Explaining freezing of gait in Parkinson's disease: motor and cognitive determinants.
Identifieur interne : 000D93 ( Main/Exploration ); précédent : 000D92; suivant : 000D94Explaining freezing of gait in Parkinson's disease: motor and cognitive determinants.
Auteurs : Sarah Vercruysse [Belgique] ; Hannes Devos ; Liesbeth Munks ; Joke Spildooren ; Jochen Vandenbossche ; Wim Vandenberghe ; Alice Nieuwboer ; Elke HeremansSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2012.
English descriptors
- KwdEn :
- Aged, Cognition Disorders (diagnosis), Cognition Disorders (etiology), Cross-Sectional Studies, Female, Freezing Reaction, Cataleptic (physiology), Gait Disorders, Neurologic (etiology), Humans, Logistic Models, Male, Middle Aged, Neuropsychological Tests, Parkinson Disease (complications), Postural Balance (physiology), Probability, Psychiatric Status Rating Scales.
- MESH :
- complications : Parkinson Disease.
- diagnosis : Cognition Disorders.
- etiology : Cognition Disorders, Gait Disorders, Neurologic.
- physiology : Freezing Reaction, Cataleptic, Postural Balance.
- Aged, Cross-Sectional Studies, Female, Humans, Logistic Models, Male, Middle Aged, Neuropsychological Tests, Probability, Psychiatric Status Rating Scales.
Abstract
Freezing of gait (FOG) is part of a complex clinical picture in Parkinson's disease (PD) and is largely refractory to standard care. Diverging hypotheses exist about its origins, but a consolidated view on what determines FOG is lacking. The aim of this study was to develop an integrative model of FOG in people with PD. This cross-sectional study included 51 Parkinson subjects: 24 patients without FOG and 27 with FOG matched for age, gender, and disease severity. Subjects underwent an extensive clinical test battery evaluating general disease characteristics, gait and balance, nongait freezing, and cognitive functions. The relative contribution of these outcomes to FOG was determined using logistic regression analysis. The combination of the following four independent contributors provided the best explanatory model of FOG (R(2) = 0.49): nongait freezing; levodopa equivalent dose (LED); cognitive impairment; and falls and balance problems. The model yields a high-risk profile for FOG (P > 95%) when Parkinson patients are affected by at least one type of nongait freezing (e.g., freezing of other repetitive movements), falls or balance problems during the last 3 months, and a Scales for Outcomes in Parkinson's Disease-Cognition score below 28. A high LED further increases the risk of FOG to 99%. Nongait freezing, increased dopaminergic drug dose, cognitive deficits, and falls and balance problems are independent determinants of FOG in people with PD and may play a synergistic role in its manifestation.
DOI: 10.1002/mds.25183
PubMed: 23115014
Affiliations:
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type="abstract" xml:lang="en">Freezing of gait (FOG) is part of a complex clinical picture in Parkinson's disease (PD) and is largely refractory to standard care. Diverging hypotheses exist about its origins, but a consolidated view on what determines FOG is lacking. The aim of this study was to develop an integrative model of FOG in people with PD. This cross-sectional study included 51 Parkinson subjects: 24 patients without FOG and 27 with FOG matched for age, gender, and disease severity. Subjects underwent an extensive clinical test battery evaluating general disease characteristics, gait and balance, nongait freezing, and cognitive functions. The relative contribution of these outcomes to FOG was determined using logistic regression analysis. The combination of the following four independent contributors provided the best explanatory model of FOG (R(2) = 0.49): nongait freezing; levodopa equivalent dose (LED); cognitive impairment; and falls and balance problems. The model yields a high-risk profile for FOG (P > 95%) when Parkinson patients are affected by at least one type of nongait freezing (e.g., freezing of other repetitive movements), falls or balance problems during the last 3 months, and a Scales for Outcomes in Parkinson's Disease-Cognition score below 28. A high LED further increases the risk of FOG to 99%. Nongait freezing, increased dopaminergic drug dose, cognitive deficits, and falls and balance problems are independent determinants of FOG in people with PD and may play a synergistic role in its manifestation.</div></front></TEI><affiliations><list><country><li>Belgique</li></country></list><tree><noCountry><name sortKey="Devos, Hannes" sort="Devos, Hannes" uniqKey="Devos H" first="Hannes" last="Devos">Hannes Devos</name><name sortKey="Heremans, Elke" sort="Heremans, Elke" uniqKey="Heremans E" first="Elke" last="Heremans">Elke Heremans</name><name sortKey="Munks, Liesbeth" sort="Munks, Liesbeth" uniqKey="Munks L" first="Liesbeth" last="Munks">Liesbeth Munks</name><name sortKey="Nieuwboer, Alice" sort="Nieuwboer, Alice" uniqKey="Nieuwboer A" first="Alice" last="Nieuwboer">Alice Nieuwboer</name><name sortKey="Spildooren, Joke" sort="Spildooren, Joke" uniqKey="Spildooren J" first="Joke" last="Spildooren">Joke Spildooren</name><name sortKey="Vandenberghe, Wim" sort="Vandenberghe, Wim" uniqKey="Vandenberghe W" first="Wim" last="Vandenberghe">Wim Vandenberghe</name><name sortKey="Vandenbossche, Jochen" sort="Vandenbossche, Jochen" uniqKey="Vandenbossche J" first="Jochen" last="Vandenbossche">Jochen Vandenbossche</name></noCountry><country name="Belgique"><noRegion><name sortKey="Vercruysse, Sarah" sort="Vercruysse, Sarah" uniqKey="Vercruysse S" first="Sarah" last="Vercruysse">Sarah Vercruysse</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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