Alterations of Regional Homogeneity in Parkinson's Disease Patients With Freezing of Gait: A Resting-State fMRI Study

Yanjun Liu; Mengyan Li; Haobo Chen; Xinhua Wei; Guihe Hu; Shaode Yu; Xiuhang Ruan; Jin Zhou; Xiaoping Pan; Ze Li; Zhenhang Luo; Yaoqin Xie

doi:10.3389/fnagi.2019.00276

Alterations of Regional Homogeneity in Parkinson's Disease Patients With Freezing of Gait: A Resting-State fMRI Study

Front Aging Neurosci. 2019 Oct 15:11:276. doi: 10.3389/fnagi.2019.00276. eCollection 2019.

Authors

Yanjun Liu¹, Mengyan Li², Haobo Chen², Xinhua Wei³, Guihe Hu², Shaode Yu^{1

4}, Xiuhang Ruan³, Jin Zhou², Xiaoping Pan², Ze Li², Zhenhang Luo⁵, Yaoqin Xie¹

Affiliations

¹ Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
² Department of Neurology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China.
³ Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China.
⁴ Department of Radiation Oncology, Southwestern Medical Center, University of Texas, Dallas, TX, United States.
⁵ GYENNO Technologies Co., Ltd., Shenzhen, China.

Abstract

Objective: The purposes of this study are to investigate the regional homogeneity (ReHo) of spontaneous brain activities in Parkinson's disease (PD) patients with freeze of gait (FOG) and to investigate the neural correlation of movement function through resting-state functional magnetic resonance imaging (RS-fMRI).

Methods: A total of 35 normal controls (NC), 33 PD patients with FOG (FOG+), and 35 PD patients without FOG (FOG-) were enrolled. ReHo was applied to evaluate the regional synchronization of spontaneous brain activities. Analysis of covariance (ANCOVA) was performed on ReHo maps of the three groups, followed by post hoc two-sample t-tests between every two groups. Moreover, the ReHo signals of FOG+ and FOG- were extracted across the whole brain and correlated with movement scores (FOGQ, FOG questionnaire; GFQ, gait and falls questionnaire).

Results: Significant ReHo differences were observed in the left cerebrum. Compared to NC subjects, the ReHo of PD subjects was increased in the left angular gyrus (AG) and decreased in the left rolandic operculum/postcentral gyrus (Rol/PostC), left inferior opercular-frontal cortex, left middle occipital gyrus, and supramarginal gyrus (SMG). Compared to that of FOG-, the ReHo of FOG+ was increased in the left caudate and decreased in the left Rol/PostC. Within the significant regions, the ReHo of FOG+ was negatively correlated with FOGQ in the left SMG/PostC (r = -0.39, p < 0.05). Negative correlations were also observed between ReHo and GFQ/FOGQ (r = -0.36/-0.38, p < 0.05) in the left superior temporal gyrus (STG) of the whole brain analysis based on AAL templates.

Conclusion: The ReHo analysis suggested that the regional signal synchronization of brain activities in FOG+ subjects was most active in the left caudate and most hypoactive in the left Rol/PostC. It also indicated that ReHo in the left caudate and left Rol/PostC was critical for discriminating the three groups. The correlation between ReHo and movement scores (GFQ/FOGQ) in the STG has the potential to differentiate FOG+ from FOG-. This study provided new insight into the understanding of PD with and without FOG.

Keywords: Parkinson’s disease; freezing of gait; movement function; regional homogeneity; resting-state fMRI.