Neuroimaging of Freezing of Gait.
Neuroimaging of Freezing of Gait.
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DOI：
10.3233/jpd-150536
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Bohnen NI
中科院分区：
文献类型：
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作者：
Fasano A;Herman T;Tessitore A;Strafella AP;Bohnen NI
功能脑成像技术似乎非常适合探索步态冻结（FOG）的病理生理学。在过去的二十年中，基于磁共振或核医学成像的技术已经发现，在FOG患者的运动网络皮层下和皮层区域之间存在许多结构变化和功能断开。FOG似乎在一定程度上与“执行-注意力”网络的中断以及区域组织的损失有关，包括运动前区、额下回、中央前回、涉及右半球视觉空间功能的顶叶和枕叶区域。一些皮层下结构也与FOG的病因有关，主要是尾状核和脑干的运动中心。在急性冲突的运动、认知或情绪刺激加工中，神经代偿失调可能会短暂出现，从而引起急性网络过载，导致偶发性步进障碍。在这篇综述中，我们将总结FOG神经影像学研究的最新进展。我们还将讨论当前方法的局限性，并描述神经影像学研究的下一步，以揭示这种神秘运动现象的病理生理学。
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.