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Parkinson's Disease and Related Disorders

開催日 2014/9/12
時間 11:00 - 12:00
会場 Poster / Exhibition(Event Hall B)

Severity of freezing gait in Parkinson's disease patients correlates with the white matter abnormality in dorsal tegmental area

  • P2-305
  • 三原 雅史 / Masahito Mihara:1 藤本 宏明 / Hiroaki Fujimoto:2 横江 勝 / Masaru Yokoe:1 小仲 邦 / Kuni Konaka:1 渡邊 嘉之 / Yoshiyuki Watanabe:3 望月 秀樹 / Hideki Mochizuki:1 
  • 1:大阪大院・医・神経内科学 / Dept Neurol, Osaka University Graduate School of Medicine, Osaka, Japan 2:森之宮病院神経リハ研 / Neurorehab Res Inst, Morinomiya Hosp, Osaka, Japan 3:大阪大院・医・放射線医学 / Dept Radiol, Osaka University Graduate School of Medicine, Osaka, Japan 

Freezing of gait (FOG) is one of the most disabling features of patients with Parkinson's disease and usually responds poorly to levodopa.
In this study, based on the hypothesis that functional and structural connectivity among previously revealed gait related regions would be important in FOG, we analyzed Diffusion Tensor Imaging (DTI) acquired from the patients with Parkinson's disease and investigate correlation between white matter integrity and severity of FOG.
We recruited fifteen patients with Parkinson's disease (68.5±10.7 years old, 7 males) without diffuse white matter lesion. Clinical measures were assessed with UPDRS, MMSE, FAB, FOGQ, and HAM-D. DTI data were acquired using 3T MRI scanner (Signa 3T Excite HD, GE medical systems) and processed using a FSL (FMRIB Software Library, FMRIB, Oxford, UK) software. After the FA maps were generated for each subject, individual maps were registered to the standard FA template and interpolated into voxel size of 1mm3. We performed voxel by voxel multiple linear regression analysis to estimate correlation between FA values and FOG severity after controlling effects of UPDRS and age. Clusters with an uncorrected p<0.001 and cluster size >80 mm3 (FWE-corrected p<0.05 at cluster level) was considered statistically significant.
There was no significant correlation between FOGQ and other clinical measures in this study. Imaging analysis using FA maps revealed significant negative correlation with FA values and FOGQ score in the upper pontine tegmentum area (MNI coordinate: x=1, y=-35, z=-26, cluster size=188mm3).
These findings suggest that the white matter integrity in the dorsal tegmentum area was closely correlated with severity of FOG. Considering that tegmentum area is in the vicinity of the mecencephalic locomotor region (MLR), loss of functional and structural connectivity between MLR and other brain regions may contribute FOG.

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