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Mobility decline in the elderly relates to lesion accrual in the splenium of the corpus callosum

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Abstract

In a previous cross-sectional study on baseline data, we demonstrated that the volume of brain white matter hyperintensities (WMH) in the splenium of corpus callosum (SCC) predicted the current mobility function of older persons. The primary aim of this follow-up study was to determine the relation of WMH volume change in SCC (SCC-∆WMH) with change in mobility measures. A secondary aim was to characterize the global and regional progression of WMH. Mobility function and WMH burden were evaluated at baseline and at 2 years in 77 community-dwelling individuals (baseline age, 82 ± 4). Regional WMH in SCC, as well as genu and body of corpus callosum, subregions of corona radiata, and superior longitudinal fasciculus were determined using a white matter parcellation atlas. The total WMH volume increased 3.3 ± 3.5 ml/year, mainly through enlargement. Significant WMH increases were observed in all selected regions, particularly within the corona radiata. While at baseline and follow-up we observed correlations between WMH burden and several measures of mobility, longitudinal change correlated only with change in chair rise (CR). SCC-∆WMH showed the highest correlation (r = −0.413, p = 0.0002) and was the best regional predictor of CR decline (OR = 1.5, r 2 = 0.3). The SCC-∆WMH was more than five times larger in the CR-decline group compared to the no-decline group (p = 0.0003). The SCC-∆WMH (top quartile) showed a higher sensitivity/specificity for CR decline compared to change in total WMH, 63/88% versus 52/84%, respectively. The findings suggest that accrual of WMHs in posterior areas of the brain supporting inter-hemispheric integration and processing of visual–spatial information is a mechanism contributing to age-related mobility deterioration.

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Acknowledgments

Study supported by the National Institute on Aging—AG022092 (LW) and AG022092-01A1S1 (NM)—University of Connecticut Health Center General Clinical Research Center Grant M01 RR06192; NIH 5 P41 RR13218. We wish to thank Istvan Csapo for his expert advice on image analysis and method validation, Yang Duang for expert neuroradiological assistance, Antal Kucsai for assistance with computer network and archiving of digital MR images, Brian Healy for advice on statistical analyses, and Julie Raulukaitis, Greg Book, and Russell Starankewicz for assistance with MR image acquisition and transfer.

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Authors and Affiliations

  1. Center for Neurological Imaging, Department of Radiology, Brigham & Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, RF-398, Boston, MA, 02115, USA

    Nicola Moscufo, Dominik Meier, Maria Liguori, Peter G. Hildenbrand & Charles R. G. Guttmann

  2. Department of Neurology, University of Connecticut Health Center, Farmington, CT, USA

    Nicola Moscufo, Leslie Wolfson, Dorothy Wakefield & Julia A. Schmidt

  3. Institute of Neurological Sciences, National Research Council, Mangone (CS), Italy

    Maria Liguori

  4. Lahey Clinic, Burlington, MA, USA

    Peter G. Hildenbrand

  5. Olin Neuropsychiatry Research Center, Hartford Hospital/IOL, Hartford, CT, USA

    Godfrey D. Pearlson

Authors
  1. Nicola Moscufo
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  2. Leslie Wolfson
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  3. Dominik Meier
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  4. Maria Liguori
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  5. Peter G. Hildenbrand
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  6. Dorothy Wakefield
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  7. Julia A. Schmidt
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  8. Godfrey D. Pearlson
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  9. Charles R. G. Guttmann
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Corresponding author

Correspondence to Nicola Moscufo.

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Fig. 1

Boxplots show the distribution of WMH volume changes (y-axis) in the two chair rise mobility groups (decline and no-decline, x-axis). The WMH variables shown are those that, in addition to the splenium of corpus callosum, showed significant correlation with decline in the chair rise test (see Table 3). Change was calculated as: [WMH burden at follow-up] − [WMH burden at baseline] (see also “Methods”). Thick horizontal line in the boxes indicates the group median. Circles, outliers; star, extreme outliers. The statistical significance of the group difference (Mann–Whitney group comparison test) is shown on top (JPEG 9 kb)

High resolution image file. (TIFF 1427 kb)

Tables 1–2

(DOC 89 kb)

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Moscufo, N., Wolfson, L., Meier, D. et al. Mobility decline in the elderly relates to lesion accrual in the splenium of the corpus callosum. AGE 34, 405–414 (2012). https://doi.org/10.1007/s11357-011-9242-4

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  • DOI: https://doi.org/10.1007/s11357-011-9242-4

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