Cognition mediates the relation between structural network efficiency and gait in small vessel disease

Mengfei Cai, Mina A. Jacob, David G. Norris, Marco Duering, Frank Erik de Leeuw, Anil M. Tuladhar*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

15 Citations (Scopus)
22 Downloads (Pure)


Cerebral small vessel disease (SVD), including white matter hyperintensities (WMH), microbleeds, lacunes, was related to gait disturbances, while the underlying mechanism is unclear. Here, we investigated the relation between structural network efficiency, cognition and gait performance in 272 elderly subjects with SVD. All participants underwent 1.5 T MRI, gait and neuropsychological assessment. Conventional MRI markers for SVD, i.e. WMH volume, number of lacunes and microbleeds, were assessed. Diffusion tensor imaging-based tractography was used to reconstruct the brain network for each individual, followed by graph-theoretical analyses to compute the well-established network measure, global efficiency. We found that lower global efficiency was associated with worse gait performance, including slower gait speed and shorter stride length, independent of conventional MRI markers for SVD. This association was partly mediated via cognitive function. We identified subnetworks of white matter connections associated with gait and cognition, characterized by dominant involvement of frontal tracts. Our findings suggest that network disruption is associated with gait disturbances through cognitive dysfunction in elderly with SVD. Gait is a highly cognitive process and the crucial role of cognition should be considered when investigating gait disturbances in the elderly with SVD.

Original languageEnglish
Article number102667
JournalNeuroImage: Clinical
Publication statusPublished - Jan 2021
Externally publishedYes


  • UT-Hybrid-D
  • Gait
  • Network efficiency
  • Small vessel disease
  • Cognition


Dive into the research topics of 'Cognition mediates the relation between structural network efficiency and gait in small vessel disease'. Together they form a unique fingerprint.

Cite this