Diffusion tensor imaging of freezing of gait in patients with white matter changes

Abstract

Background: Freezing of gait is a common and disabling symptom of parkinsonism. However, the corresponding anatomic structures have yet to be clearly elucidated. Methods: We performed diffusion tensor imaging on 40 subjects with white matter changes. We compared apparent diffusion coefficient values and fraction anisotropy values of 7 candidate anatomic structures between 14 patients with freezing of gait (freezing of gait group) and 26 without freezing of gait (control group). Results: Fraction anisotropy values of the bilateral pedunculopontine nucleus, bilateral superior premotor cortex, right orbitofrontal area, and left supplement motor area were significantly lower in the freezing of gait group than in the control group. In contrast, there were no significant differences in apparent diffusion coefficient values between freezing of gait and control groups. Conclusions: Our findings suggest that the bilateral pedunculopontine nucleus, bilateral superior premotor cortex, right orbitofrontal area, and left supplement motor area are closely related to freezing of gait.