Explaining freezing of gait in Parkinson's disease

Motor and cognitive determinants

Sarah Vercruysse, Hannes Devos, Liesbeth Munks, Joke Spildooren, Jochen Vandenbossche, Wim Vandenberghe, Alice Nieuwboer, Elke Heremans

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Freezing of gait (FOG) is part of a complex clinical picture in Parkinson's disease (PD) and is largely refractory to standard care. Diverging hypotheses exist about its origins, but a consolidated view on what determines FOG is lacking. The aim of this study was to develop an integrative model of FOG in people with PD. This cross-sectional study included 51 Parkinson subjects: 24 patients without FOG and 27 with FOG matched for age, gender, and disease severity. Subjects underwent an extensive clinical test battery evaluating general disease characteristics, gait and balance, nongait freezing, and cognitive functions. The relative contribution of these outcomes to FOG was determined using logistic regression analysis. The combination of the following four independent contributors provided the best explanatory model of FOG (R2 = 0.49): nongait freezing; levodopa equivalent dose (LED); cognitive impairment; and falls and balance problems. The model yields a high-risk profile for FOG (P > 95%) when Parkinson patients are affected by at least one type of nongait freezing (e.g., freezing of other repetitive movements), falls or balance problems during the last 3 months, and a Scales for Outcomes in Parkinson's Disease-Cognition score below 28. A high LED further increases the risk of FOG to 99%. Nongait freezing, increased dopaminergic drug dose, cognitive deficits, and falls and balance problems are independent determinants of FOG in people with PD and may play a synergistic role in its manifestation.

Original languageEnglish (US)
Pages (from-to)1644-1651
Number of pages8
JournalMovement Disorders
Volume27
Issue number13
DOIs
StatePublished - Nov 1 2012

Fingerprint

Gait
Freezing
Parkinson Disease
Levodopa
Cognition
Dopamine Agents
Cross-Sectional Studies
Logistic Models

Keywords

  • Cognitive disorders
  • Freezing of gait
  • Gait disorders
  • Parkinson's disease
  • Postural control

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Vercruysse, S., Devos, H., Munks, L., Spildooren, J., Vandenbossche, J., Vandenberghe, W., ... Heremans, E. (2012). Explaining freezing of gait in Parkinson's disease: Motor and cognitive determinants. Movement Disorders, 27(13), 1644-1651. https://doi.org/10.1002/mds.25183

Explaining freezing of gait in Parkinson's disease : Motor and cognitive determinants. / Vercruysse, Sarah; Devos, Hannes; Munks, Liesbeth; Spildooren, Joke; Vandenbossche, Jochen; Vandenberghe, Wim; Nieuwboer, Alice; Heremans, Elke.

In: Movement Disorders, Vol. 27, No. 13, 01.11.2012, p. 1644-1651.

Research output: Contribution to journalArticle

Vercruysse, S, Devos, H, Munks, L, Spildooren, J, Vandenbossche, J, Vandenberghe, W, Nieuwboer, A & Heremans, E 2012, 'Explaining freezing of gait in Parkinson's disease: Motor and cognitive determinants', Movement Disorders, vol. 27, no. 13, pp. 1644-1651. https://doi.org/10.1002/mds.25183
Vercruysse S, Devos H, Munks L, Spildooren J, Vandenbossche J, Vandenberghe W et al. Explaining freezing of gait in Parkinson's disease: Motor and cognitive determinants. Movement Disorders. 2012 Nov 1;27(13):1644-1651. https://doi.org/10.1002/mds.25183
Vercruysse, Sarah ; Devos, Hannes ; Munks, Liesbeth ; Spildooren, Joke ; Vandenbossche, Jochen ; Vandenberghe, Wim ; Nieuwboer, Alice ; Heremans, Elke. / Explaining freezing of gait in Parkinson's disease : Motor and cognitive determinants. In: Movement Disorders. 2012 ; Vol. 27, No. 13. pp. 1644-1651.
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