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Parkinson's FOG

Ken Ikeda, Takehisa Hirayama, Takanori Takazawa, Kiyokazu Kawabe, Yasuo Iwasaki
Objective Parkinson's disease (PD) is characterized by the progressive degeneration of the nigrostriatal dopaminergic neurons. Rotigotine is a non-ergot dopamine receptor agonist (DA). Its transdermal patch maintains the effective concentrations for 24 hours. Freezing of gait (FOG) is a common and devastating symptom in PD patients. Little is known about therapeutic effects of rotigotine on FOG in PD patients. Herein we compared how three non-ergot DAs of rotigotine, pramipexole LA and ropinirole CR influence FOG, besides classical motor deficits in PD patients...
2016: Internal Medicine
Won Hyuk Chang, Min Su Kim, Jin Whan Cho, Jinyoung Youn, Yun Kwan Kim, Sun Woong Kim, Ahee Lee, Yun-Hee Kim
OBJECTIVE: To investigate the potential of cumulative high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) on freezing of gait in atypical Parkinsonism. DESIGN: Randomized, single-blinded, crossover study with a blinded observer. PARTICIPANTS: Eight patients with atypical Parkinsonism. METHODS: All participants received HF-rTMS over the lower leg primary motor cortex (M1-LL) for 5 consecutive days. Alternative sham stimulation was also administered with a 2-week wash-out period...
October 12, 2016: Journal of Rehabilitation Medicine
Claudia Barthel, Elizabeth Mallia, Bettina Debû, Bastiaan R Bloem, Murielle Ursulla Ferraye
BACKGROUND: Freezing of gait (FOG) is a mysterious, complex and debilitating phenomenon in Parkinson's disease. Adequate assessment is a pre-requisite for managing FOG, as well as for assigning participants in FOG research. The episodic nature of FOG, as well as its multiple clinical expressions make its assessment challenging. OBJECTIVE: To highlight the available assessment tools and to provide practical, experience-based recommendations for reliable assessment of FOG...
September 20, 2016: Journal of Parkinson's Disease
Matthew J Georgiades, Moran Gilat, Kaylena A Ehgoetz Martens, Courtney C Walton, Patrick G Bissett, James M Shine, Simon J G Lewis
Freezing of gait (FOG) is a common, disabling symptom of Parkinson's disease (PD) that is associated with deficits in motor initiation and inhibition. Understanding of underlying neurobiological mechanisms has been limited by difficulties in eliciting and objectively characterizing such gait phenomena in the clinical setting. However, recent work suggests that virtual reality (VR) techniques might offer the potential to study motor control. This study utilized a VR paradigm to explore deficits in motor initiation and stopping performance, including stop failure in PD patients with (Freezers, 31) and without (Non-Freezers, 23) FOG, and healthy age-matched Controls (15)...
September 17, 2016: Neuroscience
Anke H Snijders, Kaoru Takakusaki, Bettina Debu, Andres M Lozano, Vibhor Krishna, Alfonso Fasano, Tipu Z Aziz, Stella M Papa, Stewart A Factor, Mark Hallett
Freezing of gait (FOG) is a common and debilitating, but largely mysterious, symptom of Parkinson disease. In this review, we will discuss the cerebral substrate of FOG focusing on brain physiology and animal models. Walking is a combination of automatic movement processes, afferent information processing, and intentional adjustments. Thus, normal gait requires a delicate balance between various interacting neuronal systems. To further understand gait control and specifically FOG, we will discuss the basic physiology of gait, animal models of gait disturbance including FOG, alternative etiologies of FOG, and functional magnetic resonance studies investigating FOG...
September 20, 2016: Annals of Neurology
Fariborz Rahimi, Angela C Roberts, Mandar Jog
OBJECTIVES: Freezing of gait (FoG) is a challenging clinical symptom in Parkinson's disease with variable improvements in FoG with rasagiline. In this prospective, uncontrolled, pre-/post- treatment pilot study, we explore the clinical variables that contribute to this variability and those that predict improvement. PATIENTS AND METHODS: Frequency and duration of FoG, along with other standardized scales, were evaluated in 18 optimally medicated PD participants with intractable FoG, prior to and after completion of a 90-day course of 1mg daily rasagiline...
November 2016: Clinical Neurology and Neurosurgery
Alberto Cucca, Milton C Biagioni, Jori E Fleisher, Shashank Agarwal, Andre Son, Pawan Kumar, Miroslaw Brys, Alessandro Di Rocco
Freezing of gait (FOG) is 'an episodic inability to generate effective stepping in the absence of any known cause other than parkinsonism or high level gait disorders'. FOG is one of the most disabling symptoms in Parkinson's disease, especially in its more advanced stages. Early recognition is important as FOG is related to higher fall risk and poorer prognosis. Although specific treatments are still elusive, there have been recent advances in the development of new therapeutic approaches. The aim of this review is to present the latest knowledge regarding the phenomenology, pathogenesis, diagnostic assessment and conventional treatment of FOG in Parkinson's disease...
