Unveiling the neural network of freezing of gait in Parkinson's disease: A coordinate-based network study

Freezing of gait (FoG) is a disabling symptom that can occur in Parkinson's disease (PD), where people suddenly find it difficult to start walking or continue moving. This can cause their feet to feel “stuck to the floor” and often happens when turning, walking in tight spaces, or during stressful situations. FoG is typically more commonly observed in the advanced stages of the disease, though not all individuals with PD experience FoG, and can significantly impact daily life and increase the risk of falling. In this study, we used advanced brain imaging techniques to understand what happens in the brain when FoG occurs. We analyzed MRI scans of 480 people with PD, comparing those who experience FoG with those who do not. We found specific areas of the brain where the gray matter was reduced in people with FoG. Using a modern mapping technique, we discovered that these brain areas are part of a connected network involving regions important for movement control, such as the midbrain, globus pallidus, and cerebellum. Our findings suggest that FoG in PD is linked to dysfunction in a brain network, rather than in a single brain region. This understanding may help identify targets for treatments, like deep brain stimulation or other therapies, to improve movement and reduce freezing episodes in people with PD.