Gait stability reflects motor tracts damage at early stages of multiple sclerosis

L. Eduardo Cofré Lizama, Myrte Strik, Anneke van der Walt, Trevor J. Kilpatrick, Scott C. Kolbe, Mary P. Galea

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)


Background: Gait in people with multiple sclerosis (PwMS) is affected even when no changes can be observed on clinical examination. A sensitive measure of gait deterioration is stability; however, its correlation with motor tract damage has not yet been established. Objective: To compare stability between PwMS and healthy controls (HCs) and determine associations between stability and diffusion magnetic resonance image (MRI) measures of axonal damage in selected sensorimotor tracts. Methods: Twenty-five PwMS (Expanded Disability Status Scale (EDSS) < 2.5) and 15 HCs walked on a treadmill. Stability from sacrum (LDE SAC), shoulder (LDE SHO) and cervical (LDE CER) was calculated using the local divergence exponent (LDE). Participants underwent a 7T-MRI brain scan to obtain fibre-specific measures of axonal loss within the corticospinal tract (CST), interhemispheric sensorimotor tract (IHST) and cerebellothalamic tract (CTT). Correlation analyses between LDE and fibre density (FD) within tracts, fibre cross-section (FC) and FD modulated by FC (FDC) were conducted. Between-groups LDE differences were analysed using analysis of variance (ANOVA). Results: Correlations between all stability measures with CST FD, between CST FDC with LDE SAC and LDE CER, and LDE CER with IHST FD and IHST FDC were significant yet moderate (R < −0.4). Stability was significantly different between groups. Conclusions: Poorer gait stability is associated with corticospinal tract (CST) axonal loss in PwMS with no-to-low disability and is a sensitive indicator of neurodegeneration.

Original languageEnglish
Pages (from-to)1773-1782
Number of pages10
Issue number11
Early online date2022
Publication statusPublished - Oct 2022


  • 7T-MRI
  • Lyapunov
  • Stability
  • balance
  • tractography
  • walking

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