Research Paper Volume 12, Issue 3 pp 2814—2824

Cerebral small vessel disease is associated with gait disturbance among community-dwelling elderly individuals: the Taizhou imaging study

Peixi Li 1, *, , Yingzhe Wang 1, *, , Yanfeng Jiang 2, 3, 4, , Kexun Zhang 4, 5, , Qi Yang 1, , Ziyu Yuan 4, , Zhen Zhu 4, 5, , Weijun Tang 6, , Min Fan 7, , Weimin Ye 4, 8, , Qiang Dong 1, , Li Jin 2, 3, 4, , Ding Ding 1, , Mei Cui 1, , Xingdong Chen 2, 3, 4, ,

  • 1 Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
  • 2 State Key Laboratory of Genetic Engineering and the Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai 200438, China
  • 3 Human Phenome Institute, Fudan University, Shanghai 200438, China
  • 4 Fudan University Taizhou Institute of Health Sciences, Taizhou 225312, Jiangsu, China
  • 5 Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
  • 6 Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
  • 7 Taixing Disease Control and Prevention Center, Taizhou 225400, Jiangsu, China
  • 8 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17177, Sweden
* Equal contribution

received: July 15, 2019 ; accepted: January 19, 2020 ; published: February 11, 2020 ;
How to Cite

Copyright © 2020 Li et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Gait disturbance is considered to be a significant clinical manifestation of cerebral small vessel disease (CSVD). We aimed to investigate the association between different imaging markers of CSVD or total CSVD burden and gait disturbance in a community-dwelling population. In the cross-sectional Taizhou Imaging Study (TIS), 314 participants free of neurological disorders underwent MRI scanning and gait assessment with quantitative wearable devices as well as clinical rating scales. In linear regression, after adjustment for demographics and vascular risks, total CSVD burden was associated with prolonged 3-m walking (β=0.118, P=0.035), shorter stride length (β=-0.106, P=0.042), and poorer Timed-Up-and-Go (TUG) performance (β=0.146, P=0.009). Lacunes were positively associated with 3-m walking (β=0.118, P=0.037) and duration of TUG test (β=0.112, P=0.047). White matter hyperintensities and cerebral microbleeds were associated with prolonged stride time (β=0.134, P=0.024) and increased stance phase time percentage (β=0.115, P=0.038), respectively. Logistic regression revealed that participants with high CSVD burden or more lacunes were more likely to have an impaired gait velocity and an impaired TUG test. These results suggest that total CSVD burden and CSVD imaging markers are associated with gait disturbance among community-dwelling elderly people. Different CSVD imaging markers may cause gait disturbance through different pathways.


CSVD: cerebral small vessel disease; TIV: total intracranial volume; WMH: white matter hyperintensities; PVS: perivascular spaces; CMBs: cerebral microbleeds; TUG: Timed-Up-and-Go; MRI: magnetic resonance imaging.