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Near infrared spectroscopy; Parkinson’s disease; Gait; Deep brain stimulation; Neuromodulation
Abstract:
Disorders of gait seriously affect the functional state and quality of life of patients with Parkinson’s disease (PD). Impaired brain function underlies disorders of movement control in PD, however functional brain imaging with magnetic resonance (fMRI) is not feasible during gait. Near-Infrared Spectroscopy (NIRS) is a portable imaging method for measuring brain activity. It uses low-energy optical radiation to detect local changes of (de)oxyhemoglobin concentration in the cerebral cortex, like a fMRI.
We included 8 patients with advanced PD chronically treated with DBS STN. Brain activity was recorded with the NIRSport. Gait was examined in 10 cycles, during which the active and resting phases alternated. Changes in oxyhemoglobin concentration were calculated from the native NIRS signal using a modified transformation of the Lambert-Beer Law. The signals were filtered in the 0.015–0.3 Hz band and the least-squares algorithm was fitted with the HRF function for each cycle separately, from which the median was finally calculated.
The activity of the motor cortex was significantly higher during gait in the OFF compared to ON state (p = 0.02). In contrast, in other regions no differences were found. A higher motor cortex activity shown in the DBS OFF compared to ON state may reflect the impairment of gait control in PD. In general terms, the present study demonstrates the potential utility of the NIRS method in detecting functional changes of the brain during gait in patients with PD.
