Differential Neural Activation Patterns in Patients with Parkinson's Disease and Freezing of Gait in Response to Concurrent Cognitive and Motor Load |
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| Authors: | James M Shine Elie Matar Philip B Ward Samuel J Bolitho Mark Pearson Sharon L Naismith Simon J G Lewis |
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| Institution: | 1. Parkinson''s Disease Clinic, Brain and Mind Research Institute, The University of Sydney, Sydney, New South Wales, Australia.; 2. School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.; 3. Schizophrenia Research Unit, South Western Sydney Local Health District, Liverpool, New South Wales, Australia.; University of Toronto, Canada, |
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| Abstract: | Freezing of gait is a devastating symptom of Parkinson''s disease (PD) that is exacerbated by the processing of cognitive information whilst walking. To date, no studies have explored the neural correlates associated with increases in cognitive load whilst performing a motor task in patients with freezing. In this experiment, 14 PD patients with and 15 PD patients without freezing of gait underwent 3T fMRI while performing a virtual reality gait task. Directions to walk and stop were presented on the viewing screen as either direct cues or as more cognitively indirect pre-learned cues. Both groups showed a consistent pattern of BOLD response within the Cognitive Control Network during performance of the paradigm. However, a between group comparison revealed that those PD patients with freezing of gait were less able to recruit the bilateral anterior insula, ventral striatum and the pre-supplementary motor area, as well as the left subthalamic nucleus when responding to indirect cognitive cues whilst maintaining a motor output. These results suggest that PD patients with freezing of gait are unable to properly recruit specific cortical and subcortical regions within the Cognitive Control Network during the performance of simultaneous motor and cognitive functions. |
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