title: Neuroimaging of Freezing of Gait.
abstract: Functional brain imaging techniques appear ideally suited to explore the pathophysiology of freezing of gait (FOG). In the last two decades, techniques based on magnetic resonance or nuclear medicine imaging have found a number of structural changes and functional disconnections between subcortical and cortical regions of the locomotor network in patients with FOG. FOG seems to be related in part to disruptions in the "executive-attention" network along with regional tissue loss including the premotor area, inferior frontal gyrus, precentral gyrus, the parietal and occipital areas involved in visuospatial functions of the right hemisphere. Several subcortical structures have been also involved in the etiology of FOG, principally the caudate nucleus and the locomotor centers in the brainstem. Maladaptive neural compensation may present transiently in the presence of acute conflicting motor, cognitive or emotional stimulus processing, thus causing acute network overload and resulting in episodic impairment of stepping.In this review we will summarize the state of the art of neuroimaging research for FOG. We will also discuss the limitations of current approaches and delineate the next steps of neuroimaging research to unravel the pathophysiology of this mysterious motor phenomenon.
authors.affiliation: Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Fasano
authors.affiliation: Center for the study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Talia
authors.initials: T
authors.lastname: Herman
authors.affiliation: Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tessitore
authors.affiliation: Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
authors.forename: Antonio P
authors.initials: AP
authors.lastname: Strafella
authors.affiliation: Departments of Radiology and Neurology, University of Michigan, and Neurology Service and GRECC, VAAAHS, Ann Arbor, MI, USA.
authors.forename: Nicolaas I
authors.initials: NI
authors.lastname: Bohnen
mesh_terms: D000109:Acetylcholine / Q000378:metabolism; D016229:Amyloid beta-Peptides / Q000378:metabolism; D000818:Animals; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D001931:Brain Mapping; D004298:Dopamine / Q000378:metabolism; D020233:Gait Disorders, Neurologic / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D066128:Gray Matter / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging / Q000639:trends*; D049268:Positron-Emission Tomography; D015899:Tomography, Emission-Computed, Single-Photon; D066127:White Matter / Q000473:pathology
chemical_list: D016229:Amyloid beta-Peptides; D000109:Acetylcholine; D004298:Dopamine
keywords: Freezing of gait; Parkinson’s disease; magnetic resonance imaging; positron emission tomography; single photon emission computed tomography