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06.08.2022 | Original Communication

Associated factors and abnormal dorsal raphe nucleus connectivity patterns of freezing of gait in Parkinson’s disease

verfasst von: Lingling Lv, Hainan Zhang, Xuling Tan, Zhe Long, Lixia Qin, Rongrong Bai, Qile Xiao, Ziwei Wu, Shenglan Hu, Changlian Tan, Haiyan Liao, Weiqian Yan, Beisha Tang, Feng Ren, Chunyu Wang

Erschienen in: Journal of Neurology | Ausgabe 12/2022

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Abstract

Background

Freezing of gait (FOG) is a common, disabling symptom of Parkinson’s disease (PD), and its exact pathophysiological mechanism is still poorly understood. The control of gait is a complex process that may be influenced by emotions modulated by serotonergic networks. Therefore, this study aimed to determine factors associated with FOG in PD patients and to evaluate the importance of the dorsal raphe nucleus (DRN; central node in the serotoninergic system) in FOG pathophysiology.

Methods

We combined cross-sectional survey data from 453 PD patients. According to the Freezing of Gait Questionnaire (FOGQ), patients were divided into two groups: the “PD with frozen gait (PD-FOG)” and “PD without frozen gait (PD-nFOG)” groups. Demographic characteristics, clinical features, and motor and nonmotor symptoms (NMS) assessments of PD patients were recorded. Univariate statistical analysis was performed between the two groups, and then regression analysis was performed on related factors. We also acquired resting-state functional MRI (rs-fMRI) data from 20 PD-FOG, 21 PD-nFOG, and 22 healthy controls (HCs) who were randomly chosen. We defined seeds in the DRN to evaluate functional connectivity (FC) patterns.

Results

The overall frequency of FOG was 11.9% patients in the PD-FOG group were older, had a longer disease duration, had a higher levodopa equivalent daily dose, had more severe motor symptoms and worse quality of life, had a higher proportion of dyskinesia, wearing-off and postural instability/gait difficulty (PIGD) clinical phenotype, and experienced more depression and impaired sleep function than those in the PD-nFOG group. Logistic regression analysis showed that H&Ystage ≥ 3, UPDRS-III scores, PIGD clinical phenotype and excessive daytime sleepiness were associated with FOG. In addition, there was significantly lower FC between the DRN and some cortical structures, including the supplementary motor area (SMA), left superior frontal gyrus (SFG), and left median cingulated cortex (MCC) in PD-FOG patients than HCs and PD-nFOG patients.

Conclusions

These results demonstrate that the severity of PD and PIGD clinical phenotype are associated factors for freezing and that DRN dysfunction may play a key role in PD-related NMS and FOG. An abnormal cortical and brainstem networks may contribute to the mechanisms underlying FOG.

Cucca A, Biagioni MC, Fleisher JE, Agarwal S, Son A, Kumar P et al (2016) Freezing of gait in Parkinson’s disease: from pathophysiology to emerging therapies. Neurodegener Dis Manag 6(5):431–446PubMedCrossRef

Nonnekes J, Snijders AH, Nutt JG, Deuschl G, Giladi N, Bloem BR (2015) Freezing of gait: a practical approach to management. Lancet Neurol 14(7):768–778PubMedCrossRef

Rahman S, Griffin HJ, Quinn NP, Jahanshahi M (2008) The factors that induce or overcome freezing of gait in Parkinson’s disease. Behav Neurol 19(3):127–136PubMedPubMedCentralCrossRef

Delval A, Snijders AH, Weerdesteyn V, Duysens JE, Defebvre L, Giladi N et al (2010) Objective detection of subtle freezing of gait episodes in Parkinson’s disease. Mov Disord 25(11):1684–1693PubMedCrossRef

Morris ME, Iansek R, Galna B (2008) Gait festination and freezing in Parkinson’s disease: pathogenesis and rehabilitation. Mov Disord 23(Suppl 2):S451–S460PubMedCrossRef

