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Parkinson's FOG

Komal Bharti, Antonio Suppa, Sara Pietracupa, Neeraj Upadhyay, Costanza Giannì, Giorgio Leodori, Francesca Di Biasio, Nicola Modugno, Nikolaos Petsas, Giovanni Grillea, Alessandro Zampogna, Alfredo Berardelli, Patrizia Pantano
In this study, we aimed to evaluate the importance of cerebellum in freezing of gait (FOG) pathophysiology. Due to the fundamental role of the cerebellum in posture and gait control, we examined cerebellar structural and functional connectivity (FC) in patients with PD and FOG. We recruited 15 PD with FOG (PD-FOG), 16 PD without FOG (PD-nFOG) patients, and 16 healthy subjects (HS). The FOG Questionnaire (FOG-Q) assessed FOG severity. Three tesla-MRI study included resting-state functional MRI, diffusion tensor imaging (DTI), and 3D T1-w images...
November 3, 2018: Cerebellum
Seong-Min Choi, Hyun-Jung Jung, Geum-Jin Yoon, Byeong C Kim
BACKGROUND: Freezing of gait (FOG) is a common and debilitating problem in patients with Parkinson's disease (PD). The aim of this study was to estimate the prevalence of FOG, and to identify factors that independently contribute to FOG in patients with PD. METHOD: We included 157 PD patients. FOG was assessed using the FOG Questionnaire (FOG-Q). Patients with or without FOG were defined as item 3 in the FOG-Q. RESULTS: One hundred eleven (70...
November 1, 2018: Neurological Sciences
Alberto Romagnolo, Maurizio Zibetti, Aristide Merola, Daniela Canova, Marianna Sarchioto, Elisa Montanaro, Carlo Alberto Artusi, Fabrizio Vallelonga, Simona Maule, Leonardo Lopiano
BACKGROUND: Falls represent one of the main complications of Parkinson's disease (PD), significantly lowering quality of life. Cardiovascular autonomic neuropathy (cAN) is one of the key contributing factors to PD-associated falls. However, a direct quantification of its impact on the risk of falling in PD is still lacking. In this 12-month prospective study, we sought to evaluate the association between cAN and falls. METHODS: Fifty consecutive patients were evaluated with a standardized battery of autonomic testing, Unified Parkinson's Disease Rating Scale, push and release (P&R) test, timed up and go test, freezing of gait (FOG) questionnaire, Montreal cognitive assessment (MoCA)...
October 31, 2018: Journal of Neurology
Helena Gonçalves, Rui Moreira, Ana Rodrigues, Cristina Santos
Freezing of Gait (FOG) is one of the most disabling gait disorders in Parkinson's Disease (PD), for which the efficacy of the medication is reduced, highlighting the use of non-pharmacological solutions. In particular, patients present less difficulties in overcoming FOG when using feedback and especially with Biofeedback Systems. In this study it is intended to detect the frequency threshold and the minimum interval of perception of the vibrotactile feedback, through a proposed wearable system, a waistband...
October 13, 2018: Journal of Medical Systems
Satyabrata Aich, Pyari Mohan Pradhan, Jinse Park, Nitin Sethi, Vemula Sai Sri Vathsa, Hee-Cheol Kim
One of the most common symptoms observed among most of the Parkinson's disease patients that affects movement pattern and is also related to the risk of fall, is usually termed as "freezing of gait (FoG)". To allow systematic assessment of FoG, objective quantification of gait parameters and automatic detection of FoG are needed. This will help in personalizing the treatment. In this paper, the objectives of the study are (1) quantification of gait parameters in an objective manner by using the data collected from wearable accelerometers; (2) comparison of five estimated gait parameters from the proposed algorithm with their counterparts obtained from the 3D motion capture system in terms of mean error rate and Pearson's correlation coefficient (PCC); (3) automatic discrimination of FoG patients from no FoG patients using machine learning techniques...
September 30, 2018: Sensors
Meng Ni, Joseph B Hazzard, Joseph F Signorile, Corneliu Luca
This systematic review and meta-analysis is to provide comprehensive evidence-based exercise recommendations targeting walking function for adults with Parkinson's disease. METHODS: Fixed- or random-effect meta-analyses estimated standardized effect sizes (Hedge's g), comparing treatment effects from exercise with nonexercise and another form of exercise (non-EXE control and EXE control). Cuing and exercise duration were used as moderators for subanalyses. RESULTS: The 40 included randomized controlled trials comprised 1656 patients...
October 2018: Neurorehabilitation and Neural Repair
Dongning Su, Huimin Chen, Wanli Hu, Yuye Liu, Zhan Wang, Xuemei Wang, Genliang Liu, Huizi Ma, Junhong Zhou, Tao Feng
This study aims to investigate how the frequency settings of deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) influence the motor symptoms of Parkinson's disease (PD). Stimulation with frequencies less than 100 Hz (mostly 60 or 80 Hz) is considered low-frequency stimulation (LFS) and with frequencies greater than 100 Hz (mostly 130 or 150 Hz) is considered high-frequency stimulation (HFS). We conducted a comprehensive literature review and meta-analysis with a random-effect model...
