Study Rationale:
Parkinson’s Disease (PD) is a neurodegenerative disorder caused by dysfunction in specific brain systems. We recently discovered a new brain system called the Somato-Cognitive Action Network (SCAN), which could be a primary site of dysfunction and neuromodulation in PD. Here, we will use magnetic resonance imaging (MRI) in persons with PD to test whether alteration in the SCAN circuit contributes to gait problems in PD. We will further test whether dopaminergic Parkinson’s medications improve gait by improving SCAN connectivity.
Hypothesis:
We will test whether the newly discovered Somato-Cognitive Action Network may be a key circuit related to gait disturbance in PD
Study Design:
We will recruit seventy persons with PD and conduct detailed assessment of their gait while there are off their dopaminergic medications, as well as scan their brain using magnetic resonance imaging (MRI) to characterize each patient’s individual-specific SCAN brain circuit. We will examine whether people with more abnormally connected SCAN circuits exhibit more gait issues. We will then repeat gait assessment and scanning while participants are on medication, and we will test whether medication-related improvements in the SCAN circuit are linked to gait improvements.
Impact on Diagnosis/Treatment of Parkinson’s disease:
If successful, this work will verify SCAN as a circuit important for gait in PD, and therefore as a new target for neuromodulatory therapies seeking to improve gait in PD.
Next Steps for Development:
First, this work would suggest the use of our MRI mapping techniques to target subcortical SCAN sites for DBS electrode placement to better treat gait dysfunction. Second, it would point towards treating gait using minimally- or non-invasive stimulation of SCAN regions in cortex and subcortex as alternatives to DBS.