Objectives. To test the relation between white matter lesions (WML) location and physical performance, in aged patients. Methods. Subjects: 29 patients (17 males), aged >65 (mean age ), with leukoaraiosis. WML was quantified with a visual scale; Apparent Diffusion Coefficient (ADC) was measured bilaterally in frontal periventricular lesioned white matter and frontal and parieto-occipital normal appearing white matter (NAWM). Motor performance was studied using the Short Physical Performance Battery (SPPB), single leg stand time, finger tapping and grooved pegboard tests (GPT). Results. There were significant correlations between the frontal region visual scale scores and SPPB chair stands ( ; ) and Grooved Pegboard ( ; ); frontal NAWM ADC values and SPPB standing balance ( ; ) and SPPB 4 meter walk ( ; ). Conclusion. Frontal WML are negatively related to motor performance in patients with leukoaraiosis. DWI results suggest that this may be true even for NAWM. 1. Introduction Leukoaraiosis was the first term introduced to characterize areas of loss of density of white matter observed on computerized tomography of the brain [1]. Later recognized as hyperintense areas on T2-weighted MR images, these findings, although probably related to vascular risk factors, are common in advanced age and thus usually designated age-related white matter changes (ARWMC). Several clinical features have been related to ARWMC, including cognitive impairment, depressive symptoms, mood disturbance, urinary dysfunction, and motor deficits. Among these, gait disturbance probably deserves further attention on account of related functional impairment [2, 3]. The pathophysiology of motor impairment in old age patients with leukoaraiosis is not fully understood. Although frequently attributed to frontal lobe dysfunction, related to disconnection effects of the lesions on white matter tracts [4], few studies have devoted their attention to the relation between ARWMC localization and motor deficits. Recently, conventional MRI studies have suggested that gait disturbance [5] and postural control [6] could be related not only to frontal but also to parieto-occipital (PO) lesions. Others have found association mainly with frontal lesions, when compared with basal ganglia and infratentorial lesions [7]. Difficulty in locating the cause of motor disturbance in patients with leukoaraiosis could be due to the low sensitivity of conventional imaging techniques to more subtle ischemic changes, occurring even in normal appearing white matter (NAWM). This could explain some mismatch between
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