{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:21:45Z","timestamp":1780582905254,"version":"3.54.1"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>External cue interventions can effectively improve gait disturbances in patients with Parkinson\u2019s Disease (PD) and Freezing of Gait (FOG). However, the cortical mechanisms underlying cueing modulation of gait have rarely been investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to compare gait performance and cerebral hemodynamic responses in patients with PD and FOG (PD-FOG) under different cueing interventions, and to further elucidate the neural mechanisms underlying the effects of different cues on gait by contrasting these findings with those of Healthy Controls (HCs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Twenty-eight PD-FOG patients and 28 HCs were enrolled. Gait parameters were measured during the walking experiment under Rhythmic Visual Cue (RVC) and Rhythmic Auditory Cue (RAC) to compare how these cues affect gait. Functional Near-infrared Spectroscopy (fNIRS) was employed to measure changes in oxyhemoglobin concentration (\u2206HbO\n                      <jats:sub>2<\/jats:sub>\n                      ). Additionally, inter-channel connectivity strength was calculated to evaluate Functional Connectivity (FC) across various Regions of Interest (ROIs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PD-FOG patients exhibit features including decreased gait velocity and stride length during freezing episodes. Both RVC and RAC enhance gait velocity and stride length. Conversely, the combined RVC and RAC (RVC\u202f+\u202fRAC) intervention did not produce meaningful changes in gait. Compared to HCs, PD-FOG patients show significantly lower \u2206HbO\n                      <jats:sub>2<\/jats:sub>\n                      in the Prefrontal Cortex (PFC) and Primary Somatosensory Cortex (S1). Both RVC and RAC interventions increase \u2206HbO\n                      <jats:sub>2<\/jats:sub>\n                      in the PFC and S1 in PD-FOG patients, whereas the RVC\u202f+\u202fRAC intervention decreases \u2206HbO\n                      <jats:sub>2<\/jats:sub>\n                      in the Premotor Cortex (PMC). Furthermore, compared with HCs, PD-FOG patients show increased FC between the S1-PFC and Primary Motor Cortex (M1)-PFC. The RVC intervention enhances FC within the PFC and between the PMC and the Visual Association Cortex (V2). The RAC intervention strengthens FC within the PFC and the PFC-Middle Temporal Gyrus (MTG). The RVC\u202f+\u202fRAC intervention increases FC within the PFC-MTG and PFC-PMC, partially compensating for functional deficits associated with cortical hypoactivation by enhancing connectivity among these ROIs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Single visual or auditory cues can improve FOG symptoms. RVC and RAC alleviate FOG by modulating cortical activation and enhancing FC between key ROIs. The heightened connectivity among these ROIs may represent the underlying neural pathway that mediates the cue-induced alleviation of FOG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnagi.2026.1776882","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T06:36:50Z","timestamp":1773988610000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The mechanism of external cueing interventions in improving freezing of gait in Parkinson\u2019s disease: an fNIRS study"],"prefix":"10.3389","volume":"18","author":[{"given":"Ziyao","family":"Zhang","sequence":"first","affiliation":[{"name":"Xuzhou Medical University","place":["Xuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyu","family":"Sheng","sequence":"additional","affiliation":[{"name":"Xuzhou Medical University","place":["Xuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guiyun","family":"Cui","sequence":"additional","affiliation":[{"name":"Xuzhou Medical University","place":["Xuzhou, China"]},{"name":"Xuzhou Medical University Affiliated Hospital","place":["Xuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlei","family":"Shan","sequence":"additional","affiliation":[{"name":"Rehabilitation Center, Tongren Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Yuanshen Rehabilitation Institute, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Xiang","sequence":"additional","affiliation":[{"name":"Xuzhou Medical University","place":["Xuzhou, China"]},{"name":"Xuzhou Medical University Affiliated Hospital","place":["Xuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e01489","DOI":"10.1002\/brb3.1489","article-title":"Cortical mapping of mirror visual feedback training for unilateral upper extremity: a functional near-infrared spectroscopy study","volume":"10","author":"Bai","year":"2020","journal-title":"Brain Behav."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"637589","DOI":"10.3389\/fnhum.2021.637589","article-title":"A methodological review of fNIRS in driving research: relevance to the future of autonomous vehicles","volume":"15","author":"Balters","year":"2021","journal-title":"Front. 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