Motor blocks during bilateral stepping in Parkinson's disease and effects of dopaminergic medication
| Autor: | Matt J. N. Brown, Julianne Baarbé, Utpal Saha, Karlo J. Lizarraga, William D. Hutchison, Alfonso Fasano, Robert Chen |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Movement disorders Parkinson's disease genetic structures Dopamine Agents Severity of Illness Index Lower limb 03 medical and health sciences Motor block User-Computer Interface 0302 clinical medicine Physical medicine and rehabilitation Rating scale Medicine Humans Gait Disorders Neurologic Aged business.industry Dopaminergic Parkinson Disease Middle Aged medicine.disease Gait 030104 developmental biology Treatment Outcome Neurology Lower Extremity Female Neurology (clinical) Geriatrics and Gerontology medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Parkinsonismrelated disorders. 85 |
| ISSN: | 1873-5126 |
| Popis: | Introduction Freezing of gait (FOG) is a complex symptom in Parkinson's disease (PD) that manifests during walking as limited forward progression despite the intention to walk. It is unclear if lower limb motor blocks (LLMB) that occur independently from FOG are related to overground FOG and the effects of dopaminergic medications. Methods Nineteen patients with PD were tested on two separate days in the dopaminergic medication “on” and “off” states. The patients completed a series of freezing-provoking tasks while videotaped. Raters assessed videos for FOG presence using Movement Disorders Society Unified Parkinson's Disease Rating Scale item 3.11 score greater than or equal to 1 and FOG severity using the standardized FOG score. Whilst seated in a virtual environment, patients and 20 healthy controls stepped in right-left sequence on foot pedals. Frequency and percent time in LLMB were assessed for accurate classification of FOG presence and correlation to the FOG score. Results Frequency and percent time spent in LLMB predicted the presence of FOG in both medication states. Percent time spent in LLMB correlated with FOG severity in both medication states. LLMB frequency predicted FOG severity in the “off” state only. Conclusions LLMB during bilateral stepping in a virtual environment predicted the presence and severity of FOG in PD in both “on” and “off” medication states. These findings support the use of this non-walking paradigm to detect and assess FOG in PD patients unable or unsafe to walk. |
| Databáze: | OpenAIRE |
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