Heart rate changes during freezing of gait in patients with Parkinson's disease
Identifieur interne : 000096 ( Istex/Corpus ); précédent : 000095; suivant : 000097Heart rate changes during freezing of gait in patients with Parkinson's disease
Auteurs : Inbal Maidan ; Meir Plotnik ; Anat Mirelman ; Aner Weiss ; Nir Giladi ; Jeffrey M. HausdorffSource :
- Movement Disorders [ 0885-3185 ] ; 2010-10-30.
English descriptors
Abstract
Freezing of gait (FOG) is one of the most disabling symptoms that affect patients with Parkinson's disease (PD). Although the pathophysiology underlying FOG largely remains an enigma, several lines of evidence suggest that the autonomic nervous system might be involved. To this end, we tested the hypothesis that heart rate (HR) increases during FOG and, further, that HR increases just before FOG. To evaluate these hypotheses, 15 healthy older adults, 10 patients with PD who experienced FOG, and 10 patients who did not were studied. Patients with PD were tested during their “off” medication state. HR and HR variability were measured as subjects carried out tasks that frequently provoke FOG; 120 FOG episodes were evaluated. During FOG, HR increased (P = 0.001) by an average of 1.8 bpm, compared with HR measured before the beginning of FOG. HR also increased just before FOG, by 1 bpm (P < 0.0001). In contrast, during sudden stops and 180° turns, HR decreased by almost 2 bpm (P < 0.0001). HR variability was not associated with FOG. To our knowledge, these findings are the first to document the association of FOG to autonomic system activation, as manifested by HR dynamics. One explanation is that the changes in HR before and during FOG may be a sympathetic response that, secondary to limbic activation, contributes to the development of freezing. Although further studies are needed to evaluate these associations, the current results provide experimental evidence linking impaired motor blockades to autonomic nervous system function among patients with PD. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.23280
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<front><div type="abstract" xml:lang="en">Freezing of gait (FOG) is one of the most disabling symptoms that affect patients with Parkinson's disease (PD). Although the pathophysiology underlying FOG largely remains an enigma, several lines of evidence suggest that the autonomic nervous system might be involved. To this end, we tested the hypothesis that heart rate (HR) increases during FOG and, further, that HR increases just before FOG. To evaluate these hypotheses, 15 healthy older adults, 10 patients with PD who experienced FOG, and 10 patients who did not were studied. Patients with PD were tested during their “off” medication state. HR and HR variability were measured as subjects carried out tasks that frequently provoke FOG; 120 FOG episodes were evaluated. During FOG, HR increased (P = 0.001) by an average of 1.8 bpm, compared with HR measured before the beginning of FOG. HR also increased just before FOG, by 1 bpm (P < 0.0001). In contrast, during sudden stops and 180° turns, HR decreased by almost 2 bpm (P < 0.0001). HR variability was not associated with FOG. To our knowledge, these findings are the first to document the association of FOG to autonomic system activation, as manifested by HR dynamics. One explanation is that the changes in HR before and during FOG may be a sympathetic response that, secondary to limbic activation, contributes to the development of freezing. Although further studies are needed to evaluate these associations, the current results provide experimental evidence linking impaired motor blockades to autonomic nervous system function among patients with PD. © 2010 Movement Disorder Society</div>
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<abstract>Freezing of gait (FOG) is one of the most disabling symptoms that affect patients with Parkinson's disease (PD). Although the pathophysiology underlying FOG largely remains an enigma, several lines of evidence suggest that the autonomic nervous system might be involved. To this end, we tested the hypothesis that heart rate (HR) increases during FOG and, further, that HR increases just before FOG. To evaluate these hypotheses, 15 healthy older adults, 10 patients with PD who experienced FOG, and 10 patients who did not were studied. Patients with PD were tested during their “off” medication state. HR and HR variability were measured as subjects carried out tasks that frequently provoke FOG; 120 FOG episodes were evaluated. During FOG, HR increased (P = 0.001) by an average of 1.8 bpm, compared with HR measured before the beginning of FOG. HR also increased just before FOG, by 1 bpm (P > 0.0001). In contrast, during sudden stops and 180° turns, HR decreased by almost 2 bpm (P > 0.0001). HR variability was not associated with FOG. To our knowledge, these findings are the first to document the association of FOG to autonomic system activation, as manifested by HR dynamics. One explanation is that the changes in HR before and during FOG may be a sympathetic response that, secondary to limbic activation, contributes to the development of freezing. Although further studies are needed to evaluate these associations, the current results provide experimental evidence linking impaired motor blockades to autonomic nervous system function among patients with PD. © 2010 Movement Disorder Society</abstract>
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<notesStmt><note type="content">*The funding agencies were not involved with data collection, data analysis, or manuscript preparation.</note>
<note type="content">*Potential conflict of interest: The authors have no competing interests to disclose.</note>
<note>The European Commission in the context of FP6 projects DAPHNet - No. fet‐018474‐2;</note>
<note>SENSACTION‐AAL - No. infso‐ist‐045622;</note>
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<correspondenceTo>Laboratory for Gait and Neurodynamics, Tel Aviv Sourarsky Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel</correspondenceTo>
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<titleGroup><title type="main" xml:lang="en">Heart rate changes during freezing of gait in patients with Parkinson's disease<link href="#fn1"></link>
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<title type="short" xml:lang="en">Heart Rate Changes During Freezing of Gait</title>