September 27, 2018: Scientific Reports
Talia Herman, Shirley Shema-Shiratzky, Liraz Arie, Nir Giladi, Jeffrey M Hausdorff
INTRODUCTION: Prospective studies identifying predictors of freezing of gait (FOG) in Parkinson's disease (PD) are limited. We aim to explore which symptoms are associated with future development of FOG in non-freezers. METHODS: Fifty-seven PD patients without FOG at baseline were re-evaluated after a mean of five years. At baseline, disease severity [Unified Parkinson's Disease Rating Scale (MDS-UPDRS)], gait under single and dual-tasking, balance, cognition and other non-motor symptoms were assessed...
September 11, 2018: Parkinsonism & related Disorders
Kerri S Rawson, Patricia Creel, Lizbeth Templin, Adam P Horin, Ryan P Duncan, Gammon M Earhart
AIM: In this pilot study, we evaluated the feasibility, safety and preliminary efficacy of a 6-week, community-based group intervention designed to reduce freezing of gait (FOG) for people with Parkinson's disease (PD). METHODS: Seven people with PD completed 'FOG Boot Camp' provided by the St. Louis Chapter of the American Parkinson Disease Association. We recorded attendance, participant's acceptance of the intervention and adverse events during classes. Pre and post-tests included measures of freezing, balance, motor severity, quality-of-life and gait speed...
October 2018: Neurodegenerative Disease Management
Brent Bluett, Sarah Banks, Dietmar Cordes, Ece Bayram, Virendra Mishra, Jeffrey Cummings, Irene Litvan
Introduction: Freezing of gait (FOG) is a disabling phenomenon characterized by a brief, episodic absence or reduction of forward progression of the feet despite the intention to walk. It is a common cause of falls and mortality in cases with Parkinson's disease (PD). This article reviews neuropsychological and neuroimaging studies to date and introduces a new study of multimodal imaging and cognition in PD-FOG. Methods: A comprehensive literature search identified studies using neuropsychological evaluation and/or neuroimaging to evaluate PD-FOG...
2018: Alzheimer's & Dementia: Translational Research & Clinical Interventions
Chioma Anidi, Johanna J O'Day, Ross W Anderson, Muhammad Furqan Afzal, Judy Syrkin-Nikolau, Anca Velisar, Helen M Bronte-Stewart
Freezing of gait (FOG) is a devastating axial motor symptom in Parkinson's disease (PD) leading to falls, institutionalization, and even death. The response of FOG to dopaminergic medication and deep brain stimulation (DBS) is complex, variable, and yet to be optimized. Fundamental gaps in the knowledge of the underlying neurobiomechanical mechanisms of FOG render this symptom one of the unsolved challenges in the treatment of PD. Subcortical neural mechanisms of gait impairment and FOG in PD are largely unknown due to the challenge of accessing deep brain circuitry and measuring neural signals in real time in freely-moving subjects...
September 6, 2018: Neurobiology of Disease
Milla Pimenta, Dandara Moreira, Taísa Nogueira, Carolina Silva, Elen B Pinto, Guilherme T Valenca, Lorena R S Almeida
Freezing of gait is a disabling feature of Parkinson's disease, and it has been shown that nonmotor symptoms, such as anxiety and cognitive impairment, may be involved in the pathophysiology of the phenomenon. However, the association between freezing of gait severity and nonmotor symptoms is yet to be determined. Therefore, the overall aim of this study was to determine factors that contribute to severity of freezing of gait in people with Parkinson's disease. Participants (N=78) were assessed by disease-specific and self-report measures, including the Hospital Anxiety and Depression Scale (HADS), the Montreal Cognitive Assessment, and the Freezing of Gait Questionnaire (FOG-Q)...
September 6, 2018: Journal of Neuropsychiatry and Clinical Neurosciences
Luis I Gómez-Jordana, James Stafford, C Lieke E Peper, Cathy M Craig
Studying freezing of gait (FOG) in the lab has proven problematic. This has primarily been due to the difficulty in designing experimental setups that maintain high levels of ecological validity whilst also permitting sufficient levels of experimental control. To help overcome these challenges, we have developed a virtual reality (VR) environment with virtual doorways, a situation known to illicit FOG in real life. To examine the validity of this VR environment, an experiment was conducted, and the results were compared to a previous "real-world" experiment...
