Poor sleep quality is associated with cognitive, mobility, and anxiety disability that underlie freezing of gait in Parkinson’s disease

Almeida, Filipe Oliveira de; Ugrinowitsch, Carlos; Milliato, Angelo; Marquesini, Raquel; Moreira-Neto, Acácio; Barbosa, Egberto Reis; Horak, Fay B.; Mancini, Martina; Silva‐Batista, Carla

doi:10.1016/j.gaitpost.2021.01.026

Cited by 11 publications

(8 citation statements)

References 28 publications

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“…In addition, we found that FOG continues to develop as PD progresses, which is in keeping with the fact that FOG is a characteristic motor phenotype of PD. We also found that there was no significant association between FOG and demographic characteristics such as sex and age, that patients with FOG had higher PSQI scores than those without FOG, which is consistent with previous reports of the association of poor sleep quality with cognitive, mobility, and anxiety‐related disabilities that underlie FOG in patients with PD 22 . Our study also found that higher dysfunction of swallow and turn over are the risk factors for FOG in two cohorts.…”

Section: Discussionsupporting

confidence: 91%

“…We also found that there was no significant association between FOG and demographic characteristics such as sex and age, that patients with FOG had higher PSQI scores than those without FOG, which is consistent with previous reports of the association of poor sleep quality with cognitive, mobility, and anxiety-related disabilities that underlie FOG in patients with PD. 22 Our study also found that higher dysfunction of swallow and turn over are the risk factors for FOG in two cohorts. One study 23 agreed that PD patients with signs for oropharyngeal freezing scored significantly higher in…”

Section: Discussionsupporting

confidence: 71%

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Development and validation of a nomogram for freezing of gait in patients with Parkinson's Disease

Zhu

Ning

et al. 2022

Acta Neuro Scandinavica

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Objectives Freezing of gait (FOG) is a common and complex disabling episodic gait disturbance in patients with Parkinson's disease (PD). Currently, the treatment of FOG remains a challenge for clinicians. The aim of our study was to develop a nomogram for FOG risk based on data collected from Chinese patients with PD. Materials & Methods A total of 379 PD patients (197 with FOG) from Kunming Medical University were recruited as a training cohort. Additionally, 339 PD patients (166 with FOG) were recruited from West China Hospital of Sichuan University, to serve as the validation cohort. The least absolute shrinkage and selection operator regression model was used to select clinical and demographic characteristics as well as blood markers, which were incorporated into a predictive model using multivariate logistic regression to predict the risk of developing FOG. The model was validated using the validation dataset, and model performance was evaluated using the C‐index, calibration plot, and decision curve analyses. Results The final predictive model included the REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) score, Parkinson's Disease Questionnaire (PDQ39), H‐Y stage, and visuospatial function. The model showed good calibration and good discrimination, with a C‐index value of 0.772 against the training cohort and 0.766 against the validation cohort. Decision curve analysis demonstrated the clinical utility of the nomogram. Conclusion A nomogram incorporating RBDSQ, PDQ39, H‐Y stage, and visuospatial function may reliably predict the risk of FOG in PD patients.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 71%

Development and validation of a nomogram for freezing of gait in patients with Parkinson's Disease

Zhu

Ning

et al. 2022

Acta Neuro Scandinavica

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“…Interestingly, a significant proportion of participants in all three arms reported sound sleep following the interventions. Lower sleep quality in patients with PD is related to decreased CLR and visuospatial functions and is associated with FOG and a decreased response to levodopa (56)(57)(58). Future studies could delve deeper into the sustained efficacy and psychological effects of TTA by objective measurements, other freezing symptoms such as hand movements and speech, and ON-state symptoms.…”

Section: Discussionmentioning

confidence: 99%

Comparing the efficacy of therapeutic Thai acupressure on plantar acupoints and laser cane therapy on freezing of gait in Parkinson’s disease: a randomized non-inferiority trial

Miyahara,

Phokaewvarangkul,

Kerr

et al. 2024

Front. Neurol.

