scholarly journals Association of Static Posturography With Severity of White Matter Hyperintensities

2021 ◽  
Vol 12 ◽  
Author(s):  
Bin Liu ◽  
Guifeng Zhao ◽  
Ling Jin ◽  
Jingping Shi
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Multiple Logistic Regression Analysis ◽  
Berg Balance Scale ◽  
Track Length ◽  
Eyes Closed ◽  
Static Posturography ◽  
Potential Marker ◽  
Grading Scale ◽  
State Examination

Background: Impaired gait and balance are associated with severity of leukoaraiosis. Evaluation of balance is based on neurological examination using Romberg's test with bipedal standing, assessment scale, and posturographic parameters. The goal of this study was to determine the relationship between static equilibrium and grades of white matter hyperintensities (WMHs) using static posturography as a quantitative technical method.Method: One hundred and eighteen (118) patients with lacunar infarct were recruited and assessed on MRI with Fazekas's grading scale into four groups. On admission, age, gender, height, weight, Berg Balance Scale (BBS), mini-mental state examination (MMSE), and static posturography parameters were recorded, and their correlations with WMHs were determined.Results: Age was significantly and positively correlated with severity of WMHs (r = 0.39, p < 0.05). WMH score was negatively correlated with BBS score (r = −0.65, p < 0.05) and MMSE score (r = −0.79, p < 0.05). There was a significant positive correlation between track length anteroposterior (AP, with eyes closed) and severity of WMHs (r = 0.70, p < 0.05). Partial correlation analysis and multiple logistic regression analysis indicated that track length AP with eyes closed, was a predictor for the severity of WMHs (p< 0.05).Conclusion: The severity of WHMs is associated with age, cognitive decline, and impairment in balance. Posturography parameter in track length in AP direction with eyes closed in relation to cognition and balance, may be a potential marker for disease progression in WMHs.

scholarly journals The competition with a concurrent cognitive task affects posturographic measures in patients with Parkinson disease

2015 ◽  
Vol 73 (11) ◽  
pp. 906-912 ◽  
Author(s):  
Alessandra Ferreira Barbosa ◽  
Carolina de Oliveira Souza ◽  
Janini Chen ◽  
Débora Valente Francato ◽  
Fátima Aparecida Caromano ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Dual Task ◽  
Cognitive Task ◽  
Berg Balance Scale ◽  
Functional Balance ◽  
Eyes Closed ◽  
Static Posturography ◽  
Eyes Open ◽  
The Impact ◽  
General Balance

ABSTRACTObjectives To estimate the impact of a sensory-motor- cognitive task on postural balance, in Parkinson disease patients (Hoehn and Yahr 2-3) and to investigate possible relationships between posturography and functional balance clinical scales.Method Parkinson disease patients (n = 40) and healthy controls (n = 27) were evaluated with fluency tests, Berg Balance scale, Mini Best test and static posturography on the conditions eyes open, eyes closed and dual-task (simultaneous balance and fluency tasks).Results Posturographic data showed that Parkinson disease patients performed worse than controls in all evaluations. In general, balance on dual-task was significantly poorer than balance with eyes closed. Posturographic data were weakly correlated to clinical balance scales.Conclusion In clinical practice, Parkinson disease patients are commonly assessed with eyes closed, to sensitize balance. Our study showed that adding a cognitive task is even more effective. Static posturographic data should be carefully overgeneralized to infer functional balance impairments.

scholarly journals Cortical thickness, white matter hyperintensities, and cognition after stroke

2019 ◽  
Vol 15 (1) ◽  
pp. 46-54 ◽  
Author(s):  
David Alexander Dickie ◽  
Kirstyn Gardner ◽  
Annika Wagener ◽  
Annick Wyss ◽  
Francesco Arba ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Cortical Thickness ◽  
Mental State ◽  
White Matter Hyperintensities ◽  
Mini Mental State Examination ◽  
Community Dwelling ◽  
White Matter Hyperintensity ◽  
Pairwise Correlation ◽  
State Examination

