Altered activation and connectivity of the supplementary motor cortex at motor initiation in Parkinson's disease patients with freezing.
Clin Neurophysiol
; 131(9): 2171-2180, 2020 09.
Article
en En
| MEDLINE
| ID: mdl-32683125
ABSTRACT
OBJECTIVE:
Motor initiation failure is a key feature of freezing of gait (FOG) due to Parkinson's disease (PD). The supplementary motor cortex (SMC) plays a central role in its pathophysiology. We aimed at investigating SMC activation, connectivity and plasticity with regard to motor initiation in FOG.METHODS:
Twelve patients with FOG and eleven without FOG underwent a multimodal electrophysiological evaluation of SMC functioning including the Bereitschaftspotential and movement-related desynchronisation of cortical beta oscillations. SMC plasticity was modulated by intermittent theta burst stimulation (iTBS) and its impact on gait initiation was assessed by a three-dimensional gait analysis.RESULTS:
Prior to volitional movements the Bereitschaftspotential was smaller and beta power was less strongly attenuated over the SMC in patients with FOG compared to those without. Pre-motor coherence between the SMC and the primary motor cortex in the beta frequency range was also stronger in patients with FOG. iTBS resulted in a relative deterioration of gait initiation.CONCLUSIONS:
Reduced activation of the SMC along with increased SMC connectivity in the beta frequency range hinder a flexible shift of the motor set as it is required for gait initiation.SIGNIFICANCE:
Altered SMC functioning plays an important role for motor initiation failure in PD-related FOG.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de Parkinson
/
Variación Contingente Negativa
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Trastornos Neurológicos de la Marcha
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Corteza Motora
/
Movimiento
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Red Nerviosa
Límite:
Aged
/
Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Clin Neurophysiol
Asunto de la revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
Año:
2020
Tipo del documento:
Article