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The aim of this study was to investigate whether brain vesicular acetylcholine transporter binding, as measured with [18F]-fluoroethoxybenzovesamicol binding PET, correlates with dynamic gait and balance impairments in 125 patients with PD (mean age 66.89 \u00b1 7.71 years) using the abbreviated balance evaluation systems test total and its four functional domain sub-scores (anticipatory postural control, reactive postural control, dynamic gait, and sensory integration). Whole brain false discovery-corrected (P &amp;lt; 0.05) correlations for total abbreviated balance evaluation systems test scores included the following bilateral or asymmetric hemispheric regions: gyrus rectus, orbitofrontal cortex, anterior part of the dorsomedial prefrontal cortex, dorsolateral prefrontal cortex, cingulum, frontotemporal opercula, insula, fimbria, right temporal pole, mesiotemporal, parietal and visual cortices, caudate nucleus, lateral and medial geniculate bodies, thalamus, lingual gyrus, cerebellar hemisphere lobule VI, left cerebellar crus I, superior cerebellar peduncles, flocculus, and nodulus. No significant correlations were found for the putamen or anteroventral putamen. The four domain-specific sub-scores demonstrated overlapping cholinergic topography in the metathalamus, fimbria, thalamus proper, and prefrontal cortices but also showed distinct topographic variations. For example, reactive postural control functions involved the right flocculus but not the upper brainstem regions. The anterior cingulum associated with reactive postural control whereas the posterior cingulum correlated with anticipatory control. The spatial extent of associated cholinergic system changes were least for dynamic gait and sensory orientation functional domains compared to the anticipatory and reactive postural control functions. We conclude that specific aspects of dynamic balance and gait deficits in PD associate with overlapping but also distinct patterns of cerebral cholinergic system changes in numerous brain regions. Our study also presents novel evidence of cholinergic topography involved in dynamic balance and gait in PD that have not been typically associated with mobility disturbances, such as the right anterior temporal pole, right anterior part of the dorsomedial prefrontal cortex, gyrus rectus, fimbria, lingual gyrus, flocculus, nodulus, and right cerebellar hemisphere lobules VI and left crus I.<\/jats:p>","DOI":"10.1093\/braincomms\/fcae286","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T21:51:12Z","timestamp":1724363472000},"source":"Crossref","is-referenced-by-count":9,"title":["Dynamic balance and gait impairments in Parkinson\u2019s disease: novel cholinergic patterns"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0352-6414","authenticated-orcid":false,"given":"Nicolaas I","family":"Bohnen","sequence":"first","affiliation":[{"name":"Department of Radiology, University of Michigan , Ann Arbor, MI 48105-9755 ,","place":["USA"]},{"name":"Department of Neurology, University of Michigan , Ann Arbor, MI 48105-9755 ,","place":["USA"]},{"name":"Morris K. Udall Center of Excellence for Parkinson\u2019s Disease Research, University of Michigan , Ann Arbor, MI 48105-9755 ,","place":["USA"]},{"name":"Parkinson\u2019s Foundation Research Center of Excellence, University of Michigan , Ann Arbor, MI 48105-9755 ,","place":["USA"]},{"name":"Neurology Service and GRECC, VA Ann Arbor Healthcare System , Ann Arbor, MI 48105-9755 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uros","family":"Marusic","sequence":"additional","affiliation":[{"name":"Institute for Kinesiology Research, Science and Research Centre Koper , 6000 Koper ,","place":["Slovenia, EU"]},{"name":"Department of Health Sciences, Alma Mater Europaea University , 2000 Maribor ,","place":["Slovenia, EU"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stiven","family":"Roytman","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Michigan , Ann Arbor, MI 48105-9755 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Paalanen","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Michigan , Ann Arbor, MI 48105-9755 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fotini","family":"Michalakis","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Michigan , Ann Arbor, MI 48105-9755 ,","place":["USA"]},{"name":"Morris K. 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Udall Center of Excellence for Parkinson\u2019s Disease Research, University of Michigan , Ann Arbor, MI 48105-9755 ,","place":["USA"]},{"name":"Neurology Service and GRECC, VA Ann Arbor Healthcare System , Ann Arbor, MI 48105-9755 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J H","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Michigan , Ann Arbor, MI 48105-9755 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Carli","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Michigan , Ann Arbor, MI 48105-9755 ,","place":["USA"]},{"name":"Morris K. Udall Center of Excellence for Parkinson\u2019s Disease Research, University of Michigan , Ann Arbor, MI 48105-9755 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger L","family":"Albin","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Michigan , Ann Arbor, MI 48105-9755 ,","place":["USA"]},{"name":"Morris K. 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