title: Regional gray matter atrophy in patients with Parkinson disease and freezing of gait.
abstract: OBJECTIVE
  FOG is a troublesome symptom of PD. Despite growing evidence suggesting that FOG in PD may be associated with cognitive dysfunction, the relationship between regional brain atrophy and FOG has been poorly investigated.
  
  
  METHODS
  Optimized VBM was applied to 3T brain MR images of 24 patients with PD and 12 HC. Patients were classified as either FOG- or FOG+ (n = 12) based on their responses to a validated FOG Questionnaire and clinical observation. All patients with PD also underwent a detailed neuropsychological evaluation.
  
  
  RESULTS
  The VBM analysis in patients with FOG+ showed a reduced GM volume in the left cuneus, precuneus, lingual gyrus, and posterior cingulate cortex compared with both patients with FOG- and HC. We did not detect any significant change of GM volume when comparing HC versus all patients with PD (FOG- and FOG+). FOG clinical severity was significantly correlated with GM loss in posterior cortical regions. Finally, patients with FOG+ scored lower on tests of frontal lobe function.
  
  
  CONCLUSIONS
  Our findings provide the first evidence that the development of FOG in patients with PD is associated with posterior GM atrophy, which may play a role in the complex pathophysiology of this disabling symptom.
authors.affiliation: Department of Neurological Sciences, Second University of Naples, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Tessitore
authors.forename: M
authors.initials: M
authors.lastname: Amboni
authors.forename: G
authors.initials: G
authors.lastname: Cirillo
authors.forename: D
authors.initials: D
authors.lastname: Corbo
authors.forename: M
authors.initials: M
authors.lastname: Picillo
authors.forename: A
authors.initials: A
authors.lastname: Russo
authors.forename: C
authors.initials: C
authors.lastname: Vitale
authors.forename: G
authors.initials: G
authors.lastname: Santangelo
authors.forename: R
authors.initials: R
authors.lastname: Erro
authors.forename: M
authors.initials: M
authors.lastname: Cirillo
authors.forename: F
authors.initials: F
authors.lastname: Esposito
authors.forename: P
authors.initials: P
authors.lastname: Barone
authors.forename: G
authors.initials: G
authors.lastname: Tedeschi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009474:Neurons / Q000473:pathology*; D010300:Parkinson Disease / Q000150:complications* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity