Heart rate changes during freezing of gait in patients with Parkinson's disease
Identifieur interne : 002D87 ( Ncbi/Merge ); précédent : 002D86; suivant : 002D88Heart rate changes during freezing of gait in patients with Parkinson's disease
Auteurs : I. Maidan [Israël] ; M. Plotnik ; A. Mirelman [États-Unis] ; N. Giladi [Israël] ; J. M. Hausdorff [Israël, États-Unis]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2010.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Analysis of Variance, Blood Pressure (physiology), Electrocardiography (methods), Female, Freezing Reaction, Cataleptic (physiology), Gait Disorders, Neurologic (etiology), Heart Rate (physiology), Humans, Male, Middle Aged, Parkinson Disease (complications), Walking (physiology).
- MESH :
- complications : Parkinson Disease.
- etiology : Gait Disorders, Neurologic.
- methods : Electrocardiography.
- physiology : Blood Pressure, Freezing Reaction, Cataleptic, Heart Rate, Walking.
- Aged, Aged, 80 and over, Analysis of Variance, Female, Humans, Male, Middle Aged.
Abstract
Freezing of gait (FOG) is one of the most disabling symptoms that affect patients with Parkinson's disease (PD). While the patho-physiology 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 prior to FOG. To evaluate these hypotheses, fifteen healthy older adults, ten patients with PD who experienced FOG and ten 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, as compared to HR measured before the beginning of FOG. HR also increased just prior to 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, secondary to limbic activation, that contributes to the development of freezing. While further studies are needed to evaluate these associations, the present results provide experimental evidence linking impaired motor blockades to autonomic nervous system function among patients with PD.
Url:
DOI: 10.1002/mds.23280
PubMed: 20721914
PubMed Central: 2964413
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PMC:2964413Le document en format XML
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<front><div type="abstract" xml:lang="en"><p id="P5">Freezing of gait (FOG) is one of the most disabling symptoms that affect patients with Parkinson's disease (PD). While the patho-physiology 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 prior to FOG. To evaluate these hypotheses, fifteen healthy older adults, ten patients with PD who experienced FOG and ten 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, as compared to HR measured before the beginning of FOG. HR also increased just prior to 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, secondary to limbic activation, that contributes to the development of freezing. While further studies are needed to evaluate these associations, the present results provide experimental evidence linking impaired motor blockades to autonomic nervous system function among patients with PD.</p>
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<front><div type="abstract" xml:lang="en"><p id="P5">Freezing of gait (FOG) is one of the most disabling symptoms that affect patients with Parkinson's disease (PD). While the patho-physiology 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 prior to FOG. To evaluate these hypotheses, fifteen healthy older adults, ten patients with PD who experienced FOG and ten 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, as compared to HR measured before the beginning of FOG. HR also increased just prior to 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, secondary to limbic activation, that contributes to the development of freezing. While further studies are needed to evaluate these associations, the present results provide experimental evidence linking impaired motor blockades to autonomic nervous system function among patients with PD.</p>
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<wicri:regionArea>Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv</wicri:regionArea>
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</affiliation>
</author>
<author><name sortKey="Plotnik, Meir" sort="Plotnik, Meir" uniqKey="Plotnik M" first="Meir" last="Plotnik">Meir Plotnik</name>
</author>
<author><name sortKey="Mirelman, Anat" sort="Mirelman, Anat" uniqKey="Mirelman A" first="Anat" last="Mirelman">Anat Mirelman</name>
</author>
<author><name sortKey="Weiss, Aner" sort="Weiss, Aner" uniqKey="Weiss A" first="Aner" last="Weiss">Aner Weiss</name>
</author>
<author><name sortKey="Giladi, Nir" sort="Giladi, Nir" uniqKey="Giladi N" first="Nir" last="Giladi">Nir Giladi</name>
</author>
<author><name sortKey="Hausdorff, Jeffrey M" sort="Hausdorff, Jeffrey M" uniqKey="Hausdorff J" first="Jeffrey M" last="Hausdorff">Jeffrey M. Hausdorff</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PubMed</idno>
<date when="2010">2010</date>
<idno type="doi">10.1002/mds.23280</idno>
<idno type="RBID">pubmed:20721914</idno>
<idno type="pmid">20721914</idno>
<idno type="wicri:Area/PubMed/Corpus">001630</idno>
<idno type="wicri:Area/PubMed/Curation">001630</idno>
<idno type="wicri:Area/PubMed/Checkpoint">001853</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en">Heart rate changes during freezing of gait in patients with Parkinson's disease.</title>
<author><name sortKey="Maidan, Inbal" sort="Maidan, Inbal" uniqKey="Maidan I" first="Inbal" last="Maidan">Inbal Maidan</name>
<affiliation wicri:level="1"><nlm:affiliation>Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.</nlm:affiliation>
<country xml:lang="fr">Israël</country>
<wicri:regionArea>Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv</wicri:regionArea>
<wicri:noRegion>Tel-Aviv</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Plotnik, Meir" sort="Plotnik, Meir" uniqKey="Plotnik M" first="Meir" last="Plotnik">Meir Plotnik</name>
</author>
<author><name sortKey="Mirelman, Anat" sort="Mirelman, Anat" uniqKey="Mirelman A" first="Anat" last="Mirelman">Anat Mirelman</name>
</author>
<author><name sortKey="Weiss, Aner" sort="Weiss, Aner" uniqKey="Weiss A" first="Aner" last="Weiss">Aner Weiss</name>
</author>
<author><name sortKey="Giladi, Nir" sort="Giladi, Nir" uniqKey="Giladi N" first="Nir" last="Giladi">Nir Giladi</name>
</author>
<author><name sortKey="Hausdorff, Jeffrey M" sort="Hausdorff, Jeffrey M" uniqKey="Hausdorff J" first="Jeffrey M" last="Hausdorff">Jeffrey M. Hausdorff</name>
</author>
</analytic>
<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
<idno type="eISSN">1531-8257</idno>
<imprint><date when="2010" type="published">2010</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Analysis of Variance</term>
<term>Blood Pressure (physiology)</term>
<term>Electrocardiography (methods)</term>
<term>Female</term>
<term>Freezing Reaction, Cataleptic (physiology)</term>
<term>Gait Disorders, Neurologic (etiology)</term>
<term>Heart Rate (physiology)</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Parkinson Disease (complications)</term>
<term>Walking (physiology)</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Gait Disorders, Neurologic</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Electrocardiography</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Blood Pressure</term>
<term>Freezing Reaction, Cataleptic</term>
<term>Heart Rate</term>
<term>Walking</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Analysis of Variance</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<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.</div>
</front>
</TEI>
</pubmed>
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