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Parkinson's FOG

Jana Seuthe, Nicholas D'Cruz, Pieter Ginis, Burkhard Weisser, Daniela Berg, Günther Deuschl, Alice Nieuwboer, Christian Schlenstedt
BACKGROUND: Walking on a split-belt treadmill (SBT) can help to modulate an asymmetric gait, particularly for people with neurological conditions, such as Parkinson's disease (PD), where asymmetry plays a role due to the laterality of the disease. RESEARCH QUESTION: This systematic review critically evaluates the literature on SBT in PD. First, different SBT paradigms and methodological approaches were evaluated. Second, the review explored how people with PD adapt their gait to different SBT conditions compared to healthy controls (HC)...
February 7, 2019: Gait & Posture
Catalina Punin, Boris Barzallo, Roger Clotet, Alexander Bermeo, Marco Bravo, Juan Pablo Bermeo, Carlos Llumiguano
A critical symptom of Parkinson's disease (PD) is the occurrence of Freezing of Gait (FOG), an episodic disorder that causes frequent falls and consequential injuries in PD patients. There are various auditory, visual, tactile, and other types of stimulation interventions that can be used to induce PD patients to escape FOG episodes. In this article, we describe a low cost wearable system for non-invasive gait monitoring and external delivery of superficial vibratory stimulation to the lower extremities triggered by FOG episodes...
February 12, 2019: Sensors
Nicolaas I Bohnen, Prabesh Kanel, Zhi Zhou, Robert A Koeppe, Kirk A Frey, William T Dauer, Roger L Albin, Martijn L T M Müller
OBJECTIVE: Postural instability and gait difficulties (PIGD) represent debilitating disturbances in Parkinson's disease (PD). Prior acetylcholinesterase PET imaging studies implicate cholinergic changes as significant contributors to PIGD features. These studies were limited in quantification of striatal cholinergic synapse integrity. Vesicular acetylcholine transporter (VAChT) PET ligands are better suited for evaluation of high binding areas. We examined associations between regional VAChT expression and freezing of gait (FoG) and falls...
February 5, 2019: Annals of Neurology
Carine Karachi, Florence Cormier-Dequaire, David Grabli, Brian Lau, Hayat Belaid, Soledad Navarro, Marie Vidailhet, Eric Bardinet, Sara Fernandez-Vidal, Marie-Laure Welter
INTRODUCTION: Freezing of gait (FOG) and falls are the most disabling motor symptoms in Parkinson's disease (PD) patients. The effects of subthalamic deep-brain-stimulation (STN-DBS) on FOG and falls are still a matter of controversy, and factors contributing to their outcome have yet to be defined. METHODS: We examined the relationship between FOG and falls after STN-DBS and preoperative clinical features, MRI voxel-based-morphometry (VBM) analysis and statistical mapping of electrode locations...
January 24, 2019: Parkinsonism & related Disorders
Huiqing Hu, Jingwu Chen, Huiyuan Huang, Caihong Zhou, Shufei Zhang, Xian Liu, Lijuan Wang, Ping Chen, Kun Nie, Lixiang Chen, Shuai Wang, Biao Huang, Ruiwang Huang
Freezing of gait (FOG), a disabling symptom of Parkinson's disease (PD), severely affects PD patients' life quality. Previous studies found neuropathologies in functional connectivity related to FOG, but few studies detected abnormal regional activities related to FOG in PD patients. In the present study, we analyzed the amplitude of low-frequency fluctuations (ALFF) to detect brain regions showing abnormal activity in PD patients with FOG (PD-with-FOG) and without FOG (PD-without-FOG). As different frequencies of neural oscillations in brain may reflect distinct brain functional and physiological properties, we conducted this study in three frequency bands, slow-5 (0...
January 21, 2019: Brain Imaging and Behavior
J S Prusch, A F R Kleiner, A P Salazar, C Pinto, R R Marchese, M Galli, A S Pagnussat
Individuals with Parkinson's disease (PD) and freezing of gait (FOG) have impaired postural control. Recent studies using foot sensory stimulation delivered by means of automated mechanical peripheral stimulation (AMPS) have demonstrated improvements of gait in individuals with PD. This study aimed to investigate the effects of AMPS on postural control in individuals with PD and FOG. Thirty-three subjects participated in this randomized controlled trial. Participants were allocated to two groups: AMPS and AMPS SHAM...
October 2018: Functional Neurology
Ilaria Clerici, Roberto Maestri, Francesca Bonetti, Paola Ortelli, Daniele Volpe, Davide Ferrazzoli, Giuseppe Frazzitta
Background: Freezing of gait (FOG) is one of the most disabling symptoms of Parkinson disease (PD). It has been found that different land-based rehabilitation approaches based on motor and cognitive strategies could be effective for treating FOG. At the same time, there are data about the efficacy of aquatic therapy (AT) in ameliorating this phenomenon. No 1 study has explored the combined effect of land plus AT in patients with PD who have FOG. Objective: The objective was to investigate the effectiveness of a multidisciplinary, intensive, motor-cognitive rehabilitation treatment (MIRT) in improving FOG and whether the implementation with AT (MIRT-AT) adds further benefits...
