression analysis of risk factors showed that only age(OR=1.689,P=0.003)and history of hypertension(OR=2.789,P=0.037)had statistically significant differences among the three groups.There were significant differences in gait and balance function results among WMH low,medium,and high burden groups.The WMH high burden group had the shortest stride length,the longest stride width,and the slowest gait speed,and the Tinetti balance and gait scores were the lowest.There were statistically significant differences between the groups(values=11.775,14.929,22.759,77.926,53.909,6.325,all P<0.05).Pearson correlation analysis found that PWMH scores were negatively correlated with step length,pace,and Tinetti balance with gait test scores(r=-0.787,-0.480,-0.670,-0.435,-0.600,all P<0.01);PWMH score was positively correlated with step width(r=0.740,P<0.01);DWMH score was negatively correlated with gait speed,total score of Tinetti,and Tinetti balance score(r=-0.402,-0.698,-0.795,all P<0.01),while DWMH score was not correlated with step length and width,and Tinetti gait score(r=-0.079,0.137,-0.046,all P>0.05).There was a correlation between PWMH score and DWMH score and walking speed,but there was no significant difference in the correlation(r=-0.480,-0.402,P<0.05).Conclusion:1.The independent risk factors affecting the severity of WMH are age and hypertension.2.WMH is associated with gait and balance disorders.As the burden of WMH increases,WMH patients can experience varying degrees of various types of shortened stride length,increased stride width,slower gait,and impaired gait and balance functions.3.PWMH has a high correlation with gait disorders,while DWMH has a high correlation with balance disorders.