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Anxiety influences the neural correlates associated with freezing of gait in Parkinson’s disease

K. Ehgoetz Martens, M. Georgiades, M. Gilat, J. Hall, J. Shine, C. Walton, S. Lewis (Camperdown, Australia)

Meeting: 2017 International Congress

Abstract Number: 1452

Keywords: Anxiety, Functional magnetic resonance imaging(fMRI), Gait disorders: Pathophysiology

Session Information

Date: Thursday, June 8, 2017

Session Title: Parkinson's Disease: Neuroimaging And Neurophysiology

Session Time: 1:15pm-2:45pm

Location: Exhibit Hall C

Objective: To evaluate whether Anxious Freezers have altered brain activity during FOG episodes compared to Non-Anxious Freezers.

Background: A growing amount of research has emphasized a critical link between anxiety and freezing of gait (FOG) in Parkinson’s disease (PD). Not only has FOG been shown to be more frequent while walking through anxiety-provoking environments, anxiety-related physiological changes have been noted prior to and during a FOG episode as well. Of the few studies that have examined neural correlates associated with freezing, altered brain activity has been shown in centres of the brain known to play a role in emotional processing. However, no studies to date have investigated whether neural activity associated with freezing might differ between different phenotypes of freezers, such as Anxious Freezers compared to Non-Anxious Freezers, despite the heterogeneity in environmental triggers of FOG and its response to treatment.

Methods: Thirty PD participants who experience FOG (18 Anxious Freezers; 12 Non-Anxious Freezers) underwent functional magnetic resonance imaging with a virtual reality gait paradigm during their ‘off’ dopaminergic state. Groups were matched in age, motor symptom severity and across a variety of cognitive assessments. Blood oxygen level dependent (BOLD) signal was compared during freezing events.

Results: Using an event-related whole brain analysis (k=5, p<0.001), significantly different BOLD responses were found in fronto-parietal areas, in Anxious Freezers compared to Non-Anxious Freezers patients during periods of freezing.

Conclusions: These results provide support for the notion that anxiety plays an important role in FOG, possibly through greater emotional processing demands and/or interference with conflict resolution. Further research needs to investigate whether different phenotypes of FOG might exist in effort to improve treatment efficacy for FOG.

To cite this abstract in AMA style:

K. Ehgoetz Martens, M. Georgiades, M. Gilat, J. Hall, J. Shine, C. Walton, S. Lewis. Anxiety influences the neural correlates associated with freezing of gait in Parkinson’s disease [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/anxiety-influences-the-neural-correlates-associated-with-freezing-of-gait-in-parkinsons-disease/. Accessed August 28, 2025.
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