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Functional MRI in Parkinson’s disease with freezing of gait: a systematic review of the literature

Neurological Sciences volume 42, pages 1759–1771 (2021)Cite this article

Abstract

Background

Freezing of gait (FOG), a common and disabling symptom of Parkinson’s disease (PD), is characterized by an episodic inability to generate effective stepping. Functional MRI (fMRI) has been used to evaluate abnormal brain connectivity patterns at rest and brain activation patterns during specific tasks in patients with PD-FOG. This review has examined the existing functional neuroimaging literature in PD-FOG, including those with treatment. Summarizing these articles provides an opportunity for a better understanding of the underlying pathophysiology in PD-FOG.

Methods

According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a literature review of studies using fMRI to investigate the underlying pathophysiological mechanisms of PD-FOG.

Results

We initially identified 201 documents. After excluding the duplicates, reviews, and other irrelevant articles, 39 articles were finally identified, including 18 task-based fMRI studies and 21 resting-state fMRI studies.

Conclusions

Studies using fMRI techniques to evaluate PD-FOG have found dysfunctional connectivity in widespread cortical and subcortical regions. Standardized imaging protocols and detailed subtypes of PD-FOG are furthered required to elucidate current findings.

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Fig. 1

Availability of data and code

Any data and code associated with this review will be made available by reasonable request to the corresponding author (PP).

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Funding

The present study was supported in part by The Natural Science Foundation of the Jiangsu Province (BK20180991)

Author information

Author notes

  1. Wenjing Song, Hafiz Khuram Raza and Li Lu contributed equally to this work.

Affiliations

  1. Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People’s Republic of China

    Wenjing Song, Hafiz Khuram Raza, Zuohui Zhang, Jie Zu, Wei Zhang, Liguo Dong, Chuanying Xu, Xiangyao Gong & Guiyun Cui

  2. Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People’s Republic of China

    Li Lu

  3. Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People’s Republic of China

    Bingchen Lv

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  1. Wenjing Song
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Guiyun Cui had the idea for the article; Jie Zu, Wei Zhang, and Liguo Dong performed the literature search; Chuanying Xu, Xiangyao Gong, and Bingchen Lv analyzed the data; Wenjing Song, Hafiz Khuram Raza, and Li Lu drafted the manuscript; Guiyun Cui and Zuohui Zhang critically revised the work.

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Correspondence to Guiyun Cui.

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Highlights

• Functional MRI provides relevant insights into the possible pathophysiology of FOG in PD.

• Current functional neuroimaging data support widespread dysfunctional connectivity between cortical and subcortical regions in PD-FOG.

• Further research is needed to characterize various FOG subtypes and perform multimodal neuroimaging.

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Song, W., Raza, H.K., Lu, L. et al. Functional MRI in Parkinson’s disease with freezing of gait: a systematic review of the literature. Neurol Sci 42, 1759–1771 (2021). https://doi.org/10.1007/s10072-021-05121-5

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  • DOI: https://doi.org/10.1007/s10072-021-05121-5

Keywords

  • Parkinson’s disease
  • Freezing of gait
  • Functional MRI
  • Gait simulation
  • Motor imagery
  • Resting state