Department of Neurology, Neurobiology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Brain Disorders, Beijing, 100053, China.
Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
Sci Rep. 2017 Dec 1;7(1):16711. doi: 10.1038/s41598-017-16922-0.
Freezing of gait (FOG) is a common and debilitating symptom in Parkinson's disease (PD). The current study investigated alterations of resting-state spontaneous brain activity in PD patients with FOG. A total of 29 patients with FOG, 28 patients without FOG and 31 controls were included. All subjects underwent resting-state functional MRI, and the amplitude of low-frequency fluctuation (ALFF) was calculated to measure the spontaneous brain activity. Between-group differences and correlations with FOG severity (both subjective and objective measures) were analyzed. Compared to those without FOG, patients with FOG showed increased ALFF in right anterior cingulate cortex (ACC) and left inferior parietal lobule (IPL), as well as decreased ALFF in right superior frontal gyrus (SFG), bilateral cerebellum and left thalamus. Correlation analyses demonstrated that ALFF within the right SFG, right ACC and bilateral pallidum were positively correlated with FOG; while ALFF within the thalamus, putamen, cerebellum and sensorimotor regions were negatively correlated. Our results indicate that FOG is associated with dysfunction within frontal-parietal regions, along with increased inhibitory outputs from basal ganglia. Additionally, altered activity of cerebellum implicates its role in the pathophysiology of FOG. These findings provide further insight into the underlying neural mechanisms of FOG in PD patients.
冻结步态（FOG）是帕金森病（PD）中一种常见且使人虚弱的症状。本研究旨在探讨伴有 FOG 的 PD 患者静息态自发性脑活动的变化。共纳入 29 例 FOG 患者、28 例无 FOG 患者和 31 名健康对照者。所有受试者均接受静息态功能磁共振成像，计算低频振幅（ALFF）以测量自发性脑活动。分析了组间差异以及与 FOG 严重程度（主观和客观测量）的相关性。与无 FOG 患者相比，FOG 患者的右侧前扣带回（ACC）和左侧顶下小叶（IPL）的 ALFF 增加，右侧额上回（SFG）、双侧小脑和左侧丘脑的 ALFF 降低。相关性分析表明，右侧 SFG、右侧 ACC 和双侧苍白球内的 ALFF 与 FOG 呈正相关；而丘脑、壳核、小脑和感觉运动区的 ALFF 与 FOG 呈负相关。研究结果表明，FOG 与额顶叶区域功能障碍有关，同时基底节的抑制性输出增加。此外，小脑活动的改变提示其在 FOG 的病理生理学中的作用。这些发现为 PD 患者 FOG 的潜在神经机制提供了进一步的见解。