Background A thinner cerebral cortex is associated with higher white matter hyperintensity burden and cognitive impairment in community-dwelling and dementia cohorts. It is important to assess these associations in people with ischemic stroke because their cerebrovascular disease profiles are different to these cohorts. Aims We aimed to determine whether cortical thickness was related to white matter hyperintensity burden and cognition after ischemic stroke. Methods We measured cortical thickness using advanced normalization tools' “KellyKapowski” function in 244 patients with ischemic stroke or transient ischemic attack from the Virtual International Stroke Trials Archive. We measured white matter hyperintensity burden via quantitative volumes and Fazekas score. We extracted data on vascular risk factors at baseline and Mini Mental State Examination scores at one year. We assessed associations between imaging and clinical data using correlation and multiple linear regression. Results Pairwise correlation showed that higher white matter hyperintensity Fazekas score was associated with a thinner cortex (rho = −0.284, P < 0.0001). White matter hyperintensities were generally distributed adjacent to and above the lateral ventricles. Voxel-wise analyses showed statistically significant negative associations between cortical thickness and white matter hyperintensities across fronto-temporal and inferior parietal cortical regions. Mean cortical thickness was positively related to Mini Mental State Examination in pair-wise correlation (r = 0.167, P = 0.0088) but there was no independent association after adjustment for age and white matter hyperintensities (beta = 0.016, P = 0.7874). Conclusions Cortical thickness was not an independent predictor of cognition after ischemic stroke. Further work is required to understand how white matter hyperintensities are associated with a thinner cortex in temporal regions but less so in more superior regions where white matter hyperintensities are generally found in people with stroke.

scholarly journals Association of White Matter Hyperintensities with HIV Status and Vascular Risk Factors

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011702
Author(s):  
Yair Mina ◽  
Tianxia Wu ◽  
Hsing-Chuan Hsieh ◽  
Dima A. Hammoud ◽  
Swati Shah ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
White Matter ◽  
Tobacco Use ◽  
Logistic Regression Analysis ◽  
White Matter Hyperintensities ◽  
Brain Mri ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Hiv Serostatus

Objective:To test the hypothesis that brain white matter hyperintensities (WMH) are more common in people living with HIV (PLWH), even in the setting of well-controlled infection, and to identify clinical parameters that correlate with these abnormalities.Methods:Research brain MRI scans, acquired within longitudinal studies evaluating neurocognitive outcomes, were reviewed to determine WMH load using the Fazekas visual rating scale in PLWH with well-controlled infection (antiretroviral therapy for at least one year and plasma viral-load < 200 copies/ml) and in socio-demographically-matched controls without HIV (CWOH). The primary outcome measure of this cross-sectional analysis was increased WMH load, determined by total Fazekas score ≥ 2. Multiple logistic regression analysis was performed to evaluate the effect of HIV serostatus on WMH load, and to identify MRI, CSF and clinical variables that associate with WMH in PLWH group.Results:The study included 203 PLWH and 58 CWOH who completed a brain MRI scan between April 2014 and March 2019. The multiple logistic regression analysis, with age and history of tobacco use as covariates, showed that the adjusted odds ratio of the PLWH group for increased WMH load is 3.7 (95% confidence interval 1.8–7.5, p=0.0004). For the PLWH group, increased WMH load was associated with older age, male sex, tobacco use, hypertension, and hepatitis C virus co-infection, and also with the presence of measurable tumor necrosis factor-alpha in CSF.Conclusions:Our results suggest that HIV serostatus affects the extent of brain WMH. This effect is mainly associated with aging and modifiable co-morbidities.

scholarly journals Cystatin C, a potential marker for cerebral microvascular compliance, is associated with white-matter hyperintensities progression

PLoS ONE ◽  
2017 ◽  
Vol 12 (9) ◽  
pp. e0184999 ◽  
Author(s):  
Woo-Jin Lee ◽  
Keun-Hwa Jung ◽  
Young Jin Ryu ◽  
Jeong-Min Kim ◽  
Soon-Tae Lee ◽  
...  
Keyword(s):  
White Matter ◽  
Cystatin C ◽  
White Matter Hyperintensities ◽  
Potential Marker

A systematic review and meta-analysis on efficacy of exercise on posture and balance in patients suffering from Diabetic Neuropathy

2020 ◽  
Vol 16 ◽  
Author(s):  
Neerja Thukral ◽  
Jaspreet Kaur ◽  
Manoj Malik
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Neuropathy ◽  
Meta Analysis ◽  
Berg Balance Scale ◽  
Risk Of Bias ◽  
Core Stability ◽  
Balance Scale ◽  
Eyes Closed ◽  
Significant Difference ◽  
Eyes Open