January 17, 2019: Physical Therapy
Ryul Kim, Han-Joon Kim, Chaewon Shin, Hyeyoung Park, Aryun Kim, Sun Ha Paek, Beomseok Jeon
OBJECTIVESubthalamic nucleus deep brain stimulation (STN DBS) is effective against freezing of gait (FOG) in Parkinson's disease (PD); however, whether this effect persists over the long term is debated. The aim of the current study was to investigate the long-term effect of STN DBS on FOG in patients with PD.METHODSData on 52 cases in which PD patients received bilateral STN DBS were obtained from a prospective registry. The authors blindly analyzed FOG incidence and its severity from the videotapes of a 5-m walking task at the baseline and at the 1-, 2-, and 5- or 7-year follow-up visits...
January 11, 2019: Journal of Neurosurgery
Elie Matar, James M Shine, Moran Gilat, Kaylena A Ehgoetz Martens, Philip B Ward, Michael J Frank, Ahmed A Moustafa, Sharon L Naismith, Simon J G Lewis
Freezing of gait (FOG) in Parkinson's disease (PD) is frequently triggered upon passing through narrow spaces such as doorways. However, despite being common the neural mechanisms underlying this phenomenon are poorly understood. In our study, 19 patients who routinely experience FOG performed a previously validated virtual reality (VR) gait paradigm where they used foot-pedals to navigate a series of doorways. Patients underwent testing randomised between both their "ON" and "OFF" medication states...
January 13, 2019: Human Brain Mapping
Fumin Jia, Aparna Wagle Shukla, Wei Hu, Leonardo Almeida, Vanessa Holanda, Jianguo Zhang, Fangang Meng, Michael S Okun, Luming Li
Introduction: Deep brain stimulation (DBS) with high frequency (HFS) is a well-established therapy for Parkinson's disease (PD); however, low frequency DBS (LFS) may control axial symptoms including freezing of gait (FOG). We conducted a pilot safety and feasibility study to examine if a novel DBS paradigm of variable frequency stimulation (VFS) that combined HFS and LFS would capture a broader set of motor symptoms. Methods: Four PD patients with bilateral STN DBS and FOG were enrolled...
September 2018: Movement Disorders Clinical Practice
Shweta Prasad, Abhishek Lenka, Albert Stezin, Rajini M Naduthota, Menka Jha, Ravi Yadav, Pramod Kumar Pal
Background: Freezing of gait (FOG) is a common and debilitating symptom in Parkinson's disease (PD); the pathogenesis and natural course of which has not been fully understood. Objectives: This study was performed to evaluate patients with FOG in PD and ascertain factors contributing to an early onset of FOG in patients with PD. Methodology: A chart review of 100 patients with PD (FOG [+] 50, FOG [-]: 50) was performed. FOG (+) patients were subdivided by a median split of time from motor onset to development of FOG (median: 6 years) into early onset FOG (EOFOG [n = 24]) and late onset FOG ( n = 26)...
October 2018: Annals of Indian Academy of Neurology
Lacramioara Dranca, Lopez de Abetxuko Ruiz de Mendarozketa, Alfredo Goñi, Arantza Illarramendi, Irene Navalpotro Gomez, Manuel Delgado Alvarado, María Cruz Rodríguez-Oroz
BACKGROUND: Parkinson's Disease (PD) is a chronic neurodegenerative disease associated with motor problems such as gait impairment. Different systems based on 3D cameras, accelerometers or gyroscopes have been used in related works in order to study gait disturbances in PD. Kinect Ⓡ has also been used to build these kinds of systems, but contradictory results have been reported: some works conclude that Kinect does not provide an accurate method of measuring gait kinematics variables, but others, on the contrary, report good accuracy results...
December 10, 2018: BMC Bioinformatics
Vittorio Rispoli, Nico Golfrè Andreasi, Giovanna Penna, Francesca Preda, Eleonora Contini, Mariachiara Sensi
Background: Gait and balance disorders in advanced Parkinson's disease (aPD) heavily impact the disease burden. In this prospective observational open-label study, our aim was to evaluate the effectiveness of levodopa/carbidopa intestinal gel (LCIG) infusion on balance and gait over a long-term follow-up. Methods: The motor status of 15 aPD patients with balance and gait symptoms was assessed with UPDRS (I-IV) and H&Y at baseline in OFF and ON conditions, and after 52 weeks of LCIG infusion...
