Freezing of gait in Parkinson's disease is associated with altered functional brain connectivity

• Published in: Parkinsonism & related disorders Vol. 24; pp. 100 - 106
• Main Authors: Lenka, Abhishek, Naduthota, Rajini M, Jha, Menka, Panda, Rajanikant, Prajapati, Arvind, Jhunjhunwala, Ketan, Saini, Jitender, Yadav, Ravi, Bharath, Rose Dawn, Pal, Pramod Kumar
• Format: Journal Article Web Resource
• Language: English
• Published: England Elsevier Ltd 01-03-2016
• Subjects: Adult; Aged; Antiparasitic Agents; Antiparasitic Agents - therapeutic use; Brain; Brain - diagnostic imaging; Disability Evaluation; Female; Freezing of gait; Functional brain connectivity; Gait Disorders, Neurologic; Gait Disorders, Neurologic - etiology; Gait Disorders, Neurologic - pathology; Geriatrics and Gerontology; Human health sciences; Humans; Image Processing, Computer-Assisted; Levodopa; Levodopa - therapeutic use; Magnetic Resonance Imaging; Male; Middle Aged; Neural Pathways; Neural Pathways - diagnostic imaging; Neurologie; Neurology; Neurology (clinical); Oxygen; Oxygen - blood; Parkinson Disease - complications; Parkinson Disease - drug therapy; Parkinson's disease; Resting state functional MRI; rs-fMRI; Sciences de la santé humaine; Severity of Illness Index; Freezing of gait; Parkinson's disease; Resting state functional MRI; Functional brain connectivity; rs-fMRI
• ISSN: 1353-8020; 1873-5126; 1873-5126
• DOI: 10.1016/j.parkreldis.2015.12.016

Abstract Background Patients with Parkinson's disease (PD) may develop several gait disturbances during the course of illness and Freezing of gait (FOG) is one of them. Several neuroimaging studies have been conducted to identify the neural correlates of FOG but results have not been uniform. Resting state functional MRI (rs-fMRI) is relatively less explored in PD patients with FOG. This study aims to compare the whole brain resting state connectivity of PD patients with and without FOG using rs-fMRI. Methods rs-fMRI was obtained for 28 PD patients (15 with and 13 patients without FOG) who were matched for various demographic and clinical characteristics. Seed to voxel analysis was performed at whole brain level and compared between the two groups. Results When compared to patients without FOG, the patients with FOG had reduced functional connectivity across multiple seeds. Major finding was reduced inter-hemispheric connectivity of left parietal opercular cortex with multiple regions of the brain primarily involving the primary somatosensory and auditory areas, which also negatively correlated with the FOGQ scores. Conclusion Our findings suggest that alterations in the resting state functional connectivity of the opercular parietal cortex may be one of the substrates of FOG. Reduced interhemispheric connectivity probably is the reason for impairment of control and coordination in bilateral leg movements while walking.