The sequence effect and gait festination in Parkinson disease: Contributors to freezing of gait?
Identifieur interne : 001179 ( Main/Exploration ); précédent : 001178; suivant : 001180The sequence effect and gait festination in Parkinson disease: Contributors to freezing of gait?
Auteurs : Robert Iansek [Australie] ; Frances Huxham [Australie] ; Jennifer Mcginley [Australie]Source :
- Movement Disorders [ 0885-3185 ] ; 2006-09.
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Abstract
Festination and freezing of gait (FOG) are poorly understood gait disorders that cause disability and falls in people with Parkinson disease (PD). In PD, basal ganglia malfunction leads to motor set deficits (hypokinesia), while altered motor cue production leads to a sequence effect, whereby movements becomes progressively smaller as in festination. We suggest both factors may contribute to FOG. Disturbance of set maintenance by the basal ganglia in PD has previously been examined in gait, but limited systematic evaluation of the sequence effect exists. In this study, we investigated the step‐to‐step amplitude relationship in 10 PD subjects with clinical evidence of festination and FOG. Four conditions were examined: off levodopa, off with attentional strategies, off with visual cues, and on levodopa. Participants demonstrated a sequence effect (F = 6.24; P = 0.001), which was reversed only by use of visual cues. In contrast, medication, attentional strategies, and visual cues all improved hypokinesia. Variability was marked both within and between participants in all conditions. The variability of FOG is suggested to relate to a combination of factors, including the sequence effect and its variability, as well as the severity of hypokinesia and its response to medications. © 2006 Movement Disorder Society
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DOI: 10.1002/mds.20998
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2006-09">2006-09</date><biblScope unit="volume">21</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1419">1419</biblScope><biblScope unit="page" to="1424">1424</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">315DBE73D3A3B3E64C3923BD67AAEF89136D3462</idno><idno type="DOI">10.1002/mds.20998</idno><idno type="ArticleID">MDS20998</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson disease</term><term>basal ganglia</term><term>festination</term><term>gait</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Festination and freezing of gait (FOG) are poorly understood gait disorders that cause disability and falls in people with Parkinson disease (PD). In PD, basal ganglia malfunction leads to motor set deficits (hypokinesia), while altered motor cue production leads to a sequence effect, whereby movements becomes progressively smaller as in festination. We suggest both factors may contribute to FOG. Disturbance of set maintenance by the basal ganglia in PD has previously been examined in gait, but limited systematic evaluation of the sequence effect exists. In this study, we investigated the step‐to‐step amplitude relationship in 10 PD subjects with clinical evidence of festination and FOG. Four conditions were examined: off levodopa, off with attentional strategies, off with visual cues, and on levodopa. Participants demonstrated a sequence effect (F = 6.24; P = 0.001), which was reversed only by use of visual cues. In contrast, medication, attentional strategies, and visual cues all improved hypokinesia. Variability was marked both within and between participants in all conditions. 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