Freezing of gait is associated with cognitive impairment in patients with Parkinson disease

Yao, Zhiwen; Shao, Yinlin; Han, Xiang

doi:10.1016/j.neulet.2017.07.004

Cited by 31 publications

(32 citation statements)

References 23 publications

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“…A number of studies have also demonstrated worse cognition in FOG across a number of domains, such as executive function and attention 10,12,13,21 . However, the majority of studies contain small sample sizes and as a result, often do not control for confounders which may affect cognition e.g.…”

Section: Discussionmentioning

confidence: 99%

Cognitive function in people with and without freezing of gait in Parkinson’s disease

Morris

Smulders

Peterson

et al. 2020

npj Parkinsons Dis.

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Freezing of gait (FOG) is common in people with Parkinson's disease (PD) which is extremely debilitating. One hypothesis for the cause of FOG episodes is impaired cognitive control, however, this is still in debate in the literature. We aimed to assess a comprehensive range of cognitive tests in older adults and people with Parkinson's with and without FOG and associate FOG severity with cognitive performance. A total of 227 participants took part in the study which included 80 healthy older adults, 81 people with PD who did not have FOG and 66 people with PD and FOG. A comprehensive battery of neuropsychological assessments tested cognitive domains of global cognition, executive function/attention, working memory, and visuospatial function. The severity of FOG was assessed using the new FOG questionnaire and an objective FOG severity score. Cognitive performance was compared between groups using an ANCOVA adjusting for age, gender, years of education and disease severity. Correlations between cognitive performance and FOG severity were analyzed using partial correlations. Cognitive differences were observed between older adults and PD for domains of global cognition, executive function/attention, and working memory. Between those with and without FOG, there were differences for global cognition and executive function/attention, but these differences disappeared when adjusting for covariates. There were no associations between FOG severity and cognitive performance. This study identified no significant difference in cognition between those with and without FOG when adjusting for covariates, particularly disease severity. This may demonstrate that complex rehabilitation programs may be undertaken in those with FOG.

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Section: Discussionmentioning

confidence: 99%

Cognitive function in people with and without freezing of gait in Parkinson’s disease

Morris

Smulders

Peterson

et al. 2020

npj Parkinsons Dis.

View full text Add to dashboard Cite

show abstract

“…Despite the fact that the size of the effect varies, interestingly, all the studies categorized within the “cognitive training” group obtained positive findings, thus emphasizing that cognitive dysfunction may play a role in the pathophysiology of FOG. Indeed, several lines of evidence have shown that cognitive impairment, particularly in executive function and attentional domains, is more frequent in patients with FOG . Curiously, patients with FOG have altered organization of the dorsal attention network, potentially explaining the higher risk of FOG during complex walking situations .…”

Section: Discussionmentioning

confidence: 99%

Nonpharmacological, Nonsurgical Treatments for Freezing of Gait in Parkinson's Disease: A Systematic Review

et al. 2019

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Freezing of gait is a disabling phenomenon that appears in a substantial number of Parkinson's disease (PD) patients as the disease evolves. It is considered to be one of the most relevant contributing factors to worsening of quality of life. Current pharmacological or surgical treatment options have limited efficacy. Thus, alternative nonpharmacological/nonsurgical approaches have emerged in recent years in an attempt to improve quality of life in PD. This systematic review summarizes studies of such therapies over the past 5 years. Thirty‐five studies were evaluated by use of a qualitative evaluation, while the methodological quality was assessed using validated tools. According to our results, there appear to be two broad categories of nonpharmacological therapies: those that seek a long‐lasting benefit and those that aim to achieve a transient effect to overcome the freezing of gait episode. Among the former, it is possible to differentiate between “passive” therapies, which include transcranial magnetic stimulation or transcranial direct current stimulation, and “active” therapies, which are based on different cognitive or physical training programs. Finally, “transient effect” therapies use different types of cues, such as visual, auditory, or proprioceptive stimuli, to attempt to shift the patient's habitual motor control to a goal‐directed one. In conclusion, a broad spectrum of nonpharmacological/nonsurgical approaches for freezing of gait has emerged in recent years with promising results. © 2019 International Parkinson and Movement Disorder Society

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“…This confirms findings of several studies reporting that increased muscle activity during REM sleep is a comorbid feature of patients with PD who exhibit FOG [ 74 , 76 , 79 ]. Yao et al ([ 78 ]) demonstrated that FOG is related to impaired cognitive functions in PD patients. They found a significant negative correlation between scores of FOG–Q and MMSE.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Relationship Between Hypokinetic Dysarthria and the Freezing of Gait in Parkinson’s Disease

et al. 2018

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Hypokinetic dysarthria (HD) and freezing of gait (FOG) are both axial symptoms that occur in patients with Parkinson’s disease (PD). It is assumed they have some common pathophysiological mechanisms and therefore that speech disorders in PD can predict FOG deficits within the horizon of some years. The aim of this study is to employ a complex quantitative analysis of the phonation, articulation and prosody in PD patients in order to identify the relationship between HD and FOG, and establish a mathematical model that would predict FOG deficits using acoustic analysis at baseline. We enrolled 75 PD patients who were assessed by 6 clinical scales including the Freezing of Gait Questionnaire (FOG–Q). We subsequently extracted 19 acoustic measures quantifying speech disorders in the fields of phonation, articulation and prosody. To identify the relationship between HD and FOG, we performed a partial correlation analysis. Finally, based on the selected acoustic measures, we trained regression models to predict the change in FOG during a 2-year follow-up. We identified significant correlations between FOG–Q scores and the acoustic measures based on formant frequencies (quantifying the movement of the tongue and jaw) and speech rate. Using the regression models, we were able to predict a change in particular FOG–Q scores with an error of between 7.4 and 17.0 %. This study is suggesting that FOG in patients with PD is mainly linked to improper articulation, a disturbed speech rate and to intelligibility. We have also proved that the acoustic analysis of HD at the baseline can be used as a predictor of the FOG deficit during 2 years of follow-up. This knowledge enables researchers to introduce new cognitive systems that predict gait difficulties in PD patients.

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Freezing of gait is associated with cognitive impairment in patients with Parkinson disease

Cited by 31 publications

References 23 publications

Cognitive function in people with and without freezing of gait in Parkinson’s disease

Cognitive function in people with and without freezing of gait in Parkinson’s disease

Nonpharmacological, Nonsurgical Treatments for Freezing of Gait in Parkinson's Disease: A Systematic Review

Quantitative Analysis of Relationship Between Hypokinetic Dysarthria and the Freezing of Gait in Parkinson’s Disease

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