The Study On The Gait,Cognitive Characteristics And Correlation In Patients With Cerebral Small Vessel Disease

1.ObjectiveA clinical controlled trial was designed to explore the gait,cognitive characteristics and the correlation between cognition and gait in patients with cerebral small vessel disease(CSVD),so as to provide new therapeutic knowledge for early intervention of CSVD.2.MethodsA total of 58 patients with cerebral small vessel disease were selected from December 2018 to October 2019 in the Department Chino-francais Neurology of Gansu Provincial Hospital,who met the diagnostic criteria and included criteria.Patients with dementia were excluded according to Mini-Mental State Examination(MMSE).According to montreal cognitive assessment(MoCA),the patients were divided into two groups: cognitive impairment group(total score < 26)and normal cognitive group(total score ?26).Clinical evaluation was carried out,and Walker-view digital treadmill was used to collect gait parameters,including step frequency,step length,step length variability and stance time,for quantitative evaluation of gait.The Time Up and Go(TUG)test was used to predict the risk of falls.3.Results(1)There was no significant difference in the baseline data between the two groups in terms of sex,age,body mass index,education level,hypertension and diabetes(P > 0.05).The results were comparable.(2)Compared with the normal cognitive group,the patients with cognitive impairment had lower scores in general cognition,visual space / execution,delayed memory and attention(P < 0.05).There was no significant difference in naming,language,abstract thinking and orientation(P > 0.05).(3)Compared with the normal cognitive group,the step length of the cognitive impairment group was shorter,the step length variability was larger,and the TUG test time was longer(P < 0.05).There was no significant difference in step frequency and stance time(P > 0.05).(4)General cognition was positively correlated with step length,and negatively correlated with step length variability(B=1.669,P=0.004;B=-1.187,P=0.012).Visual space / execution was positively correlated with step length,negatively correlated with step length variability,and negatively correlated with stance time(B=3.90,P=0.009;B=-2.928,P=0.004;B=-0.487,P=0.031).(5)Compared with the normal cognitive group,the levels of serum uric acid,blood homocysteine and systolic blood pressure in the cognitive impairment group were significantly higher(P < 0.05).Further binary logistic regression analysis showed that blood homocysteine and systolic blood pressure were the risk factors affecting cognition(B=0.134,P=0.018;B = 0.129,P = 0.036).4.ConclusionsThe cognitive impairment of cerebral small vessel disease is mainly manifested in visual space / execution,attention and delayed memory.The main manifestations of gait abnormality in patients with cognitive impairment are shorter step length,larger step length variability,longer TUG test time,and high risk of fall.General cognition was positively correlated with step length,and negatively correlated with step length variability.Visual space / execution was positively correlated with step length,negatively correlated with step length variability,and negatively correlated with stance time.Homocysteine and systolic blood pressure were risk factors affecting cognition.