Levodopa-resistant freezing of gait and executive dysfunction in Parkinson's disease

Autor: Valérie Fraix, Eugénie Lhommée, Bettina Debû, Pierre Pollak, Stephan Chabardes, Paul Krack, Alim-Louis Benabid, Claire Ardouin, Eric Seigneuret, Murielle Ursulla Ferraye
Rok vydání: 2012
Předmět:
Male
medicine.medical_specialty
Levodopa
Cognition Disorders/*etiology/therapy
Parkinson's disease
genetic structures
Parkinson Disease/*complications/therapy
Deep Brain Stimulation
Neuropsychological Tests
Severity of Illness Index
Antiparkinson Agents
Executive Function
Physical medicine and rehabilitation
Subthalamic Nucleus
Deep Brain Stimulation/methods
Severity of illness
medicine
Humans
Prospective Studies
Gait Disorders
Neurologic
Executive Function/*physiology
Gait Disorders
Neurologic/*etiology/therapy
Aged
Retrospective Studies
Cognition
Parkinson Disease
Middle Aged
medicine.disease
Executive functions
Gait
Subthalamic Nucleus/physiology
Subthalamic nucleus
Neurology
Levodopa/*adverse effects
Physical therapy
Female
Neurology (clinical)
Psychology
Cognition Disorders
Antiparkinson Agents/*adverse effects
Executive dysfunction
medicine.drug
Zdroj: European Neurology, Vol. 69, No 5 (2013) pp. 281-288
ISSN: 1421-9913
0014-3022
Popis: We examined executive functioning in patients with Parkinson's disease exhibiting, or not, levodopa-resistant freezing of gait (L-FOG). 38 advanced-stage patients with L-FOG were identified in a consecutive series of 400 patients. They were matched with 38 patients without L-FOG. All patients underwent prospective evaluations of cognitive and motor functioning before subthalamic nucleus surgery, and 1 year after. A composite frontal score, a measure of executive functioning, was compared between the two groups. We also examined correlations between the frontal score and the score on the FOG item of the Unified Parkinson Disease Rating Scale II. Results show that after surgery, patients with L-FOG, as a group, were more impaired in executive functioning than control patients. However, individual data analysis showed preserved executive functions in 11 patients with L-FOG. In addition, there was no correlation between L-FOG severity and the degree of executive impairment. Therefore, frontal dysfunction may be one mechanism underlying L-FOG in a number of patients with Parkinson's disease. However, since some patients develop L-FOG despite the preservation of executive functions, lesions or dysfunction of other neuronal structures are likely to be involved.
Databáze: OpenAIRE
Externí odkaz: