認知正常中老年人大腦白質徑完整性與單一及雙重任務步態表現之關聯性：擴散頻譜造影研究

杜建廣

doi:10.6342/NTU201700346

山西大学，您好！

感谢采购，人社期刊库｜人社论文库，期间：2025/01/01~2025/12/31

感谢试用，科学期刊库｜科学论文库，期间：2024/10/20~2025/01/20

浏览高级检索

关闭
检索检索高级检索出版物检索
浏览期刊主题浏览核心期刊浏览期刊拼音浏览

关闭

查询符号(半角)	查询符号意义说明
空格	表示为「AND」两个查询词之交集
双引号 ( " " )	片语以双引号标示开始及结束，而且只寻找出现顺序相同的字词，例： " image process "
?	表示一个字母切截，输入两个?表两个字母，依此类推，例：输入「Appl?」，查得结果应为appl e , appl y … ( 常用于英文字查询 )
*	表示不限字母切截，由0~n. 例：输入「appl*」，查得结果应为appl e , appl es , appl y , appl ied , appl ication … ( 常用于英文字查询 )
AND、OR、NOT	布尔逻辑组合关键字，用来扩大或缩小查询范围的技巧。 (1) AND ：缩小查询范围 (2) OR ：扩大查询范围(3) NOT：排除不相关的范围

DOI 是数位物件识别码（ D igital O bject I dentifier ）的简称，
为物件在网路上的唯一识别码，可用于永久连结并引用目标物件。

使用DOI作为永久连结

每个DOI号前面加上「 http://dx.doi.org/ 」便成为永久网址。
如以DOI号为 10.5297/ser.1201.002 的文献为例，此文献的永久连结便是： http://dx.doi.org/ 10.5297/ser.1201.002 。
日后不论出版单位如何更动此文献位置，永久连结所指向的位置皆会即时更新，不再错失重要的研究。

引用含有DOI的文献

有DOI的文献在引用时皆应同时引用DOI。若使用APA、Chicago以外未规范DOI的引用格式，可引用DOI永久连结。

DOI可强化引用精确性、增强学术圈连结，并给予使用者跨平台的良好使用经验，目前在全世界已有超过五千万个对象申请DOI。如想对DOI的使用与概念有进一步了解，请参考（）。

书目管理工具

相关连结

问题回报

全文下载

认知正常中老年人大脑白质径完整性与单一及双重任务步态表现之关联性：扩散频谱造影研究

Relationships between Structural Integrity of Cerebral White Matter Tracts and Single- and Dual-Task Gait Performance in Cognitively Normal Middle-Aged and Older Adults: A Diffusion Spectrum Imaging Study

杜建广 , 硕士　　导师：汤佩芳　　

繁体中文 DOI： 10.6342/NTU201700346

中老年人；步态；双重任务；脑白质径；扩散频谱造影；以路径为基础之自动化神经纤维束分析； middle-aged and older adults ； gait ； dual-task ； white matter tracts ； diffusion spectrum imaging ； tract-based automatic analysis

