Association of Dual-Task Gait Cost and White Matter Hyperintensity Burden Poststroke: Results From the ONDRI

What EXACTLY about this will get survivors recovered? Or is this more useless research because there is NO STRATEGY TO SOLVE STROKE TO 100% RECOVERY?

 

Association of Dual-Task Gait Cost and White Matter Hyperintensity Burden Poststroke: Results From the ONDRI

Frederico Pieruccini-Faria, PhD https://orcid.org/0000-0002-7659-4285 frederico.faria@sjhc.london.on.ca, Benjamin Cornish, MSc, […], and the ONDRI Investigators+40View all authors and affiliations

Volume 37, Issue 7

https://doi.org/10.1177/15459683231177606

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• • Abstract
  • Introduction
  • Methods
  • Results
  • Discussion
  • Conclusion
  • Acknowledgments
  • Declaration of Conflicting Interests
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Abstract

Background

Acute change in gait speed while performing a mental task [dual-task gait cost (DTC)], and hyperintensity magnetic resonance imaging signals in white matter are both important disability predictors in older individuals with history of stroke (poststroke).(You do realize predicting disability is totally fucking useless for survivors? They would like to get recovered. WHAT THE FUCK ARE YOU DOING TO GET THERE?) It is still unclear, however, whether DTC is associated with overall hyperintensity volume from specific major brain regions in poststroke.

Methods

This is a cohort study with a total of 123 older (69 ± 7 years of age) participants with history of stroke were included from the Ontario Neurodegenerative Disease Research Initiative. Participants were clinically assessed and had gait performance assessed under single- and dual-task conditions. Structural neuroimaging data were analyzed to measure both, white matter hyperintensity (WMH) and normal appearing volumes. Percentage of WMH volume in frontal, parietal, occipital, and temporal lobes as well as subcortical hyperintensities in basal ganglia + thalamus were the main outcomes. Multivariate models investigated associations between DTC and hyperintensity volumes, adjusted for age, sex, years of education, global cognition, vascular risk factors, APOE4 genotype, residual sensorimotor symptoms from previous stroke and brain volume.

Results

There was a significant positive global linear association between DTC and hyperintensity burden (adjusted Wilks’ λ = .87, P = .01). Amongst all WMH volumes, hyperintensity burden from basal ganglia + thalamus provided the most significant contribution to the global association (adjusted β = .008, η² = .03; P = .04), independently of brain atrophy.

Conclusions

In poststroke, increased DTC may be an indicator of larger white matter damages, specifically in subcortical regions, which can potentially affect the overall cognitive processing and decrease gait automaticity by increasing the cortical control over patients’ locomotion.