Association of Dual-Task Gait Cost and White Matter Hyperintensity Burden Poststroke: Results From the ONDRI.

The study is cross-sectional, so it cannot show that white matter hyperintensity burden caused higher dual-task gait cost. There was no age-matched control group without stroke, so white matter hyperintensity volumes cannot be compared with healthy individuals without history of stroke. Participants had very low stroke symptoms (NIHSS 0 to 6) and had to walk unassisted for at least 10 m, so findings may not apply to more impaired poststroke patients. 18 participants who walked faster during dual-tasking were excluded, along with 18 missing-data cases and 2 outliers, so the final 123 may not represent all poststroke adults. The imaging pipeline did not assess some tracts and subregions, including pre-motor cortex, motor cortex, putamen, caudate and thalamic radiations. Few detected strokes prevented analysis of stroke location.

The authors declared no potential conflicts of interest. The research was supported in part by the Ontario Brain Institute, an independent non-profit funded partially by the Ontario government (Grant# ONDRI/OBI-34739).

Do not read the basal ganglia and thalamus finding as a clinical diagnostic rule. The study found a group-level association in poststroke adults with low stroke symptoms, and it did not show that dual-task gait cost caused, or was caused by, white matter lesion burden.