Movement Disorders (revue)

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The clinical spectrum of freezing of gait in atypical parkinsonism

Identifieur interne : 000040 ( Istex/Corpus ); précédent : 000039; suivant : 000041

The clinical spectrum of freezing of gait in atypical parkinsonism

Auteurs : Stewart A. Factor

Source :

RBID : ISTEX:8C494CAC77747E578B261F3B896CD737EE92EAC8

English descriptors

Abstract

Freezing of gait (FOG), commonly seen in advanced Parkinson's disease (PD), has been classified as its fifth cardinal feature. However, its presence frequently leads to a misdiagnosis of PD. FOG is actually more common in atypical parkinsonism (AP): including vascular Parkinsonism (VP), progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD), dementia with Lewy bodies (DLB), and higher level gait disorders (HLGDs). VP is the result of multiple small vessel infarcts (lacunar state or Binswanger's disease), particularly involving the frontal, parietal, and basal ganglia regions. Approximately 50% have FOG (often referred to as lower body parkinsonism). FOG is also common in neurodegenerative forms of AP, present in 45–57%. Of these, FOG is present in 53% of PSP, 54% MSA, 54% DLB, 25% CBD, and 40% HLGD. It is generally seen in the late stages. There are two syndromes closely associated with AP that are dominated by FOG; pure akinesia (PA) and primary progressive freezing gait (PPFG). PA is characterized by akinesia of gait (including FOG), writing, and speech. Tremor, rigidity, dementia, and response to levodopa are notably absent. PPFG is defined by early FOG (often the initial feature) that progresses to include postural instability. It is accompanied by bradykinesia, rigidity, postural tremor, dementia, and levodopa unresponsiveness. Both syndromes are heterogeneous but PSP seems to be the most common cause. CBD and DLB can also present as PPFG. FOG is a common feature of AP and although typically occurring late in disease may also be an early symptom. © 2008 Movement Disorder Society

Url:
DOI: 10.1002/mds.21849

Links to Exploration step

ISTEX:8C494CAC77747E578B261F3B896CD737EE92EAC8

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<affiliation>Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA</affiliation>
<description>Correspondence: Department of Neurology, Emory University School of Medicine, 1841 Clifton Road NE, Atlanta, Georgia 30329</description>
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<dateIssued encoding="w3cdtf">2008</dateIssued>
<dateCaptured encoding="w3cdtf">2007-08-13</dateCaptured>
<dateValid encoding="w3cdtf">2007-10-17</dateValid>
<copyrightDate encoding="w3cdtf">2008</copyrightDate>
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<abstract lang="en">Freezing of gait (FOG), commonly seen in advanced Parkinson's disease (PD), has been classified as its fifth cardinal feature. However, its presence frequently leads to a misdiagnosis of PD. FOG is actually more common in atypical parkinsonism (AP): including vascular Parkinsonism (VP), progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD), dementia with Lewy bodies (DLB), and higher level gait disorders (HLGDs). VP is the result of multiple small vessel infarcts (lacunar state or Binswanger's disease), particularly involving the frontal, parietal, and basal ganglia regions. Approximately 50% have FOG (often referred to as lower body parkinsonism). FOG is also common in neurodegenerative forms of AP, present in 45–57%. Of these, FOG is present in 53% of PSP, 54% MSA, 54% DLB, 25% CBD, and 40% HLGD. It is generally seen in the late stages. There are two syndromes closely associated with AP that are dominated by FOG; pure akinesia (PA) and primary progressive freezing gait (PPFG). PA is characterized by akinesia of gait (including FOG), writing, and speech. Tremor, rigidity, dementia, and response to levodopa are notably absent. PPFG is defined by early FOG (often the initial feature) that progresses to include postural instability. It is accompanied by bradykinesia, rigidity, postural tremor, dementia, and levodopa unresponsiveness. Both syndromes are heterogeneous but PSP seems to be the most common cause. CBD and DLB can also present as PPFG. FOG is a common feature of AP and although typically occurring late in disease may also be an early symptom. © 2008 Movement Disorder Society</abstract>
<note type="content">*No potential conflicts of interest.</note>
<subject lang="en">
<genre>Keywords</genre>
<topic>freezing of gait</topic>
<topic>atypical parkinsonism</topic>
<topic>progressive supranuclear palsy</topic>
<topic>multiple system atrophy</topic>
<topic>corticobasal degeneration</topic>
<topic>diffuse Lewy body disease</topic>
<topic>pure akinesia</topic>
<topic>primary progressive freezing gait</topic>
<topic>vascular parkinsonism.</topic>
</subject>
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<title>Movement Disorders</title>
<subTitle>Official Journal of the Movement Disorder Society</subTitle>
</titleInfo>
<titleInfo type="abbreviated">
<title>Mov. Disord.</title>
</titleInfo>
<name type="personal">
<namePart type="termsOfAddress">Dr.</namePart>
<namePart type="family">Giladi</namePart>
</name>
<name type="personal">
<namePart type="termsOfAddress">Dr.</namePart>
<namePart type="family">Nieuwboer</namePart>
</name>
<subject>
<genre>article category</genre>
<topic>Review</topic>
</subject>
<identifier type="ISSN">0885-3185</identifier>
<identifier type="eISSN">1531-8257</identifier>
<identifier type="DOI">10.1002/(ISSN)1531-8257</identifier>
<identifier type="PublisherID">MDS</identifier>
<part>
<date>2008</date>
<detail type="volume">
<caption>vol.</caption>
<number>23</number>
</detail>
<detail type="issue">
<caption>no.</caption>
<number>S2</number>
</detail>
<detail type="supplement">
<caption>Suppl. no.</caption>
<number>S2</number>
</detail>
<extent unit="pages">
<start>S431</start>
<end>S438</end>
<total>8</total>
</extent>
</part>
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<identifier type="istex">8C494CAC77747E578B261F3B896CD737EE92EAC8</identifier>
<identifier type="DOI">10.1002/mds.21849</identifier>
<identifier type="ArticleID">MDS21849</identifier>
<accessCondition type="use and reproduction" contentType="copyright">Copyright © 2008 Movement Disorder Society</accessCondition>
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