Features of visual, cognitive and neuroimaging changes in Parkinson’s disease patients with freezing of gait

Abstract

To determine visual and cognitive impairments in relation to MRI changes in patients with freezing of Gait (FOG) in Parkinson’s disease (PD). We examined 78 patients with PD without dementia, who were divided into groups according to the presence (FOG«+» group) or absence (FOG«–» group) of «freezing» episodes. A decrease in contrast sensitivity (CS) and retinal photosensitivity was determined in all subjects with PD, but in patients with FOG, the decrease in CS was more pronounced. There was a significant decrease in the volume of the cuneus, lingual gyrus, posterior cingulate gyrus, superior parietal lobe and middle frontal gyrus in the FOG«+» group. It was revealed that patients with FOG had cognitive impairments of both the frontal and posterior cortical subtypes, while in the FOG«–» group, only visuospatial deficit prevailed. A direct correlation was determined between the severity of FOG and part I of the UPDRS scale, between a decrease in CS and cortical areas related to the dorsal and ventral visual information processing systems. The presence of a negative relationship between the scores of the FOG-Q, Timed Up and Go test and the volume of cortical areas of the frontal lobe responsible for planning and programming of movements indicates their role in the development of FOG in PD. Thus, visual impairments associated with PD, along with a heterogeneous profile of cognitive impairment, make a significant contribution to the development of FOG.