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Mobility Decline in the Elderly Relates to Lesion Accrual in the Splenium of the Corpus Callosum

Institution:
Center for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Publisher:
Springer
Publication Date:
Apr-2012
Journal:
Age (Dordr)
Volume Number:
34
Issue Number:
2
Pages:
405-14
Citation:
Age (Dordr). 2012 Apr;34(2):405-14.
PubMed ID:
21505765
PMCID:
PMC3312641
Keywords:
Aging, Mobility, Brain, White matter hyperintensities, Splenium of Corpus Callosum, Magnetic resonance imaging
Appears in Collections:
CNI, NAC, SLICER, SPL
Sponsors:
P41 RR013218/RR/NCRR NIH HHS/United States
R01 AG022092/AG/NIA NIH HHS/United States
M01 RR006192/RR/NCRR NIH HHS/United States
Generated Citation:
Moscufo N., Wolfson L., Meier D., Liguori M., Hildenbrand P.G., Wakefield D., Schmidt J.A., Pearlson G.D., Guttmann C.R.G. Mobility Decline in the Elderly Relates to Lesion Accrual in the Splenium of the Corpus Callosum. Age (Dordr). 2012 Apr;34(2):405-14. PMID: 21505765. PMCID: PMC3312641.
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In a previous cross-sectional study on baseline data, we demonstrated that the volume of brain white matter hyperintensities (WMH) in the splenium of corpus callosum (SCC) predicted the current mobility function of older persons. The primary aim of this follow-up study was to determine the relation of WMH volume change in SCC (SCC-∆WMH) with change in mobility measures. A secondary aim was to characterize the global and regional progression of WMH. Mobility function and WMH burden were evaluated at baseline and at 2 years in 77 community-dwelling individuals (baseline age, 82 ± 4). Regional WMH in SCC, as well as genu and body of corpus callosum, subregions of corona radiata, and superior longitudinal fasciculus were determined using a white matter parcellation atlas. The total WMH volume increased 3.3 ± 3.5 ml/year, mainly through enlargement. Significant WMH increases were observed in all selected regions, particularly within the corona radiata. While at baseline and follow-up we observed correlations between WMH burden and several measures of mobility, longitudinal change correlated only with change in chair rise (CR). SCC-∆WMH showed the highest correlation (r = -0.413, p = 0.0002) and was the best regional predictor of CR decline (OR = 1.5, r(2) = 0.3). The SCC-∆WMH was more than five times larger in the CR-decline group compared to the no-decline group (p = 0.0003). The SCC-∆WMH (top quartile) showed a higher sensitivity/specificity for CR decline compared to change in total WMH, 63/88% versus 52/84%, respectively. The findings suggest that accrual of WMHs in posterior areas of the brain supporting inter-hemispheric integration and processing of visual-spatial information is a mechanism contributing to age-related mobility deterioration.

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Moscufo-Age2012-fig1.jpg (125.147kB)