scholarly journals Neural Correlates of Freezing of Gait in Parkinson's Disease: An Electrophysiology Mini-Review

2020 ◽  
Vol 11 ◽  
Author(s):  
J. Sebastian Marquez ◽  
S. M. Shafiul Hasan ◽  
Masudur R. Siddiquee ◽  
Corneliu C. Luca ◽  
Virendra R. Mishra ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Neural Correlates

025 The neural correlates of doorway freezing in parkinson’s disease

2018 ◽  
Vol 89 (6) ◽  
pp. A10.3-A11 ◽  
Author(s):  
Elie Matar ◽  
James M Shine ◽  
Moran Gilat ◽  
Kaylena Ehgoetz-Martens ◽  
Phillip B Ward ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Virtual Reality ◽  
Functional Connectivity ◽  
Freezing Of Gait ◽  
Neural Correlates ◽  
Blood Oxygenation ◽  
List Type ◽  
Oxygenation Level ◽  
Dependent Signal

IntroductionFreezing of gait (FOG) in Parkinson’s disease (PD) is a disabling symptom of advanced PD and is frequently triggered upon passing through narrow spaces such as doorways.1 Despite being common, the mechanisms underlying this phenomenon are poorly understood. We have previously shown that increased footstep latency in a virtual reality (VR) environment is a surrogate measure of FOG.2 In this study we aimed to model doorway freezing utilising the VR paradigm in conjunction with functional magnetic resonance imaging (fMRI) to determine the neural correlates of this phenomenon.MethodsIn our study, nineteen patients who routinely experience FOG performed a previously validated VR gait paradigm3 where they used foot-pedals to navigate a series of doorways. Patients underwent testing randomised between both their ‘ON’ and ‘OFF’ medication states. Task performance in conjunction with blood oxygenation level dependent signal changes were compared within each patient.ResultsWe were able to reproduce the finding that patients in the OFF state demonstrated significantly longer ‘footstep’ latencies as they passed through a doorway in the VR environment compared to the ON state. As seen clinically with FOG this locomotive delay was primarily triggered by narrow doorways rather than wide doorways. fMRI analysis revealed that doorway-provoked footstep delay was associated with selective hypoactivation in the pre-supplementary motor area (pSMA) bilaterally. Task-based functional connectivity analyses showed that this delay was inversely correlated with the degree of functional connectivity between the pSMA and the subthalamic nucleus (STN) across both hemispheres. Furthermore, increased frequency of prolonged footstep latency was associated with increased connectivity between the bilateral STN.ConclusionThese findings suggest that the effect of environmental cues on triggering FOG reflects a degree of impaired processing within the pSMA and disrupted signalling between the pSMA and STN, thus implicating the ‘hyperdirect’ pathway in the generation of this phenomenon.References. Giladi N, Treves TA, Simon ES, Shabtai H, Orlov Y, Kandinov B, Paleacu D, Korczyn AD. Freezing of gait in patients with advanced Parkinson’s disease. J Neural Transm (Vienna)2001;108:53–61.. Matar E, Shine JM, Naismith SL, Lewis SJ.Virtual realitywalking and dopamine: opening new doorways to understanding freezing of gait in Parkinson’s disease. J Neurol Sci 2014;344:182–5.. Shine JM, Matar E, Bolitho SJ, Dilda V, Morris TR, Naismith SL, Moore ST, Lewis SJ. Modelling freezing of gait in Parkinson’s disease with a virtual reality paradigm. Gait Posture2013;38:104–8.

