Lower myelin content is associated with poorer gait variability in older adults with cerebral small vessel disease and mild cognitive impairment

N‡rlon C‡ssio Boa Sorte Silva (Corresponding Author), Teresa Liu-Ambrose, Elizabeth Dao, Chun Liang Hsu, Roger Tam, Ryan G. Stein, Walid Ahmed Alkeridy, Cornelia Laule, Irene M. Vavasour

Research output: Journal article publicationComment/debate/erratum


Background: Mobility decline is often observed in individuals with cerebral small vessel disease (cSVD). Loss of myelin in the cerebral white matter is a common feature of cSVD and could be one of the mechanisms contributing to poor mobility; however, this hypothesis remains to be tested. Using myelin water fraction (MWF), we investigated whether myelin content is associated with gait parameters in older adults with cSVD. Method: Cross-sectional data from individuals with cSVD and mild cognitive impairment were analyzed. Myelin content was assessed via MRI multi-echo gradient and spin echo T2 relaxation sequence, indexed as myelin water fraction (MWF). Gait parameters were measured using an electronic walkway. Hierarchical regression models adjusting for total intracranial volume, age, sex, body mass index, and Mini-Mental State Examination were conducted to determine the associations between MWF and gait parameters. Significant models were further adjusted for white matter hyperintensity burden. Result: Sixty-four participants were included (mean [SD], age = 75.2y [5.4], 62.5% female). In adjusted models, lower MWF in the cingulum (Unstandardized B (95% CI): -5.12 [-9.21 to -1.04], R2change = 0.09, Fchange = 6.31, pchange = 0.015), superior longitudinal fasciculus (-3.79 [-7.29 to -0.29], R2change = 0.07, Fchange = 4.70, pchange = 0.034), posterior corona radiata (-4.86 [-9.45 to -0.27], R2change = 0.07, Fchange = 4.49, pchange = 0.039), and body of the corpus callosum (-4.19 [-8.19 to -0.20], R2change = 0.06, Fchange = 4.41, pchange = 0.040) was associated with higher cycle time variability. White matter hyperintensity burden weakened these associations. Conclusion: In older adults with cSVD, Lower myelin content in specific white matter tracts may contribute to higher gait variability, increasing the overall risk of mobility impairment.

Original languageEnglish
Article numbere066978
JournalAlzheimer's and Dementia
Issue numberS5
Publication statusPublished - Dec 2022
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health


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