Delgado-Alvarado M, Marano M, Santurtun A, Urtiaga-Gallano A, Tordesillas-Gutierrez D, Infante J (2020) Nonpharmacological, nonsurgical treatments for freezing of gait in Parkinson’s disease: a systematic review. Mov Disord 35(2):204–214PubMedCrossRef

Ebersbach G, Moreau C, Gandor F, Defebvre L, Devos D (2013) Clinical syndromes: Parkinsonian gait. Mov Disord 28(11):1552–1559PubMedCrossRef

Smulders K, Esselink RA, Bloem BR, Cools R (2015) Freezing of gait in Parkinson’s disease is related to impaired motor switching during stepping. Mov Disord 30(8):1090–1097PubMedCrossRef

Ou R, Guo X, Song W, Cao B, Yang J, Wei Q et al (2014) Freezing of gait in Chinese patients with Parkinson disease. J Neurol Sci 345(1–2):56–60PubMedCrossRef

10.

Contreras A, Grandas F (2012) Risk factors for freezing of gait in Parkinson’s disease. J Neurol Sci 320(1–2):66–71PubMedCrossRef

11.

Banks SJ, Bayram E, Shan G, LaBelle DR, Bluett B (2019) Non-motor predictors of freezing of gait in Parkinson’s disease. Gait Posture 68:311–316PubMedCrossRef

12.

Dujardin K, Sgambato V (2020) Neuropsychiatric disorders in Parkinson’s disease: What do we know about the role of dopaminergic and non-dopaminergic systems? Front Neurosci 14:25PubMedPubMedCentralCrossRef

13.

Muñoz A, Lopez-Lopez A, Labandeira CM, Labandeira-Garcia JL (2020) Interactions between the serotonergic and other neurotransmitter systems in the basal Ganglia: role in Parkinson’s disease and adverse effects of L-DOPA. Front Neuroanat 14:26. https://doi.org/10.3389/fnana.2020.00026CrossRefPubMedPubMedCentral

14.

Miguelez C, Morera-Herreras T, Torrecilla M, Ruiz-Ortega JA, Ugedo L (2014) Interaction between the 5-HT system and the basal ganglia: functional implication and therapeutic perspective in Parkinson’s disease. Front Neural Circuits 8:21PubMedPubMedCentralCrossRef

15.

Briand LA, Gritton H, Howe WM, Young DA, Sarter M (2007) Modulators in concert for cognition: modulator interactions in the prefrontal cortex. Prog Neurobiol 83(2):69–91PubMedPubMedCentralCrossRef

16.

Mirelman A, Bonato P, Camicioli R, Ellis TD, Giladi N, Hamilton JL et al (2019) Gait impairments in Parkinson’s disease. Lancet Neurol 18(7):697–708PubMedCrossRef

17.

Maillet A, Pollak P, Debu B (2012) Imaging gait disorders in parkinsonism: a review. J Neurol Neurosurg Psychiatry 83(10):986–993PubMedCrossRef

18.

Pozzi NG, Canessa A, Palmisano C, Brumberg J, Steigerwald F, Reich MM et al (2019) Freezing of gait in Parkinson’s disease reflects a sudden derangement of locomotor network dynamics. Brain 142(7):2037–2050PubMedPubMedCentralCrossRef

19.

Okuma Y, Yanagisawa N (2008) The clinical spectrum of freezing of gait in Parkinson’s disease. Mov Disord 23(Suppl 2):S426–S430PubMedCrossRef

20.

Lewis SJ, Shine JM (2016) The next step: a common neural mechanism for freezing of gait. Neuroscientist 22(1):72–82PubMedCrossRef

21.

Youn J, Lee JM, Kwon H, Kim JS, Son TO, Cho JW (2015) Alterations of mean diffusivity of pedunculopontine nucleus pathway in Parkinson’s disease patients with freezing of gait. Parkinsonism Relat Disord 21(1):12–17PubMedCrossRef

22.

