Department of Neurology, First Affiliated Hospital of Dalian Medical University, Zhongshan Road, Dalian, Liaoning 116011, China.
School of Health, Fujian Medical University, Xuefubei Road, Fuzhou 350122, Fujian, China.
Cereb Cortex. 2023 Feb 7;33(4):959-968. doi: 10.1093/cercor/bhac114.
Previous studies have revealed that, compared with Parkinson's disease (PD) patients without freezing of gait (FoG), the ones with FoG showed greater prefrontal activation while doing lower-limb movements involving standing, walking and turning, which require both locomotor and balance control. However, the relation between FoG and pure locomotor control as well as its underlying mechanism remain unclear.
A total of 56 PD subjects were recruited and allocated to PD-FoG and PD-noFoG subgroups, and 34 age-matched heathy adults were included as heathy control (HC). Functional near-infrared spectroscopy was used to measure their prefrontal activation in a sitting lower-limb movement task, wherein subjects were asked to sit and tap their right toes as big and as fast as possible.
Result of one-way ANOVA (Group: PD-FoG vs. PD-noFoG vs. HC) revealed greater activation in the right prefrontal cortex in the PD-FoG group than in the other 2 groups. Linear mixed-effects model showed consistent result. Furthermore, the right prefrontal activation positively correlated with the severity of FoG symptoms in PD-FoG patients.
These findings suggested that PD patients with FoG require additional cognitive resources to compensate their damaged automaticity in locomotor control, which is more pronounced in severe FoG patients than milder ones.
先前的研究表明，与无冻结步态（FoG）的帕金森病（PD）患者相比，有 FoG 的患者在进行涉及站立、行走和转弯的下肢运动时，前额叶的激活程度更大，这些运动既需要运动控制又需要平衡控制。然而，FoG 与单纯运动控制的关系及其潜在机制仍不清楚。
共招募了 56 名 PD 患者，并将其分为 PD-FoG 和 PD-noFoG 亚组，同时纳入 34 名年龄匹配的健康成年人作为健康对照组（HC）。使用功能近红外光谱技术测量他们在坐姿下肢运动任务中的前额叶激活情况，要求受试者坐在那里尽可能大且快地敲击右脚脚趾。
单因素方差分析（组：PD-FoG 与 PD-noFoG 与 HC）的结果显示，PD-FoG 组的右侧前额叶皮质激活程度高于其他 2 组。线性混合效应模型得出了一致的结果。此外，PD-FoG 患者的右侧前额叶激活与 FoG 症状的严重程度呈正相关。
这些发现表明，有 FoG 的 PD 患者需要额外的认知资源来补偿其运动控制中受损的自动性，在严重 FoG 患者中比在轻度 FoG 患者中更为明显。
