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The relationship between limb motor dysfunction and white matter in patients with Alzheimer's disease
Xiaohong ZHAN
Chinese Journal of Alzheimer's Disease and Related Disorders ›› 2026, Vol. 9 ›› Issue (2) : 101-105.
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Abbreviation (ISO4): Chinese Journal of Alzheimer's Disease and Related Disorders
Editor in chief: Jun WANG
PDF(886 KB)
The relationship between limb motor dysfunction and white matter in patients with Alzheimer's disease
Objective: To investigate the relationship between limb motor dysfunction and white matter structural changes in patients with Alzheimer 's disease (AD). Methods: A total data of 66 AD patients admitted to the hospital from January 2022 to September 2025 were retrospectively collected. Six cases were excluded according to the inclusion and exclusion criteria, and 60 cases were finally included. According to whether the patients were accompanied by limb motor dysfunction, they were divided into group A (simple AD) 33 cases and group B (with limb motor dysfunction) 27 cases. All subjects underwent MRI scans, including cross-sectional T1W1, T2W1, ASL sequences, and DWI. Imaging indicators included deep subcortical white matter hyperintensity (DWMH), white matter hyperintensity (PVWMH), and WMH. The clinical data and imaging indexes of the two groups were compared. Spearman correlation analysis was used to explore the correlation between each index and limb motor dysfunction. Multivariate Logistics regression was used to analyze the independent influencing factors of limb motor dysfunction in AD patients. Results: The albumin level, scores of Berg balance scale (BBS), Montreal cognitive assessment scale (MoCA) score and walking ability in activities of daily living (ADL) in group B were lower than those in group A (P<0.05). DWMH, PVWMH and WMH in group B were higher than those in group A (P<0.05). Albumin level, BBS score, MoCA score and walking score were negatively correlated with limb motor dysfunction (P<0.05), while DWMH, PVWMH and WMH were positively correlated with limb motor dysfunction (P<0.05). The increase of DWMH, PVWMH and WMH was an independent influencing factor of limb motor dysfunction (P<0.05). Conclusions: The occurrence of limb motor dysfunction in AD patients is closely related to the structural changes of white matter. DWMH, PVWMH and WMH values are key imaging markers for predicting limb motor dysfunction in AD. In clinical practice, for high-risk AD patients with these imaging changes, interventions such as establishing individualized exercise plans or adopting task-oriented gait training and balance training systems should be adopted to delay the decline of motor function.
Alzheimer 's disease / Limb motor dysfunction / White matter of brain / Magnetic resonance imaging
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In this longitudinal study, we aimed to examine if slowing gait speed preceded cognitive decline and correlated with brain amyloidosis.The sample (n = 287) was derived from the Gothenburg H70 Birth Cohort Studies, with follow-ups between 2000 and 2015. Gait speed was measured by indoor walk, and cognition using the Clinical Dementia Rating (CDR) score. All participants had CDR = 0 at baseline. Some participants had data on cerebrospinal fluid (CSF) amyloid beta (Aβ) concentrations at the 2009 examination.Gait speed for participants who worsened in CDR score during follow-up was slower at most examinations. Baseline gait speed could significantly predict CDR change from baseline to follow-up. Subjects with pathological CSF Aβ concentrations at the 2009 visit had lost more gait speed compared to previous examinations.Our results indicate that gait speed decline precedes cognitive decline, is linked to Alzheimer's pathology, and might be used for early detection of increased risk for dementia development.© 2021 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.
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Gait impairment is common in neurodegenerative disorders. Specifically, gait variability-the stride-to-stride fluctuations in distance and time-has been associated with neurodegeneration and cognitive impairment. However, quantitative comparisons of gait impairments across the cognitive spectrum of dementias have not been systematically investigated.Older adults (N = 500) with subjective cognitive impairment, Parkinson disease (PD), mild cognitive impairment (MCI), PD-MCI, Alzheimer's disease (AD), PD-dementia, Lewy body dementia, and frontotemporal dementia, as well cognitive normal controls, who were assessed for their gait and cognitive performance.Factor analyses grouped 11 quantitative gait parameters and identified four independent gait domains: rhythm, pace, variability, and postural control, for group comparisons and classification analysis. Among these domains, only high gait variability was associated with lower cognitive performance and accurately discriminated AD from other neurodegenerative and cognitive conditions.Our findings indicate that high gait variability is a marker of cognitive-cortical dysfunction, which can help to identify Alzheimer's disease dementia.© 2021 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.
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利益冲突声明：所有作者在本研究中不存在任何利益冲突。
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