Fasano A, Herman T, Tessitore A, Strafella AP, Bohnen NI (2015) Neuroimaging of freezing of gait. J Parkinsons Dis 5(2):241–254PubMedPubMedCentralCrossRef

23.

Snijders AH, Leunissen I, Bakker M, Overeem S, Helmich RC, Bloem BR et al (2011) Gait-related cerebral alterations in patients with Parkinson’s disease with freezing of gait. Brain 134(Pt 1):59–72PubMedCrossRef

24.

Schweder PM, Hansen PC, Green AL, Quaghebeur G, Stein J, Aziz TZ (2010) Connectivity of the pedunculopontine nucleus in parkinsonian freezing of gait. NeuroReport 21(14):914–916PubMedCrossRef

25.

Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W et al (2015) MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord 30(12):1591–1601PubMedCrossRef

26.

Giladi N, Tal J, Azulay T, Rascol O, Brooks DJ, Melamed E et al (2009) Validation of the freezing of gait questionnaire in patients with Parkinson’s disease. Mov Disord 24(5):655–661PubMedCrossRef

27.

Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE (2010) Systematic review of levodopa dose equivalency reporting in Parkinson’s disease. Mov Disord 25(15):2649–2653PubMedCrossRef

28.

Goetz CG, Tilley BC, Shaftman SR, Stebbins GT, Fahn S, Martinez-Martin P et al (2008) Movement Disorder Society-sponsored revision of the unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord 23(15):2129–2170PubMedCrossRef

29.

Hoehn M, Yahr MD (1967) Parkinsonism: onset, progression, and mortality. Neurology 17(5):427–442PubMedCrossRef

30.

Chaudhuri KR, Martinez-Martin P, Brown RG, Sethi K, Stocchi F, Odin P et al (2007) The metric properties of a novel non-motor symptoms scale for Parkinson’s disease: results from an international pilot study. Mov Disord 22(13):1901–1911PubMedCrossRef

31.

Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198PubMedCrossRef

32.

Montgomery SA, Asberg M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 134:382–389PubMedCrossRef

33.

Millar Vernetti P, Perez Lloret S, Rossi M, Cerquetti D, Merello M (2012) Validation of a new scale to assess olfactory dysfunction in patients with Parkinson’s disease. Parkinsonism Relat Disord 18(4):358–361PubMedCrossRef

34.

Chaudhuri KR, Pal S, DiMarco A, Whately-Smith C, Bridgman K, Mathew R et al (2002) The Parkinson’s disease sleep scale: a new instrument for assessing sleep and nocturnal disability in Parkinson’s disease. J Neurol Neurosurg Psychiatry 73(6):629–635PubMedPubMedCentralCrossRef

35.

Shen SS, Shen Y, Xiong KP, Chen J, Mao CJ, Huang JY et al (2014) Validation study of REM sleep behavior disorder questionnaire-Hong Kong (RBDQ-HK) in east China. Sleep Med 15(8):952–958PubMedCrossRef

36.

Simuni T, Caspell-Garcia C, Coffey C, Chahine LM, Lasch S, Oertel WH et al (2015) Correlates of excessive daytime sleepiness in de novo Parkinson’s disease: a case control study. Mov Disord 30(10):1371–1381PubMedPubMedCentralCrossRef

37.

Peto V, Jenkinson C, Fitzpatrick R, Greenhall R (1995) The development and validation of a short measure of functioning and well being for individuals with Parkinson’s disease. Mov Disord 3:241–248

38.

Xin HW, Fang XC, Zhu LM, Xu T, Fei GJ, Wang ZF et al (2014) Diagnosis of functional constipation: agreement between Rome III and Rome II criteria and evaluation for the practicality. J Dig Dis 15(6):314–320PubMedPubMedCentralCrossRef

39.

Stebbins GT, Goetz CG, Burn DJ, Jankovic J, Khoo TK, Tilley BC (2013) How to identify tremor dominant and postural instability/gait difficulty groups with the movement disorder society unified Parkinson’s disease rating scale: comparison with the unified Parkinson’s disease rating scale. Mov Disord 28(5):668–670PubMedCrossRef

40.

