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Structural disconnectome analysis of acute freezing of gait due to parietal stroke: implications for FOG pathogenesis
  1. Axel Ferreira1,
  2. Paulo Simões Coelho1,
  3. Pedro Nascimento Alves2 and
  4. Vanessa Carvalho2
  1. 1Department of Neurology, Hospital Pedro Hispano, Matosinhos, Porto, Portugal
  2. 2Department of Neurosciences and Mental Health, Hospital de Santa Maria, Lisboa, Portugal
  1. Correspondence to Dr Axel Ferreira; axelferr{at}gmail.com

Abstract

Acute onset isolated freezing of gait (FOG) is a rare and defying diagnosis. Its pathophysiology is not yet totally understood and several brain regions seem to be involved. Postlesional FOG can help to shed light on the networks involved.

We report a case of an 80-year-old woman who presented to the emergency department with acute onset impairment of gait. Her medical history was unremarkable. On neurological examination she was presented with difficulties in gait initiation, turning and progressing through narrow spaces. Her remaining neurological examination was unremarkable. Brain CT showed a subacute cortico-subcortical right parieto-occipital infarction. Acute isolated FOG due to parieto-occipital stroke was diagnosed. A structural disconnectome analysis showed that the lesion disrupted structural connections with the ipsilateral ventral striatum. This case highlights that acute onset FOG might be a consequence of a parietal cortical lesion.

  • stroke
  • movement disorders (other than parkinsons)

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Footnotes

  • Contributors AF and VC drafted the work and revised it critically for important intellectual content; they also substantially contributed to the conception and design of the work. PSC and PNA were responsible for the acquisition, analysis and interpretation of important data for the work, they also revised it critically for important intellectual content. All authors approved the current version and agreed to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.