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<creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Inbal</givenNames>
<familyName>Maidan</familyName>
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<creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Meir</givenNames>
<familyName>Plotnik</familyName>
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<familyName>Mirelman</familyName>
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<creator xml:id="au5" creatorRole="author" affiliationRef="#af1 #af3"><personName><givenNames>Nir</givenNames>
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<creator xml:id="au6" creatorRole="author" affiliationRef="#af1 #af2 #af4" corresponding="yes"><personName><givenNames>Jeffrey M.</givenNames>
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<contactDetails><email>jhausdor@tasmc.health.gov.il</email>
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<keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword>
<keyword xml:id="kwd2">gait</keyword>
<keyword xml:id="kwd3">heart rate</keyword>
<keyword xml:id="kwd4">autonomic nervous system</keyword>
<keyword xml:id="kwd5">freezing of gait</keyword>
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<fundingInfo><fundingAgency>The European Commission in the context of FP6 projects DAPHNet</fundingAgency>
<fundingNumber>fet‐018474‐2</fundingNumber>
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<fundingInfo><fundingAgency>SENSACTION‐AAL</fundingAgency>
<fundingNumber>infso‐ist‐045622</fundingNumber>
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<fundingInfo><fundingAgency>The National Parkinson Foundation</fundingAgency>
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<abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title>
<p>Freezing of gait (FOG) is one of the most disabling symptoms that affect patients with Parkinson's disease (PD). Although the pathophysiology underlying FOG largely remains an enigma, several lines of evidence suggest that the autonomic nervous system might be involved. To this end, we tested the hypothesis that heart rate (HR) increases during FOG and, further, that HR increases just before FOG. To evaluate these hypotheses, 15 healthy older adults, 10 patients with PD who experienced FOG, and 10 patients who did not were studied. Patients with PD were tested during their “off” medication state. HR and HR variability were measured as subjects carried out tasks that frequently provoke FOG; 120 FOG episodes were evaluated. During FOG, HR increased (<i>P</i>
= 0.001) by an average of 1.8 bpm, compared with HR measured before the beginning of FOG. HR also increased just before FOG, by 1 bpm (<i>P</i>
< 0.0001). In contrast, during sudden stops and 180° turns, HR decreased by almost 2 bpm (<i>P</i>
< 0.0001). HR variability was not associated with FOG. To our knowledge, these findings are the first to document the association of FOG to autonomic system activation, as manifested by HR dynamics. One explanation is that the changes in HR before and during FOG may be a sympathetic response that, secondary to limbic activation, contributes to the development of freezing. Although further studies are needed to evaluate these associations, the current results provide experimental evidence linking impaired motor blockades to autonomic nervous system function among patients with PD. © 2010 Movement Disorder Society</p>
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<noteGroup><note xml:id="fn1"><p>The funding agencies were not involved with data collection, data analysis, or manuscript preparation.</p>
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<note xml:id="fn2"><p>Potential conflict of interest: The authors have no competing interests to disclose.</p>
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<titleInfo type="abbreviated" lang="en"><title>Heart Rate Changes During Freezing of Gait</title>
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<abstract lang="en">Freezing of gait (FOG) is one of the most disabling symptoms that affect patients with Parkinson's disease (PD). Although the pathophysiology underlying FOG largely remains an enigma, several lines of evidence suggest that the autonomic nervous system might be involved. To this end, we tested the hypothesis that heart rate (HR) increases during FOG and, further, that HR increases just before FOG. To evaluate these hypotheses, 15 healthy older adults, 10 patients with PD who experienced FOG, and 10 patients who did not were studied. Patients with PD were tested during their “off” medication state. HR and HR variability were measured as subjects carried out tasks that frequently provoke FOG; 120 FOG episodes were evaluated. During FOG, HR increased (P = 0.001) by an average of 1.8 bpm, compared with HR measured before the beginning of FOG. HR also increased just before FOG, by 1 bpm (P < 0.0001). In contrast, during sudden stops and 180° turns, HR decreased by almost 2 bpm (P < 0.0001). HR variability was not associated with FOG. To our knowledge, these findings are the first to document the association of FOG to autonomic system activation, as manifested by HR dynamics. One explanation is that the changes in HR before and during FOG may be a sympathetic response that, secondary to limbic activation, contributes to the development of freezing. Although further studies are needed to evaluate these associations, the current results provide experimental evidence linking impaired motor blockades to autonomic nervous system function among patients with PD. © 2010 Movement Disorder Society</abstract>
<note type="content">*The funding agencies were not involved with data collection, data analysis, or manuscript preparation.</note>
<note type="content">*Potential conflict of interest: The authors have no competing interests to disclose.</note>
<note type="funding">The European Commission in the context of FP6 projects DAPHNet - No. fet‐018474‐2; </note>
<note type="funding">SENSACTION‐AAL - No. infso‐ist‐045622; </note>
<note type="funding">The National Parkinson Foundation</note>
<subject lang="en"><genre>Keywords</genre>
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<topic>gait</topic>
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<topic>freezing of gait</topic>
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