Yan C, Wang X, Zuo X, Zang Y (2016) DPABI: Data processing and analysis for (resting-state) brain imaging. Neuroinformatics 14(3):339–351PubMedCrossRef

41.

Yan CG, Cheung B, Kelly C, Colcombe S, Craddock RC, Di Martino A et al (2013) A comprehensive assessment of regional variation in the impact of head micromovements on functional connectomics. Neuroimage 76:183–201PubMedCrossRef

42.

Chao-Gan Y, Yu-Feng Z (2010) DPARSF: a MATLAB toolbox for “pipeline” data analysis of resting-state fMRI. Front Syst Neurosci 4:13PubMedPubMedCentral

43.

Rolls ET, Huang C-C, Lin C-P, Feng J, Joliot M (2020) Automated anatomical labelling atlas 3. NeuroImage 206:116189. https://doi.org/10.1016/j.neuroimage.2019.116189CrossRefPubMed

44.

Amboni M, Stocchi F, Abbruzzese G, Morgante L, Onofrj M, Ruggieri S et al (2015) Prevalence and associated features of self-reported freezing of gait in Parkinson disease: the DEEP FOG study. Parkinsonism Relat Disord 21(6):644–649PubMedCrossRef

45.

Macht M, Kaussner Y, Moller JC, Stiasny-Kolster K, Eggert KM, Kruger HP et al (2007) Predictors of freezing in Parkinson’s disease: a survey of 6,620 patients. Mov Disord 22(7):953–956PubMedCrossRef

46.

Takahashi M, Tabu H, Ozaki A, Hamano T, Takeshima T, group Rs (2019) Antidepressants for depression, apathy, and gait instability in Parkinson’s disease: a multicenter randomized study. Intern Med 58(3):361–368PubMedCrossRef

47.

Devos D, Defebvre L, Bordet R (2010) Dopaminergic and non-dopaminergic pharmacological hypotheses for gait disorders in Parkinson’s disease. Fundam Clin Pharmacol 24(4):407–421PubMedCrossRef

48.

Paulus W, Jellinger K (1991) The neuropathologic basis of different clinical subgroups of Parkinson’s disease. J Neuropathol Exp Neurol 50(6):743–755PubMedCrossRef

49.

Herman T, Shema-Shiratzky S, Arie L, Giladi N, Hausdorff JM (2019) Depressive symptoms may increase the risk of the future development of freezing of gait in patients with Parkinson’s disease: findings from a 5-year prospective study. Parkinsonism Relat Disord 60:98–104PubMedCrossRef

50.

Giladi N, McDermott MP, Fahn S, Przedborski S, Jankovic J, Stern M et al (2001) Freezing of gait in PD prospective assessment in the DATATOP cohort. Neurology 56(12):1712–1721PubMedCrossRef

51.

Giladi N, Treves TA, Simon ES, Shabtai H, Orlov Y, Kandinov B et al (2002) Freezing of gait in patients with advanced Parkinson’s disease. J Neural Transm 108(1):53–61CrossRef

52.

Forsaa EB, Larsen JP, Wentzel-Larsen T, Alves G (2015) A 12-year population-based study of freezing of gait in Parkinson’s disease. Parkinsonism Relat Disord 21(3):254–258PubMedCrossRef

53.

Ehgoetz Martens KA, Lukasik EL, Georgiades MJ, Gilat M, Hall JM, Walton CC et al (2018) Predicting the onset of freezing of gait: a longitudinal study. Mov Disord 33(1):128–135PubMedCrossRef

54.

Factor SA, Steenland NK, Higgins DS, Molho ES, Kay DM, Montimurro J et al (2011) Postural instability/gait disturbance in Parkinson’s disease has distinct subtypes: an exploratory analysis. J Neurol Neurosurg Psychiatry 82(5):564–568PubMedCrossRef

55.

Perez-Lloret S, Negre-Pages L, Damier P, Delval A, Derkinderen P, Destée A et al (2014) Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease. JAMA Neurol 71(7):884PubMedCrossRef

56.

