The relation between total cerebral small vessel disease burden and gait impairment in patients with minor stroke

Caroline M.J. Loos, Caroline McHutchison, Vera Cvoro, Stephen Makin, Julie Staals, Francesca Chappell, Martin Dennis, Robert J van Oostenbrugge, Joanna Wardlaw

Research output: Contribution to journalArticlepeer-review

Abstract

Background and aims – Individual MRI markers of cerebral small vessel disease(cSVD) are associated with gait impairment. The impact of total cSVD-related brain damage, expressed by a cSVD MRI burden score, on mobility after stroke, has not been considered, although this score gives a better representation of the overall effect of cSVD on the brain. We determined if the total cSVD burden is associated with gait impairment three years after minor stroke.Methods – In total, 200 patients with minor lacunar or non-lacunar stroke (NIHSS≤7) underwent a brain MRI at presentation. Presence of lacunes, white matter hyperintensities, cerebral microbleeds and perivascular spaces were summed in a total cSVD MRI burden score (range 0–4). Gait disturbances, measured by timed-upand-go test and self-reported Stroke Impact Scale mobility domain were assessed three years after stroke. We tested associations adjusted for key variables by linear regression analysis.Results – Total cSVD burden was not associated with gait impairment after minorstroke in all patients, nor in lacunar stroke patients (n=87). In non-lacunar stroke patients (n=113) total cSVD burden was associated with lower Stroke Impact Scale mobility domain scores, independent of age, vascular risk factors and stroke severity (unstandardized B -4.61; 95% CI -8.42;-0.79, p<0.05).Conclusion – Patients with non-lacunar stroke and a higher total cSVD burden have more subjective mobility impairment three years after stroke. The total cSVD MRI burden score is a possible marker to identify patients at risk for subjective gait impairment. These findings should be confirmed in larger studies.
Original languageEnglish
Pages (from-to)518-524
JournalInternational Journal of Stroke
Volume13
Issue number5
Early online date14 Sep 2017
DOIs
Publication statusPublished - 1 Jul 2018

Keywords

  • cerebral small vessel disease
  • minor stroke
  • total cerebral small vessel dsease burden
  • gait impairment
  • stroke impact scale
  • functional outcome

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