Subthalamic functional connectivity associated with freezing of gait dopa-response.

Autor: Lench DH; Department of Neurology, Medical University of South Carlina, Charleston, SC, USA. Electronic address: lenchd@musc.edu., Doolittle JD; Department of Neurology, Medical University of South Carlina, Charleston, SC, USA., Ramakrishnan V; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA., Rowland N; Department of Neurosurgery, Medical University of South Carlina, Charleston, SC, USA; MUSC Institute for Neuroscience Discovery (MIND), Medical University of South Carolina, Charleston, SC, 29425, USA., Revuelta GJ; Department of Neurology, Medical University of South Carlina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA.
Jazyk: angličtina
Zdroj: Parkinsonism & related disorders [Parkinsonism Relat Disord] 2024 Jan; Vol. 118, pp. 105952. Date of Electronic Publication: 2023 Dec 10.
DOI: 10.1016/j.parkreldis.2023.105952
Abstrakt: Introduction: Freezing of gait (FOG) is a prevalent and debilitating feature of Parkinson's Disease (PD). The subthalamic nucleus (STN) is a center for controlled locomotion and a common DBS target. The objective of this study was to identify STN circuitry associated with FOG response to dopaminergic medication. In this study, we compare BOLD functional connectivity of the subthalamic nucleus (STN) in participants with and without dopa-responsive FOG.
Methods: 55 PD participants either with FOG (n = 38) or without FOG (n = 17) were recruited. Among FOG participants 22 were dopa-responsive and 16 were dopa-unresponsive. STN whole-brain connectivity was performed using CONN toolbox. The relationship between the degree of self-reported FOG dopa-response and STN connectivity was evaluated using partial correlations corrected for age, disease duration, and levodopa equivalent daily dose.
Results: Right STN connectivity with the cerebellar locomotor region and the temporal/occipital cortex was greater in the dopa-responsive FOG group (voxel threshold p < 0.01, FWE corrected p < 0.05). Left STN connectivity with the occipital cortex was greater in the dopa-responsive FOG group and connectivity with the postcentral gyrus was greater in the dopa-unresponsive FOG group. Strength of connectivity to these regions correlated with l-dopa induced improvement in UPDRS Item-14 (FOG), but not UPDRS Part-III (overall motor score).
Discussion: We demonstrate that dopa-unresponsive FOG is associated with changes in BOLD functional connectivity between the STN and locomotor as well as sensory processing regions. This finding supports the conceptual framework that effective treatment for freezing of gait likely requires the engagement of both locomotor and sensory brain regions.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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