Altered Resting-state Whole Brain Functional Connectivity In Parkinson’s Disease Patients With Freezing Of Gait

Purpose: Freezing of gait(FOG)is a common disabling motor symptom in Parkinson’s disease(PD),but the potential pathogenic mechanisms are still unclear.This study intends to use the resting-state functional magnetic resonance imaging(rs-f MRI)method to explore the changes of the whole brain functional connectivity(FC)in PD patients with FOG,so as to provide a new perspective for further clarifying the neuropathological mechanism of PD with FOG.Methods: A total of 50 PD patients met with Parkinson’s disease clinical diagnostic criteria and 33 healthy controls(HC)matched with age,gender and education level were enrolled.The structural and resting-state functional MRI images,as well as the general clinical data and the clinical scale information were collected.The 50 PD patients were divided into two groups of 22 PD patients with FOG(PD-FOG)and 28 PD patients without FOG(PDn FOG)according to the Freezing of Gait Questionnaire(FOGQ).The right middle frontal gyrus(RMFG)area was defined as the seed region by the degree centrality(DC)analysis method,and then the voxel-wise seed-based FC was used to analyze the whole brain FC alterations.In addition,Spearman correlation analyses were carried out between the DC,FC values of the altered regions and the FOGQ scores of PD-FOG patients.Results: In DC analysis,compared to HC,PD-FOG and PD-n FOG groups showed similarity abnormal DC regions in bilateral precentral gyrus,bilateral postcentral gyrus,bilateral caudate nucleus,bilateral cerebellum and left inferior temporal gyrus.Compared to PD-n FOG group,PD-FOG group exhibited remarkably increased DC values in the RMFG region,and mean DC values in the RMFG were negatively correlated with FOGQ scores(r =-0.534,P < 0.05).In FC analysis with the RMFG as the seed region,compared to HC and PD-n FOG groups,PD-FOG group showed increased FC in the right precuneus and right cerebellum,and showed decreased FC in the right superior frontal gyrus and right inferior frontal gyrus,and only mean FC values in the right cerebellum region was negatively correlated with FOGQ scores(r =-0.534,P < 0.05).Conclusions: This study suggested that PD-FOG patients have a wide range of brain functional activity and brain network FC alterations,including the right frontal gyrus,right precuneus and cerebellum,predicating that the frontal cortex network,default mode network(DMN)and cerebellum may have great potential in brain dysfunction in PD with FOG,this may provide a new perspective for further exploring the neural network mechanism of PD-FOG.