2018: Parkinson's Disease
Lois Rosenthal, Dean Sweeney, Anne-Louise Cunnington, Leo R Quinlan, Gearóid ÓLaighin
Introduction: Freezing of gait (FoG) is a movement abnormality that presents with advancing Parkinson's disease (PD) and is one of the most debilitating symptoms of the disease. The mainstay of nonpharmacological management of FoG is typically through external cueing techniques designed to relieve or prevent the freezing episode. Previous work shows that electrical stimulation may prove useful as a gait guidance technique, but further evidence is required. The main objective of this study was to determine whether a "fixed" rhythmic sensory electrical stimulation (sES) cueing strategy would significantly (i) reduce the time taken to complete a walking task and (ii) reduce the number of FoG episodes occurring when performing the task...
2018: Journal of Healthcare Engineering
Makio Takahashi, Hayato Tabu, Akihiko Ozaki, Toshiaki Hamano, Takao Takeshima
Objective Depression, apathy, and gait instability are cardinal symptoms in patients with Parkinson' s disease (PD). Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are used for treating the psychiatric symptoms of PD. This is the first prospective randomized study to compare the efficacy of an SNRI (duloxetine) with SSRIs (paroxetine, escitalopram) in improving depressive symptoms and apathy (primary) and freezing of gait (FOG; secondary) in patients with PD...
August 24, 2018: Internal Medicine
Martina Mancini, Katrijn Smulders, Graham Harker, Samuel Stuart, John G Nutt
Turning impairments are common in Parkinson's disease (PD) and can elicit freezing of gait (FoG). Extensive examination of open-loop cueing interventions has demonstrated that they can ameliorate gait deficits in PD; less is known about efficacy to improve turning. Here, we investigate the immediate effectiveness of open- and closed-loop cueing in improving turning characteristics in people with PD. Twenty-five subjects with and 18 subjects without FoG participated in the study. Subjects turned in place for one minute under single- and dual-task for 3 randomized conditions: (i) Baseline; (ii) Turning to the beat of a metronome (open-loop); and (iii) Turning with phase-dependent tactile biofeedback (closed-loop)...
August 24, 2018: Scientific Reports
E M J Bekkers, B W Dijkstra, E Heremans, S M P Verschueren, B R Bloem, A Nieuwboer
Postural instability and freezing of gait (FoG) are key features of Parkinson's disease (PD) closely related to falls. Growing evidence suggests that co-existing postural deficits could influence the occurrence and severity of FoG. To date, the exact nature of this interrelationship remains largely unknown. We analyzed the complex interaction between postural instability and gait disturbance by comparing the findings available in the posturographic literature between patients with and without FoG. Results showed that FoG and postural instability are intertwined, can influence each other behaviorally and may coincide neurologically...
August 17, 2018: Neuroscience and Biobehavioral Reviews
Pasquale Varriale, Antoine Collomb-Clerc, Angele Van Hamme, Anaik Perrochon, Gilles Kemoun, Giuseppe Sorrentino, Nathalie George, Brian Lau, Carine Karachi, Marie-Laure Welter
OBJECTIVE: Freezing of gait (FOG) represents a major burden for Parkinson's disease (PD) patients. High-frequency (130-Hz) subthalamic deep-brain-stimulation (STN-DBS) has been reported to aggravate FOG whereas lowering the frequency to 60-80 Hz improves FOG. To further understand the effects of STN-DBS on FOG, we assessed the effects of 80-Hz and 130-Hz STN-DBS on gait initiation performance, in relation to motor and executive function processing. METHODS: Gait initiation was recorded in 19 PD patients and 20 controls, combined or not with a cognitive interference task with a modified Stroop paradigm...
November 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Éric Parmentier, Victor De Pasqua, Kévin D'Ostilio, Frédérique Depierreux, Gaëtan Garraux, Alain Maertens de Noordhout
OBJECTIVE: A network of cortical, subcortical and brainstem structures might be involved in freezing of gait (FOG). Subthalamic nucleus (STN) deep brain stimulation (DBS) could modulate this network. The audio-spinal reflex (ASR), reduced in PD, but increased by treatment, can be used to further investigate that locomotor network. The aim of this study is to find whether a correlation exists between ASR and FOG in PD patients under DBS. METHODS: In 14 PD patients with STN DBS and previous FOG, ASR was recorded, with DBS switched on and off...
October 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Esther M J Bekkers, Sam Van Rossom, Elke Heremans, Kim Dockx, Surendar Devan, Sabine M P Verschueren, Alice Nieuwboer
Introduction: Freezing of gait (FOG) is a powerful determinant of falls in Parkinson's disease (PD). Automatic postural reactions serve as a protective strategy to prevent falling after perturbations. However, differences in automatic postural reactions between patients with and without FOG in response to perturbation are at present unclear. Therefore, the present study aimed to compare the response patterns and neuromuscular control between PD patients with and without FOG and healthy controls (HCs) after postural perturbations...
2018: Frontiers in Neurology
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