Zhang H, Yin X, Ouyang Z, Chen J, Zhou S, Zhang C et al (2016) A prospective study of freezing of gait with early Parkinson disease in Chinese patients. Medicine (Baltimore) 95(26):e4056CrossRef

57.

Garcia-Ruiz PJ, Del Val J, Fernandez IM, Herranz A (2012) What factors influence motor complications in Parkinson disease?: A 10-year prospective study. Clin Neuropharmacol 35(1):1–5PubMedCrossRef

58.

Auyeung M, Tsoi TH, Mok V, Cheung CM, Lee CN, Li R et al (2012) Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson’s disease patients. J Neurol Neurosurg Psychiatry 83(6):607–611PubMedCrossRef

59.

Giladi N, McDermott MP, Fahn S, Przedborski S, Jankovic J, Stern M et al (2001) Freezing of gait in PD: prospective assessment in the DATATOP cohort. Neurology 56(12):1712–1721PubMedCrossRef

60.

Sawada M, Wada-Isoe K, Hanajima R, Nakashima K (2019) Clinical features of freezing of gait in Parkinson’s disease patients. Brain Behav 9(4):e01244PubMedPubMedCentralCrossRef

61.

Maidan I, Plotnik M, Mirelman A, Weiss A, Giladi N, Hausdorff JM (2010) Heart rate changes during freezing of gait in patients with Parkinson’s disease. Mov Disord 25(14):2346–2354PubMedPubMedCentralCrossRef

62.

Ehgoetz Martens KA, Ellard CG, Almeida QJ (2014) Does anxiety cause freezing of gait in Parkinson’s disease? PLoS ONE 9(9):e106561PubMedPubMedCentralCrossRef

63.

Lord S, Galna B, Coleman S, Burn D, Rochester L (2013) Mild depressive symptoms are associated with gait impairment in early Parkinson’s disease. Mov Disord 28(5):634–639PubMedCrossRef

64.

Giladi N, Hausdorff JM (2006) The role of mental function in the pathogenesis of freezing of gait in Parkinson’s disease. J Neurol Sci 248(1–2):173–176PubMedCrossRef

65.

Amboni M, Cozzolino A, Longo K, Picillo M, Barone P (2008) Freezing of gait and executive functions in patients with Parkinson’s disease. Mov Disord 23(3):395–400PubMedCrossRef

66.

Nantel J, McDonald JC, Tan S, Bronte-Stewart H (2012) Deficits in visuospatial processing contribute to quantitative measures of freezing of gait in Parkinson’s disease. Neuroscience 221:151–156PubMedCrossRef

67.

Abbott RD, Ross GW, White LR, Tanner CM, Masaki KH, Nelson JS et al (2005) Excessive daytime sleepiness and subsequent development of Parkinson disease. Neurology 65(9):1442–1446PubMedCrossRef

68.

Stewart J, Bachman G, Cooper C, Liu L, Ancoli-Israel S, Alibiglou L (2018) Circadian dysfunction and fluctuations in gait initiation impairment in Parkinson’s disease. Exp Brain Res 236(3):655–664PubMedCrossRef

69.

Tang X, Yu L, Yang J, Guo W, Liu Y, Xu Y et al (2021) Association of sleep disturbance and freezing of gait in Parkinson disease: prevention/delay implications. J Clin Sleep Med 17(4):779–789PubMedPubMedCentralCrossRef

70.

Ou R, Wei Q, Cao B, Song W, Hou Y, Liu H et al (2018) Predictors of freezing of gait in Chinese patients with Parkinson’s disease. Brain Behav 8(3):e00931PubMedPubMedCentralCrossRef

71.

Long K, Wan C, Xiang Y, Liu J, Xu Q, Sun Q et al (2020) Study on the clinical features of Parkinson’s disease with probable rapid eye movement sleep behavior disorder. Front Neurol 11:979PubMedPubMedCentralCrossRef

72.

