Imagine a well-choreographed dance routine. Each dancer moves in harmony with the others, creating a seamless performance. But what happens when one dancer freezes in place, disrupting the entire flow? This is similar to what occurs in freezing of gait (FOG) in Parkinson’s disease (PD). FOG is a condition where individuals experience temporary episodes of being ‘stuck’ during walking, leading to disability and affecting their quality of life.One way researchers are studying FOG is by looking at the brain activity and connections that are involved. In this study, scientists investigated abnormal regional homogeneity (ReHo) and functional connectivity (FC) in individuals who converted to FOG compared to those who did not. They found that converters had reduced ReHo in certain regions of the brain, such as the frontal cortex, which was related to difficulties with posture and walking. Additionally, they observed decreased ReHo in areas associated with anxiety and autonomic dysfunction, as well as increased ReHo in regions linked to rapid eye movement sleep disorder. Moreover, converters exhibited diminished FC in brain regions involved in movement control, emotions, and cognitive functions.The findings suggest that abnormalities in both brain activity and connectivity may occur early on in FOG. By understanding these patterns, researchers hope to develop better ways to identify and intervene earlier in patients at risk of developing FOG. So, put on your dancing shoes and explore the fascinating research behind freezing of gait in Parkinson’s disease!

BackgroundFreezing of gait (FOG) is common in the late stage of Parkinson’s disease (PD), which can lead to disability and impacts the quality of life. Therefore, early recognition is crucial for therapeutic intervention. We aimed to explore the abnormal regional homogeneity (ReHo) and functional connectivity (FC) in FOG converters and evaluate their diagnostic values.MethodsThe data downloaded from the Parkinson’s Disease Progression Markers Project (PPMI) cohort was subdivided into PD-FOG converters (n = 16) and non-converters (n = 17) based on whether FOG appeared during the 3-year follow-up; 16 healthy controls were well-matched. ReHo and FC analyses were used to explore the variations in spontaneous activity and interactions between significant regions among three groups of baseline data. Correlations between clinical variables and the altered ReHo values were assessed in FOG converter group. Last, logistic regression and receiver operating characteristic curve (ROC) were used to predict diagnostic value.ResultsCompared with the non-converters, FOG converters had reduced ReHo in the bilateral medial superior frontal gyrus (SFGmed), which was negatively correlated with the postural instability and gait difficulty (PIGD) score. ReHo within left amygdala/olfactory cortex/putamen (AMYG/OLF/PUT) was decreased, which was correlated with anxiety and autonomic dysfunction. Also, increased ReHo in the left supplementary motor area/paracentral lobule was positively correlated with the rapid eye movement sleep behavior disorder screening questionnaire. FOG converters exhibited diminished FC in the basal ganglia, limbic area, and cognitive control cortex, as compared with non-converters. The prediction model combined ReHo of basal ganglia and limbic area, with PIGD score was the best predictor of FOG conversion.ConclusionThe current results suggested that abnormal ReHo and FC in the basal ganglia, limbic area, and cognitive control cortex may occur in the early stage of FOG. Basal ganglia and limbic area dysfunction combined with higher PIGD score are useful for the early recognition of FOG conversion.

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