Heart rate changes during freezing of gait in patients with Parkinson's disease
Identifieur interne : 000109 ( Pmc/Curation ); précédent : 000108; suivant : 000110Heart 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.
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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<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>
</div>
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<title-group><article-title>Heart rate changes during freezing of gait in patients with Parkinson's disease</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Maidan</surname>
<given-names>I.</given-names>
</name>
<degrees>MScPT</degrees>
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<given-names>M.</given-names>
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<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A4">4</xref>
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<contrib contrib-type="author"><name><surname>A.Weiss</surname>
</name>
<degrees>BS</degrees>
<xref ref-type="aff" rid="A1">1</xref>
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<contrib contrib-type="author"><name><surname>Giladi</surname>
<given-names>N.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A3">3</xref>
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<aff id="A1"><label>1</label>
Movement Disorders Unit, Dept of Neurology, Tel-Aviv Sourasky Medical Center</aff>
<aff id="A2"><label>2</label>
Dept of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Israel</aff>
<aff id="A3"><label>3</label>
Dept of Neurology, Sackler Faculty of Medicine, Tel-Aviv University, Israel</aff>
<aff id="A4"><label>4</label>
Harvard Medical School, Boston, MA</aff>
<author-notes><fn id="FN1"><p id="P1"><bold>AUTHOR ROLES</bold>
<list list-type="order" id="L1"><list-item><p id="P2">Research project: A. Conception, B. Organization, C. Execution;</p>
</list-item>
<list-item><p id="P3">Statistical Analysis: A. Design, B. Execution, C. Review and Critique;</p>
</list-item>
<list-item><p id="P4">Manuscript: A. Writing of the first draft, B. Review and Critique;</p>
</list-item>
</list>
Maidan 1a 1b 1c 2b 2c 3a 3b Plotnik 1a 1b 2a 2c 3b Mirelman 1b 2a 2b 2c 3b A.Weiss 1c 2c 3b Giladi 1a 1b 2c 3b Hausdorff 1a 1b 2c 3b</p>
</fn>
<corresp id="CR1"><italic><underline>Address for Proofs and Reprint Requests</underline>
</italic>
Prof. Jeffrey M. Hausdorff Laboratory for Gait & Neurodynamics Tel Aviv Sourarsky Medical Center 6 Weizmann Street Tel Aviv 64239 Israel <email>jhausdor@tasmc.health.gov.il</email>
or <email>jhausdor@bidmc.harvard.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>3</day>
<month>6</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="ppub"><day>30</day>
<month>10</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>30</day>
<month>10</month>
<year>2011</year>
</pub-date>
<volume>25</volume>
<issue>14</issue>
<fpage>2346</fpage>
<lpage>2354</lpage>
<abstract><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>
</abstract>
<kwd-group><kwd>Parkinson's disease</kwd>
<kwd>gait</kwd>
<kwd>heart rate</kwd>
<kwd>autonomic nervous system</kwd>
<kwd>freezing of gait</kwd>
</kwd-group>
<contract-num rid="AG1">R01 AG014100-09
||AG</contract-num>
<contract-num rid="AG1">P60 AG008812-129005
||AG</contract-num>
<contract-sponsor id="AG1">National Institute on Aging : NIA</contract-sponsor>
</article-meta>
</front>
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