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Parkinson's FOG

Esther M J Bekkers, Kim Dockx, Surendar Devan, Sam Van Rossom, Sabine M P Verschueren, Bastiaan R Bloem, Alice Nieuwboer
BACKGROUND: Postural instability and freezing of gait (FOG) are major problems in patients with Parkinson's disease (PD), and both contribute to falls. However, the interrelationship between these 2 deficits is still unclear. OBJECTIVE: This study investigated whether dual-tasking influenced postural control differently in freezers (FOG+) and nonfreezers (FOG-). METHODS: Thirty-three patients with PD (19 FOG+, 14 FOG-, well-matched) and 28 healthy controls underwent 4 postural control tasks, consisting of standing on either stable or unstable surfaces with eyes open or closed...
February 2018: Neurorehabilitation and Neural Repair
Ruwei Ou, Qianqian Wei, Bei Cao, Wei Song, Yanbing Hou, Hui Liu, Xiaoqin Yuan, Bi Zhao, Ying Wu, Huifang Shang
Objective: To explore the clinical predictors of freezing of gait (FOG) in Chinese patients with Parkinson's disease (PD). Methods: This study included 225 patients with PD who completed a three-year follow-up visit. The end-point was the presence of FOG (freezers), which was assessed during the follow-up visit. Group comparisons were conducted, followed by a further forward binary logistic regression analysis. Results: Eighty-five patients with PD (38%) had developed FOG at the end of study...
March 2018: Brain and Behavior
Jiayue Cai, Soojin Lee, Fang Ba, Saurabh Garg, Laura J Kim, Aiping Liu, Diana Kim, Z Jane Wang, Martin J McKeown
Falls and balance difficulties remain a major source of morbidity in Parkinson's Disease (PD) and are stubbornly resistant to therapeutic interventions. The mechanisms of gait impairment in PD are incompletely understood but may involve changes in the Pedunculopontine Nucleus (PPN) and its associated connections. We utilized fMRI to explore the modulation of PPN connectivity by Galvanic Vestibular Stimulation (GVS) in healthy controls ( n = 12) and PD subjects even without overt evidence of Freezing of Gait (FOG) while on medication ( n = 23)...
2018: Frontiers in Neuroscience
Ryul Kim, Joongyub Lee, Yoon Kim, Aryun Kim, Mihee Jang, Han-Joon Kim, Beomseok Jeon, Un Jung Kang, Stanley Fahn
INTRODUCTION: The current study was designed to determine whether the degree of presynaptic striatal dopamine depletion can predict the later development of freezing of gait (FOG) in Parkinson's disease (PD). METHODS: This retrospective cohort study included 390 de novo patients with PD without FOG at baseline. The participants were divided into tertiles according to the baseline dopamine transporter (DAT) uptake of each striatal subregion, and the cumulative risk of FOG was compared using the Kaplan-Meier method...
February 28, 2018: Parkinsonism & related Disorders
A M Ardi Handojoseno, Ganesh R Naik, Moran Gilat, James M Shine, Tuan N Nguyen, Quynh T Ly, Simon J G Lewis, Hung T Nguyen
Freezing of gait (FOG) is an episodic gait disturbance affecting initiation and continuation of locomotion in many Parkinson's disease (PD) patients, causing falls and a poor quality of life. FOG can be experienced on turning and start hesitation, passing through doorways or crowded areas dual tasking, and in stressful situations. Electroencephalography (EEG) offers an innovative technique that may be able to effectively foresee an impending FOG. From data of 16 PD patients, using directed transfer function (DTF) and independent component analysis (ICA) as data pre-processing, and an optimal Bayesian neural network as a predictor of a transition of 5 seconds before the impending FOG occurs in 11 in-group PD patients, we achieved sensitivity and specificity of 85...
2018: Studies in Health Technology and Informatics
Chuyi Huang, Heling Chu, Yan Zhang, Xiaoping Wang
Freezing of gait (FOG) is a gait disorder featured by recurrent episodes of temporary gait halting and mainly found in advanced Parkinson's disease (PD). FOG has a severe impact on the quality of life of patients with PD. The pathogenesis of FOG is unclear and considered to be related to several brain areas and neural circuits. Its close connection with cognitive disorder has been proposed and some researchers explain the pathogenesis using the cognitive model theory. FOG occurs concurrently with cognitive disorder in some PD patients, who are poorly responsive to medication therapy...
2018: Frontiers in Neuroscience
Lasse Reimer, Louise Buur Vesterager, Cristine Betzer, Jin Zheng, Lærke Dalsgaard Nielsen, Rikke Hahn Kofoed, Louise Berkhoudt Lassen, Ulrik Bølcho, Søren Riis Paludan, Karina Fog, Poul Henning Jensen
Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy comprise a group of neurodegenerative diseases termed synucleinopathies. Synucleinopathie are, characterized by presence of inclusion bodies in degenerating brain cells which contain aggregated α-synuclein phosphorylated on Ser129. Although the inflammation-associated serine-threonine kinase, PKR (EIF2AK2), promotes cellular protection against infection, we demonstrate a pro-degenerative role of activated PKR in an α-synuclein-dependent cell model of multiple system atrophy, where inhibition and silencing of PKR decrease cellular degeneration...
