Characteristics of balance disorder in patients with cerebral small vessel disease

Abstract

Objective The present study aimed to explore the characteristics of balance instability in patients with cerebral small vessel disease (CSVD). Methods A total of 45 patients with CSVD and 37 age⁃, sex⁃, height⁃ and weight⁃matched healthy controls were recruited from April 2018 to August 2020. Imaging buden of CSVD was measured including lacunar infarct (LACI), white matter hyperintensity (WMH), cerebral microbleeds (CMBs) and enlarged perivascular space (EPVS). Balance function was measured by Tinetti Balance and Gait Analysis (TGBA). Horizontal and vertical directions of the different actions (standing on both feet+put hands to hips+open/closed eyes, standing on both feet+put hands to fronts+open/closed eyes) static balance data (including total movement speed, horizontal velocity and amplitude, vertical velocity and amplitude, coverage area of barycenter offset) were collected through a balance tester. Results All the CSVD patients demonstrated LACI, WMH, CMBs and EPVS, with a total CSVD burden score of 1, 2, 3 and 4 in 18 (40%), 15 (33.33%), 7 (15.56%) and 5 (11.11%) cases respectively. The ability of balance was similar between CSVD group and control group by TGBA score (t=1.431, P=0.156). In a standing position with their eyes open, the CSVD group demonstrated higher gravity excursion amplitude in horizontal direction, no matter they put their on their hips (t=3.718, P=0.000) or hands to their fronts (t=2.708, P=0.008), while they demonstrated higher gravity excursion velocity (t=2.292, P=0.025) and gravity excursion amplitude (t=2.679, P=0.009) in vertical direction and higher gravity excursion cover (t=4.457, P=0.000) when they put their hands to their fronts. In a standing position with their eyes closed, the CSVD group demonstrated higher total gravity excursion velocity (t=3.007, P=0.004; t=3.456, P=0.001), higher gravity excursion velocity (t=2.944, P=0.005; t=3.077, P=0.003) and gravity excursion amplitude (t=4.714, P=0.000; t=5.009, P=0.000) in horizontal direction, higher gravity excursion velocity（t=2.661, P=0.010; t=3.333, P=0.001) in vertical direction and higher gravity excursion cover (t=4.196, P=0.000; t=3.814, P=0.000), no matter they put their hands to their fronts or on their hips, while they demonstrated higher gravity excursion amplitude in vertical direction when they put their hands on their hips (t=3.053, P=0.003). Conclusions CSVD patients have impaired balance ability in early and medium stage, the balance tester plays a positive role in early detection of balance disorders in CSVD patients.

doi：10.3969/j.issn.1672⁃6731.2021.10.007