Background: Peripheral neuropathy is a major and chronic complication of diabetes mellitus affecting more than 50% of patients suffering from diabetes. There is involvement of both large and small diameter nerve fibres leading to altered somatosensory and motor sensations, thereby causing impaired balance and postural instability. Objective: To assess the effects of exercises on posture and balance in patients suffering from diabetes mellitus. Method: Mean changes in Timed Up and Go test(TUGT), Berg Balance Scale and Postural Sway with eyes open and eyes closed on Balance System were primary outcome measures. RevMan 5.3 software was used for the meta-analyses. Eighteen randomized controlled trials met the selection criteria and were included in the study. All the studies ranked high on PEDro Rating scale. Risk of bias was assessed by Cochrane collaboration tool of risk of bias. Included studies had low risk of bias. Sixteen RCT’s were included for the meta-analysis. Result: Results of meta-analysis showed that there was statistically significant improvement in TUGT with p≤ 0.05 and substantial heterogeneity (I 2 = 84%, p < 0.00001) in experimental group as compared to control group. There was statistically significant difference in Berg Balance Scale scores and heterogeneity of I 2 = 62%, p < 0.00001 and significant changes in postural stability (eyes open heterogeneity of I 2 = 100%, p =0.01 and eyes closed, heteogeneity I 2 = 0%, p =0.01). Sensitivity analysis causes change in heterogeneity. Conclusion: It can be concluded that various exercises like balance training, core stability, Tai-Chi, proprioceptive training etc. have a significant effect in improving balance and posture in diabetic neuropathy.

scholarly journals Sustained Opening of the Blood-Brain Barrier with Progressive Accumulation of White Matter Hyperintensities Following Ischemic Stroke

2019 ◽  
Vol 9 (1) ◽  
pp. 16 ◽  
Author(s):  
Imama Naqvi ◽  
Emi Hitomi ◽  
Richard Leigh
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Stroke ◽  
Blood Brain Barrier ◽  
White Matter Hyperintensities ◽  
Brain Barrier ◽  
Common Finding ◽  
Blood Brain ◽  
History Of ◽  
Iv Tpa

Objective: To report a patient in whom an acute ischemic stroke precipitated chronic blood-brain barrier (BBB) disruption and expansion of vascular white matter hyperintensities (WMH) into regions of normal appearing white matter (NAWM) during the following year. Background: WMH are a common finding in patients with vascular risk factors such as a history of stroke. The pathophysiology of WMH is not fully understood; however, there is growing evidence to suggest that the development of WMH may be preceded by the BBB disruption in the NAWM. Methods: We studied a patient enrolled in the National Institutes of Health Natural History of Stroke Study who was scanned with magnetic resonance imaging (MRI) after presenting to the emergency room with an acute stroke. After a treatment with IV tPA, she underwent further MRI scanning at 2 h, 24 h, 5 days, 30 days, 90 days, 6 months, and 1-year post stroke. BBB permeability images were generated from the perfusion weighted imaging (PWI) source images. MRIs from each time point were co-registered to track changes in BBB disruption and WMH over time. Results: An 84-year-old woman presented after acute onset right hemiparesis, right-sided numbness and aphasia with an initial NIHSS of 13. MRI showed diffusion restriction in the left frontal lobe and decreased blood flow on perfusion imaging. Fluid attenuated inversion recovery (FLAIR) imaging showed bilateral confluent WMH involving the deep white matter and periventricular regions. She was treated with IV tPA without complication and her NIHSS improved initially to 3 and ultimately to 0. Permeability maps identified multiple regions of chronic BBB disruption remote from the acute stroke, predominantly spanning the junction of WMH and NAWM. The severity of BBB disruption was greatest at 24 h after the stroke but persisted on subsequent MRI scans. Progression of WMH into NAWM over the year of observation was detected bilaterally but was most dramatic in the regions adjacent to the initial stroke. Conclusions: WMH-associated BBB disruption may be exacerbated by an acute stroke, even in the contralateral hemisphere, and can persist for months after the initial event. Transformation of NAWM to WMH may be evident in areas of BBB disruption within a year after the stroke. Further studies are needed to investigate the relationship between chronic BBB disruption and progressive WMH in patients with a history of cerebrovascular disease and the potential for acute stroke to trigger or exacerbate the process leading to the development of WMH.

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