Dual-task gait and white matter hyperintensities in Lewy body diseases: An exploratory analysis

Ipinuoluwakiye Fatokun; Myrlene Gee; Krista Nelles; Fang Ba; Mahsa Dadar; Simon Duchesne; Breni Sharma; Mario Masellis; Sandra E Black; Quincy J Almeida; Eric E Smith; Frederico Pieruccini-Faria; Manuel Montero-Odasso; Richard Camicioli

doi:10.3389/fnagi.2023.1088050

Dual-task gait and white matter hyperintensities in Lewy body diseases: An exploratory analysis

Front Aging Neurosci. 2023 Apr 5:15:1088050. doi: 10.3389/fnagi.2023.1088050. eCollection 2023.

Authors

Ipinuoluwakiye Fatokun¹, Myrlene Gee¹, Krista Nelles¹, Fang Ba^{1

2}, Mahsa Dadar³, Simon Duchesne^{4

5}, Breni Sharma^{6

7}, Mario Masellis^{8

9}, Sandra E Black^{8

9}, Quincy J Almeida¹⁰, Eric E Smith^{6

7

11

12}, Frederico Pieruccini-Faria^{13

14

15}, Manuel Montero-Odasso^{13

14

15}, Richard Camicioli^{1

2}

Affiliations

¹ Department of Medicine, Division of Neurology, University of Alberta, Edmonton, AB, Canada.
² Neuroscience and Mental Health Institute (NMHI), University of Alberta, Edmonton, AB, Canada.
³ Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montréal, QC, Canada.
⁴ Department of Radiology and Nuclear Medicine, Faculty of Medicine, Laval University, Québec City, QC, Canada.
⁵ CERVO Brain Research Centre, Québec City, QC, Canada.
⁶ Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
⁷ Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
⁸ Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
⁹ Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
¹⁰ Movement Disorders Research and Rehabilitation Consortium, Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada.
¹¹ Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
¹² Seaman Family MR Research Centre, University of Calgary, Calgary, AB, Canada.
¹³ Gait and Brain Lab, Parkwood Institute Research and Lawson Health Research Institute, London, ON, Canada.
¹⁴ Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, London, ON, Canada.
¹⁵ Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.

Abstract

Background: Parkinson's disease (PD) and dementia with Lewy bodies (DLB) are part of a spectrum of Lewy body disorders, who exhibit a range of cognitive and gait impairments. Cognitive-motor interactions can be examined by performing a cognitive task while walking and quantified by a dual task cost (DTC). White matter hyperintensities (WMH) on magnetic resonance imaging have also been associated with both gait and cognition. Our goal was to examine the relationship between DTC and WMH in the Lewy body spectrum, hypothesizing DTC would be associated with increased WMH volume.

Methods: Seventy-eight participants with PD, PD with mild cognitive impairment (PD-MCI), PD with dementia or DLB (PDD/DLB), and 20 cognitively unimpaired participants were examined in a multi-site study. Gait was measured on an electronic walkway during usual gait, counting backward, animal fluency, and subtracting sevens. WMH were quantified from magnetic resonance imaging using an automated pipeline and visual rating. A median split based on DTC was performed. Models included age as well as measures of global cognition and cardiovascular risk.

Results: Compared to cognitively unimpaired participants, usual gait speed was lower and DTC was higher in PD-MCI and PDD/DLB. Low DTC participants had higher usual gait speed. WMH burden was greater in high counting DTC participants. Frontal WMH burden remained significant after adjusting for age, cardiovascular risk and global cognition.

Conclusion: Increased DTC was associated with higher frontal WMH burden in Lewy body disorders after adjusting for age, cardiovascular risk, and global cognition. Higher DTC was associated with age.

Keywords: Lewy body disease; Parkinson’s disease; cognition; dual task; gait; white matter hyperintensities.

Grants and funding

This study was supported by the Canadian Institutes of Health Research (CIHR) as part of its support for the Canadian Consortium on Neurodegeneration in Aging (CCNA) and the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study. The Functional Assessment of Vascular Reactivity in Small Vessel Disease (FAVR) study was supported by CIHR and Brain Canada (ES, PI).