September 2018: Movement Disorders Clinical Practice
Ryul Kim, Joongyub Lee, Han-Joon Kim, Aryun Kim, Mihee Jang, Beomseok Jeon, Un Jung Kang
OBJECTIVE: To determine whether CSF biomarkers can be used as a predictor of freezing of gait (FOG) in Parkinson disease (PD) and to investigate the predictive value of clinical, dopamine transporter (DAT) imaging, and CSF parameters both separately and in combination. METHODS: This study using the PPMI data included 393 patients with newly diagnosed PD without FOG at baseline. We evaluated CSF for β-amyloid 1-42 (Aβ42 ), α-synuclein, total tau, phosphorylated tau181 , and the calculated ratio of Aβ42 to total tau at baseline...
January 1, 2019: Neurology
Brent Bluett, Ece Bayram, Irene Litvan
INTRODUCTION: Freezing of gait is an episodic inability to move the feet forward despite the intention to walk. It is a common cause of falls and subsequent morbidity and mortality in Parkinson's disease. Virtual reality paradigms provide an opportunity to safely evaluate freezing of gait, in order to better understand the underlying pathophysiology. This article focuses on the methodology, threshold used to define freezing of gait, results, limitations of studies using virtual reality paradigms, and proposes future directions of research...
November 15, 2018: Parkinsonism & related Disorders
Ana Francisca Rozin Kleiner, Diana M Cubillos, C Pinto, A P Salazar, R R Marchese, R M L Barros, M Galli, A S Pagnussat
The required coefficient of friction (RCOF) is frequently reported in the literature as an indicator of slip propensity, a consequence of the collisional aspect of legged locomotion. Little is known about the RCOF in pathological gait. Therefore, this study aimed to quantify the RCOF in subjects with Parkinson's disease (PD) and freezing of gait (FOG) during the OFF-pharma phase, and to investigate the interplay between RCOF parameters and ankle kinematic and kinetic gait variables. Fourteen subjects with PD and 14 healthy age-matched subjects were instructed to walk barefoot at self-selected speed over a force platform...
July 2018: Functional Neurology
Komal Bharti, Antonio Suppa, Sara Pietracupa, Neeraj Upadhyay, Costanza Giannì, Giorgio Leodori, Francesca Di Biasio, Nicola Modugno, Nikolaos Petsas, Giovanni Grillea, Alessandro Zampogna, Alfredo Berardelli, Patrizia Pantano
In this study, we aimed to evaluate the importance of cerebellum in freezing of gait (FOG) pathophysiology. Due to the fundamental role of the cerebellum in posture and gait control, we examined cerebellar structural and functional connectivity (FC) in patients with PD and FOG. We recruited 15 PD with FOG (PD-FOG), 16 PD without FOG (PD-nFOG) patients, and 16 healthy subjects (HS). The FOG Questionnaire (FOG-Q) assessed FOG severity. Three tesla-MRI study included resting-state functional MRI, diffusion tensor imaging (DTI), and 3D T1-w images...
November 3, 2018: Cerebellum
Seong-Min Choi, Hyun-Jung Jung, Geum-Jin Yoon, Byeong C Kim
BACKGROUND: Freezing of gait (FOG) is a common and debilitating problem in patients with Parkinson's disease (PD). The aim of this study was to estimate the prevalence of FOG, and to identify factors that independently contribute to FOG in patients with PD. METHOD: We included 157 PD patients. FOG was assessed using the FOG Questionnaire (FOG-Q). Patients with or without FOG were defined as item 3 in the FOG-Q. RESULTS: One hundred eleven (70...
November 1, 2018: Neurological Sciences
Alberto Romagnolo, Maurizio Zibetti, Aristide Merola, Daniela Canova, Marianna Sarchioto, Elisa Montanaro, Carlo Alberto Artusi, Fabrizio Vallelonga, Simona Maule, Leonardo Lopiano
BACKGROUND: Falls represent one of the main complications of Parkinson's disease (PD), significantly lowering quality of life. Cardiovascular autonomic neuropathy (cAN) is one of the key contributing factors to PD-associated falls. However, a direct quantification of its impact on the risk of falling in PD is still lacking. In this 12-month prospective study, we sought to evaluate the association between cAN and falls. METHODS: Fifty consecutive patients were evaluated with a standardized battery of autonomic testing, Unified Parkinson's Disease Rating Scale, push and release (P&R) test, timed up and go test, freezing of gait (FOG) questionnaire, Montreal cognitive assessment (MoCA)...
October 31, 2018: Journal of Neurology
Helena Gonçalves, Rui Moreira, Ana Rodrigues, Cristina Santos
Freezing of Gait (FOG) is one of the most disabling gait disorders in Parkinson's Disease (PD), for which the efficacy of the medication is reduced, highlighting the use of non-pharmacological solutions. In particular, patients present less difficulties in overcoming FOG when using feedback and especially with Biofeedback Systems. In this study it is intended to detect the frequency threshold and the minimum interval of perception of the vibrotactile feedback, through a proposed wearable system, a waistband...
October 13, 2018: Journal of Medical Systems
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