Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences and Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan.
Mov Disord. 2020 Jun;35(6):1037-1045. doi: 10.1002/mds.28024. Epub 2020 Mar 12.
Gait automaticity, which is impaired in patients with Parkinson's disease (PD), can be quantified by gait variability analysis. Among the 3 regions of the striatum (sensorimotor, executive, and limbic), the sensorimotor region may play a crucial role in motor automaticity in healthy individuals. However, neural correlates of impaired gait automaticity are poorly investigated in PD.
We aimed to examine the relationship between gait automaticity and striatal dopaminergic depletion in drug-naïve PD patients.
A total of 21 drug-naïve PD patients and 12 healthy controls were enrolled. Gait parameters were measured via wearable inertial sensors under fast-paced gait or cognitive dual-task conditions, and their respective coefficient of variation (CV) and dual-task cost were calculated. The extent of striatal dopaminergic depletion was evaluated by dopamine transporter (DAT) imaging with single-photon emission computed tomography using N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-[ I]iodophenyl)nortropane. Correlation between DAT uptake and gait variables was analyzed using the region-of-interest analysis for the 3 right or left striatal regions and voxel-based analysis.
PD had higher mean bilateral CV and dual-task cost of stride length than healthy controls. The mean bilateral CV of stride length was negatively correlated with DAT uptake in the bilateral executive regions of the striatum. Voxel-based analysis revealed a negative correlation between the mean bilateral CV of stride length and DAT uptake in the anteromedial striatum.
Dopaminergic denervation in the anteromedial striatum, a part of the executive region, is associated with impaired gait automaticity in drug-naïve PD patients. This region may compensate for the posterior sensorimotor striatum, maintaining gait automaticity. © 2020 International Parkinson and Movement Disorder Society.
帕金森病（PD）患者的步态自动性受损，可以通过步态变异性分析来量化。在纹状体的 3 个区域（感觉运动、执行和边缘）中，感觉运动区域可能在健康个体的运动自动性中起着至关重要的作用。然而，PD 患者步态自动性受损的神经相关性研究甚少。
我们旨在研究药物初治 PD 患者步态自动性与纹状体多巴胺能缺失之间的关系。
共纳入 21 例药物初治 PD 患者和 12 例健康对照者。使用可穿戴惯性传感器在快速步态或认知双重任务条件下测量步态参数，并计算各自的变异系数（CV）和双重任务成本。使用单光子发射计算机断层扫描（SPECT）通过 N-ω-氟丙基-2β-羧基-3β-[4-[ I]碘苯基]去甲托烷（N-ω-fluoropropyl-2β-carbomethoxy-3β-[4-[ I]iodophenyl]nortropane，FP-CIT）进行多巴胺转运体（DAT）成像，评估纹状体多巴胺能缺失程度。使用感兴趣区分析和基于体素的分析，对 3 个右侧或左侧纹状体区域和体素水平进行分析，以分析 DAT 摄取与步态变量之间的相关性。
PD 患者的双侧 CV 和步长的双重任务成本均高于健康对照组。双侧 CV 与双侧纹状体执行区的 DAT 摄取呈负相关。基于体素的分析显示，双侧 CV 与anteromedial 纹状体的 DAT 摄取呈负相关。
anteromedial 纹状体（执行区的一部分）的多巴胺能去神经支配与药物初治 PD 患者的步态自动性受损有关。该区域可能补偿后传感器运动纹状体，维持步态自动性。 © 2020 国际帕金森病和运动障碍协会。
