Abstract

Freezing of gait (FOG) in Parkinson's disease (PD) leads to devastating consequences; however, little is known about its functional brain network. We explored the differences in degree centrality (DC) of functional networks among PD with FOG (PD FOG+), PD without FOG (PD FOG–), and healthy control (HC) groups. In all, 24 PD FOG+, 37 PD FOG–, and 22 HCs were recruited and their resting-state functional magnetic imaging images were acquired. The whole brain network was analyzed using graph theory analysis. DC was compared among groups using the two-sample t-test. The DC values of disrupted brain regions were correlated with the FOG Questionnaire (FOGQ) scores. Receiver operating characteristic curve analysis was performed. We found significant differences in DC among groups. Compared with HCs, PD FOG+ patients showed decreased DC in the middle frontal gyrus (MFG), superior temporal gyrus (STG), parahippocampal gyrus (PhG), inferior temporal gyrus (ITG), and middle temporal gyrus (MTG). Compared with HC, PD FOG– presented with decreased DC in the MFG, STG, PhG, and ITG. Compared with PD FOG–, PD FOG+ showed decreased DC in the MFG and ITG. A negative correlation existed between the DC of ITG and FOGQ scores; the DC in ITG could distinguish PD FOG+ from PD FOG– and HC. The calculated AUCs were 81.3, 89.5, and 77.7% for PD FOG+ vs. HC, PD FOG– vs. HC, and PD FOG+ vs. PD FOG–, respectively. In conclusion, decreased DC of ITG in PD FOG+ patients compared to PD FOG– patients and HCs may be a unique feature for PD FOG+ and can likely distinguish PD FOG+ from PD FOG– and HC groups.

Highlights

  • Freezing of gait (FOG) is a disabling condition that often affects people with advanced-stage Parkinson’s disease (PD) [1]

  • As for age, education level, sex, and Mini-Mental State Examination (MMSE) scores, no significant differences have been found between healthy control (HC), PD FOG, and PD FOG+ groups (p > 0.05)

  • PD FOG+ patients showed significant differences in disease duration, FOG Questionnaire (FOGQ), Frontal Assessment Battery (FAB), and Timed Up and Go (TUG) scores (p < 0.05), but there was no difference in terms of Unified Parkinson’s Disease Rating Scale (UPDRS)-III score, Hoehn and Yahr (H&Y) scale score, Montreal Cognitive Assessment (MoCA), Hamilton Depression Rating Scale (HDRS), or Hamilton Anxiety Rating Scale (HARS) scores (p > 0.05) between PD FOG+ and PD FOG– groups

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Summary

Introduction

Freezing of gait (FOG) is a disabling condition that often affects people with advanced-stage Parkinson’s disease (PD) [1]. The clinical manifestation of FOG is that when the patients attempt to walk or advance, their steps are suddenly. PD FOG+ patients often report that their feet seem stuck to the floor or sucked by the floor, making it difficult to lift their feet and/or step forward [5]. The typical FOG symptom usually lasts for a few seconds, but occasionally can last for 30 s or more [6]. FOG cannot be satisfactorily managed by dopaminergic medication or deep brain stimulation [7, 8]

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