Exercise Neuroscience Research Group, University of São Paulo, São Paulo, Brazil; Department of Radiology, University of São Paulo, São Paulo, Brazil.
School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.
Hum Mov Sci. 2022 Dec;86:103018. doi: 10.1016/j.humov.2022.103018. Epub 2022 Nov 2.
Individuals with Parkinson's disease (PD) and freezing of gait (FOG) have difficulty initiating and maintaining a healthy gait pattern; however, the relationship among FOG severity, gait initiation, and gait automaticity, in addition to the neural substrate of this relationship has not been investigated. This study investigated the association among FOG severity during turning (FOG-ratio), gait initiation (anticipatory postural adjustment [APA]), and gait automaticity (dual-task cost [DTC]), and the neural substrates of these associations. Thirty-four individuals with FOG of PD were assessed in the ON-medication state. FOG-ratio during a turning test, gait automaticity using DTC on stride length and gait speed, and APA during an event-related functional magnetic resonance imaging protocol to assess brain activity from the regions of interest (e.g., dorsolateral prefrontal cortex [DLPFC] and mesencephalic locomotor region [MLR]) were assessed in separated days. Results showed that FOG-ratio, APA amplitude, and DTC on stride length are negatively associated among them (P < 0.05). APA amplitude and DTC on stride length explained 59% of the FOG-ratio variance (P < 0.05). Although the activity of the right DLPFC and right MLR explained 55% of the FOG-ratio variance (P < 0.05) and 30% of the DTC on stride length variance (P ≤ 0.05), only the activity of the right MLR explained 23% of the APA amplitude (P < 0.05). FOG severity during turning, APA amplitude, and stride length automaticity are associated among them and share a similar locomotor substrate, as the MLR activity was a common brain region in explaining the variance of these variables.
帕金森病（PD）患者和冻结步态（FOG）患者在启动和维持健康步态模式方面存在困难；然而，FOG 严重程度、步态启动和步态自动性之间的关系，以及这种关系的神经基础尚未得到研究。本研究调查了转向时 FOG 严重程度（FOG-ratio）、步态启动（预期姿势调整 [APA]）和步态自动性（双任务成本 [DTC]）之间的关联，以及这些关联的神经基础。34 名患有 FOG 的 PD 患者在 ON 药物状态下接受评估。在不同的日子里，通过转向测试评估 FOG-ratio、通过 DTC 评估步长和步态速度的步态自动性、通过事件相关功能磁共振成像协议评估大脑活动的区域（例如，背外侧前额叶皮层 [DLPFC] 和中脑运动区 [MLR]）。结果表明，FOG-ratio、APA 幅度和 DTC 之间呈负相关（P<0.05）。APA 幅度和 DTC 对步长解释了 59%的 FOG-ratio 方差（P<0.05）。尽管右 DLPFC 和右 MLR 的活动解释了 55%的 FOG-ratio 方差（P<0.05）和 30%的 DTC 对步长方差（P≤0.05），但只有右 MLR 的活动解释了 23%的 APA 幅度（P<0.05）。转向时的 FOG 严重程度、APA 幅度和步长自动性之间存在关联，并且共享相似的运动基础，因为 MLR 活动是解释这些变量方差的共同脑区。
