Abstract
ObjectivesTo support the cognitive model of Freezing of Gait (FoG) we investigated FoG in a cohort of patients with Dementia with Lewy Bodies (DLB).Materials and MethodsWe assessed FoG frequency in 19 DLB patients compared to 19 control PD patients within 2 years from symptom onset and with at least 5 years follow‐up. The two groups were matched by age and motor presentation at onset, severity of parkinsonism and disease duration. The presence and severity of FoG was identified as those with a score of 1 or greater on subitem 14 of the Unified Parkinson's Disease Rating Scale Part II (UPDRS II).ResultsAt T0, 68.4% DLB and 10.5% PD patients experienced FoG ≥1. The prevalence of FoG increased with disease progression (94.7% DLB and 47.3% PD subjects had FoG ≥1 at T5). DLB also showed a more severe FoG (FoG ≥2) than PD (21% vs. 0% at T0 and 52.6% vs. 10.5% at T5), consistently with previous studies reporting FoG prevalence in DLB.ConclusionThis is the first study looking specifically at FoG in DLB, identifying it as a frequent and early feature of DLB and emphasizing the crucial role of cognitive impairment in the occurrence of this mysterious phenomenon.
Highlights
Freezing of Gait (FoG) is an episodic, brief, and unpredictable gait disorder in which patients feel as their feet are glued to the ground with an inability to produce effective steps despite the intention to walk (Nutt et al, 2011)
We found that FoG is a frequent feature of Dementia with Lewy Bodies (DLB) supporting the link between this disorder and dementia
In his overview of FoG in atypical parkinsonian conditions, Factor con‐ firmed the frequent occurrence of FoG in these entities, such as DLB, with over 50% of patients reporting it in the advanced disease (Factor, 2008)
Summary
Freezing of Gait (FoG) is an episodic, brief, and unpredictable gait disorder in which patients feel as their feet are glued to the ground with an inability to produce effective steps despite the intention to walk (Nutt et al, 2011). It is a very disabling symptom, correlates with postural instability, interferes with daily life, impairs mobil‐ ity, and represents one of the major causes of falls. FoG can be classified on the basis of its response to dopaminergic treatments in FoG‐ON, which is resistant to dopaminergic replace‐ ment therapy, and FoG‐OFF (the most common), which is relieved by dopaminergic medication.
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