Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Gyeonggi-do, Republic of Korea.
Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Clin Neurophysiol. 2020 Jan;131(1):46-53. doi: 10.1016/j.clinph.2019.09.027. Epub 2019 Nov 4.
To investigate gait characteristics in patients with freezing of gait (FOG) after hypoxic-ischemic brain injury (HIBI) and to elucidate neural correlates for FOG using F-18 fluoro-2-deoxy-d-glucose positron emission tomography.
We enrolled 12 patients with FOG after HIBI and 17 patients without FOG after HIBI. We performed three-dimensional gait analyses and compared each parameter and gait variability. Brain metabolism was measured, and we compared regional brain metabolism using a voxel-by-voxel-based statistical mapping analysis.
The FOG group revealed a significantly decreased joint range of motion (ROM), particularly in the sagittal plane for three-joint summated ROM (p < 0.0025). Spatiotemporal results demonstrated that stride length and step length were decreased in the with FOG group (p < 0.005). FOG severity was negatively correlated with brain metabolism in the left thalamus, and three-joint summated ROM in the sagittal plane was positively associated with brain metabolism in the left thalamus and midbrain (p < 0.05).
Central organizational level amplitude disorder may play an important role in the pathophysiology, and disturbance in the cholinergic pathway might contribute to the development of FOG in patients with HIBI.
These findings contribute to understanding FOG in HIBI.
使用 F-18 氟代-2-脱氧-D-葡萄糖正电子发射断层扫描技术，探究缺氧缺血性脑损伤（HIBI）后冻结步态（FOG）患者的步态特征，并阐明 FOG 的神经相关性。
我们纳入了 12 例 HIBI 后出现 FOG 的患者和 17 例 HIBI 后未出现 FOG 的患者。我们进行了三维步态分析，并比较了每个参数和步态变异性。测量了脑代谢，并使用基于体素的统计映射分析比较了区域脑代谢。
FOG 组的关节活动度（ROM）明显降低，尤其是三关节总和 ROM 的矢状面（p < 0.0025）。时空结果表明，FOG 组的步幅和步长减小（p < 0.005）。FOG 严重程度与左丘脑的脑代谢呈负相关，而矢状面三关节总和 ROM 与左丘脑和中脑的脑代谢呈正相关（p < 0.05）。
中枢组织水平幅度障碍可能在 HIBI 患者的病理生理学中起重要作用，而胆碱能通路的紊乱可能导致 FOG 的发生。
这些发现有助于理解 HIBI 中的 FOG。
