Neuroimaging mechanisms of cerebellar compensation in the rehabilitation of gait disorders in Parkinson disease

Parkinson disease (PD) gait disorders are associated with a high rate of disability. These gait disorders arise from multiple factors, including basal ganglia dysfunction, and the rehabilitation mechanisms are complex. Recent studies have found that the cerebellum, through its extensive network, functionally compensates for the impaired basal ganglia-cortical loop, not only improving gait but also supporting cognitive function, particularly relying on the cerebellum-frontal lobe pathway during gait-cognitive dual tasks. Cerebellar compensation can improve basic gait parameters through functional remodeling and exert a cognitive regulatory role in dual tasks by strengthening the cerebellum-frontal lobe pathway. Understanding the cerebellar compensation mechanisms and critical time windows revealed by neuroimaging will provide new insights for developing individualized and precise rehabilitation strategies and improving long-term prognosis for patients.