Gray matter atrophy and freezing of gait in Parkinson's disease: Is the evidence black-on-white?

Authors

  • Talia Herman MscPT,

    1. Movement Disorders Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
    2. The Dr. Miriam and Sheldon G. Adelson Graduate School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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  • Keren Rosenberg-Katz PhD,

    1. Movement Disorders Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
    2. Functional Brain Center, Wohl Institute for Advanced Imaging, Tel Aviv, Israel
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  • Yael Jacob MSc,

    1. Movement Disorders Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
    2. Functional Brain Center, Wohl Institute for Advanced Imaging, Tel Aviv, Israel
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  • Nir Giladi MD,

    1. Movement Disorders Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
    2. Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
    3. Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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  • Jeffrey M. Hausdorff PhD

    Corresponding author
    1. Movement Disorders Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
    2. Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
    3. Harvard Medical School, Boston, Massachusetts, USA
    4. Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
    • Correspondence to: Prof. J.M. Hausdorff, Movement Disorders Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel; jhausdor@tlvmc.gov.il

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  • Funding agencies: This work was supported, in part, by the Michael J. Fox Foundation for Parkinson Research.

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.

ABSTRACT

Objectives

The pathophysiology underlying freezing of gait (FOG) in Parkinson's disease (PD) is poorly understood. We tested whether gray matter (GM) atrophy contributes to FOG in PD.

Methods

Voxel-based morphometry quantified GM atrophy in 106 patients who were classified as freezers (n = 30) or nonfreezers (n = 76). Well-matched smaller subgroups were also studied. Balance, gait, and cognitive function were assessed, and we evaluated the relationship between GM, FOG severity, and symptoms associated with FOG.

Results

GM was significantly reduced in the inferior parietal lobe and angular gyrus in the matched freezers (n = 22), compared to nonfreezers (n = 22; P < 0.015, cluster-level corrected). In the entire cohort, FOG severity was related to bilateral caudate volumes.

Conclusions

GM atrophy in cortical (i.e., parietal lobe and angular gyrus) and subcortical areas (i.e., caudate) are related to FOG. Disparities among the existing findings suggest that inferences regarding specific brain regions should be made with caution. © 2013 International Parkinson and Movement Disorder Society

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