Exploring Cortical Myelination to Understand Freezing of Gait in Parkinson’s Disease

Motivation: Cortical myelination (CM) has not been explored as a biomarker for predicting freezing of gait (FoG) or differentiating Parkinson's disease (PD) subtypes, despite the limited accessibility of current neuroimaging techniques for FoG study. Goal(s): This study investigates CM differences across PD-FoG, PD-Non-FoG, and HC, aiming to correlate CM with clinical metrics of motor impairment and disease progression. Approach: Using T1/T2-weighted MRI, we analyzed hemispheric-specific CM to identify their variations and associations with clinical and physical therapy metrices. Results: We found reduced CM in PD-FoG, especially in motor-related regions, with CM levels correlating positively with motor severity and disease progression. Impact: Cortical myelination reduction correlated with clinical and PT scores, suggests CM as a useful biomarker in settings needing detailed symptom tracking. CM could guide interventions, preserving mobility and reducing fall risks in severe PD-FoG cases.