From Resting-State to Movement: The Role of Cortical Networks in Parkinsonian Gait

BACKGROUND: Gait impairments in Parkinson's disease (PD) arise from disruptions in automatic motor control, requiring compensatory engagement of cortical networks. This study compared resting-state functional connectivity in specific cortical regions (frontal, central, parietal, occipital, and temporal) between people with PD and healthy individuals and explored its potential association with multidimensional gait domains. METHODS: Twenty individuals with PD and 19 healthy controls participated. Resting-state electroencephalography was recorded, and functional connectivity was analyzed using local efficiency measures. Spatiotemporal gait parameters were assessed to calculate scores for five gait domains. Spearman correlations were used to evaluate the association between regional connectivity and gait domains. RESULTS: Individuals with PD exhibited reduced functional connectivity in frontal and central regions compared to healthy controls. Connectivity in the frontal region significantly correlated with the pace domain in PD, highlighting its role in compensatory mechanisms for maintaining gait speed. In healthy controls, broader correlations were observed: parietal and occipital connectivity were associated with pace and rhythm, suggesting more integrated and adaptive network functionality. CONCLUSION: Current findings highlight the distinct roles of cortical regions in regulating gait domains and the compensatory mechanisms employed in PD. The findings underscore the potential role of connectivity-based biomarkers in improving our understanding of gait impairments and informing targeted interventions, such as neuromodulation and rehabilitation. However, their clinical utility remains limited by methodological and feasibility challenges, and future research should focus on validating their applicability in larger, longitudinal, and task-based studies.