Regional Gray Matter Atrophy in Patients with Parkinson Disease and Freezing of Gait

Tessitore, Alessandro; Amboni, Marianna; Cirillo, Giovanni; Corbo, Daniele; Picillo, Marina; Russo, Antonio; Vitale, Carmine; Santangelo, Gabriella; Erro, Roberto; Cirillo, Mario; Esposito, Fabrizio; Barone, Paolo; Tedeschi, Gioacchino

doi:10.3174/ajnr.a3066

Cited by 105 publications

(89 citation statements)

References 42 publications

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“…2) The cerebral cortex seems to modify the relation between the cycle and the force, formulated in the basal ganglia, depending on the context in which walking movements are performed. This idea is in good agreement with the recent findings revealed by new imaging techniques [30][31][32]. These studies showed that white matter lesions disrupted balance/locomotor circuits and thereby caused the highlevel gait disorders characterized by deficits in strength, tone, sensation or coordination.…”

Section: How Is the Gait Strategy Selected By Neural Circuitry?supporting

confidence: 80%

A Newly Developed Wearable Device for Continuous Measurement of Gait- Induced Accelerations in Daily Activities

Mitoma

Yoneyama²

2014

rain Disord Ther

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For assessment of gait disorders, speed and stride are measured during 10m-walking test. However, changes in these two parameters are nonspecific since they are observed in various gait disorders. In addition, the10-m walking is short and reflects only one aspect of daily living and the results could be affected by emotional stress. To examine the step cycles and forces for step-in and kick off, which are directly controlled by a complex neural circuitry, during daily walking and over a long period of time, we developed a new wearing device, the portable gait rhythmogram (PGR), which monitors gait-induced accelerations for up to 70 hours. Quantitative analysis of the gait acceleration cycle and amplitude has allowed characterization of the bradykinematic features of gait disorders in patients with Parkinson's disease: 1) A decrease in amplitude of gait acceleration in the early stages of the disease, which is compensated by fast stepping. 2) Subjective motor fluctuation did not necessarily coincide with changes in gait parameters. The results suggest that the rhythms-force correlation is set by the basal ganglia, but can be modified by the cerebral cortex. Analysis of voluntary gait in daily life could enhance our understanding of the pathomechanisms of gait disorders.

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Section: How Is the Gait Strategy Selected By Neural Circuitry?supporting

confidence: 80%

A Newly Developed Wearable Device for Continuous Measurement of Gait- Induced Accelerations in Daily Activities

Mitoma

Yoneyama²

2014

rain Disord Ther

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“…10 In addition, some studies have failed to find any GM change. [11][12][13][14] In fact, few of these previous findings were wholly consistent with each other. These inconsistencies may result from the patient heterogeneity, such as the age, disease duration, disease severity, and variable covariates used in VBM analysis, which may confound the effect of results in between-group differences.…”

mentioning

confidence: 64%

Longitudinal Study of Gray Matter Changes in Parkinson Disease

Jia

Liang

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The pathology of Parkinson disease leads to morphological brain volume changes. So far, the progressive gray matter volume change across time specific to patients with Parkinson disease compared controls remains unclear. Our aim was to investigate the pattern of gray matter changes in patients with Parkinson disease and to explore the progressive gray matter volume change specific to patients with Parkinson disease with disease progression by using voxel-based morphometry analysis.

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“…5 ) did not reveal any regional cortical atrophy specific for FOG on the whole-brain level, but described local GM atrophy in a small portion of the mesencephalic locomotor region (MLR) along with functional hyperactivation during walking imagery 5 . In contrast, when Tessitore et al 6 directly contrasted PD patients with and without FOG, they found GM atrophy in the left cuneus, lingual gyrus, precuneus, and posterior cingulate cortex. On the other hand, when comparing GM atrophy in PD patients with FOG to both control subjects and PD patients with no FOG, Kostic et al 7 observed atrophy of the left inferior frontal gyrus, left precentral gyrus, and left inferior parietal gyrus.…”

Section: Discussionmentioning

confidence: 96%

“…In this study, we used the FreeSurfer implementation of surfacebased analysis and our results demonstrate that patients with FOG exhibited atrophy of the bilateral cingulate cortex (mostly in mid-anterior part), left supplementary motor area (SMA), and right frontal operculum. In summary, earlier publications reported rather complex pattern of functional and morphological changes [6][7][8][9][10][11]29 , suggesting a complex pathophysiological substrate of FOG. Whereas the automatic control of gait appears to be subserved by brainstem nuclei and their corresponding circuits, involvement of cortical brain structures is presumed in FOG because of frequent manifestation of freezing in situations with emotional or cognitive context.…”

Section: Discussionmentioning

confidence: 99%

“…Although the methods for group comparison of VBM data are highly sophisticated, they are prone to bias from various optional user settings, leading potentially to inconsistencies 4 . Several previous studies investigated the brain alterations associated with FOG in patients with PD using VBM, but they yielded variable outcomes [5][6][7][8][9][10][11] . Because of these differences, potentially related to VBM methodology, it may be worth exploring cortical atrophy with a different method.…”

Section: Introductionmentioning

confidence: 99%

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Freezing of gait is associated with cortical thinning in mesial frontal cortex

Vaštík¹,

Hok²,

Valošek³

et al. 2017

BIOMED PAP

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Aims.The relationship between freezing of gait (FOG) and regional brain atrophy has been intensively investigated, but it is still not clearly understood. The study objective was to test whether grey matter (GM) atrophy contributes to FOG in Parkinson´s disease (PD) using a surface-based algorithm. Methods. We investigated 21 patients with PD, 11 with FOG and 10 without FOG. Both groups were assessed using a FOG questionnaire and Hoehn and Yahr staging. High resolution T1-weighted brain images were acquired for each subject using a 1.5T MRI scanner. A surface-based method implemented in FreeSurfer was used to quantify the GM atrophy. A vertex-wise and region of interest (ROI) comparison of spatially normalized subject data using a general linear model and the Wilcoxon rank sum test were to assess significant group differences. Results. Higher global levels of cortical atrophy were detected in freezers, although this was not statistically significant. The vertex-wise analysis revealed significant local reduction in grey matter thickness in the left supplementary motor area, m iddle/anterior cingulate cortex, temporal pole and right frontal operculum in freezers at P<0.001, uncorrected. The ROI analysis of average thickness confirmed the regional atrophy in bilateral anterior and posterior cingulate cortices. No significant relative regional cortical atrophy was observed in non-freezers. Conclusion. FOG was associated with regional cortical atrophy, especially in mesial frontal and cingulate cortices. Our findings provide additional evidence that the development of FOG in patients with PD is associated with local structural cortical changes.

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Regional Gray Matter Atrophy in Patients with Parkinson Disease and Freezing of Gait

Abstract: BACKGROUND AND PURPOSE:FOG is a troublesome symptom of PD. Despite growing evidence suggesting that FOG in PD may be associated with cognitive dysfunction, the relationship between regional brain atrophy and FOG has been poorly investigated.

Cited by 105 publications

References 42 publications

A Newly Developed Wearable Device for Continuous Measurement of Gait- Induced Accelerations in Daily Activities

A Newly Developed Wearable Device for Continuous Measurement of Gait- Induced Accelerations in Daily Activities

Longitudinal Study of Gray Matter Changes in Parkinson Disease

Freezing of gait is associated with cortical thinning in mesial frontal cortex

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