Freezing of gait subtypes have different cognitive correlates in Parkinson's disease

Factor, Stewart A.; Scullin, Michael K.; Sollinger, Ann; Land, J.O.; Wood-Siverio, Cathy; Zanders, Lavezza; Freeman, Alan; Bliwise, Donald L.; Goldstein, Felicia C.

doi:10.1016/j.parkreldis.2014.09.023

Cited by 57 publications

(61 citation statements)

References 27 publications

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“…Finally, we found that the presence of hallucinations is an independent risk factor for PD patients with FOG, which verifies the findings of two observational studies (Factor et al., ; Virmani et al., ). It indicates that earlier cortical involvement could lead to gait impairment because numerous nonmotor features of PD are thought to be related to the presence of Lewy bodies in the cortex (Virmani et al., ).…”

Section: Discussionsupporting

confidence: 91%

Predictors of freezing of gait in Chinese patients with Parkinson's disease

Wei

Cao

et al. 2018

Brain and Behavior

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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.At baseline, freezers exhibited higher age, longer disease duration, higher scores in Unified PD Rating Scale (UPDRS) III and Hamilton Depression/Anxiety Rating Scale, lower Frontal Assessment Battery (FAB) score, higher subscores (e.g., "urgency") and frequencies (e.g., "hallucinations") in Non-Motor Symptoms Scale, higher annual changes in MoCA, UPDRS III and FAB scores, and higher incidences of festination and falls than nonfreezers (p < .05). The forward binary logistic regression model indicated that a longer disease duration, a higher UPDRS III score, higher annual changes in UPDRS III score and "visuospatial/executive abilities" subscore, onset in lower limbs, and the presence of festination, falls, and hallucinations were associated with the development of FOG. Conclusions:Patients with onset in the lower limbs and the presence of festination, falls, and hallucinations may be prone to develop FOG episodes. FOG also likely occurs with the deterioration of PD severity and visuospatial function.

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Section: Discussionsupporting

confidence: 91%

Predictors of freezing of gait in Chinese patients with Parkinson's disease

Wei

Cao

et al. 2018

Brain and Behavior

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“…This hypothesis is consistent with evidence that individuals with PD have difficulty with set-shifting in both cognitive and motor tasks (Chong et al, 2000; Dirnberger and Jahanshahi, 2013). Moreover, impairments in cognitive set-shifting are associated with freezing of gait, which has been characterized as an inability to switch from gait initiation to walking (Factor et al, 2014). For postural control, this results in motor patterns that are inappropriate for a given biomechanical context.…”

Section: Neuromechanics Of Motor Impairment and Rehabilitationmentioning

confidence: 99%

Neuromechanical Principles Underlying Movement Modularity and Their Implications for Rehabilitation

Ting

Chiel

Trumbower

et al. 2015

Neuron

341

317

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Summary Neuromechanical principles define the properties and problems that shape neural solutions for movement. Although the theoretical and experimental evidence is debated, we present arguments for consistent structures in motor patterns, i.e. motor modules, that are neuromechanical solutions for movement particular to an individual and shaped by evolutionary, developmental, and learning processes. As a consequence, motor modules may be useful in assessing sensorimotor deficits specific to an individual, and define targets for the rational development of novel rehabilitation therapies that enhance neural plasticity and sculpt motor recovery. We propose that motor module organization is disrupted and may be improved by therapy in spinal cord injury, stroke, and Parkinson’s disease. Recent studies provide insights into the yet unknown underlying neural mechanisms of motor modules, motor impairment and motor learning, and may lead to better understanding of the causal nature of modularity and its underlying neural substrates.

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“…Finally, the questionnaires were used to assess freezing status; however, for the most reliable assessment, FOG classification should be based on objective confirmation by an experienced observer during clinical assessment, particularly because participants with FOG in different medication states (eg, refs. ) may experience related fall risk at different times. These results suggest that these and other variables could potentially be very important during future prospective studies of fall risk.…”

Section: Discussionmentioning

confidence: 99%

“…No attempts were made to quantify FOG during motor examination or to query patients as to during which medication state FOG occurred (eg, refs. ).…”

Section: Methodsmentioning

confidence: 97%

Lower Limb Rigidity Is Associated with Frequent Falls in Parkinson's Disease

McKay

Hackney

Factor

et al. 2019

Movement Disord Clin Pract

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Background and Objective The role of muscle rigidity as an etiological factor of falls in Parkinson's disease (PD) is poorly understood. Our objective was to determine whether lower leg rigidity was differentially associated with frequent falls in PD compared to upper limb, neck, and total rigidity measures. Methods We examined the associations between Unified Parkinson's Disease Rating Scale–Part III (motor) rigidity subscores and the history of monthly or more frequent falls in 216 individuals with PD (age, 66 ± 10 years; 36% female; disease duration, 7 ± 5 years) with logistic regression. Results A total of 35 individuals were frequent fallers. Significant associations were identified between lower limb rigidity and frequent falls (P = 0.01) after controlling for age, sex, PD duration, total Unified Parkinson's Disease Rating Scale– Part III score, and presence of freezing of gait. No significant associations (P ≥ 0.14) were identified for total, arm, or neck rigidity. Conclusion Lower limb rigidity is related to frequent falls in people with PD. Further investigation may be warranted into how parkinsonian rigidity could cause falls.

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Freezing of gait subtypes have different cognitive correlates in Parkinson's disease

Cited by 57 publications

References 27 publications

Predictors of freezing of gait in Chinese patients with Parkinson's disease

Predictors of freezing of gait in Chinese patients with Parkinson's disease

Neuromechanical Principles Underlying Movement Modularity and Their Implications for Rehabilitation

Lower Limb Rigidity Is Associated with Frequent Falls in Parkinson's Disease

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