JPD: Neurodegeneration in the medial globus pallidus, closely related to dopa responses in freezing gait

Freezing gait (FOG) is a common disabling feature of Parkinson's disease (PD), leading to increased frequency of falls and decreased quality of life

While there is no effective way to manage FOG, some patients respond strongly to dopaminergic therapy, while others do n.

Figure 1: Paper Cover Image Even FOG in response to dopa, management is limited by motor fluctuations that can become increasingly complex and ultimately lead to loss of respon.

These observations implicate the dopaminergic system in the pathophysiology of FOG and suggest that further understanding of the biological basis of dopa responses in FOG may provide an important therapeutic targ.

FOGs have been classified in several ways based on their dopa respon.

OFF-FOG is commonly used to refer to FOG that occurs in the actual defined OFF medication state, while ON FOG occurs in the actual defined ON medication state; however, FOG may only occur in the ON state, which is known as dopa induced F.

When FOG occurs in both ON and OFF states and improves with further dose increases, participants are referred to as pseudo-ON FOG, and biphasic FOG has also been recently describ.

In this study, if dopaminergic therapy did not have any effect on FOG, this was called dopa-resistant F.

In this study, we classified patients as dopa-responsive if there was clinically significant improvement in FOG with dopaminergic thera.

To date, a limited number of studies have investigated the neurobiological basis of dopa response and empirically based treatments to improve FOG in dopa non-responders, which remain elusi.

Therefore, the establishment of brain-based markers of FOG response to dopaminergic therapy is needed to advance our understanding of dopa-unresponsive F.

Freezing gait (FOG) is a common disabling feature of Parkinson's disease (PD), leading to increased frequency of falls and decreased quality of life

While there is no effective way to manage FOG, some patients respond strongly to dopaminergic therapy, while others do n.

Quality of life managementFigure 1: Paper cover image Even FOG in response to dopa, management is limited by motor fluctuations that can become increasingly complex and ultimately lead to loss of respon.

These observations implicate the dopaminergic system in the pathophysiology of FOG and suggest that further understanding of the biological basis of dopa responses in FOG may provide an important therapeutic targ.

FOGs have been classified in several ways based on their dopa respon.

OFF-FOG is commonly used to refer to FOG that occurs in the actual defined OFF medication state, while ON FOG occurs in the actual defined ON medication state; however, FOG may only occur in the ON state, which is known as dopa induced F.

When FOG occurs in both ON and OFF states and improves with further dose increases, participants are referred to as pseudo-ON FOG, and biphasic FOG has also been recently describ.

In this study, if dopaminergic therapy did not have any effect on FOG, this was called dopa-resistant F.

In this study, we classified patients as dopa-responsive if there was clinically significant improvement in FOG with dopaminergic thera.

To date, a limited number of studies have investigated the neurobiological basis of dopa response and empirically based treatments to improve FOG in dopa non-responders, which remain elusi.

Therefore, a brain-based marker of FOG response to dopaminergic therapy needs to be established to advance our understanding of dopa-unresponsive FOG

The MLR receives input from the descending basal ganglia via GABAergic projections from the globus pallidus internus (GPi) and glutamatergic projections from the subthalamic nucleus (ST.

This was demonstrated in studies in non-human primates where GPi stimulation reduced the mean firing rate of PPN neurons and GABA antagonists attenuated dyskines.

From this, Daniel.

In the current study, they sought to assess changes in GPi, STN, and MLR structural integrity using diffusion kurtosis imaging (DKI) to compare participants with dopa-responsive and dopa-unresponsive F.

They recruited 36 participants with PD and definite FOG for diffusion kurtosis imaging (DKI) and multiple assessments of dopa responsiveness (UPDRS score, gait time on and off medicatio.

Figure 2: The results of the paper

Figure 2: The results of the paper

They found that patients with dopa-responsive FOG showed fractional anisotropy, a decrease in mean kurtosis (MK), and an increase in radial diffusivity in the right GPi compared with patients with dopa-responsive F.

They found that patients with dopa-responsive FOG showed fractional anisotropy, a decrease in mean kurtosis (MK), and an increase in radial diffusivity in the right GPi compared with patients with dopa-responsive F.

The right GPi in patients with dopa-responsive FOG showed fractional anisotropy, a decrease in mean kurtosis (MK), and an increase in radial diffusivi.

Furthermore, using probability maps, they observed a decrease in MK and an increase in mean diffusivity along the right GPi-MLR tract in patients with dopa-responsive F.

MK on the right GPi was associated with subjective dopa response to FOG (r = -360, df = 30, p = 043), but not with overall motor dopa respon.

Furthermore, using probability maps, they observed a decrease in MK and an increase in mean diffusivity along the right GPi-MLR tract in patients with dopa-responsive F.

MK on the right GPi was associated with subjective dopa response to FOG (r = -360, df = 30, p = 043), but not with overall motor dopa respon.

The significance of this study lies in the discovery of: The structural integrity of GPi as a correlative factor in the dopa response to FOG

Furthermore, DKI indicators may be sensitive biomarkers for clinical studies targeting dopaminergic circuits and improving FOG behavi.

The significance of this study lies in the discovery of: The structural integrity of GPi as a correlative factor in the dopa response to FOG

Original source:Lench DH, Keith K, Wilson S, et .
Neurodegeneration of the Globus Pallidum Internus as a Neural Correlate to Dopa-Response in Freezing of Ga.
_JP.
Published online March 28, 2022:1-1 doi:[ 13233/JPD-213062](https://d.
org/13233/JPD-213062) Neurodegeneration of the Globus Pallidum Internus as a Neural Correlate to Dopa-Response in Freezing of Ga.
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