Abstract
Freezing of gait is a disabling symptom in advanced Parkinson's disease. Positive effects have been suggested with MAO-B inhibitors. We report on an open label clinical study on the efficacy of rasagiline as add-on therapy on freezing of gait and quality of life in patients with Parkinson's disease. Forty two patients with freezing of gait were treated with 1 mg rasagiline daily as an add-on therapy. Patients were assessed at baseline and after 1, 2 and 3 months of treatment. Freezing of gait severity was assessed using the Freezing of Gait Questionnaire, motor impairment by the modified MDS UPDRS part III, and quality of life using the PDQ-39 questionnaire. Patients treated with rasagiline had a statistically significant decrease in FoG-Q score and modified MDS UPDRS score after 1, 2 and 3 months of therapy. A moderately strong (r = 0.686, P = 0.002) correlation between the effects on mobility and freezing of gait was found. We also observed a statistically significant improvement in global QoL and in the subscales mobility, ADL, stigma and bodily discomfort in patients after 3 months of rasagiline therapy. A significant correlation (r = 0.570, P = 0.02) between baseline FoG-Q score and the baseline score for the PDQ Mobility subscale was found. In our study rasagiline as add-on antiparkinsonian therapy significantly improved mobility, freezing of gait and quality of life. The positive effect on freezing of gait appears to be related to improvement of mobility.
Highlights
Freezing of gait (FoG) is a gait disorder that occurs in patients with Parkinson’s disease (PD)
Patients with symptoms of FoG, defined as having scored 1 or more for Question 3 of the Freezing of Gait Questionnaire (FoG-Q) – “ Do you feel that your feet get glued to the floor while walking, making a turn or when trying to initiate walking?”
We evaluated as another secondary outcome the quality of life (QoL) with the Slovak version of the PDQ-39
Summary
Freezing of gait (FoG) is a gait disorder that occurs in patients with Parkinson’s disease (PD). FoG is defined as a few seconds episodic failure to produce effective steps in the absence of evident causative factors other than PD and “high-level” gait disorder. FoG is clinically important as it can cause loss of balance and is the most frequent cause of falls in PD patients. The pathophysiology of FoG is complex, and some authors consider it a cardinal symptom of PD, whilst others have suggested links with high-dose levodopa, treatment with dopamine agonists, or the duration of the disease[1]. Our anecdotal experience suggested a positive effect of rasagiline on FoG. We decided to conduct a formal study of the effects of rasagiline in everyday clinical practice, focusing on FoG
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