Lench Daniel H, Embry Aaron, Malakouti Niloufar, DeTurk Nathan, Revuelta Gonzalo J
Department of Neurology, Medical University of South Carolina, Charleston, SC, USA.
Department of Rehabilitation Science, Tufts University, Boston, MA, USA.
Brain Imaging Behav. 2025 Mar 18. doi: 10.1007/s11682-025-00996-w.
Freezing of gait (FOG) in individuals with Parkinson's Disease is associated with a loss of gait automaticity. This loss of automaticity is demonstrated by worsening gait performance while dual tasking. Functional connectivity between the cerebellar vermis and cortex have previously been associated with spatiotemporal measures of gait in PD. The objective of this study was to determine whether this corticocerebellar connectivity is associated with gait automaticity as measured by dual task interference in PD FOG. 55 participants with PD were recruited (38 FOG, 17 non-FOG controls) to undergo a resting-state functional magnetic resonance imaging scan. Gait automaticity was quantified using spatiotemporal metrics from single and dual task time up and go trials. FOG participants demonstrated shorter step length and gait velocity compared to non-FOG PD controls. A trend toward greater dual task interference of step length in the FOG group was found. Using a seed-based connectivity approach we observed that FOG participants have greater vermis connectivity than non-FOG PD participants to several cortical regions including the superior parietal lobe, supplemental motor area, precentral gyrus and posterior cingulate (voxel threshold p < 0.01, cluster FWE corrected p < 0.05). Meanwhile, vermis connectivity to the occipital cortex was reduced in FOG participants relative to non-FOG controls. Dual task interference of step length among the FOG group correlated with the degree of vermis connectivity to the sensorimotor cortex and superior parietal cortex (voxel threshold p < 0.01, cluster FWE corrected p < 0.05). We conclude that increased corticocerebellar connectivity may be associated with loss of gait automaticity in individuals with PD FOG.
帕金森病患者的冻结步态（FOG）与步态自动性丧失有关。这种自动性丧失在执行双重任务时步态表现恶化中得到体现。此前，小脑蚓部与皮层之间的功能连接已被证明与帕金森病患者的步态时空测量指标有关。本研究的目的是确定这种皮质小脑连接是否与通过帕金森病冻结步态中的双重任务干扰所测量的步态自动性有关。招募了55名帕金森病患者（38名有冻结步态，17名无冻结步态作为对照）进行静息态功能磁共振成像扫描。使用单任务和双重任务计时起立行走试验中的时空指标对步态自动性进行量化。与无冻结步态的帕金森病对照相比，有冻结步态的参与者步长和步态速度更短。在有冻结步态的组中发现了步长双重任务干扰更大的趋势。使用基于种子的连接性方法，我们观察到，与无冻结步态的帕金森病参与者相比，有冻结步态的参与者与包括顶上叶、辅助运动区、中央前回和后扣带回在内的几个皮质区域的蚓部连接性更强（体素阈值p<0.01，聚类FWE校正p<0.05）。同时，与无冻结步态的对照相比，有冻结步态的参与者与枕叶皮层的蚓部连接性降低。有冻结步态组中步长的双重任务干扰与蚓部与感觉运动皮层和顶上叶皮层的连接程度相关（体素阈值p<
