Vascular gait disorders What's the matter with the white and gray matter?

Small vessel disease is the commonest known brain disorder, and, among its hallmarks, difficulty walking is a major cause of increased dependency and reduced quality of life, as well as death. Although gait problems relate to the presence and extent of various neuroimaging markers of small vessel disease (e.g., white matter hyperintensities, lacunes, and cerebral microbleeds), the exact mechanisms involved, and any additional role of neurodegenerative pathology, are not well-understood. A key question is how small vessel disease affects white matter integrity and ultimately motor and cognitive function to result in clinical symptoms.