title: Pattern of brain tissue loss associated with freezing of gait in Parkinson disease.
abstract: OBJECTIVE
  To investigate whether a specific pattern of gray matter (GM) tissue loss is associated with freezing of gait (FOG) in patients with Parkinson disease (PD).
  
  
  METHODS
  Seventeen patients with PD with FOG (PD-FOG), 20 patients with PD with no FOG (PD-noFOG), and 34 healthy control subjects were recruited. PD-FOG and PD-noFOG patients were matched on an individual basis for age, disease duration, and Hoehn and Yahr stage. Patients were also administered a comprehensive neuropsychological battery focused on executive functions. The extent and distribution of GM atrophy were assessed using voxel-based morphometry.
  
  
  RESULTS
  In patients with PD, the severity of FOG correlated with frontal executive deficits. Compared with healthy control subjects, PD-FOG patients showed a distributed pattern of GM atrophy including the dorsolateral prefrontal, medial, and lateral temporal, inferior parietal, and occipital cortices. PD-noFOG patients showed only small regions of GM atrophy in the bilateral frontal and temporal cortex. The left inferior frontal gyrus, left precentral gyrus, and left inferior parietal gyrus were more atrophic in PD-FOG patients relative to both healthy control subjects and PD-noFOG patients. In PD-FOG patients, the severity of FOG was associated with GM volumes of the frontal and parietal cortices bilaterally.
  
  
  CONCLUSIONS
  GM frontal and parietal atrophy occur in PD-FOG patients. FOG in PD seems to share with executive dysfunction and perception deficits a common pattern of structural damage to the frontal and parietal cortices.
authors.affiliation: Department of Neurology, University of Belgrade, Belgrade, Serbia.
authors.forename: V S
authors.initials: VS
authors.lastname: Kostic
authors.forename: F
authors.initials: F
authors.lastname: Agosta
authors.forename: M
authors.initials: M
authors.lastname: Pievani
authors.forename: E
authors.initials: E
authors.lastname: Stefanova
authors.forename: M
authors.initials: M
authors.lastname: Jecmenica-Lukic
authors.forename: A
authors.initials: A
authors.lastname: Scarale
authors.forename: V
authors.initials: V
authors.lastname: Spica
authors.forename: M
authors.initials: M
authors.lastname: Filippi
mesh_terms: D000368:Aged; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000473:pathology* / Q000503:physiopathology; D012720:Severity of Illness Index