October 2016: Neurodegenerative Disease Management
Alexandre Mendes, Alexandra Gonçalves, Nuno Vila-Chã, Margarida Calejo, Inês Moreira, Joana Fernandes, Joana Damásio, Armando Teixeira-Pinto, Paul Krack, António Bastos Lima, Sara Cavaco
BACKGROUND: The rate of Parkinson's disease (PD) progression varies widely between patients. Current knowledge does not allow to accurately predict the evolution of symptoms in a given individual over time. OBJECTIVES: To develop regression-based models of PD progression and to explore its predictive value in a three-year follow-up. METHODS: At baseline, 300 consecutive PD patients were assessed using the Unified Parkinson's Disease Rating Scale (UPDRS) - subscales II and III, Hoehn & Yahr (H&Y) and Schwab and England Independence Scale (S&E); and the Freezing of Gait Questionnaire (FOG-Q)...
August 31, 2016: Journal of Parkinson's Disease
Nadja Bredo Rasmussen, Mikkel Vestergaard Olesen, Tomasz Brudek, Per Plenge, Anders Bue Klein, Jenny E Westin, Karina Fog, Gitta Wörtwein, Susana Aznar
The 5-HT2A receptor is highly involved in aspects of cognition and executive function and seen to be affected in neurodegenerative diseases like Alzheimer's disease and related to the disease pathology. Even though Parkinson's disease (PD) is primarily a motor disorder, reports of impaired executive function are also steadily being associated with this disease. Not much is known about the pathophysiology behind this. The aim of this study was thereby twofold: (1) to investigate 5-HT2A receptor binding levels in Parkinson's brains and (2) to investigate whether PD associated pathology, alpha-synuclein (AS) overexpression, could be associated with 5-HT2A alterations...
2016: Parkinson's Disease
Marianna Capecci, Lucia Pepa, Federica Verdini, Maria Gabriella Ceravolo
INTRODUCTION: The freezing of gait (FOG) is a common and highly distressing motor symptom in patients with Parkinson's Disease (PD). Effective management of FOG is difficult given its episodic nature, heterogeneous manifestation and limited responsiveness to drug treatment. METHODS: In order to verify the acceptance of a smartphone-based architecture and its reliability at detecting FOG in real-time, we studied 20 patients suffering from PD-related FOG. They were asked to perform video-recorded Timed Up and Go (TUG) test with and without dual-tasks while wearing the smartphone...
August 21, 2016: Gait & Posture
Lucia Ricciardi, Michela Ebreo, Adriana Graziosi, Marianna Barbuto, Chiara Sorbera, Letterio Morgante, Francesca Morgante
INTRODUCTION: Speech disturbances in Parkinson's disease (PD) are heterogeneous, ranging from hypokinetic to hyperkinetic types. Repetitive speech disorder has been demonstrated in more advanced disease stages and has been considered the speech equivalent of freezing of gait (FOG). We aimed to verify a possible relationship between speech and FOG in patients with PD. METHODS: Forty-three consecutive PD patients and 20 healthy control subjects underwent standardized speech evaluation using the Italian version of the Dysarthria Profile (DP), for its motor component, and subsets of the Battery for the Analysis of the Aphasic Deficit (BADA), for its procedural component...
August 15, 2016: Parkinsonism & related Disorders
K A Ehgoetz Martens, J M Hall, M Gilat, M J Georgiades, C C Walton, S J G Lewis
Previous research has shown that anxiety in Parkinson's disease (PD) is associated with freezing of gait (FOG), and may even contribute to the underlying mechanism. However, limited research has investigated whether PD patients with FOG (PD+FOG) have higher anxiety levels when compared directly to non-freezing PD patients (PD-NF) and moreover, how anxiety might contribute to FOG. The current study evaluated whether: (i) PD+FOG have greater anxiety compared to PD-NF, and (ii) anxiety in PD is related to attentional set-shifting, in order to better understand how anxiety might be contributing to FOG...
September 2016: Gait & Posture
Benoît Sijobert, Christine Azevedo-Coste, David Andreu, Claudia Verna, Christian Geny
This study aims to investigate the effect of a sensitive cueing on Freezing of Gait (FOG) and gait disorders in subjects suffering from Parkinson's disease (PD). 13 participants with Parkinson's disease were equipped with an electrical stimulator and a foot mounted inertial measurement unit (IMU). An IMU based algorithm triggered in real time an electrical stimulus applied on the arch of foot at heel off detection. Starting from standing, subjects were asked to walk at their preferred speed on a path comprising 5m straight, u-turn and walk around tasks...
