A 12-year population-based study of freezing of gait in Parkinson's disease

Forsaa, Elin Bjelland; Larsen, Jan Petter; Wentzel‐Larsen, Tore; Alves, Guido

doi:10.1016/j.parkreldis.2014.12.020

Cited by 104 publications

(106 citation statements)

References 30 publications

(35 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Considering previous studies already suggested non-tremor dominant subtype, such as akinetic-rigid subtype or postural instability and gait disturbance subtype, to be a risk factor for falls in PD patients 11, 12 , our results were concomitant with previous studies. Even though non-tremor dominant subtype was also associated with FOG as well as postural instability 33 , akinetic-rigid subtype was predictor for falling into non-forward directions, not falling forward, in our study. Non-tremor dominant subtype is related with more severe and progressive PD 34 , and both FOG and postural instability are common in advanced PD patients.…”

Section: Discussioncontrasting

confidence: 70%

Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease

Youn

Okuma

Hwang

et al. 2017

Sci Rep

View full text Add to dashboard Cite

Falls are a common and disabling symptom in patients with Parkinson’s disease (PD). For prevention, it is important to understand the pathophysiology of falls in PD patients, but the predictors for the possible mechanisms underlying such falls have not been clearly elucidated. In this prospective observational study, we investigated the implications of falling direction to predict the mechanisms of recurrent falls in PD patients. We enrolled 62 recurrent fallers with PD and divided them into two groups according to the main falling directions: 45 PD fallers who fell forward (forward fallers), and 17 PD fallers who fell in the other directions (non-forward fallers). Although there was no difference in demographic data, parkinsonism, or frontal lobe function, forward fallers showed more severe falls and tended to fall during walking or turning, while non-forward fallers usually fell during sitting/standing or turning. Additionally, forward fallers revealed higher score on a freezing of gait (FOG) questionnaire. Logistic regression analysis demonstrated that FOG was associated with falling forward, while balance impairment, akinetic-rigid subtype, and neuropsychiatric symptoms were associated with falling into the other directions. Our results indicate that FOG and balance impairment are two major mechanisms for recurrent falling in PD patients, and falling direction is an important predictor for these mechanisms.

show abstract

Section: Discussioncontrasting

confidence: 70%

Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease

Youn

Okuma

Hwang

et al. 2017

Sci Rep

View full text Add to dashboard Cite

show abstract

“…A majority of people with PD eventually develop freezing of gait (FoG) – the subjective feeling that the feet are ‘glued to the ground’ – during the course of the disease [48]. Even without a freezing event, patients prone to FoG show differences in gait parameters compared to PD patients who do not freeze.…”

Section: Gait Deficits In Parkinson's Diseasementioning

confidence: 99%

Pharmacological treatment in Parkinson's disease: Effects on gait

Smulders

Dale

Carlson‐Kuhta

et al. 2016

Parkinsonism & Related Disorders

134

129

View full text Add to dashboard Cite

Gait impairments are a hallmark of Parkinson's disease (PD), both as an early symptom and an important cause of disability later in the disease course. Although levodopa has been shown to improve gait speed and step length, the effect of dopamine replacement therapy on other aspects of gait is less well understood. In fact, falls are not reduced and some aspects of postural instability during gait are unresponsive to dopaminergic treatment. Moreover, many medications, other than dopaminergic agents, can benefit or impair gait in people with PD. We review the effects of pharmacological interventions used in PD on gait, discriminating, whenever possible, among effects on four components of everyday mobility: straight walking, gait initiation, turning, gait adaptability. Additionally, we summarize the effects on freezing of gait. There is substantial evidence for improvement of spatial characteristics of simple, straight-ahead gait with levodopa and levodopa-enhancing drugs. Recent work suggests that drugs aiming to enhance the acetylcholine system might improve gait stability measures. There is a lack of well-designed studies to evaluate effects on more complex, but highly relevant walking abilities such as turning and flexible adjustments of gait. Finally, paucity in the literature exists on detrimental effects of drugs used in PD that are known to worsen gait and postural stability in the elderly population.

show abstract

“…Freezing of gait (FOG) is a disabling gait disturbance that affects more than half of individuals with Parkinson’s disease (PD) [1]. A recent consensus paper defined FOG as a “brief, episodic absence or marked reduction of forward progression of the feet despite the intention to walk” [2].…”

Section: Introductionmentioning

confidence: 99%

Reduced after-effects following podokinetic adaptation in people with Parkinson's disease and freezing of gait

Nemanich

Earhart

2016

Parkinsonism & Related Disorders

View full text Add to dashboard Cite

Introduction Gait dysfunction is common in people with Parkinson’s disease (PD). Freezing of gait (FOG) is one such gait disturbance that significantly impacts mobility and quality of life in PD. Recent evidence suggests that cerebellar connectivity may differ in people with PD and FOG (PD+FOG) relative to those without FOG (PD−FOG). Investigation of gait adaptation, or the ability to change gait patterns in response to external perturbations, is cerebellum-dependent, is a practical means of probing cerebellar integrity and may provide additional insights regarding the FOG phenomenon. Methods In this study, we investigated gait adaptation in PD and FOG by measuring after-effects, namely whole-body rotation, following stepping on a rotating disc in PD+FOG compared to PD−FOG and older healthy adults. We refer to the period of stepping on the rotating disc as the podokinetic (PK) stimulation and after-effects as podokinetic after-rotation (PKAR). Our primary measure of adaptation was the magnitude and rate of decay of the after-effects. Results We noted that PKAR was diminished in PD+FOG compared to the other groups, indicating reduced storage of the adapted gait pattern in PD+FOG. In the PD groups, FOG explained about 20% of the variability in peak velocity. Furthermore, these differences were independent of stepping cadence or motor sign severity. Conclusion Our results show that gait adaptation is impaired in PD+FOG, suggesting the cerebellum may be differentially impacted in PD+FOG compared to PD−FOG. This supports previous neuroimaging evidence of cerebellar dysfunction in PD+FOG. Overall, these data further our understanding of gait deficits in PD+FOG.

show abstract

A 12-year population-based study of freezing of gait in Parkinson's disease

Cited by 104 publications

References 30 publications

Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease

Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease

Pharmacological treatment in Parkinson's disease: Effects on gait

Reduced after-effects following podokinetic adaptation in people with Parkinson's disease and freezing of gait

Contact Info

Product

Resources

About