title: Shape abnormalities of the caudate nucleus correlate with poorer gait and balance: results from a subset of the LADIS study.
abstract: OBJECTIVE
  Functional deficits seen in several neurodegenerative disorders have been linked with dysfunction in frontostriatal circuits and with associated shape alterations in striatal structures. The severity of visible white matter hyperintensities (WMHs) on magnetic resonance imaging has been found to correlate with poorer performance on measures of gait and balance. This study aimed to determine whether striatal volume and shape changes were correlated with gait dysfunction.
  
  
  METHODS
  Magnetic resonance imaging scans and clinical gait/balance data (scores from the Short Physical Performance Battery [SPPB]) were sourced from 66 subjects in the previously published LADIS trial, performed in nondisabled individuals older than age 65 years with WMHs at study entry. Data were obtained at study entry and at 3-year follow-up. Caudate nuclei and putamina were manually traced using a previously published method and volumes calculated. The relationships between volume and physical performance on the SPPB were investigated with shape analysis using the spherical harmonic shape description toolkit.
  
  
  RESULTS
  There was no correlation between the severity of WMHs and striatal volumes. Caudate nuclei volume correlated with performance on the SPPB at baseline but not at follow-up, with subsequent shape analysis showing left caudate changes occurred in areas corresponding to inputs of the dorsolateral prefrontal, premotor, and motor cortex. There was no correlation between putamen volumes and performance on the SPPB.
  
  
  CONCLUSIONS
  Disruption in frontostriatal circuits may play a role in mediating poorer physical performance in individuals with WMHs. Striatal volume and shape changes may be suitable biomarkers for functional changes in this population.
authors.affiliation: Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, Australian Capital Territory, Australia. Electronic address: mmacfarlane1@gmail.com.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Macfarlane
authors.affiliation: Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, Australian Capital Territory, Australia; Division of Clinical Geriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institute, Stockholm, Sweden.
authors.forename: Jeffrey C L
authors.initials: JC
authors.lastname: Looi
authors.affiliation: Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital and University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Walterfang
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institute, Stockholm, Sweden.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Spulber
authors.affiliation: Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital and University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Dennis
authors.initials: D
authors.lastname: Velakoulis
authors.affiliation: Neuroimaging Research and Analysis Laboratories, Carolina Institute of Developmental Disabilities, Departments of Psychiatry and Computer Science, University of North Carolina, Chapel Hill, NC.
authors.forename: Martin
authors.initials: M
authors.lastname: Styner
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institute, Stockholm, Sweden.
authors.forename: Milita
authors.initials: M
authors.lastname: Crisby
authors.affiliation: Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden; Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Orndahl
authors.affiliation: Department of Neurological Sciences, University of Helsinki, Finland; Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Erkinjuntti
authors.affiliation: Memory Disorders Research Group, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Gunhild
authors.initials: G
authors.lastname: Waldemar
authors.affiliation: Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital, Hvidovre, Denmark.
authors.forename: Ellen
authors.initials: E
authors.lastname: Garde
authors.affiliation: Department of Neurology, Universitäts Medizin Mannheim UMM, University of Heidelberg, Mannheim, Germany.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Hennerici
authors.affiliation: Department of Neurology, Universitäts Medizin Mannheim UMM, University of Heidelberg, Mannheim, Germany.
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Bäzner
authors.affiliation: Department of Neurology, Universitäts Medizin Mannheim UMM, University of Heidelberg, Mannheim, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Blahak
authors.affiliation: Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Wallin
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institute, Stockholm, Sweden.
authors.forename: Lars-Olof
authors.initials: LO
authors.lastname: Wahlund
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002421:Caudate Nucleus / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D056784:Leukoencephalopathies / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D004856:Postural Balance / Q000502:physiology*
keywords: MRI; Striatum; caudate nucleus; gait; white matter disease
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