White matter lesions and disequilibrium in older people. I. Case-control comparison
R. W. Baloh, Q. Yue, T. M. Socotch and K. M. Jacobson
Department of Neurology, UCLA School of Medicine, USA.
OBJECTIVE: To investigate the relationship between subcortical white matter
lesions identified on magnetic resonance imaging and gait and balance
problems in older people. DESIGN: Magnetic resonance imaging scans of the
brain in 27 community-dwelling older patients (> 75 years of age) who
had subjective and objective abnormalities of gait and balance of unknown
cause were compared with those of 27 age- and sex-matched control subjects.
The T2-weighted intense lesions of the subcortical white matter were graded
on a scale of 0 to 2. SETTING: Outpatient clinic. RESULTS: The patient had
significantly (P < .01, chi 2) more severe subcortical white matter
hyperintensities on magnetic resonance imaging than did the control group.
Patients fell more frequently than did the control subjects and had slower
motor responses and prolonged reaction times compared with the control
subjects. CONCLUSIONS: Subcortical white matter lesions identified on
magnetic resonance imaging are associated with gait and balance dysfunction
in ambulatory older people. These lesions probably interfere with central
processing of sensorimotor signals leading to impaired postural responses.