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Freezing of gait executive

Clement Hamani, Tipu Aziz, Bastiaan R Bloem, Peter Brown, Stephan Chabardes, Terry Coyne, Kelly Foote, Edgar Garcia-Rill, Etienne C Hirsch, Andres M Lozano, Paolo A M Mazzone, Michael S Okun, William Hutchison, Peter Silburn, Ludvic Zrinzo, Mesbah Alam, Laurent Goetz, Erlick Pereira, Anand Rughani, Wesley Thevathasan, Elena Moro, Joachim K Krauss
Several lines of evidence over the last few years have been important in ascertaining that the pedunculopontine nucleus (PPN) region could be considered as a potential target for deep brain stimulation (DBS) to treat freezing and other problems as part of a spectrum of gait disorders in Parkinson disease and other akinetic movement disorders. Since the introduction of PPN DBS, a variety of clinical studies have been published. Most indicate improvements in freezing and falls in patients who are severely affected by these problems...
October 11, 2016: Stereotactic and Functional Neurosurgery
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
Aaron Kucinski, Inge E M de Jong, Martin Sarter
Falls are a leading cause of death in the elderly and, in a majority of patients with Parkinson's disease (PD), the leading levodopa-insensitive cause of hospitalization and long-term care. Falling in PD has been attributed to degeneration of forebrain cholinergic neurons that, in interaction with striatal dopamine losses, impairs the cognitive control of balance, gait, and movement. We previously established an animal model of these dual cholinergic-dopaminergic losses ("DL rats") and a behavioral test system (Michigan Complex Motor Control Task, MCMCT) to measure falls associated with traversing dynamic surfaces and distractors...
July 29, 2016: European Journal of Neuroscience
Samuel T Nemanich, Gammon M Earhart
OBJECTIVE: Freezing of gait (FOG) is a locomotor disturbance in Parkinson disease (PD) related to impaired motor automaticity. In this study, we investigated the impact of freezing on automaticity in the oculomotor system using an anti-saccade paradigm. METHODS: Subjects with PD with (PD-FOG, n=13) and without (PD-NON, n=13) FOG, and healthy age-matched controls (CTRL, n=12) completed automatic pro-saccades and non-automatic anti-saccades. Primary outcomes were saccade latency, velocity, and gain...
June 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Lena Storzer, Markus Butz, Jan Hirschmann, Omid Abbasi, Maciej Gratkowski, Dietmar Saupe, Alfons Schnitzler, Sarang S Dalal
Although bicycling and walking involve similar complex coordinated movements, surprisingly Parkinson's patients with freezing of gait typically remain able to bicycle despite severe difficulties in walking. This observation suggests functional differences in the motor networks subserving bicycling and walking. However, a direct comparison of brain activity related to bicycling and walking has never been performed, neither in healthy participants nor in patients. Such a comparison could potentially help elucidating the cortical involvement in motor control and the mechanisms through which bicycling ability may be preserved in patients with freezing of gait...
2016: Frontiers in Human Neuroscience
Gonzalo J Revuelta, Aaron Embry, Jordan J Elm, Chris Gregory, Amy Delambo, Steve Kautz, Vanessa K Hinson
BACKGROUND: Freezing of gait (FoG) is a common and debilitating condition in Parkinson's disease (PD) associated with executive dysfunction. A subtype of FoG does not respond to dopaminergic therapy and may be related to noradrenergic deficiency. This pilot study explores the effects of atomoxetine on gait in PD patients with dopa-unresponsive FoG using a novel paradigm for objective gait assessment. FINDINGS: Ten patients with PD and dopa-unresponsive FoG were enrolled in this eight-week open label pilot study...
2015: Translational Neurodegeneration
Jin Yong Hong, Hyuk Jin Yun, Mun Kyung Sunwoo, Jee Hyun Ham, Jong-Min Lee, Young H Sohn, Phil Hyu Lee
Pure akinesia with gait freezing (PAGF) is considered a clinical phenotype of progressive supranuclear palsy. The brain atrophy and cognitive deficits in PAGF are expected to be less prominent than in classical Richardson's syndrome (RS), but this hypothesis has not been explored yet. We reviewed the medical records of 28 patients with probable RS, 19 with PAGF, and 29 healthy controls, and compared cortical thickness, subcortical gray matter volume, and neuropsychological performance among the three groups...