June 13, 2016: European Journal of Translational Myology
Alfonso Fasano, Christian Schlenstedt, Jan Herzog, Meir Plotnik, Franziska E M Rose, Jens Volkmann, Günther Deuschl
BACKGROUND: The pathophysiology behind gait impairments seen in Parkinson's disease (PD), in particular freezing of gait (FOG), is not fully understood. Here we study the interplay between several gait features related to FOG during different split-belt treadmill (SBTM) conditions. METHODS: We investigated the spatiotemporal properties, the phenomenon of sequence effect and the inter-limb symmetry and temporal coordination of gait during different split-belt conditions in 20 patients with advanced Parkinson's disease and different severities of freezing...
July 2016: Gait & Posture
Luis Santos, Javier Fernandez-Rio, Kristian Winge, Beatriz Barragán-Pérez, Vicente Rodríguez-Pérez, Vicente González-Díez, Miguel Blanco-Traba, Oscar E Suman, Charles Philip Gabel, Javier Rodríguez-Gómez
PURPOSE: The aim of this study was to assess whether supervised slackline training reduces the risk of falls in people with Parkinson's disease (PD). METHODS: Twenty-two patients with idiopathic PD were randomized into experimental (EG, N = 11) and control (CG, N = 11) groups. Center of Pressure (CoP), Freezing of Gait (FOG), and Falls Efficacy Scale (FES) were assessed at pre-test, post-test and re-test. Rate perceived exertion (RPE, Borg's 6-20 scale) and local muscle perceived exertion (LRPE) were also assessed at the end of the training sessions...
July 14, 2016: Disability and Rehabilitation
Hongbo Zhang, Xifan Yin, Zhiyuan Ouyang, Jing Chen, Shenghua Zhou, Changguo Zhang, Xin Pan, Shiliang Wang, Junxiang Yang, Yaoyao Feng, Ping Yu, Qiangchun Zhang
This study investigated the risk factors for freezing of gait (FOG) in the early stage of Parkinson disease in China, using a sample of 248 patients who were followed for 3 years. Part III of the Unified Parkinson Disease Rating Scale and the modified Hoehn-Yahr grading scale were used to evaluate the severity of motor symptoms. Nonmotor symptoms were assessed using the Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale (HAMD), and Non-Motor Symptoms Scale (NMSS). The end-point was the presence of FOG at the end of follow-up; patients with FOG were classified as freezers...
June 2016: Medicine (Baltimore)
Céline Tard, Hervé Devanne, Luc Defebvre, Arnaud Delval
OBJECTIVE: To investigate the efficiency of intermittent theta-burst stimulation (iTBS) to alleviate the symptoms of freezing of gait (FoG) in Parkinson's disease (PD). METHODS: We performed a cross-over, sham-controlled study of patients with severe PD, bilateral motor signs and debilitating, severe FoG, that was levodopa-sensitive but not controlled by optimal dopatherapy. We applied iTBS to the left premotor cortex and measured FoG, gait initiation and continuous gait, before and immediately after the iTBS session...
August 15, 2016: Neuroscience Letters
Marcelo P Pereira, Lilian T B Gobbi, Quincy J Almeida
INTRODUCTION: The role of proprioceptive integration impairments as the potential mechanism underlying Freezing of gait (FOG) in Parkinson's disease (PD) is still an open debate. The effects of muscle vibration (a well-known manipulation of proprioception) could provide the answer to the debate. The aim of this study was to determine whether proprioceptive manipulation, through muscle vibration, could reduce FOG severity. METHODS: Sixteen PD patients who experience FOG were required to walk with small step lengths (15 cm)...
August 2016: Parkinsonism & related Disorders
Min Wang, Siming Jiang, Yongsheng Yuan, Li Zhang, Jian Ding, Jianwei Wang, Jiejin Zhang, Kezhong Zhang, Jie Wang
This study assessed the patterns of functional and structural connectivity abnormalities in patients with Parkinson's disease with freezing of gait (PD FOG+) compared with those without freezing (PD FOG-) and healthy controls (HCs). Resting state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI) scans were obtained from 14 PD FOG+, 16 PD FOG- and 16HCs. Between-group difference in pedunculopontine nucleus (PPN) functional connectivity (FC) was performed to assess FC dysfunction. Tract-based spatial statistics (TBSS) was applied to compare white matter (WM) impairment across the whole brain between groups...
August 2016: Journal of Neurology
Miroslav Vastik, Pavel Hok, Petr Hlustik, Pavel Otruba, Zbyněk Tüdös, Petr Kanovsky
BACKGROUND: Freezing of gait (FOG) is a common disabling symptom of (in) Parkinson's disease (PD). The mechanism of FOG is (in) not clearly understood. We investigated the clinical effect and changes of the activity of the sensorimotor system using repeated functional MRI (fMRI) before and after application of botulinum toxin in Parkinson's disease patients with FOG. METHODS: We investigated 20 patients with PD, 10 with FOG and 10 without FOG. PD patients with FOG were treated with intramuscular application of botulinum toxin type A into the tensor fasciae latae muscle bilaterally...
2016: Neuro Endocrinology Letters
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