Brain Network Oscillations During Gait in Parkinson's Disease

Human bipedal walking is a complex motor task that requires supraspinal control for balance and flexible coordination of timing and scaling of many muscles in different environment. Gait impairments are a hallmark of Parkinson's disease (PD), reflecting dysfunction of cortico-basal ganglia-brainstem circuits. Recent studies using implanted electrodes and surface electroencephalography have demonstrated gait-related brain oscillations in the basal ganglia and cerebral cortex. Here, we review the physiological and pathophysiological roles of (1) basal ganglia oscillations, (2) cortical oscillations, and (3) basal ganglia-cortical interactions during walking. These studies extend a novel framework for movement of disorders where specific patterns of abnormal oscillatory synchronization in the basal ganglia thalamocortical network are associated with specific signs and symptoms. Therefore, we propose that many gait dysfunctions in PD arise from derangements in brain network, and discuss potential therapies aimed at restoring gait impairments through modulation of brain network in PD.