Baseline cerebral structural morphology predict freezing of gait in early drug-naïve Parkinson’s disease

Abstract

Freezing of gait (FOG) greatly impacts the daily life of patients with Parkinson’s disease (PD). However, predictors of FOG in early PD are limited. Moreover, recent neuroimaging evidence of cerebral morphological alterations in PD is heterogeneous. We aimed to develop a model that could predict the occurrence of FOG using machine learning, collaborating with clinical, laboratory, and cerebral structural imaging information of early drug-naïve PD and investigate alterations in cerebral morphology in early PD. Data from 73 healthy controls (HCs) and 158 early drug-naïve PD patients at baseline were obtained from the Parkinson’s Progression Markers Initiative cohort. The CIVET pipeline was used to generate structural morphological features with T1-weighted imaging (T1WI). Five machine learning algorithms were calculated to assess the predictive performance of future FOG in early PD during a 5-year follow-up period. We found that models trained with structural morphological features showed fair to good performance (accuracy range, 0.67–0.73). Performance improved when clinical and laboratory data was added (accuracy range, 0.71–0.78). For machine learning algorithms, elastic net-support vector machine models (accuracy range, 0.69–0.78) performed the best. The main features used to predict FOG based on elastic net-support vector machine models were the structural morphological features that were mainly distributed in the left cerebrum. Moreover, the bilateral olfactory cortex (OLF) showed a significantly higher surface area in PD patients than in HCs. Overall, we found that T1WI morphometric markers helped predict future FOG occurrence in patients with early drug-naïve PD at the individual level. The OLF exhibits predominantly cortical expansion in early PD.

A meta-analysis identifies factors predicting the future development of freezing of gait in Parkinson’s disease

“…A small part of patients received optimized anti-PD medication at baseline, so FOG during the follow-up may have been interfered by pharmacological effects. 8 Li et al 93 Retrospective cohort n 158, FOG in 66 (42%) UPDRS items 2.13 OR item 3.11 5 years Demographics, clinical and laboratory characteristics, MRI T1 imaging. T1-weighted imaging predicts FOG.…”

Reorganization of Gray Matter Networks in Patients with Moyamoya Disease

“…The OLF has close connections with the insula, hypothalamus, and hippocampus, which are essential for learning and memory 21 . The aberration of the surface area of the OLF has been reported as a biomarker for cognitive dysfunction in patients with Parkinson's disease 22 .…”