title: Neuropsychological and imaging profile of patients with Parkinson's disease and freezing of gait.
abstract: BACKGROUND
  Neuropsychological evaluation with advanced neuroimaging may be a useful tool to determine the anatomical substrates that play crucial role in freezing of gait (FOG) in patients with Parkinson's Disease (PD).
  
  
  OBJECTIVE
  To compare the cognitive profile and gray matter (GM) changes (using Voxel Based Morphometry - VBM) between patients with PD with and without FOG (FOG+ve and FOG-ve).
  
  
  METHODS
  Seventeen FOG+ve (M:F = 11:6) and 21 FOG-ve (M:F = 11:10) were evaluated clinically and with a structured neuropsychological battery. All patients underwent 3 T MRI. In order to determine areas of GM atrophy, T1W volumetric MRI data of the two groups were compared using VBM and Statistical Parametric Mapping 8.
  
  
  RESULTS
  The mean age of FOG+ve and FOG-ve patients were 56.9 ± 6.6 and 47.4 ± 9.1 years respectively. There was no significant difference in the duration (6.0 ± 4.9 vs 5.2 ± 3.5 years, p < 0.05) and stage of PD (Hoehn & Yahr stage: 1.96 ± 0.53 vs 1.78 ± 0.37) between the two groups. Compared to the FOG-ve group, the FOG+ve group had (i) significant impairment in memory, attention, executive and visuospatial functions on neuropsychological tests, and (ii) significant GM atrophy in the right cerebellum (pyramis, declive), left cerebrum (Brodmann area (BA) 21 and 22) and right cerebrum (BA 10 and 6) on VBM analysis.
  
  
  CONCLUSIONS
  The FOG+ve group showed widespread involvement of cognition localizing to frontal, temporal (especially left) and parietal areas. VBM analysis showed significant GM atrophy in FOG+ve group in left temporal, right frontal areas (coinciding with that observed in neuropsychological tests) and significant involvement of right cerebellum.
authors: Departments of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, Karnataka, India.
authors: Menka
authors: M
authors: Jha
authors: Departments of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, Karnataka, India.
authors: Ketan
authors: K
authors: Jhunjhunwala
authors: Regional Occupational Health Centre (Southern), NIOH, ICMR, Bangalore, Karnataka, India.
authors: Bagepally B
authors: BB
authors: Sankara
authors: Neuroimaging & Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India.
authors: Jitender
authors: J
authors: Saini
authors: Clinical Psychology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India.
authors: J Keshav
authors: JK
authors: Kumar
authors: Departments of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, Karnataka, India.
authors: Ravi
authors: R
authors: Yadav
authors: Departments of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, Karnataka, India. Electronic address: pal.pramod@rediffmail.com.
authors: Pramod Kumar
authors: PK
authors: Pal
mesh_terms: D001284:Atrophy; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000473:pathology / Q000523:psychology; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000473:pathology* / Q000523:psychology*
keywords: Freezing of gait; Neuropsychological assessment; Parkinson's disease; Voxel based morphometry