Association of Cerebral Small Vessel Disease With Gait and Balance Disorders

Abstract

Cerebral small vessel disease (CSVD) is a common cerebrovascular disease and an important cause of gait and balance disorders. Gait and balance disorders can further lead to an increased risk of falls and a decreased quality of life. CSVD can damage gait and balance function by affecting cognitive function or directly disrupting motor pathways, and different CSVD imaging features have different characteristics of gait and balance impairment. In this article, the correlation between different imaging features of sporadic CSVD and gait and balance disorders has been reviewed as follows, which can provide beneficial help for standardized management of CSVD.

Keywords: brain atrophy; cerebral microbleeds; cerebrovascular disease; enlarged perivascular space; gait and balance disorders; lacunar infarction; white matter hyperintensity.

Figure 1

The framework of the associated mechanisms between cerebral small vascular disease (CSVD) and gait and balance disorders. (1) White matter hyperintensities (WMH) can disrupt gait and balance by interfering with motion pathways and cortical thickness. (2) Lacunar infarctions (LI) impair gait and balance by interfering with cognition and motion pathways. (3) Cerebral microbleeds (CMB) affect gait and balance by damaging motion pathways. (4) Brain atrophy can disrupt gait and balance by damage to cognition, nucleus atrophy related to motion control, and cortex and white matter atrophy. (5) Enlarged perivascular spaces (EPVS) have shown no direct evidence to disrupt gait and balance. (6) CSVD can aggravate the impairment of gait and balance by affecting neurodegenerative diseases.