Freezing of gait: Moving forward on a mysterious clinical phenomenon
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TLDR
Physiological, functional imaging, and clinical-pathological studies point to disturbances in frontal cortical regions, the basal ganglia, and the midbrain locomotor region as the probable origins of FoG.Abstract:
Freezing of gait (FoG) is a unique and disabling clinical phenomenon characterised by brief episodes of inability to step or by extremely short steps that typically occur on initiating gait or on turning while walking. Patients with FoG, which is a feature of parkinsonian syndromes, show variability in gait metrics between FoG episodes and a substantial reduction in step length with frequent trembling of the legs during FoG episodes. Physiological, functional imaging, and clinical-pathological studies point to disturbances in frontal cortical regions, the basal ganglia, and the midbrain locomotor region as the probable origins of FoG. Medications, deep brain stimulation, and rehabilitation techniques can alleviate symptoms of FoG in some patients, but these treatments lack efficacy in patients with advanced FoG. A better understanding of the phenomenon is needed to aid the development of effective therapeutic strategies.read more
Citations
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Neurophysiology of gait: From the spinal cord to the frontal lobe
TL;DR: The basic locomotor motor pattern is generated by spinal interneuronal networks, termed central pattern generators (CPGs), which modify the locomotor pattern in cooperation with descending signals from the brainstem structures and the cerebral cortex.
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Long-term effects of exercise and physical therapy in people with Parkinson disease
TL;DR: Evidence suggests that a minimum of 4 weeks of gait training or 8 weeks of balance training can have positive effects that persist for 3–12 months after treatment completion, and that sustained strength training, aerobic training, tai chi or dance therapy lasting at least 12 weeks can produce long-term beneficial effects.
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Freezing of gait: a practical approach to management
TL;DR: This work reviews medical and non-medical treatment strategies for freezing of gait and presents a practical algorithm for the management of this disorder, based on a combination of evidence, when available, and clinical experience of the authors.
Journal ArticleDOI
Resting-state brain connectivity in patients with Parkinson's disease and freezing of gait
Alessandro Tessitore,Marianna Amboni,Fabrizio Esposito,Antonio Russo,Marina Picillo,Laura Marcuccio,Maria Teresa Pellecchia,Carmine Vitale,Mario Cirillo,Gioacchino Tedeschi,Paolo Barone +10 more
TL;DR: The findings suggest that a resting-state functional connectivity disruption of "executive-attention" and visual neural networks may be associated with the development of freezing of gait in patients with Parkinson's disease.
Journal ArticleDOI
Motor automaticity in Parkinson's disease.
Tao Wu,Mark Hallett,Piu Chan +2 more
TL;DR: Motor automaticity associated motor deficits in PD, such as reduced arm swing, decreased stride length, freezing of gait, micrographia and reduced facial expression are reviewed.
References
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Book
An Essay on the Shaking Palsy
TL;DR: In this article, the authors present a conciliatory explanation for the present publication, in which, it is acknowledged, that mere conjecture takes the place of experiment; and, that analogy is the substitute for anatomical examination, the only sure foundation for pathological knowledge.
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Falls and freezing of gait in Parkinson's disease : a review of two interconnected, episodic phenomena
TL;DR: A review of the literature and the current state‐of‐the‐art suggests that clinicians should not feel deterred by the complex nature of falls and freezing of gait; a careful clinical approach may lead to an individually tailored treatment, which can offer at least partial relief for many affected patients.
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Cortical Mapping of Gait in Humans: A Near-Infrared Spectroscopic Topography Study
Ichiro Miyai,Hiroki C. Tanabe,Ichiro Sase,Hideo Eda,Ichiro Oda,Ikuo Konishi,Yoshio Tsunazawa,Tsunehiko Suzuki,Toshio Yanagida,Kisou Kubota,Kisou Kubota +10 more
TL;DR: Cortical activation patterns of human gait were visualized by measuring relative changes in local hemoglobin oxygenation using a recently developed near-infrared spectroscopic (NIRS) topography technique to provide new insight into cortical control of human locomotion.
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Cueing training in the home improves gait-related mobility in Parkinson’s disease: the RESCUE trial
Alice Nieuwboer,Gert Kwakkel,Lynn Rochester,Derek K. Jones,E.E.H. van Wegen,A M Willems,F Chavret,V. Hetherington,Katherine Baker,I. Lim +9 more
TL;DR: Cueing training in the home has specific effects on gait, freezing and balance and may be a useful therapeutic adjunct to the overall management of gait disturbance in Parkinson’s disease.