0 个人觉得这篇文章赞

摘要 │ 参考文献 (193) │ 国际计量

摘要〈TOP〉

背景与目的：步态表现与脑白质径皆会随着年龄而退化，然而两者间之关系尚未被完整探讨。本研究旨在探讨：在认知正常的中老年族群中，其单一与双重任务下时间及空间步态参数是否可归类为数个独立的步态面向，且特定脑白质径完整性是否与步态面向的表现有独立的相关性。方法：本研究纳入103名50岁以上（平均64.3 ± 5.6岁）认知功能正常之中老年人。受试者均接受心智与体能评估；单一、动作双重、与认知双重任务三种情境下舒适速度行走之步态评估；以及脑部磁振造影(Magnetic Resonance Imaging，MRI)影像扫描。脑部影像包含T1-权重、T2-权重及扩散频谱造影（diffusion spectrum imaging）等影像资料。步态资料之收集与分析皆使用GaitMatIITM，分析得三种情境下之八个步态时间及空间参数以及其变异性。透过T1-权重影像及T2-权重影像资料分析，分别取得量化之脑体积及脑白质病变严重度目测评级；扩散频谱影像资料则采以路径为基础之自动化分析（tract-based automatic analysis），得到76条脑白质径之普扩散不等向性值（general fractional anisotropy），以代表纤维束之完整性。统计分析预计采用PASW 18.0软体进行主成分分析（principle component analysis），分析三种情境下之步态面向，并以单变数回归分析先找出与各情境下各步态面向有关的脑白质径完整性。最後以多变数回归分析，找出影响各情境下各步态面向之最重要脑白质径完整性因子。所有回归分析中皆会控制八个共变项。
结果：主成分分析显示，单一任务下之步态参数可归类为步调、节律、相位、支撑底面积、步调变异、节律变异-相位变异等六个面向；动作与认知双重任务下之步态参数则可归类为节律、相位、支撑底面积、步调变异-节律变异、相位变异等五个面向。多变数回归分析结果显示，单一任务下，影响步调、相位、与支撑底面积面向之脑白质径完整性分别为右侧皮质脊髓径（β = 0.236, p = 0.018）、右侧弓状束（β =－0.205, p = 0.035）、与左侧钩束（β = 0.236, p = 0.015）。动作双重任务下，影响相位、支撑底面积、步调变异-节律变异、与相位变异面向之脑白质径完整性分别为左侧额叶纹状体径（β = 0.216, p = 0.025）、左侧皮质脊髓径（β = 0.206, p = 0.049）、左侧扣带回径（β = 0.359, p = <0.001）、与胼胝体径（β = －0.251, p = 0.006）。认知双重任务下，影响相位、支撑底面积、与相位变异面向之脑白质径完整性分别为右侧上纵束（β = 0.241, p = 0.014）、右侧扣带回径（β = 0.234, p = 0.017）、与左侧丘脑辐射径（β =－0.309, p = 0.003）。
讨论与结论：中老年人单一任务及两种双重任务下之步态参数可被归类为数个但稍有不同的独立步态面向。在单一任务下，步态表现与动作及边缘系统相关之脑白质径完整性较有关。动作双重任务下，动作皮质区、基底核及胼肢体等负责动作协调之相关神经束完整性越高，步态表现越佳。认知双重任务下，与整合认知、感觉与动作讯息相关之大脑皮质-大脑皮质或大脑皮质-大脑皮质下神经束完整性越高，步态表现越佳。

