Abstract
ObjectiveThe purposes of this study are to investigate the regional homogeneity (ReHo) of spontaneous brain activities in Parkinson’s disease (PD) patients with freeze of gait (FOG) and to investigate the neural correlation of movement function through resting-state functional magnetic resonance imaging (RS-fMRI).MethodsA total of 35 normal controls (NC), 33 PD patients with FOG (FOG+), and 35 PD patients without FOG (FOG−) were enrolled. ReHo was applied to evaluate the regional synchronization of spontaneous brain activities. Analysis of covariance (ANCOVA) was performed on ReHo maps of the three groups, followed by post hoc two-sample t-tests between every two groups. Moreover, the ReHo signals of FOG+ and FOG− were extracted across the whole brain and correlated with movement scores (FOGQ, FOG questionnaire; GFQ, gait and falls questionnaire).ResultsSignificant ReHo differences were observed in the left cerebrum. Compared to NC subjects, the ReHo of PD subjects was increased in the left angular gyrus (AG) and decreased in the left rolandic operculum/postcentral gyrus (Rol/PostC), left inferior opercular-frontal cortex, left middle occipital gyrus, and supramarginal gyrus (SMG). Compared to that of FOG−, the ReHo of FOG+ was increased in the left caudate and decreased in the left Rol/PostC. Within the significant regions, the ReHo of FOG+ was negatively correlated with FOGQ in the left SMG/PostC (r = −0.39, p < 0.05). Negative correlations were also observed between ReHo and GFQ/FOGQ (r = −0.36/−0.38, p < 0.05) in the left superior temporal gyrus (STG) of the whole brain analysis based on AAL templates.ConclusionThe ReHo analysis suggested that the regional signal synchronization of brain activities in FOG+ subjects was most active in the left caudate and most hypoactive in the left Rol/PostC. It also indicated that ReHo in the left caudate and left Rol/PostC was critical for discriminating the three groups. The correlation between ReHo and movement scores (GFQ/FOGQ) in the STG has the potential to differentiate FOG+ from FOG−. This study provided new insight into the understanding of PD with and without FOG.
Highlights
Parkinson’s disease (PD) is a kind of neurodegenerative disease characterized by motor deficits (Villarreal et al, 2018)
Freezing of gait (FOG) is more commonly observed in PD patients with advanced disease stages and old age, it may occur in the early stage of idiopathic PD
In the most recent decade, an increasing number of neuroimaging studies have focused on exploring the pathophysiology of PD patients with FOG by using different imaging modalities (Bartels and Leenders, 2008; Fasano et al, 2015) such as positron emission tomography (PET) (Park et al, 2009; Bohnen et al, 2014), functional near-infrared spectroscopy (Maidan et al, 2015), diffusion tensor imaging (DTI) (Schweder et al, 2010; Herman et al, 2013), and functional magnetic resonance imaging (Tessitore et al, 2012b; Wang et al, 2016; Li et al, 2018)
Summary
Parkinson’s disease (PD) is a kind of neurodegenerative disease characterized by motor deficits (Villarreal et al, 2018). Freezing of gait (FOG) is a disabling symptom characterized by brief episodes of an inability to take a step or taking extremely short steps that typically occurs on initiating gait or on turning while walking (Nutt et al, 2011). FOG is more commonly observed in PD patients with advanced disease stages and old age, it may occur in the early stage of idiopathic PD. Though FOG is transient and lasts for only a few seconds, it greatly impacts the quality of life of affected patients. FOG in PD patients is suggested to be associated with abnormalities in motor, executive, cognitive, and affective functions (Amboni et al, 2008; Shine et al, 2013b). The pathophysiological mechanisms of FOG are not yet fully understood
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