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Neuroimaging as a Window into Gait Disturbances and Freezing of Gait in Patients with Parkinson’s Disease

  • Neuroimaging (DJ Brooks, Section Editor)
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Abstract

Neuroimaging has been applied to better understand the neural mechanisms underlying gait disturbances in Parkinson’s disease (PD). In the present paper, we review studies that used neuroimaging methods to investigate mobility, walking and freezing of gait (FOG) in PD, focusing on the recent literature. Examination of these studies suggests that gait changes in PD are due to widespread alterations in the structure and function of the brain that go beyond the basal ganglia. For example, cortical structures including the frontal and parietal lobes, the mesencephalic locomotor region and specifically, the pedunculopontine nucleus, all apparently play important roles in the control of gait in PD. Nonetheless, there are some significant inconsistencies across the different studies and many questions remain regarding the precise pathological processes that contribute to gait disturbances, in general, and to FOG, more specifically. A discussion of new insights into the neural mechanisms underlying gait disturbances are presented along with a summary of the disadvantages and limitations of the existing techniques and suggestions for future directions.

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Acknowledgment

Jeffrey M. Hausdorff has received grant support from the Michael J. Fox Foundation and the European commission.

Nir Giladi has received grant support from the Michael J. Fox Foundation, the National Parkinson Foundation, and Israel Science Officer.

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Talia Herman declares that she has no conflict of interest.

Nir Giladi has been a consultant for TEVA LUNDBECK, UCB, Neuroderm, Pharma2B, Intec Pharma, Armon. He is employed by Tel Aviv Medical Center and Tel Aviv University. He has given expert testimony for GlaxoSmithKline. He has received honoraria from Teva and Novartis. He receives royalties from Medoc publisher for a book. He has received travel/accommodations expenses covered or reimbursed from Teva, the Michael J. Fox Foundation, and the National Parkinson Foundation.

Jeffrey M. Hausdorff declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Movement Disorders Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv, 64239, Israel

    Talia Herman, Nir Giladi & Jeffrey M. Hausdorff

  2. The Dr. Miriam and Sheldon G. Adelson Graduate School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Talia Herman

  3. Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel

    Nir Giladi & Jeffrey M. Hausdorff

  4. Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Nir Giladi

  5. Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Jeffrey M. Hausdorff

  6. Department of Medicine, Harvard Medical School, Boston, MA, USA

    Jeffrey M. Hausdorff

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  1. Talia Herman
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  2. Nir Giladi
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  3. Jeffrey M. Hausdorff
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Correspondence to Jeffrey M. Hausdorff.

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Herman, T., Giladi, N. & Hausdorff, J.M. Neuroimaging as a Window into Gait Disturbances and Freezing of Gait in Patients with Parkinson’s Disease. Curr Neurol Neurosci Rep 13, 411 (2013). https://doi.org/10.1007/s11910-013-0411-y

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