Validating a Seated Virtual Reality Threat Paradigm for Inducing Anxiety and Freezing of Gait in Parkinson’s Disease

2021 ◽  
pp. 1-12
Author(s):  
Dione Y. L. Quek ◽  
Kristin Economou ◽  
Hamish MacDougall ◽  
Simon J.G. Lewis ◽  
Kaylena A. Ehgoetz Martens
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Virtual Reality ◽  
Functional Mri ◽  
Freezing Of Gait ◽  
Neural Correlates ◽  
Future Studies ◽  
Anxiety Levels ◽  
Ground Condition

Background: Although prior research has established that freezing of gait (FOG) in Parkinson’s disease (PD) is associated with anxiety, only one study to date has directly manipulated anxiety levels to induce FOG. Objective: The current study aimed to replicate these previous findings and evaluate whether a seated version of a ‘threat’ virtual reality (VR) paradigm could induce anxiety and provoke FOG. Methods: Twenty-four PD patients with FOG were assessed across various threat conditions in both a walking VR paradigm (Experiment 1) and a seated VR paradigm (Experiment 2). Both paradigms manipulated the height (i.e., elevated vs ground) and width (wide vs narrow) of the planks participants were instructed to walk across. Results: Across both experiments, the Elevated + Narrow condition provoked significantly greater number of freezing episodes compared to all other conditions. Higher levels of self-reported anxiety were reported during the Elevated+Narrow condition compared to all other conditions in Experiment 1, and compared to the Ground condition in Experiment 2. Conclusion: These findings confirm that anxiety contributes to FOG and validates the use of a seated VR threat paradigm for provoking anxiety-related freezing. This enables future studies to combine this paradigm with functional MRI to explore the neural correlates underlying the role of anxiety in FOG.

scholarly journals The Neural Correlates of Upper Limb Motor Blocks in Parkinson's Disease and Their Relation to Freezing of Gait

2013 ◽  
Vol 24 (12) ◽  
pp. 3154-3166 ◽  
Author(s):  
S. Vercruysse ◽  
J. Spildooren ◽  
E. Heremans ◽  
N. Wenderoth ◽  
S. P. Swinnen ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Freezing Of Gait ◽  
Neural Correlates

Chronological View of Peak and Diphasic Dyskinesia, Wearing Off and Freezing of Gait in Parkinson’s Disease

2019 ◽  
Vol 9 (4) ◽  
pp. 741-747 ◽  
Author(s):  
Young Eun Kim ◽  
Beomseok Jeon ◽  
Ji Young Yun ◽  
Hui-Jun Yang ◽  
Han-Joon Kim
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Wearing Off

Effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life for patients with Parkinson’s disease: A systematic review and meta-analysis

2021 ◽  
pp. 026921552199052
Author(s):  
Zonglei Zhou ◽  
Ruzhen Zhou ◽  
Wen Wei ◽  
Rongsheng Luan ◽  
Kunpeng Li
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Function ◽  
Meta Analysis ◽  
Freezing Of Gait ◽  
Movement Therapy ◽  
Walking Velocity

Objective: To conduct a systematic review evaluating the effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life among individuals with Parkinson’s disease. Data sources: A systematic search of PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, and Physiotherapy Evidence Database was carried out to identify eligible papers published up to December 10, 2020. Review methods: Literature selection, data extraction, and methodological quality assessment were independently performed by two investigators. Publication bias was determined by funnel plot and Egger’s regression test. “Trim and fill” analysis was performed to adjust any potential publication bias. Results: Seventeen studies involving 598 participants were included in this meta-analysis. Music-based movement therapy significantly improved motor function (Unified Parkinson’s Disease Rating Scale motor subscale, MD = −5.44, P = 0.002; Timed Up and Go Test, MD = −1.02, P = 0.001), balance (Berg Balance Scale, MD = 2.02, P < 0.001; Mini-Balance Evaluation Systems Test, MD = 2.95, P = 0.001), freezing of gait (MD = −2.35, P = 0.039), walking velocity (MD = 0.18, P < 0.001), and mental health (SMD = −0.38, P = 0.003). However, no significant effects were observed on gait cadence, stride length, and quality of life. Conclusion: The findings of this study show that music-based movement therapy is an effective treatment approach for improving motor function, balance, freezing of gait, walking velocity, and mental health for patients with Parkinson’s disease.

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