Abstract Details

Title Different Patterns of Brain Activity During Lower Limb Movements in Parkinson’s Disease Patients With and Without Freezing of Gait

Topic Movement Disorders

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-011

Objective To assess brain functional MRI (fMRI) activity during a feet movement task in Parkinson’s disease patients with (PD-FoG) and without freezing of gait (PD-noFoG) and healthy controls.

Background To date, few studies investigated task-based fMRI alterations underlying gait difficulties in PD-FoG patients suggesting an abnormal interplay between motor, basal ganglia, pedunculopontine and cognitive control networks. However, the mechanisms underlying FoG are still debated.

Design/Methods 10 PD-noFoG, 17 PD-FoG patients and 18 matched healthy controls were recruited. PD-FoG were divided into 9 with mild and 8 with moderate FoG according to the New FoG-Questionnaire (NFoG-Q). Patients underwent motor (Timed Up and Go test, 10-meters-walking test, UPDRSIII) and neuropsychological evaluations (executive-attentive, visuo-spatial and memory domains). Both patients and controls performed an fMRI task consisting of alternate dorsal/plantar feet flexion movements according to an auditory stimulus of 0.5 Hz.

Results PD-FoG and PD-noFoG patients were similar for all motor variables except for the presence of FoG. Only PD-FoG patients performed worse in executive-attentive, visuo-spatial and memory functions relative to healthy controls. fMRI results showed decreased activity in sensorimotor areas in PD-FoG and PD-noFoG patients relative to healthy controls. PD-noFoG patients showed an increased activation of frontal-striatal network while PD-FoG subjects had an increased parieto-occipital and cerebellar cortices recruitment compared to healthy subjects. PD-FoG showed a decreased basal ganglia activity relative to PD-noFoG. Analysing PD-FoG subgroups, mild PD-FoG subjects revealed an increased fronto-parietal activation relative to moderate PD-FoG patients.

Conclusions All PD subjects showed a decrease recruitment of sensorimotor areas during feet movements relative to healthy controls. Despite this common feature, this study revealed the presence of two different patterns of brain activity during feet movements in PD-FoG and PD-noFoG patients, suggesting a compensatory role of parieto-occipital network to overcome the fronto-striatal failure in PD-FoG subjects.

Authors/Disclosures
Noemi Piramide, MSc (Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neu) PRESENTER	Noemi Piramide has nothing to disclose.
Elisabetta Sarasso	Elisabetta Sarasso has nothing to disclose.
	No disclosure on file
Elisa Canu (Ospedale San Raffaele)	The institution of Elisa Canu has received research support from Italian Ministry of Health .
Sebastiano Galantucci (San Raffaele Scientific Institute)	Mr. Galantucci has nothing to disclose.
	No disclosure on file
Andrea Tettamanti	No disclosure on file
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Federica Agosta (San Raffaele Scientific Institute)	Federica Agosta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Philips. Federica Agosta has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier INC.

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