Freezing of gait, gait initiation, and gait automaticity share a similar neural substrate in Parkinson's disease. 2022

Acácio Moreira-Neto, and Carlos Ugrinowitsch, and Daniel Boari Coelho, and Andrea Cristina de Lima-Pardini, and Egberto Reis Barbosa, and Luis Augusto Teixeira, and Edson Amaro, and Fay B Horak, and Martina Mancini, and Mariana Penteado Nucci, and Carla Silva-Batista
Exercise Neuroscience Research Group, University of São Paulo, São Paulo, Brazil; Department of Radiology, University of São Paulo, São Paulo, Brazil. Electronic address: acacio@usp.br.

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.

UI MeSH Term Description Entries
D008124 Locomotion Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. Locomotor Activity,Activities, Locomotor,Activity, Locomotor,Locomotor Activities
D010300 Parkinson Disease A progressive, degenerative neurologic disease characterized by a TREMOR that is maximal at rest, retropulsion (i.e. a tendency to fall backwards), rigidity, stooped posture, slowness of voluntary movements, and a masklike facial expression. Pathologic features include loss of melanin containing neurons in the substantia nigra and other pigmented nuclei of the brainstem. LEWY BODIES are present in the substantia nigra and locus coeruleus but may also be found in a related condition (LEWY BODY DISEASE, DIFFUSE) characterized by dementia in combination with varying degrees of parkinsonism. (Adams et al., Principles of Neurology, 6th ed, p1059, pp1067-75) Idiopathic Parkinson Disease,Lewy Body Parkinson Disease,Paralysis Agitans,Primary Parkinsonism,Idiopathic Parkinson's Disease,Lewy Body Parkinson's Disease,Parkinson Disease, Idiopathic,Parkinson's Disease,Parkinson's Disease, Idiopathic,Parkinson's Disease, Lewy Body,Parkinsonism, Primary
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D005684 Gait Manner or style of walking. Gaits
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D020233 Gait Disorders, Neurologic Gait abnormalities that are a manifestation of nervous system dysfunction. These conditions may be caused by a wide variety of disorders which affect motor control, sensory feedback, and muscle strength including: CENTRAL NERVOUS SYSTEM DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; or MUSCULAR DISEASES. Ambulation Disorders, Neurologic,Charcot Gait,Charcot's Gait,Duck Gait,Gait Disorder, Sensorimotor,Gait Dysfunction, Neurologic,Gait, Athetotic,Gait, Broadened,Gait, Drop Foot,Gait, Festinating,Gait, Frontal,Gait, Hemiplegic,Gait, Hysterical,Gait, Reeling,Gait, Rigid,Gait, Scissors,Gait, Shuffling,Gait, Spastic,Gait, Stumbling,Gait, Unsteady,Gait, Widebased,Locomotion Disorders, Neurologic,Marche a Petit Pas,Neurologic Ambulation Disorders,Neurologic Locomotion Disorders,Rapid Fatigue of Gait,Sensorimotor Gait Disorder,Ambulation Disorder, Neurologic,Athetotic Gait,Broadened Gait,Charcot Gaits,Charcots Gait,Drop Foot Gait,Festinating Gait,Foot Gait, Drop,Frontal Gait,Gait Disorder, Neurologic,Gait Disorders, Sensorimotor,Gait Dysfunctions, Neurologic,Gait, Charcot,Gait, Charcot's,Gait, Duck,Gaits, Charcot,Hemiplegic Gait,Hysterical Gait,Locomotion Disorder, Neurologic,Neurologic Ambulation Disorder,Neurologic Gait Disorder,Neurologic Gait Disorders,Neurologic Gait Dysfunction,Neurologic Gait Dysfunctions,Neurologic Locomotion Disorder,Reeling Gait,Rigid Gait,Scissors Gait,Sensorimotor Gait Disorders,Shuffling Gait,Shuffling Gaits,Spastic Gait,Stumbling Gait,Unsteady Gait,Widebased Gait

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