March 1, 2018: Neurobiology of Disease
Christian Schlenstedt, Martina Mancini, Jay Nutt, Amie P Hiller, Walter Maetzler, Günther Deuschl, Fay Horak
Introduction: This study aims at investigating whether impaired anticipatory postural adjustments (APA) during gait initiation contribute to the occurrence of freezing of gait (FOG) or whether altered APAs compensate for FOG in Parkinson's disease (PD). Methods: Gait initiation after 30 s quiet stance was analyzed without and with a cognitive dual task (DT) in 33 PD subjects with FOG (PD+FOG), 30 PD subjects without FOG (PD-FOG), and 32 healthy controls (HC). APAs were characterized with inertial sensors and muscle activity of the tensor fasciae latae (TFL), gastrocnemius, and tibialis anterior was captured with electromyography recordings...
2018: Frontiers in Aging Neuroscience
Hiroshi Kataoka, Noriyuki Tanaka, Takao Kiriyama, Nobuyuki Eura, Masanori Ikeda, Tesseki Izumi, Yoshiko Furiya, Kazuma Sugie, Satoshi Ueno
BACKGROUND: Freezing of gait (FOG) has been linked to increased numbers of steps taken while walking. We tested the hypothesis that an increased number of steps associated with FOG might predict the exacerbation of the severity of Parkinson's disease (PD). METHODS: We prospectively studied 26 patients. Clinical assessments were performed and balance was evaluated in 30 patients with Hoehn-Yahr stage III PD 6 years previously. Gait parameters were analyzed with the use of an originally designed, suddenly narrowed path...
February 22, 2018: European Neurology
Olivia Samotus, Andrew Parrent, Mandar Jog
BACKGROUND: Benefits of dopaminergic therapy and deep brain stimulation are limited and unpredictable for axial symptoms in Parkinson's disease. Dorsal spinal cord stimulation may be a new therapeutic approach. The objective of this study was to investigate the therapeutic effect of spinal cord stimulation on gait including freezing of gait in advanced PD patients. METHODS: Five male PD participants with significant gait disturbances and freezing of gait underwent midthoracic spinal cord stimulation...
February 14, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Martina Mancini, Aner Weiss, Talia Herman, Jeffrey M Hausdorff
Difficulty in turning while walking is common among patients with Parkinson's disease (PD). This difficulty often leads to significant disability, falls, and loss of function; moreover, turning is a common trigger for freezing of gait (FoG). We hypothesized that the quantity and quality of turning mobility while walking during daily life would be different among subjects with PD with and without FoG. Here, we investigated, for the first time, the turning quality during daily life as it relates to FoG in people with PD using a single inertial sensor...
2018: Frontiers in Neurology
Susanna Mezzarobba, Michele Grassi, Roberto Valentini, Paolo Bernardis
INTRODUCTION: The intricate linkage between Freezing of Gait (FoG) and postural control in Parkinson's disease (PD) is unclear. We analyzed the impact of FoG on dynamic postural control. METHODS: 24 PD patients, 12 with (PD + FoG), 12 without FoG (PD-FoG), and 12 healthy controls, were assessed in ON state. Mobility and postural control were measured with clinical scales (UPDRS III, BBS, MPAS) and with kinematic and kinetic analysis during three tasks, characterized by levels of increasing difficulty to plan sequential movement of postural control: walk (W), gait initiation (GI) and sit-to-walk (STW)...
February 2, 2018: Gait & Posture
Minji Son, Sang-Myung Cheon, Changhong Youm, Youkyung Kim, Jae Woo Kim
Freezing of gait (FOG) is a major risk factor for falls and fall-related injuries in patients with Parkinson's disease (PD). The characteristics of gait in PD patients with FOG have been studied but remain controversial. To investigate gait characteristics of FOG in PD, this study analyzed the forward and backward walking of patients with PD. Twenty-six patients with PD were recruited [age: 71.0 ± 6.2 years, Hoehn and Yahr stage: 2-3 (median 2.5)]. Based on responses to the New Freezing of Gait Questionnaire, we classified patients into either the "freezer" or "non-freezer" group...