2015: Frontiers in Aging Neuroscience
Courtney C Walton, Claire O'Callaghan, Julie M Hall, Moran Gilat, Loren Mowszowski, Sharon L Naismith, James R Burrell, James M Shine, Simon J G Lewis
Freezing of gait is a poorly understood symptom of Parkinson's disease (PD) that is commonly accompanied by executive dysfunction. This study employed an antisaccade task to measure deficits in inhibitory control in patients with freezing, and to determine if these are associated with a specific pattern of grey matter loss using voxel-based morphometry. PD patients with (n = 15) and without (n = 11) freezing along with 10 age-matched controls were included. A simple prosaccade task was administered, followed by a second antisaccade task that required subjects to either look towards or away from a peripheral target...
December 2015: Journal of Neurology
Heidemarie Zach, Arno M Janssen, Anke H Snijders, Arnaud Delval, Murielle U Ferraye, Eduard Auff, Vivian Weerdesteyn, Bastiaan R Bloem, Jorik Nonnekes
BACKGROUND: Freezing of gait (FOG) is a common and debilitating phenomenon in Parkinson's disease (PD). Wearable accelerometers might help to assess FOG in the research setting. Here, we evaluate whether accelerometry can detect FOG while executing rapid full turns and while walking with rapid short steps (the two most common provoking circumstances for FOG). METHODS: We included 23 PD patients, who all had objective FOG. Participants performed several walking tasks, including walking rapidly with short steps and rapid full turns in both directions with a triaxial linear waist-mounted accelerometer...
November 2015: Parkinsonism & related Disorders
Julie M Hall, James M Shine, Claire O'Callaghan, Courtney C Walton, Moran Gilat, Sharon L Naismith, Simon J G Lewis
BACKGROUND: Freezing of gait is a common disabling symptom of Parkinson's disease (PD) with limited treatment options. The pathophysiological mechanisms of freezing behaviour are still contentious. OBJECTIVE: To investigate the prevalence of freezing of gait and its associations with increasing disease severity to gain a better understanding of the underlying pathophysiology. METHODS: This exploratory study included 389 idiopathic PD patients, divided into four groups; early and advanced PD with freezing of gait, and early and advanced PD without freezing of gait...
2015: Journal of Parkinson's Disease
C J Egerton, P McCandless, B Evans, J Janssen, J D Richards
BACKGROUND: Freezing of gait (FOG) is a serious gait disorder affecting up to two-thirds of people with Parkinson's disease (PD). Cueing has been explored as a method of generating motor execution using visual transverse lines on the floor. However, the impact of a laser light visual cue remains unclear. OBJECTIVE: To determine the biomechanical effect of a laser cane on FOG in a participant with PD compared to a healthy age- and gender-matched control. METHODS: The participant with PD and healthy control were given a task of initiating gait from standing...
2015: Physiotherapy Theory and Practice
Isabelle Killane, Conor Fearon, Louise Newman, Conor McDonnell, Saskia M Waechter, Kristian Sons, Timothy Lynch, Richard B Reilly
Freezing of gait (FOG), an episodic gait disturbance characterized by the inability to generate effective stepping, occurs in more than half of Parkinson's disease patients. It is associated with both executive dysfunction and attention and becomes most evident during dual tasking (performing two tasks simultaneously). This study examined the effect of dual motor-cognitive virtual reality training on dual-task performance in FOG. Twenty community dwelling participants with Parkinson's disease (13 with FOG, 7 without FOG) participated in a pre-assessment, eight 20-minute intervention sessions, and a post-assessment...
November 2015: IEEE Journal of Biomedical and Health Informatics
Daniel S Peterson, Laurie A King, Rajal G Cohen, Fay B Horak
People with Parkinson disease (PD) who show freezing of gait also have dysfunction in cognitive domains that interact with mobility. Specifically, freezing of gait is associated with executive dysfunction involving response inhibition, divided attention or switching attention, and visuospatial function. The neural control impairments leading to freezing of gait have recently been attributed to higher-level, executive and attentional cortical processes involved in coordinating posture and gait rather than to lower-level, sensorimotor impairments...
May 2016: Physical Therapy
Menka Jha, Ketan Jhunjhunwala, Bagepally B Sankara, Jitender Saini, J Keshav Kumar, Ravi Yadav, Pramod Kumar Pal
BACKGROUND: Neuropsychological evaluation with advanced neuroimaging may be a useful tool to determine the anatomical substrates that play crucial role in freezing of gait (FOG) in patients with Parkinson's Disease (PD). OBJECTIVES: To compare the cognitive profile and gray matter (GM) changes (using Voxel Based Morphometry - VBM) between patients with PD with and without FOG (FOG+ve and FOG-ve). METHODS: Seventeen FOG+ve (M:F = 11:6) and 21 FOG-ve (M:F = 11:10) were evaluated clinically and with a structured neuropsychological battery...
