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Parkinson's FOG

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...
August 2, 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...
July 21, 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
G V Prateek, Isaac Skog, Marie E McNeely, Ryan P Duncan, Gammon M Earhart, Arye Nehorai
In this paper, we develop new methods to automatically detect the onset and duration of freezing of gait (FOG) in people with Parkinson disease (PD) in real-time, using inertial sensors. We first build a physical model that describes the trembling motion during the FOG events. Then, we design a generalized likelihood ratio test framework to develop a two-stage detector for determining the zero-velocity and trembling events during gait. Thereafter, to filter out falsely detected FOG events, we develop a point-process filter that combines the output of the detectors with information about the speed of the foot, provided by a foot-mounted inertial navigation system...
December 20, 2017: IEEE Transactions on Bio-medical Engineering
María José Gallardo, Juan Pablo Cabello, María Jesus Corrales, Javier Torres-Donaire, Jose Javier Bravo, María Prado Talavera, Alberto León, Julia Vaamonde-Gamo
OBJECTIVE: The objective of the study is to study a group of patients with Parkinson's disease (PD) with and without freezing of gait (FOG) and analyze neuropsychological differences, especially regarding executive functions, according to their performance in a set of tests, and potential anomalies in functional positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-d-glucose integrated with computed tomography (18 F-FDG PET/CT) neuroimaging results of the frontal lobe. METHODS: The study recruited 23 patients...
July 9, 2018: Neurological Research
Elisa Pelosin, Roberta Barella, Cristina Bet, Elisabetta Magioncalda, Martina Putzolu, Francesca Di Biasio, Cecilia Cerulli, Mauro Casaleggio, Giovanni Abbruzzese, Laura Avanzino
Freezing of gait (FoG) is among the most disabling symptoms of Parkinson's disease (PD) patients. Recent studies showed that action observation training (AOT) with repetitive practice of the observed actions represents a strategy to induce longer-lasting effects compared with standard physiotherapy. We investigated whether AOT may improve FoG and mobility in PD, when AOT is applied in a group-based setting. Sixty-four participants with PD and FoG were assigned to the experimental (AO) or control groups and underwent a 45-minute training session, twice a week, for 5 weeks...
2018: Neural Plasticity
Walter Di Iorio, Alessandro Ciarimboli, Giorgio Ferriero, Michele Feleppa, Luigi Baratto, Giuseppe Matarazzo, Giovanni Gentile, Stefano Masiero, Patrizio Sale
The aim of this study was to assess the role of Action Observation (AO) to improve balance, gait, reduce falls, and to investigate the changes in P300 pattern. Five cognitively intact People with Parkinson’s disease (PwP) were enrolled in this prospective, quasi-experimental study to undergo a rehabilitation program of AO for gait and balance recovery of 60 min, three times a week for four weeks. The statistical analysis showed significant improvements for Unified Parkinson’s Disease Rating Scale (UPDRS) motor section III p = 0...
July 4, 2018: Diseases (Basel)
Chiahao Lu, Sommer L Amundsen Huffmaster, Paul J Tuite, Colum D MacKinnon
OBJECTIVE: We investigated if anodal transcranial direct current stimulation (A-tDCS), applied over the supplementary motor areas (SMAs), could improve gait initiation in Parkinson's disease (PD) with freezing of gait (FOG). METHODS: In this double-blinded cross-over pilot study, ten PD with FOG underwent two stimulation sessions: A-tDCS (1 mA, 10 min) and sham stimulation. Eight blocks of gait initiation were collected per session: (1) pre-tDCS, with acoustic cueing; (2) pre-tDCS, self-initiated (no cue); and (3-8) post-tDCS, self-initiated...
September 2018: Journal of Neurology
Ana Francisca Rozin Kleiner, Aline Souza Pagnussat, Camila Pinto, Ritchele Redivo Marchese, Ana Paula Salazar, Manuela Galli
OBJECTIVE: To assess the effects of automated peripheral stimulation (AMPS) in reducing gait variability of subjects with Parkinson disease (PD) and freezing of gait (FOG) treated with AMPS and to explore the effects of this treatment on gait during a single task (walking) and a dual task (walking while attending the word-color Stroop test). DESIGN: Interventional, double-blinded, placebo-controlled, randomized trial. SETTING: Clinical rehabilitation...
June 11, 2018: Archives of Physical Medicine and Rehabilitation
Laurent Goetz, Manik Bhattacharjee, Murielle U Ferraye, Valérie Fraix, Carina Maineri, Daniela Nosko, Albert J Fenoy, Brigitte Piallat, Napoléon Torres, Alexandre Krainik, Eric Seigneuret, Olivier David, Martin Parent, André Parent, Pierre Pollak, Alim-Louis Benabid, Bettina Debu, Stéphan Chabardès
BACKGROUND: Experimental studies led to testing of deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) as a new therapy to treat freezing of gait (FOG) in Parkinson disease (PD). Despite promising initial results fueling a growing interest toward that approach, several clinical studies reported heterogeneity in patient responses. Variation in the position of electrode contacts within the rostral brainstem likely contributes to such heterogeneity. OBJECTIVE: To provide anatomoclinical correlations of the effect of DBS of the caudal mesencephalic reticular formation (cMRF) including the PPN to treat FOG by comparing the normalized positions of the active contacts among a series of 11 patients at 1- and 2-yr follow-up and to provide an optimal target through an open-label study...
May 25, 2018: Neurosurgery
Etienne Goubault, Hung P Nguyen, Sarah Bogard, Pierre J Blanchet, Erwan Bézard, Claude Vincent, Mélanie Langlois, Christian Duval
BACKGROUND: Clinical and anecdotal observations propose that patients with Parkinson's disease (PD) may show drug-induced dyskinesia (DID) concomitantly with cardinal motor features. However, the extent of the concomitant presence of DID and cardinal features remains to be determined. OBJECTIVES: This cross-sectional study measured peak-dose choreic-type DID in a quantitative manner in patients diagnosed with PD, and determined whether symptoms such as tremor, bradykinesia, rigidity, postural instability or freezing of gait (FoG) were still detectable in these patients...
2018: Journal of Parkinson's Disease
Ruth Djaldetti, Amihai Rigbi, Lior Greenbaum, Johnathan Reiner, Mordechai Lorberboym
BACKGROUND: The role of nuclear imaging in predicting Parkinson's disease (PD) progression is unclear. This study investigated whether the degree of reduced striatal dopamine transporter binding at diagnosis of PD predicts later motor complications and time to disease progression. METHODS: We retrospectively studied 41 patients with early PD who underwent 123 I-FP-CIT SPECT and were followed thereafter with a mean disease duration of 9.51 ± 3.18 years. The association of quantitatively analyzed 123 I-FP-CIT binding in striatal subregions with the development of motor fluctuations, dyskinesias, freezing of gait (FOG) and falls as well as the time to Hoehn and Yahr (H&Y) stage 3 was evaluated...
July 15, 2018: Journal of the Neurological Sciences
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