Clinical features of freezing of gait in Parkinson's disease patients.

Makoto Sawada,Ritsuko Hanajima,Kenji Wada‐Isoe,Kenji Nakashima

doi:10.1002/brb3.1244

Makoto Sawada, Ritsuko Hanajima + Show 2 more

Open Access

https://doi.org/10.1002/brb3.1244

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Abstract

ObjectiveTo clarify the clinical features of freezing of gait (FOG) in Parkinson's disease (PD) patients by classification into two groups: Clinically observed FOG (CFOG) and self‐reported FOG (SFOG).MethodsTwo hundred twenty‐nine PD patients were medically examined in an examination room as well as subjected to a New Freezing of Gait Questionnaire (NFOG‐Q) and analysis of nonmotor symptoms including sleep, cognition, depression, and fatigue.ResultsThe prevalence of CFOG was 17.9%, while 53.7% of the patients without CFOG reported the presence of FOG via the NFOG‐Q. Univariate analysis revealed that CFOG was associated with longer disease duration, motor dysfunction, sleepiness, fatigue, and cognitive dysfunction. These symptoms, excluding akinesia, apathy, rapid eye movement (REM) sleep Behavior Disorder, and cognitive dysfunction, were also associated with SFOG. Multivariate analysis revealed that long PD duration, postural instability, and gait difficulty (PIGD), along with fatigue, were independent factors for SFOG.ConclusionsSFOG and CFOG have many common clinical features. Although the clinical relevance of SFOG remains unclear, careful attention should be paid to related features in clinical practice.

Highlights

Freezing of gait (FOG) is a major disabling motor symptom that af‐ fects the daily quality of life of Parkinson's disease (PD) patients
According to Kruskal–Wallis tests, we found significant differences in the New Freezing of Gait Questionnaire (NFOG‐Q), duration of disease, severity of Hoehn and Yahr stage (HY) stage, Unified Parkinson's Disease Rating Scale (UPDRS) Part 3 (Rigidity, Akinesia, PIGD), Geriatric Depression Scale (GDS), Apathy Scale (AS), Pittsburgh Sleep Quality Index (PSQI), Japanese version of the Epworth Sleepiness Scale (JESS), REM sleep Behavior Disorder Screening Questionnaire (RBDSQ)‐J, Parkinson Fatigue Scale (PFS), Mini Mental State Examination (MMSE), Frontal Assessment Battery (FAB), Montreal Cognitive Assessment (MoCA)‐J, and levodopa equivalent daily dose (LEDD)
We found that the higher the PIGD, the more self‐reported FOG (SFOG) and Clinically observed FOG (CFOG) increased

Summary

| INTRODUCTION

Freezing of gait (FOG) is a major disabling motor symptom that af‐ fects the daily quality of life of Parkinson's disease (PD) patients. FOG in PD patients is the main cause of falling, fracture risk, and activities of daily living disability (Okuma, 2014; Okuma, Silva de Lima, Fukae, Bloem, & Snijders, 2018). The detection of FOG by wearable devices has been attempted (Silva de Lima et al, 2017). This technology is still in the research stage and is not used in clinical practice. To identify FOG in daily practice by a clinical examination and a questionnaire. To compare the clinical features (such as demo‐ graphic characteristics, motor symptoms, nonmotor symptoms, cogni‐ tive function, and medication use) between FOG identified by a clinical examination and FOG identified by a questionnaire

| METHODS

Findings

| DISCUSSION