October 2015: Parkinsonism & related Disorders
Marina Picillo, Raffaele Dubbioso, Rosa Iodice, Alessandro Iavarone, Chiara Pisciotta, Emanuele Spina, Lucio Santoro, Paolo Barone, Marianna Amboni, Fiore Manganelli
Freezing of gait (FOG) is one of the most common gait disturbances in patients with Parkinson's disease (PD). Recently, a PET study has documented that PD patients with FOG display cholinergic deficits selectively driven by nucleus basalis of Meynert (nbM)-neocortical denervation and not by peduncolopontine nucleus (PPN)-thalamic degeneration. Short-latency afferent inhibition (SAI) is a neurophysiological technique that allows evaluating major cholinergic sources in the central nervous system in vivo. We sought to determine whether central cholinergic circuits, evaluated by means of SAI testing, are impaired in patients with PD with FOG (FOG+) as compared to those without (FOG-)...
November 2015: Journal of Neural Transmission
Florian Brugger, Eugenio Abela, Stefan Hägele-Link, Stephan Bohlhalter, Marian Galovic, Georg Kägi
Current hypotheses postulate a relationship between executive dysfunction and freezing of gait (FOG) in Parkinson's disease (PD). Hitherto, most evidence comes from entirely clinical approaches, while knowledge about this relationship on the morphological level is sparse. The aim of this study was therefore to assess the overlap of gray matter atrophy associated with FOG and executive dysfunction in PD. We included 18 PD patients with FOG and 20 without FOG in our analysis. A voxel-based morphometry approach was used to reveal voxel clusters in the gray matter which were associated with FOG and executive dysfunction as measured by the Frontal Assessment Battery, respectively...
September 15, 2015: Journal of the Neurological Sciences
Johan Ottosson, Lillian Lavesson, Stefan Pinzke, Patrik Grahn
Freezing of Gait (FOG) is a common condition in people with Parkinson's disease (PD). FOG entails suddenly experiencing difficulties moving or feeling that one's feet are as glued to the ground. It is triggered, e.g., when passing through doorways. Earlier studies suggest that being in natural environments affects FOG in a positive way. Five subjects were recruited to serve as five single subject cases. We used interviews, observations, questionnaires and collected gait pattern data with aid of an accelerometer...
July 2015: International Journal of Environmental Research and Public Health
Tao Wu, Mark Hallett, Piu Chan
Bradykinesia is the most important feature contributing to motor difficulties in Parkinson's disease (PD). However, the pathophysiology underlying bradykinesia is not fully understood. One important aspect is that PD patients have difficulty in performing learned motor skills automatically, but this problem has been generally overlooked. Here we review motor automaticity associated motor deficits in PD, such as reduced arm swing, decreased stride length, freezing of gait, micrographia and reduced facial expression...
October 2015: Neurobiology of Disease
V E Kelly, C O Johnson, E L McGough, A Shumway-Cook, F B Horak, K A Chung, A J Espay, F J Revilla, J Devoto, C Wood-Siverio, S A Factor, B Cholerton, K L Edwards, A L Peterson, J F Quinn, T J Montine, C P Zabetian, J B Leverenz
INTRODUCTION: Research suggests an association between global cognition and postural instability/gait disturbance (PIGD) in Parkinson disease (PD), but the relationship between specific cognitive domains and PIGD symptoms is not clear. This study examined the association of cognition (global and specific cognitive domains) with PIGD symptoms in a large, well-characterized sample of individuals with PD. METHODS: Cognitive function was measured with a detailed neuropsychological assessment, including global cognition, executive function, memory, visuospatial function, and language...
July 2015: Parkinsonism & related Disorders
Carolina R A Silveira, Kaylena A Ehgoetz Martens, Frederico Pieruccini-Faria, Danielle Bell-Boucher, Eric A Roy, Quincy J Almeida
Although the underlying mechanisms of freezing of gait in Parkinson's disease (PD) are not fully understood, impaired sensory-perceptual processing has been proposed as an important contributor to freezing episodes. The aims of this cross-sectional study were to disentangle how sensory-perceptual deficits involved in planning (prior to movement) and sensory-perceptual feedback processing (during movement execution) contribute to freezing of gait in narrow spaces. Thirteen PD participants with freezing (PD FOG), 14 PD participants without freezing (PD non-FOG), and 15 healthy individuals made a perceptual estimate of the width of the distal opening of a corridor in two conditions: parallel and narrowing walls...
July 2015: Journal of Neurology
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