Objective: In the study ,fNIRS technique was used to study the activation level and activation mode of prefrontal cerebral cortex for patients with FOG under cognitive processing,in order to analyze the correlation between the severity of FOG and the prefrontal cortex function and to explore the pathophysiology of PD with FOG.To provide a theoretical basis for the diagnosis,intervention and treatment of PD with FOG,to help patients establish confidence,improve symptoms and improve quality of life.

Background: FNIRS is a real-time brain function monitoring,with its protability,noninvasive,high temporal resolution,low cost and other unique advantages are widely used in the field of cognitive neuroscience.The pathophysiology of FOG remains obscure and some research suggests that cognitive impairment plays a key role in the occurrence of FOG.

Methods: The patients were divided into two groups:parkinson’s disease with freezing of gait(PD-FOG+) and parkinson’s disease without freezing of gait(PD-FOG-) according to the clinical diagnostic criteria of the United kingdom Parkinson’s disease Society Brain Bank and FOG questionnaire.Patients was assessed using the Hoehn and Yahr scale(H&Y),motor section of the Unified Parkinson’s Disease Rating Scale(UPDRS-Ⅲ) in the “off”（minimum of 12h without anti-parkinsonian medication）.All patients underwent MMSE、HAMD and FAB testing.The VFT was used as a stimulus task,recording group words or idioms,and the 52-channel fNIRS system was used to perform signal acquisition when the patient performed the VFT task.The activation of the prefrontal cortex was compared between the two groups.

Results: ①When the VFT task was performed,the number of words or idioms set out in the PD-FOG+ group was significantly less than that of the PD-FOG- group,and the FOG questionnaire was negatively correlated with the VFT result.②For the PD-FOG+ group the activation area of the prefrontal cortex was lesser than that of lower.③The mean oxygen hemoglobin concentrations in the left ventrolateral prefrontal cortex of PD-FOG+ group were significantly lower than the PD-FOG- group,and the severity of the FOG was negatively correlated with the mean oxygen hemoglobin concentration.

Conclusions: In PD-FOG+ patients,executive function is impaired,cognitive flexibility,inhibition,memory,language use ability decreased significantly.There is a specific pattern of structure and /or functional impairment in the left ventrolateral prefrontal cortex of PD with FOG patients,so when the need for selection,memory,reaction inhibition and other more complex cognitive activities can not be effectively recruited to solve the problem.Suggesting that executive dysfunction and FOG may have a common neuropathological mechanism in the ventrolateral prefrontal cortex and the specific model brain network damage of the wentrolateral prefrontal cortex is closely related to the occurrence of FOG.

References: 1. Maidan I, Bernad-Elazari H, Gazit E, et al. Changes in oxygenated hemoglobin link freezing of gait to frontal activation in patients with Parkinson disease: an fNIRS study of transient motor-cognitive failures[J]. Journal of Neurology, 2015, 262(4):899. 2.Imamura K, Okayasu N, Nagatsu T. Cerebral blood flow and freezing of gait in Parkinson’s disease[J]. Acta Neurologica Scandinavica, 2012, 126(3):210. 3.Tessitore A, Amboni M, Esposito F, et al. Resting-state brain connectivity in patients with Parkinson’s disease and freezing of gait.[J]. Parkinsonism & Related Disorders, 2012, 18(6):781.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/research-on-nearinfrared-brain-function-imaging-for-freezing-of-gait-in-parkinsons-disease/