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帕金森病伴冻结步态患者小脑连接模式异常。

Abnormal Cerebellar Connectivity Patterns in Patients with Parkinson's Disease and Freezing of Gait.

机构信息

Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.

IRCCS Neuromed, Pozzilli, IS, Italy.

出版信息

Cerebellum. 2019 Jun;18(3):298-308. doi: 10.1007/s12311-018-0988-4.


DOI:10.1007/s12311-018-0988-4
PMID:30392037
Abstract

In this study, we aimed to evaluate the importance of cerebellum in freezing of gait (FOG) pathophysiology. Due to the fundamental role of the cerebellum in posture and gait control, we examined cerebellar structural and functional connectivity (FC) in patients with PD and FOG. We recruited 15 PD with FOG (PD-FOG), 16 PD without FOG (PD-nFOG) patients, and 16 healthy subjects (HS). The FOG Questionnaire (FOG-Q) assessed FOG severity. Three tesla-MRI study included resting-state functional MRI, diffusion tensor imaging (DTI), and 3D T1-w images. We located seed regions in the cerebellar locomotor region, fastigial, and dentate nucleus to evaluate their FC. DTI parameters were obtained on the superior, middle, and inferior cerebellar peduncles. Global and lobular cerebellum volumes were also calculated. Cerebellar locomotor and fastigial FC was higher in cerebellar and posterior cortical areas in PD-FOG than in HS. FC of the cerebellar locomotor region with cerebellar areas positively correlated with FOG-Q. Dentate FC was lower in the prefrontal and parieto-occipital cortices in PD-FOG than in HS and in the brainstem, right basal ganglia, and frontal and parieto-occipital cortices than in PD-nFOG. DTI parameters in superior and middle cerebellar peduncles were altered in PD-FOG compared with PD-nFOG and significantly correlated with FOG-Q. There were no differences in cerebellar volumes between PD-FOG and either PD-nFOG or HS. Our results suggest that altered connectivity of the cerebellum contributes to the pathophysiology of FOG. FC of the cerebellar locomotor region and white matter (WM) properties of cerebellar peduncles correlate with FOG severity, supporting the hypothesis that abnormal cerebellar function underlies FOG in PD.

摘要

在这项研究中,我们旨在评估小脑在冻结步态(FOG)发病机制中的重要性。由于小脑在姿势和步态控制中的基本作用,我们检查了 PD 伴 FOG(PD-FOG)患者、不伴 FOG(PD-nFOG)患者和健康对照者(HS)的小脑结构和功能连接(FC)。我们招募了 15 名 PD-FOG 患者、16 名 PD-nFOG 患者和 16 名健康对照者。使用冻结步态问卷(FOG-Q)评估 FOG 严重程度。3T-MRI 研究包括静息态功能 MRI、弥散张量成像(DTI)和 3D T1 加权图像。我们定位小脑运动区、顶核和齿状核的种子区域以评估其 FC。在小脑上、中、下脚获得 DTI 参数。还计算了小脑整体和叶体积。与 HS 相比,PD-FOG 患者的小脑运动和顶核 FC 更高,位于小脑和皮质后区。小脑运动区与小脑区的 FC 与 FOG-Q 呈正相关。与 HS 相比,PD-FOG 患者的齿状核 FC 在前额和顶枕皮质较低,与 PD-nFOG 相比,在脑干、右侧基底节和额顶枕皮质较低。与 PD-nFOG 相比,PD-FOG 患者的上、中小脑脚的 DTI 参数发生改变,与 FOG-Q 显著相关。PD-FOG 与 PD-nFOG 或 HS 之间小脑体积无差异。我们的结果表明,小脑连接的改变有助于 FOG 的发病机制。小脑运动区的 FC 和小脑脚的白质(WM)特性与 FOG 严重程度相关,支持小脑功能异常是 PD 中 FOG 的基础这一假说。

相似文献

[1]
Abnormal Cerebellar Connectivity Patterns in Patients with Parkinson's Disease and Freezing of Gait.

Cerebellum. 2019-6

[2]
Alterations of functional and structural connectivity of freezing of gait in Parkinson's disease.

