Freezing of gait (FoG) is a brief, episodic absence or marked reduction of forward progression of the feet, despite the intention to walk, that is common in people with Parkinson’s disease (PD). We hypothesized that not only motor, but higher level cognitive and attention areas may be impaired in freezers. In this study, we aimed to characterize differences in cortical and subcortical functional connectivity specific to FoG. We examined resting state neuroimaging and objective measures of FoG severity and gait from 103 individuals (28 PD + FoG, 36 PD − FoG and 39 healthy controls). Inertial sensors were used to quantify freezing severity and gait. Groups with and without FoG were matched on age, disease severity, cognitive status, and levodopa medication. MRI data was processed using surface-based registration. High-quality imaging data were used to characterize differences in connectivity specific to FoG using a pre-defined set of Regions of Interest (ROIs) and validated using whole-brain connectivity analysis. Associations between functional connectivity and objective measures of FoG were determined via predictive modeling using hold-out cross validation. We found that connectivity between the left globus pallidus (GP) and left somatosensory cortex and between two brain areas in the default and insular/vestibular networks exhibited significant differences specific to FoG and were also strong and significant predictors of FoG severity. Our findings suggest that the interplay among motor, default and vestibular areas of the left cortex are critical in the pathology of FoG.

冻结步态 (FoG) 是指尽管有行走意图，但足部的向前行进出现短暂、间歇性缺失或显着减少，这在帕金森病 (PD) 患者中很常见。我们假设，在冰箱中，不仅运动区域，更高水平的认知和注意力区域也可能受到损害。在这项研究中，我们的目的是表征 FoG 特有的皮质和皮质下功能连接的差异。我们检查了 103 名个体（28 名 PD + FoG、36 名 PD - FoG 和 39 名健康对照）的静息态神经影像学以及 FoG 严重程度和步态的客观测量。惯性传感器用于量化冻结严重程度和步态。有和没有 FoG 的组在年龄、疾病严重程度、认知状态和左旋多巴药物方面进行匹配。 MRI 数据使用基于表面的配准进行处理。使用高质量的成像数据，使用一组预定义的感兴趣区域 (ROI) 来表征 FoG 特有的连接差异，并使用全脑连接分析进行验证。功能连接和 FoG 客观测量之间的关联是通过使用保留交叉验证的预测模型确定的。我们发现，左侧苍白球 (GP) 和左侧体感皮层之间以及默认网络和岛叶/前庭网络中两个大脑区域之间的连接表现出 FoG 特有的显着差异，并且也是 FoG 严重程度的有力且显着的预测因子。我们的研究结果表明，左皮质运动区、默认区和前庭区之间的相互作用对于 FoG 的病理学至关重要。