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BackgroundON-freezing of gait (ON-FOG) in Parkinson’s disease (PD), often resistant to medication, is linked to sensory deficits and proprioceptive impairment, and results in falls and reduced life quality. While visual cues from a laser cane (LC), which rapidly accesses the motor cortex, are commonly used to compensate for proprioceptive impairment, increased visual reliance may be affected by disease progression. Emerging evidence suggests that modulation of peripheral sensory processing may alleviate ON-FOG, and therapeutic Thai acupressure (TTA) may be a solution. This study aims to evaluate the effect of TTA in alleviating ON-FOG and compare its effectiveness to LC in patients with PD.MethodsThis open-label, non-inferiority trial randomized 90 PD patients with ON-FOG equally into three arms: TTA for plantar nerve stimulation for 96 s, LC for visual cueing, and sham control (SC). Stride length was the primary non-inferiority endpoint [non-inferiority margin: lower limit of 95% confidence interval (CI) above −10 cm in mean change difference in pre- and immediately post-intervention in TTA versus LC (one-sided)]. Secondary outcomes included FOG episodes, double support time, velocity, cadence, step length, timed up and go (TUG) test, and visual analog scale (VAS) score.ResultsTTA showed non-inferiority to LC in stride length (mean = −0.7 cm; 95% CI: −6.55; 5.15) (one-sided). The improvements with TTA and LC versus SC were comparable between (mean = 13.11 cm; 95% CI: 7.26; 18.96) and (mean = 13.8 cm; 95% CI: 7.96; 19.65) (one-sided). Secondary outcomes favored TTA and LC over SC with improved FOG, velocity, step length, and VAS scores, while only TTA resulted in improved double support time, cadence, and TUG test results. No complications occurred.ConclusionThe efficacy of TTA, which improves stride length, is non-inferior to that of LC and consequently alleviates FOG comparable to LC. TTA might enhance proprioceptive function and reduce visual dependence. Therefore, TTA, characterized by its non-invasive, simple, and safe techniques, is a potential non-pharmacological alternative for ON-FOG treatment and might enhance overall quality of life. However, further research into the mechanism, efficacy, and utilization of TTA is essential.Clinical trial registrationhttps://www.thaiclinicaltrials.org/show/TCTR20200317001, identifier TCTR20200317001.

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“…Yet studies exploring the impact of poor sleep quality in PwPD are limited. Previous studies in PwPD correlated poor sleep quality with increased freezing of gait [25], gait deficits [26], impaired cognition, and mobility limitations [27]. However, the relationship of sleep quality with FOF and falls in PwPD has not been established.…”

Section: Introductionmentioning

confidence: 99%

Cognitive status and sleep quality can explain the fear of falling and fall history in people with Parkinson’s disease

Alissa,

Rehan,

Al-Sharman

et al. 2023

International Journal of Rehabilitation Research

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Fear of falling (FOF) is highly prevalent in people with Parkinson’s disease (PwPD) and contributes to high fall risk. Studies reporting on the relationship between falls, FOF, and non-motor factors such as cognitive function and sleep quality in Parkinson’s disease are limited. This study aimed to investigate (1) the relationship of cognitive function and sleep quality with FOF, and history of falls in PwPD; (2) differences in cognitive function and sleep quality between Parkinson’s disease fallers and non-fallers; and (3) a cut-off score for cognitive function and sleep quality to discriminate Parkinson’s disease fallers from non-fallers. Fifty PwPD were assessed for FOF [Falls Efficacy Scale-International (FES-I)], cognition [Montréal Cognitive Assessment (MOCA)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)], and falls history. The MOCA is significantly associated with FES-I scores (R 2 = 0.429, P < 0.0001). Both MOCA (P = 0.012) and PSQI (P = 0.027) were associated with falls history even after adjusting for confounding factors (age, sex, L-dopa use, Parkinson’s disease severity). Both MOCA and PSQI scores were able to distinguish fallers from non-fallers with cut-off scores of 15.5 and 7.5, respectively. Although our findings revealed that both cognitive function and sleep quality are important factors influencing falls and FOF in PwPD, it remains to be determined if addressing cognitive impairments and poor sleep quality may favorably impact balance before integrating such screenings into fall prevention programs.

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Poor sleep quality is associated with cognitive, mobility, and anxiety disability that underlie freezing of gait in Parkinson’s disease

Cited by 11 publications

References 28 publications

Development and validation of a nomogram for freezing of gait in patients with Parkinson's Disease

Development and validation of a nomogram for freezing of gait in patients with Parkinson's Disease

Comparing the efficacy of therapeutic Thai acupressure on plantar acupoints and laser cane therapy on freezing of gait in Parkinson’s disease: a randomized non-inferiority trial

Cognitive status and sleep quality can explain the fear of falling and fall history in people with Parkinson’s disease

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