J Neurol. 2016-8

[3]
Freezing of gait in Parkinson's disease: gray and white matter abnormalities.

J Neurol. 2017-11-11

[4]
Associated factors and abnormal dorsal raphe nucleus connectivity patterns of freezing of gait in Parkinson's disease.

J Neurol. 2022-12

[5]
Comparative analysis of freezing of gait in distinct Parkinsonism types by diffusion tensor imaging method and cognitive profiles.

J Neural Transm (Vienna). 2023-4

[6]
Brain structural and functional connectivity in Parkinson's disease with freezing of gait.

Hum Brain Mapp. 2015-12

[7]
Microstructural changes in white matter associated with freezing of gait in Parkinson's disease.

Mov Disord. 2015-4

[8]
Aberrant functional connectivity in patients with Parkinson's disease and freezing of gait: a within- and between-network analysis.

Brain Imaging Behav. 2020-10

[9]
Functional reorganization of the locomotor network in Parkinson patients with freezing of gait.

PLoS One. 2014-6-17

[10]
Changes in Resting-State Functional Connectivity Related to Freezing of Gait in Parkinson's Disease.

Neuroscience. 2019-8-31

引用本文的文献

[1]
The Role of Aquaporin-4 in Freezing of Gait and Dynamic Balance Learning in Parkinson's Disease.

Sci Rep. 2025-8-30

[2]
Gait dynamics and brain function abnormalities in Parkinson's disease with freezing of gait: a clinical study using resting-state fMRI and wearable devices.

Front Neurosci. 2025-7-3

[3]
Functional remapping in networks of the Parkinsonian brain: A preclinical neuroimaging perspective with clinical correlates.

Transl Neurosci. 2025-6-14

[4]
White matter lesions contribute to motor and non-motor disorders in Parkinson's disease: a critical review.

Geroscience. 2025-2

[5]
Cerebellum in neurodegenerative diseases: Advances, challenges, and prospects.

iScience. 2024-10-18

[6]
Cerebellar activity in PINK1 knockout rats during volitional gait.

Brain Commun. 2024-10-25

[7]
Cerebellar tDCS combined with augmented reality treadmill for freezing of gait in Parkinson's disease: a randomized controlled trial.

J Neuroeng Rehabil. 2024-9-28

[8]
Investigation of total cerebellar and flocculonodular lobe volume in Parkinson's disease and healthy individuals: a brain segmentation study.

Neurol Sci. 2024-9

[9]
Differentiation between Parkinson's Disease and the Parkinsonian Subtype of Multiple System Atrophy Using the Magnetic Resonance T1w/T2w Ratio in the Middle Cerebellar Peduncle.

Diagnostics (Basel). 2024-1-17

[10]
A fixel-based analysis of white matter reductions early detects Parkinson disease with mild cognitive impairment.

Biomed J. 2024-10

本文引用的文献

[1]
Freezing of gait in Parkinson's disease: gray and white matter abnormalities.

J Neurol. 2017-11-11

[2]
Lesions causing freezing of gait localize to a cerebellar functional network.

Ann Neurol. 2017-1

[3]
Alterations of functional and structural connectivity of freezing of gait in Parkinson's disease.

J Neurol. 2016-8

[4]
MDS clinical diagnostic criteria for Parkinson's disease.

Mov Disord. 2015-10

[5]
Brain structural and functional connectivity in Parkinson's disease with freezing of gait.

Hum Brain Mapp. 2015-12

[6]
Neuroimaging of Freezing of Gait.

J Parkinsons Dis. 2015

[7]
Microstructural changes in white matter associated with freezing of gait in Parkinson's disease.

Mov Disord. 2015-4

[8]
The validation of an Italian version of the Freezing of Gait Questionnaire.

Neurol Sci. 2015-5

[9]
Alterations of mean diffusivity of pedunculopontine nucleus pathway in Parkinson's disease patients with freezing of gait.

Parkinsonism Relat Disord. 2015-1

[10]
Functional reorganization of the locomotor network in Parkinson patients with freezing of gait.

PLoS One. 2014-6-17

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