并列摘要〈TOP〉

Background: Gait performance and white matter tracts both decline with age. However, the relationship between the degeneration of white matter tracts and gait performance in middle-aged and older adults has not been comprehensively studied. Therefore, the aims of this study were to investigate whether spatiotemporal gait parameters under single- and dual-task walking conditions in cognitively normal middle-aged and older adults could be classified into independent domains, and whether the integrity of specific cerebral white matter tracts independently correlated with the these gait domains. Methods: One-hundred-and-three cognitively normal middle-aged and older adults over the age of 50 years (mean 64.3 ± 5.6 years) participated in this study. All participants received assessments of mental status, motor function, gait performance of comfortable-speed walking under single-task, motor dual-task and cognitive dual-task conditions, and brain MRI scans, including the T1-weighted, T2-weighted, and diffusion spectrum imaging (DSI). The GaitMatIITM was used for collection and analysis of spatiotemporal gait parameters and their stride-to-stride variabilities under the three conditions. Quantified brain volume measures and the visual rating of white matter lesions were obtained from T1-weighted and T2-weighted imaging, respectively. Values of general fractional anisotropy (GFA), which indicated the microstructural integrity of white matter fiber tracts, of 76 white matter fiber tracts were obtained from the DSI, using a validated tract-based automatic analysis technique. Principle component analysis (PCA) was used to classify gait domains under the three conditions. Univariate regression analyses were used to determine the tracts independently correlated with scores of gait domains under each condition, and multivariate regression analyses were used to determine the most important tracts that independently affacted scores of gait domains. Eight covariates were used in all regression analyses. Results: The gait domains emerged from the PCA of single-task gait were: pace, rhythm, phase, base of support, pace variability, and rhythm variability-phase variability; and those emerged from the PCA of motor and cognitive dual-task gait were: rhythm, phase, base of support, pace variability-rhythm variability, and phase variability. Multivariate regression analyses showed that the integrity of the right corticospinal tract (β = 0.236, p = 0.018), right arcuate fasciculus (β =－0.205, p = 0.035), and left uncinate fasciculus (β = 0.236, p = 0.015) independently contributed to the pace, phase, and base of support domains of single-task gait performance, respectively. The integrity of the left frontostriatal tracts (β = 0.216, p = 0.025), left corticospinal tract (β = 0.206, p = 0.049), left cingulate bundle (β = 0.359, p = <0.001), and callosal tract (β =－0.251, p = 0.006) independently contributed to the phase, base of support, pace variability-rhythm variability, and phase variability domains of motor dual-task gait performance, respectively. The integrity of the the right superior longitudinal fasciculus (β = 0.241, p = 0.014), right cingulate bundle (β = 0.234, p = 0.017), and left thalamic radition (β =－0.309, p = 0.003) independently contributed to the phase, base of support, and phase variability domains of cognitive dual-task gait performance, respectively. Discussion & Conclusions: Spatiotemporal gait parameters of single-task and dual-task walking in middle-aged and older adults could be categorized into different independent domains. The single-task gait performance correlated mainly with the integrity of white matter tracts of the motor and limbic systems. The better the integrity of white matter tracts related to the motor cortex, basal ganglia, and corpus callosum was, the better the motor dual-task gait performance was. The better the white matter tracts integrity of cortico-cortical and cortico-subcortical tracts integrating cognitive, sensory, and motor systems, the better the cognitive dual-task gait performance was.

参考文献 ( 193 ) 〈TOP〉

Allali, G., Annweiler, C., Predovan, D., Bherer, L., Beauchet, O., 2016. Brain volume changes in gait control in patients with mild cognitive impairment compared to cognitively healthy individuals; GAIT study results. Exp Gerontol 76, 72-79.
连结：
Allen, M.D., Doherty, T.J., Rice, C.L., Kimpinski, K., 2016. Physiology in medicine: neuromuscular consequences of diabetic neuropathy. J Appl Physiol 121, 1-6.
连结：
Alvarez, J.A., Emory, E., 2006. Executive function and the frontal lobes: a meta-analytic review. Neuropsychology review 16, 17-42.
连结：
Al-Yahya, E., Dawes, H., Smith, L., Dennis, A., Howells, K., Cockburn, J., 2011. Cognitive motor interference while walking: a systematic review and meta-analysis. Neurosci Biobehav Rev 35, 715-728.
连结：
Annegarn, J., Spruit, M.A., Savelberg, H.H., Willems, P.J., van de Bool, C., Schols, A.M., Wouters, E.F., Meijer, K., 2012. Differences in walking pattern during 6-min walk test between patients with COPD and healthy subjects. PLoS One 7, e37329.
连结：

国际计量

〈TOP〉

E-mail ：

文章公开取用时，将寄通知信至您填写的信箱地址

E-mail ：

使用DOI作为永久连结

引用含有DOI的文献

DOI可强化引用精确性、增强学术圈连结，并给予使用者跨平台的良好使用经验，目前在全世界已有超过五千万个对象申请DOI。 如想对DOI的使用与概念有进一步了解，请参考 （ ） 。

DOI可强化引用精确性、增强学术圈连结，并给予使用者跨平台的良好使用经验，目前在全世界已有超过五千万个对象申请DOI。如想对DOI的使用与概念有进一步了解，请参考（）。