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

Lenka, Abhishek; Naduthota, Rajini M; Jha, Menka; Panda, Rajanikant; Prajapati, Arvind; Jhunjhunwala, Ketan; Saini, Jitender; Yadav, Ravi; Bharath, Rose Dawn; Pal, Pramod Kumar

doi:10.1016/j.parkreldis.2015.12.016

Cited by 42 publications

(29 citation statements)

References 30 publications

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“…Another report confirmed previous findings and showed that freezing of gait was associated with a decreased resting‐state functional connectivity within the sensorimotor and default mode networks . More recent studies have shown a reduced functional connectivity of parietal areas in PD patients with freezing of gait, as well as disrupted functional connectivity of the cortico‐pontine‐cerebellar pathways . Recent findings also demonstrated a functional alteration of limbic circuits in patients with freezing of gait, suggesting a multifactorial pathophysiological mechanism underlying this phenomenon involving the functional interactions between motor, cognitive, and affective networks …”

Section: Introductionsupporting

confidence: 78%

Resting‐state Functional MRI in Parkinsonian Syndromes

Filippi

Sarasso

Agosta

2019

Movement Disord Clin Pract

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Background Background: Functional MRI (fMRI) has been widely used to study abnormal patterns of functional connectivity at rest in patients with movement disorders such as idiopathic Parkinson's disease (PD) and atypical parkinsonisms. Methods Methods: This manuscript provides an educational review of the current use of resting-state fMRI in the field of parkinsonian syndromes. ResultsResults: Resting-state fMRI studies have improved the current knowledge about the mechanisms underlying motor and non-motor symptom development and progression in movement disorders. Even if its inclusion in clinical practice is still far away, resting-state fMRI has the potential to be a promising biomarker for early disease detection and prediction. It may also aid in differential diagnosis and monitoring brain responses to therapeutic agents and neurorehabilitation strategies in different movement disorders. ConclusionsConclusions: There is urgent need to identify and validate prodromal biomarkers in PD patients, to perform further studies assessing both overlapping and disease-specific fMRI abnormalities among parkinsonian syndromes, and to continue technical advances to fully realize the potential of fMRI as a tool to monitor the efficacy of chronic therapies.

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Section: Introductionsupporting

confidence: 78%

Resting‐state Functional MRI in Parkinsonian Syndromes

Filippi

Sarasso

Agosta

2019

Movement Disord Clin Pract

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“…The right-PPC, in connection with frontal regions, is strongly involved in multiple types of attention [ 12 , 51 ]. On the other hand, the left PPC has been recently shown to play a major role as a sensorimotor integrator as PD patients that exhibit FoG display reduced functional connectivity between left PPC and multiple brain regions such as the somatosensory and auditory areas [ 52 ]. Left PPC is therefore suggested to work as a sensorimotor integrator during online movement planning and monitoring, whereas the right PPC actively engages with different attentional networks.…”

Section: Discussionmentioning

confidence: 99%

Neural predictors of gait stability when walking freely in the real-world

Pizzamiglio

Abdalla

Naeem

et al. 2018

J NeuroEngineering Rehabil

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BackgroundGait impairments during real-world locomotion are common in neurological diseases. However, very little is currently known about the neural correlates of walking in the real world and on which regions of the brain are involved in regulating gait stability and performance. As a first step to understanding how neural control of gait may be impaired in neurological conditions such as Parkinson’s disease, we investigated how regional brain activation might predict walking performance in the urban environment and whilst engaging with secondary tasks in healthy subjects.MethodsWe recorded gait characteristics including trunk acceleration and brain activation in 14 healthy young subjects whilst they walked around the university campus freely (single task), while conversing with the experimenter and while texting with their smartphone. Neural spectral power density (PSD) was evaluated in three brain regions of interest, namely the pre-frontal cortex (PFC) and bilateral posterior parietal cortex (right/left PPC). We hypothesized that specific regional neural activation would predict trunk acceleration data obtained during the different walking conditions.ResultsVertical trunk acceleration was predicted by gait velocity and left PPC theta (4–7 Hz) band PSD in single-task walking (R-squared = 0.725, p = 0.001) and by gait velocity and left PPC alpha (8–12 Hz) band PSD in walking while conversing (R-squared = 0.727, p = 0.001). Medio-lateral trunk acceleration was predicted by left PPC beta (15–25 Hz) band PSD when walking while texting (R-squared = 0.434, p = 0.010).ConclusionsWe suggest that the left PPC may be involved in the processes of sensorimotor integration and gait control during walking in real-world conditions. Frequency-specific coding was operative in different dual tasks and may be developed as biomarkers of gait deficits in neurological conditions during performance of these types of, now commonly undertaken, dual tasks.

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“…Patients often describe their feet as "stuck" while trying to lift them forward, as if they were stuck to the ground. This process usually lasts for a few seconds [6]. The content includes three aspects: starting freezing, turning freezing and walking freezing, which can occur or aggravate when patients face space obstacles, under pressure, low attention or dual tasks.…”

Section: Freezing Of Gait (Fog) a Kind Of Pathological Gait With Dismentioning

confidence: 99%

Improvement of Freezing of Gait in Patients with Parkinson's Disease by Music Exercise Therapy: A Study Protocol for a Randomized Controlled Trial

Zhou

et al. 2020

Preprint

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Background: Freezing of gait, a common pathological gait in Parkinson's disease, is progressive with the progression of the disease. It is an important risk factor for patients to fall easily, lose their independent living ability and decline their quality of life. The treatment of Parkinson's disease with freezing of gait is very difficult, and the effect of medicine and operation is not ideal. Music exercise therapy is a kind of treatment technology that can change the behavior, emotion and physiological activity of patients by listening to music at the same time of exercise therapy. In recent years, music exercise therapy has been widely used in motor disorders and neurological diseases, and has achieved remarkable results. The small sample study in the early stage of this research group initially found that music exercise therapy can improve the freezing of gait of Parkinson's patients and improve the quality of life of patients. The overall purpose of this experiment is to expand the sample size to further evaluate the clinical effect of music exercise therapy on freezing of gait of Parkinson's patients.Methods/design: This randomized controlled trial will evaluate the clinical efficacy of music exercise therapy in improving the freezing of gait of Parkinson's patients. The patients will receive music exercise therapy, exercise therapy without music and routine rehabilitation therapy at random. We will recruit 81 inpatients of Parkinson's who meet the trial criteria to observe the changes of gait and limb motor function after 4 weeks of intervention. The first evaluation index is to use three-dimensional gait analysis system to evaluate the change of patients' gait. The second evaluation index includes limb function, activity of daily living and fall risk assessment.Discussion: Our aim is to evaluate the efficacy of music exercise therapy in the treatment of Parkinson's patients with freezing of gait. This result will provide more evidence for the clinical application of this therapy in the future.Trial registration: The trial has been registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn) on September 20, 2019. Registration number: ChiCTR1900026063

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

Cited by 42 publications

References 30 publications

Resting‐state Functional MRI in Parkinsonian Syndromes

Resting‐state Functional MRI in Parkinsonian Syndromes

Neural predictors of gait stability when walking freely in the real-world

Improvement of Freezing of Gait in Patients with Parkinson's Disease by Music Exercise Therapy: A Study Protocol for a Randomized Controlled Trial

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