Vastik Miroslav, Hok Pavel, Valosek Jan, Hlustik Petr, Mensikova Katerina, Kanovsky Petr
Department of Neurology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
Department of Biomedical Engineering, University Hospital Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2017 Dec;161(4):389-396. doi: 10.5507/bp.2017.035. Epub 2017 Sep 13.
The relationship between freezing of gait (FOG) and regional brain atrophy has been intensively investigated, but it is still not clearly understood. The study objective was to test whether grey matter (GM) atrophy contributes to FOG in Parkinson's disease (PD) using a surface-based algorithm.
We investigated 21 patients with PD, 11 with FOG and 10 without FOG. Both groups were assessed using a FOG questionnaire and Hoehn and Yahr staging. High resolution T1-weighted brain images were acquired for each subject using a 1.5T MRI scanner. A surface-based method implemented in FreeSurfer was used to quantify the GM atrophy. A vertex-wise and region of interest (ROI) comparison of spatially normalized subject data using a general linear model and the Wilcoxon rank sum test were to assess significant group differences.
Higher global levels of cortical atrophy were detected in freezers, although this was not statistically significant. The vertex-wise analysis revealed significant local reduction in grey matter thickness in the left supplementary motor area, middle/anterior cingulate cortex, temporal pole and right frontal operculum in freezers at P<0.001, uncorrected. The ROI analysis of average thickness confirmed the regional atrophy in bilateral anterior and posterior cingulate cortices. No significant relative regional cortical atrophy was observed in non-freezers.
FOG was associated with regional cortical atrophy, especially in mesial frontal and cingulate cortices. Our findings provide additional evidence that the development of FOG in patients with PD is associated with local structural cortical changes.
已经对冻结步态（FOG）与脑区萎缩之间的关系进行了深入研究，但仍未完全明确。本研究的目的是使用基于表面的算法来测试帕金森病（PD）中灰质（GM）萎缩是否导致FOG。
我们研究了21例PD患者，其中11例有FOG，10例无FOG。两组均使用FOG问卷以及Hoehn和Yahr分期进行评估。使用1.5T MRI扫描仪为每个受试者采集高分辨率T1加权脑图像。使用FreeSurfer中实现的基于表面的方法来量化GM萎缩。使用一般线性模型和Wilcoxon秩和检验对空间归一化的受试者数据进行逐顶点和感兴趣区域（ROI）比较，以评估组间的显著差异。
在有冻结步态的患者中检测到更高的整体皮质萎缩水平，尽管这在统计学上并不显著。逐顶点分析显示，有冻结步态的患者在未校正的P<0.001水平下，左侧辅助运动区、中/前扣带回皮质、颞极和右侧额盖的灰质厚度有显著局部减少。平均厚度的ROI分析证实了双侧前扣带回和后扣带回皮质的区域萎缩。在无冻结步态的患者中未观察到显著的相对区域皮质萎缩。
FOG与区域皮质萎缩有关，尤其是在内侧额叶和扣带回皮质。我们的研究结果提供了额外的证据，表明PD患者中FOG的发生与局部皮质结构变化有关。
