Objective: To assess the subcortical motor structures of the brain associated with independent gait domains from Lord et al’s gait models (1, 2), in Parkinson’s disease (PD) patients and healthy age-matched controls.

Background: PD is associated with poor gait, yet the underlying mechanisms of gait are not well understood, limiting its therapeutic management. Several groups have reported associations between quantitative gait measures and regional brain structures in healthy ageing; few have studied structural associations in PD, or assessed quantitative gait using a robust gait model. It is postulated that movement-related subcortical regions are responsible for several aspects of gait, and that regional associations differ in movement disorders such as PD.

Methods: Within 6 months of diagnosis, 100 PD patients and 47 healthy controls underwent quantitative gait assessment and a magnetic resonance imaging (MRI) scan through the ICICLE-PD and ICICLE-Gait studies. 3T MRI acquisitions utilized a standard T1-weighted volumetric sequence; cerebellar, brainstem, caudate and putamen volumes were measured with Freesurfer image processing software. For gait assessment, participants walked continuously for 2 minutes around a 25m circuit, with gait repeatedly sampled as participants walked over a 7m X 0.6m instrumented walkway included in the circuit. As appropriate, parametric or non-parametric correlations were made between motor-related subcortical brain structures and gait domains, with multiple comparison adjustment and including age, gender and total intracranial volume as covariates. p<0.01 was considered of interest for this exploratory analysis.

Results: Preliminary analysis suggests two of five older adult gait domains significantly correlated to caudate volume in controls. A positive correlation was observed between right caudate volume and the postural control domain, whereas a negative association was evident between left caudate volume and the variability domain (for both, p<0.01). No associations were made between any PD gait domain and subcortical motor structures.

Conclusions: This study gives evidence for the caudate nucleus being responsible for postural control and gait variability during gait in typical healthy ageing, but not PD gait. Not all of the assessed gait domains related to the subcortical regions investigated here, suggesting that cortical regions may have more involvement in the control of other aspects of gait.

References: 1. Lord S, Galna B, Verghese J, Coleman S, Burn D, Rochester L. Independent domains of gait in older adults and associated motor and nonmotor attributes: Validation of a factor analysis approach. Journals of Gerontology – Series A Biological Sciences and Medical Sciences. 2013;68(7):820-7. 2. Lord S, Galna B, Rochester L. Moving forward on gait measurement: Toward a more refined approach. Movement Disorders. 2013;28(11):1534-43.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/structural-neural-correlates-of-independent-gait-domains-in-parkinsons-disease/