Objective: To investigate topological organization of the functional brain connectome at the early non-freezing stage of Parkinson’s disease (PD) patients with freezing of gait (FOG).

Background: FOG is a common and debilitating gait disturbance in patients with advanced PD that substantially impacts quality of life. Up to date, the topological organization of functional brain networks at the early non-freezing stage of Parkinson’s disease patients with FOG remains unknown.

Method: Sixty-five patients with early-stage PD without FOG were recruited. All patients were divided into transitional freezers and non-transitional freezers according to the NFOG-Q at the end of follow-up. The functional brain connectome was constructed by using resting-state functional magnetic resonance imaging (MRI) data, and the topologic properties were analyzed by using graph theory approaches.

Results: We recruited 20 transitional freezers, 20 non-transitional freezers, and 20 healthy controls. In the present study, we found that  PD patients, transitional freezers, non-transitional freezers, and healthy controls exhibited typical features of small-worldness, and there was no significant difference between any two groups in global network measures, which indicated that PD patients and two subgroups still kept a relatively integrated global function. Compared with healthy controls, transitional freezers showed decreased nodal centralities in the frontal lobe (left middle frontal gyrus and left gyrus rectus), visual cortex (bilateral inferior occipital gyrus and left fusiform gyrus), while increased nodal centralities in the vermis_6. Compared with non-transitional freezers, transitional freezers showed significantly decreased in the left middle frontal gyrus, and had the lowest or highest nodal properties values in the other five brain regions. Additionally, transitional freezers exhibited increased functional connections between the frontal lobe and the visual cortex compared with healthy controls.

Conclusion: Only altered local network measures was found at the early non-freezing stage of Parkinson’s disease patients with FOG, such as significantly decreased nodal centrality in the left middle frontal gyrus. Therefore, our findings provide a better understanding of the pathophysiology of FOG in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/disrupted-functional-brain-connectome-at-the-early-non-freezing-stage-of-parkinsons-disease-patients-with-freezing-of-gait/