Brain and Mind Research Institute, The University of Sydney, Level 4, Building F, 94 Mallett Street, Camperdown, New South Wales 2050, Australia.
J Clin Neurosci. 2010 Aug;17(8):984-7. doi: 10.1016/j.jocn.2009.12.006. Epub 2010 Apr 18.
Freezing of gait (FOG) is a common cause of disability in Parkinson's disease (PD) but its underlying pathophysiology is poorly understood. A recent hypothesis has proposed that FOG is related to a problem of set-shifting between motor, cognitive and limbic pathways. In this model, the functional convergence of these pathways on the output nuclei of the basal ganglia is believed to result in paroxysmal excessive inhibition of the thalamus and brainstem nuclei leading to freezing episodes. This hypothesis could be assessed with functional neuroimaging but would require a behavioural paradigm capable of modelling FOG. In this experiment, 12 patients with PD underwent assessment on a novel computer-based paradigm where they navigated a realistic three-dimensional environment in which cognitive and limbic load could be manipulated. Performance on this paradigm was significantly correlated with self-reported FOG symptoms assessed by a validated questionnaire. We believe this paradigm is capable of accurately modelling FOG and will have validity in future functional neuroimaging and therapeutic intervention studies.
冻结步态（FOG）是帕金森病（PD）患者致残的常见原因，但其潜在的病理生理学机制尚不清楚。最近的一个假说提出，FOG与运动、认知和边缘通路之间的定势转移问题有关。在该模型中，这些通路在基底神经节的输出核上的功能收敛被认为导致丘脑和脑干核阵发性过度抑制，从而导致冻结发作。该假说可以通过功能神经影像学来评估，但需要一种能够模拟 FOG 的行为范式。在这项实验中，12 名 PD 患者接受了一项新的基于计算机的范式评估，他们在该范式中导航一个逼真的三维环境，其中可以操纵认知和边缘负荷。该范式的表现与通过验证问卷评估的自我报告 FOG 症状显著相关。我们相信，这种范式能够准确地模拟 FOG，并且在未来的功能神经影像学和治疗干预研究中具有有效性。
