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- Title
Brain morphometries and gait dysfunction in progressive supranuclear palsy and vascular parkinsonism.
- Authors
Chatterjee, Koustav; Paul, Subhadip; Banerjee, Rebecca; Choudhury, Supriyo; Tiwari, Mona; Basu, Purba; Kumar, Hrishikesh
- Abstract
Aims and Objective: Progressive supranuclear palsy (PSP) and vascular parkinsonism (VaP) often show overlapping clinical symptoms, including gait difficulty and postural instability, despite their heterogeneous etiologies. The objective of the study was to compare the gait parameters of PSP and VaP patients. Also, we wanted to define the neuroanatomical correlates of gait impairment among our cohort of patients. Materials and Methods: A total of 20 PSP-Richardson's syndrome (PSP-RS) and 13 VaP patients were recruited consecutively. A pressure-sensitive electronic walkway was used to examine spatiotemporal gait characteristics. Regional cortical thickness, and volumes of subcortical and cortical regions were estimated from the T1-weighted magnetic resonance images (MRIs) using FreeSurfer analysis pipeline. Group differences in gait variables, morphometric measures, and their association were analyzed using statistical tool. Results and Conclusion: Patients with PSP-RS exhibited increased measures of dynamic instability compared to VaP patients, even in the comparable age groups [Figure 1]. Also, increased atrophy of the bilateral cerebellar cortex, left thalamus, and left caudate was noticed in PSP-RS compared to VaP. On the other hand, significant volume loss in the hippocampus bilaterally was observed in VaP compared to PSP-RS. Regional cortical thickness including left transverse temporal and bilateral insula was found to be significantly smaller in VaP patients than in PSP-RS patients. Univariate analyses showed that stance and step time variability of PSP-RS were associated with their volume of right cerebellar cortex normalized to the total subcortical gray matter volume [Figure 2] and with the thickness of left transverse temporal gyrus as well [Figure 3]. Our findings demonstrate the disease-specific morphometric changes between PSP-RS and VaP. These differences reflect the involvement of distinct gait mechanisms in them. This study highlights upon the neural correlates of gait and balance impairment, which is a crucial step toward understanding the pathophysiology and finding effective interventions in PSP and VaP.
- Subjects
PARKINSONIAN disorders; DIAGNOSIS of brain diseases; GAIT disorders
- Publication
Annals of Movement Disorders, 2022, Vol 5, pS8
- ISSN
2590-3446
- Publication type
Abstract