February 1, 2018: Gait & Posture
Moran Gilat, Kaylena A Ehgoetz Martens, Oscar Miranda-Domínguez, Ishu Arpan, James M Shine, Martina Mancini, Damien A Fair, Simon J G Lewis, Fay B Horak
Freezing of gait (FOG) is a poorly understood symptom affecting many patients with Parkinson's disease (PD). Despite growing evidence of a behavioral link between anxiety, attention and FOG in PD, no research to date has investigated the neural mechanisms that might explain this relationship. The present study therefore examined resting-state MRI functional connectivity between the amygdala, striatum and frontoparietal attentional control network in PD patients with (freezers: n = 19) and without FOG (non-freezers: n = 21) in the dopaminergic 'off' state...
January 31, 2018: Neuroscience
Maurizio Zibetti, Serena Angrisano, Francesca Dematteis, Carlo Alberto Artusi, Alberto Romagnolo, Aristide Merola, Leonardo Lopiano
OBJECTIVE: To determine the impact of levodopa-carbidopa intestinal gel (LCIG) infusion on different subtypes of freezing of gait (FoG) classified according to levodopa responsiveness in advanced Parkinson disease (PD) patients. METHODS: We retrospectively assessed the presence and severity of FoG in 32 advanced PD patients based on the Unified PD Rating Scale (UPDRS) item 14 score. Different FoG subtypes were inferred from the score variation with oral dopaminergic medications...
February 15, 2018: Journal of the Neurological Sciences
Evelien Nackaerts, Alice Nieuwboer, Sanne Broeder, Stephan Swinnen, Wim Vandenberghe, Elke Heremans
Recently, it was shown that patients with Parkinson's disease (PD) and freezing of gait (FOG) can also experience freezing episodes during handwriting and present writing problems outside these episodes. So far, the neural networks underlying increased handwriting problems in subjects with FOG are unclear. This study used dynamic causal modeling of fMRI data to investigate neural network dynamics underlying freezing-related handwriting problems and how these networks changed in response to visual cues. Twenty-seven non-freezers and ten freezers performed a pre-writing task with and without visual cues in the scanner with their right hand...
December 14, 2017: Journal of Neurology
Ana Francisca Rozin Kleiner, Aline S Pagnussat, Giulia di Prisco, Alessandro Vagnini, Fabrizio Stocchi, Maria Francesca De Pandis, Manuela Galli
The ability to carry out two tasks at once is critical to effective functioning in the real world and deficits are termed Dual-task interference or effect-DTE. DTE substantially compromised the gait of subjects with Parkinson's disease and freezing of gait (PD + FOG), leading to exaggerated slowing, increasing gait dysrhythmicity, and inducing FOG episodes. This study aimed to investigate the DTE in gait variability of subjects with PD and freezing of gait (PD + FOG). Thirty-three patients with PD + FOG and 14 healthy individuals (REFERENCE) took part at this study...
December 2, 2017: Aging Clinical and Experimental Research
Tao-Mian Mi, Shan-Shan Mei, Pei-Peng Liang, Lin-Lin Gao, Kun-Cheng Li, Tao Wu, Piu Chan
Freezing of gait (FOG) is a common and debilitating symptom in Parkinson's disease (PD). The current study investigated alterations of resting-state spontaneous brain activity in PD patients with FOG. A total of 29 patients with FOG, 28 patients without FOG and 31 controls were included. All subjects underwent resting-state functional MRI, and the amplitude of low-frequency fluctuation (ALFF) was calculated to measure the spontaneous brain activity. Between-group differences and correlations with FOG severity (both subjective and objective measures) were analyzed...
December 1, 2017: Scientific Reports
Benoît Sijobert, Christine Azevedo, David Andreu, Claudia Verna, Christian Geny
This study aims to investigate the effect of a somatosensory cueing on gait disorders in subjects with Parkinson's disease (PD). After having performed stepping in place and timed up and go assessing tasks, 13 participants with PD were equipped with an electrical stimulator and an inertial measurement unit (IMU) located under the lateral malleolus on the sagittal plane. Electrodes were positioned under the arch of the foot and electrical stimulation (ES) parameters (five 500 µs/phase charge-balanced biphasic pulses delivered at 200 Hz, repeated four times at 10 Hz) adjusted to deliver a sensitive signal...
November 2017: Artificial Organs
Sara Pietracupa, Antonio Suppa, Neeraj Upadhyay, Costanza Giannì, Giovanni Grillea, Giorgio Leodori, Nicola Modugno, Francesca Di Biasio, Alessandro Zampogna, Claudio Colonnese, Alfredo Berardelli, Patrizia Pantano
Freezing of gait (FOG) is a disabling disorder that often affects Parkinson's disease (PD) patients in advanced stages of the disease. To study structural gray matter (GM) and white matter (WM) changes in PD patients with and without FOG, twenty-one PD patients with FOG (PD-FOG), 16 PD patients without FOG (PD-nFOG) and 19 healthy subjects (HS) underwent a standardized MRI protocol. For the gray matter evaluation, cortical volume (CV), cortical thickness (CTh), and surface area (SA) were analyzed using the FreeSurfer pipeline...
November 11, 2017: Journal of Neurology
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