Sensory integration deficits in Parkinson’s disease with freezing of gait: cortical network dynamics and paradoxical dopaminergic modulation

This study reveals a medication-dependent, biphasic cortical dysfunction in PD-FOG. The OFF-medication state shows compensatory hyperconnectivity that fails under sensory challenges, indicating deficient plasticity, whereas the ON-medication state exhibits a paradoxical suppression of sensorimotor and integrative networks despite gait improvement. This reconceptualizes FOG as a dynamic network adaptation failure and points to state-specific therapeutic strategies. Registration number ChiCTR2300072744.