帕金森病的灰质萎缩和冻结步态：证据确凿吗？
Gray matter atrophy and freezing of gait in Parkinson's disease: Is the evidence black-on-white?
机构信息
Movement Disorders Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; The Dr. Miriam and Sheldon G. Adelson Graduate School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
Mov Disord. 2014 Jan;29(1):134-9. doi: 10.1002/mds.25697. Epub 2013 Oct 21.
OBJECTIVES
The pathophysiology underlying freezing of gait (FOG) in Parkinson's disease (PD) is poorly understood. We tested whether gray matter (GM) atrophy contributes to FOG in PD.
METHODS
Voxel-based morphometry quantified GM atrophy in 106 patients who were classified as freezers (n = 30) or nonfreezers (n = 76). Well-matched smaller subgroups were also studied. Balance, gait, and cognitive function were assessed, and we evaluated the relationship between GM, FOG severity, and symptoms associated with FOG.
RESULTS
GM was significantly reduced in the inferior parietal lobe and angular gyrus in the matched freezers (n = 22), compared to nonfreezers (n = 22; P < 0.015, cluster-level corrected). In the entire cohort, FOG severity was related to bilateral caudate volumes.
CONCLUSIONS
GM atrophy in cortical (i.e., parietal lobe and angular gyrus) and subcortical areas (i.e., caudate) are related to FOG. Disparities among the existing findings suggest that inferences regarding specific brain regions should be made with caution.
目的
帕金森病（PD）冻结步态（FOG）的病理生理学机制尚不清楚。我们测试了灰质（GM）萎缩是否与 PD 中的 FOG 有关。
方法
基于体素的形态计量学方法对 106 名患者的 GM 萎缩进行了量化，这些患者被分为冻结者（n = 30）和非冻结者（n = 76）。还研究了匹配的较小亚组。评估了平衡、步态和认知功能，并评估了 GM、FOG 严重程度以及与 FOG 相关的症状之间的关系。
结果
与非冻结者（n = 22；P < 0.015，簇水平校正）相比，匹配的冻结者（n = 22）的顶下小叶和角回 GM 明显减少。在整个队列中，FOG 严重程度与双侧尾状核体积相关。
结论
皮质（即顶叶和角回）和皮质下区域（即尾状核）的 GM 萎缩与 FOG 有关。现有研究结果之间的差异表明，应谨慎得出关于特定脑区的推论。
Zotero 插件