Zhao HY, Zhang ZQ, Huang YH, Li H, Wei FY. Performance of the walking trail making test in older adults with white matter hyperintensities. World J Psychiatry 2024; 14(1): 102-110 [PMID: 38327891 DOI: 10.5498/wjp.v14.i1.102]
Corresponding Author of This Article
Fang-Yuan Wei, MD, PhD, Director, Department of Hand and Foot Surgery, Beijing University of Chinese Medicine Third Affiliated Hospital, No. 51 Xiaoguan Street, Andingmenwai, Chaoyang District, Beijing 100029, China. footwfy@126.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. Jan 19, 2024; 14(1): 102-110 Published online Jan 19, 2024. doi: 10.5498/wjp.v14.i1.102
Performance of the walking trail making test in older adults with white matter hyperintensities
Hong-Yi Zhao, Zhi-Qiang Zhang, Yong-Hua Huang, Hong Li, Fang-Yuan Wei
Hong-Yi Zhao, Department of Neurology, No. 984 Hospital of PLA, Beijing 100094, China
Hong-Yi Zhao, Yong-Hua Huang, Department of Neurology, The Seventh Medical Center of PLA General Hospital, Beijing 100700, China
Zhi-Qiang Zhang, Mental Health Institute of Inner Mongolia Autonomous Region, The Third Hospital of Inner Mongolia Autonomous Region, Hohhot 010010, Inner Mongolia Autonomous Region, China
Hong Li, Department of Neurosurgery, No. 984 Hospital of PLA, Beijing 100094, China
Fang-Yuan Wei, Department of Hand and Foot Surgery, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China
Fang-Yuan Wei, Engineering Research Center of Chinese Orthopaedic and Sports Rehabilitation Artificial Intelligent, Ministry of Education, Beijing 100029, China
Co-first authors: Hong-Yi Zhao and Zhi-Qiang Zhang.
Author contributions: Zhao HY and Zhang ZQ were responsible for data collection, analysis and writing of the actual manuscript; Wei FY was responsible for study design; Huang YH and Li H were responsible for manuscript preparation.
Supported byThe Wu Jieping Medical Foundation, No. 320.6750.18456.
Institutional review board statement: The study was approved by the Seventh Medical Center of PLA General Hospital ethics committee, reference number: (2021) Ethics Review (015).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors report no conflict of interest.
Data sharing statement: Dataset available from the corresponding author at huangyonghua2017@126.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fang-Yuan Wei, MD, PhD, Director, Department of Hand and Foot Surgery, Beijing University of Chinese Medicine Third Affiliated Hospital, No. 51 Xiaoguan Street, Andingmenwai, Chaoyang District, Beijing 100029, China. footwfy@126.com
Received: August 26, 2023 Peer-review started: August 26, 2023 First decision: September 29, 2023 Revised: October 30, 2023 Accepted: December 21, 2023 Article in press: December 21, 2023 Published online: January 19, 2024 Processing time: 145 Days and 11.4 Hours
Abstract
BACKGROUND
Several studies have reported that the walking trail making test (WTMT) completion time is significantly higher in patients with developmental coordination disorders and mild cognitive impairments. We hypothesized that WTMT performance would be altered in older adults with white matter hyperintensities (WMH).
AIM
To explore the performance in the WTMT in older people with WMH.
METHODS
In this single-center, observational study, 25 elderly WMH patients admitted to our hospital from June 2019 to June 2020 served as the WMH group and 20 participants matched for age, gender, and educational level who were undergoing physical examination in our hospital during the same period served as the control group. The participants completed the WTMT-A and WTMT-B to obtain their gait parameters, including WTMT-A completion time, WTMT-B completion time, speed, step length, cadence, and stance phase percent. White matter lesions were scored according to the Fazekas scale. Multiple neuropsychological assessments were carried out to assess cognitive function. The relationships between WTMT performance and cognition and motion in elderly patients with WMH were analyzed by partial Pearson correlation analysis.
RESULTS
Patients with WMH performed significantly worse on the choice reaction test (CRT) (0.51 ± 0.09 s vs 0.44 ± 0.06 s, P = 0.007), verbal fluency test (VFT, 14.2 ± 2.75 vs 16.65 ± 3.54, P = 0.012), and digit symbol substitution test (16.00 ± 2.75 vs 18.40 ± 3.27, P = 0.010) than participants in the control group. The WMH group also required significantly more time to complete the WTMT-A (93.00 ± 10.76 s vs 70.55 ± 11.28 s, P < 0.001) and WTMT-B (109.72 ± 12.26 s vs 82.85 ± 7.90 s, P < 0.001). WTMT-A completion time was positively correlated with CRT time (r = 0.460, P = 0.001), while WTMT-B completion time was negatively correlated with VFT (r = -0.391, P = 0.008). On the WTMT-A, only speed was found to statistically differ between the WMH and control groups (0.803 ± 0.096 vs 0.975 ± 0.050 m/s, P < 0.001), whereas on the WTMT-B, the WMH group exhibited a significantly lower speed (0.778 ± 0.111 vs 0.970 ± 0.053 m/s, P < 0.001) and cadence (82.600 ± 4.140 vs 85.500 ± 5.020 steps/m, P = 0.039), as well as a higher stance phase percentage (65.061 ± 1.813% vs 63.513 ± 2.465%, P = 0.019) relative to controls.
CONCLUSION
Older adults with WMH showed obviously poorer WTMT performance. WTMT could be a potential indicator for cognitive and motor deficits in patients with WMH.
Core Tip: A new modified trail making test [walking trail making test (WTMT)], was used to explore the cognitive and motor deficits in older adults with WMH. In addition, wearable sensors were selected firstly in the WTMT to analyze the gait features of subjects. The results implied that WTMT could be a potential indicator for the cognitive and motor deficits in WMH patients.