Videnovic A, Marlin C, Alibiglou L, Planetta PJ, Vaillancourt DE, MacKinnon (2013) Increased REM sleep without atonia in Parkinson disease with freezing of gait. Neurology 81:1030–1035PubMedPubMedCentralCrossRef

73.

Kotagal V, Albin RL, Muller ML, Koeppe RA, Chervin RD, Frey KA et al (2012) Symptoms of rapid eye movement sleep behavior disorder are associated with cholinergic denervation in Parkinson disease. Ann Neurol 71(4):560–568PubMedPubMedCentralCrossRef

74.

Fox SH, Chuang R, Brotchie JM (2009) Serotonin and Parkinson’s disease: on movement, mood, and madness. Mov Disord 24(9):1255–1266PubMedCrossRef

75.

Prinz A, Selesnew LM, Liss B, Roeper J, Carlsson T (2013) Increased excitability in serotonin neurons in the dorsal raphe nucleus in the 6-OHDA mouse model of Parkinson’s disease. Exp Neurol 248:236–245PubMedCrossRef

76.

Albin RL, Koeppe RA, Bohnen NI, Wernette K, Kilbourn MA, Frey KA (2007) Spared caudal brainstem SERT binding in early Parkinson’s disease. J Cereb Blood Flow Metab 28(3):441–444PubMedCrossRef

77.

Heckman CJ, Mottram C, Quinlan K, Theiss R, Schuster J (2009) Motoneuron excitability: the importance of neuromodulatory inputs. Clin Neurophysiol 120(12):2040–2054PubMedPubMedCentralCrossRef

78.

Nutt JG, Bloem BR, Giladi N, Hallett M, Horak FB, Nieuwboer A (2011) Freezing of gait: moving forward on a mysterious clinical phenomenon. Lancet Neurol 10(8):734–744PubMedPubMedCentralCrossRef

79.

Nachev P, Kennard C, Husain M (2008) Functional role of the supplementary and pre-supplementary motor areas. Nat Rev Neurosci 9(11):856–869PubMedCrossRef

80.

Brugger F, Wegener R, Walch J, Galovic M, Hagele-Link S, Bohlhalter S et al (2020) Altered activation and connectivity of the supplementary motor cortex at motor initiation in Parkinson’s disease patients with freezing. Clin Neurophysiol 131(9):2171–2180PubMedCrossRef

81.

Nutt JG, Marsden CD, Thompson PD (1993) Human walking and higher-level gait disorders, particularly in the elderly. Neurology 43(2):268–279PubMedCrossRef

82.

Shine JM, Naismith SL, Lewis SJ (2013) The differential yet concurrent contributions of motor, cognitive and affective disturbance to freezing of gait in Parkinson’s disease. Clin Neurol Neurosurg 115(5):542–545PubMedCrossRef

83.

Pietracupa S, Suppa A, Upadhyay N, Gianni C, Grillea G, Leodori G et al (2018) Freezing of gait in Parkinson’s disease: gray and white matter abnormalities. J Neurol 265(1):52–62PubMedCrossRef

84.

Vogt BA, Berger GR, Derbyshire SW (2003) Structural and functional dichotomy of human midcingulate cortex. Eur J Neurosci 18(11):3134–3144PubMedPubMedCentralCrossRef

85.

Nieuwboer A, Giladi N (2013) Characterising freezing of gait in Parkinson’s disease: models of an episodic. Mov Disord 28(11):1509–1519PubMedCrossRef

Titel: Associated factors and abnormal dorsal raphe nucleus connectivity patterns of freezing of gait in Parkinson’s disease
verfasst von: Lingling Lv
Hainan Zhang
Xuling Tan
Zhe Long
Lixia Qin
Rongrong Bai
Qile Xiao
Ziwei Wu
Shenglan Hu
Changlian Tan
Haiyan Liao
Weiqian Yan
Beisha Tang
Feng Ren
Chunyu Wang
Publikationsdatum: 06.08.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 12/2022
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-022-11294-6

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