The prevalence of freezing of gait in Parkinson\u2019s disease and in patients with different disease durations and severities

Hong-Liang Ge,Xiao-Yong Chen,Zhang-Ya Lin,Chen-Yu Ding,Yuan-Xiang Lin,De-Zhi Kang,Liang-Hong Yu,Xi-Yue Wu,Ting-Juan Ge

doi:10.1186/s41016-020-00197-y

Abstract

BackgroundThe prevalence rates of freezing of gait (FOG) in Parkinson’s disease (PD) vary widely, ranging from 14.0 to 55.1%. Our aim is to calculate the overall prevalence of FOG in all PD patients with different disease durations and severities.MethodsUsing Medline/PubMed/Embase, we carried out a systematic literature search for studies reporting the PD and clinically relevant FOG.ResultsAfter primary screening, a total of 35 studies were identified and further analyzed for inclusion into the analysis, and 29 studies fulfilled the quality criteria and included in this meta-analysis. The overall prevalence of FOG in PD was 39.9% (95% CI 35.3-44.5%). The FOG identified by the freezing of gait questionnaire item 3 may be more prevalent (43.8%, 95% CI 38.5-49.1%) than the FOG identified by the Unified Parkinson’s Disease Rating Scale item 14 (36.0%, 95% CI 29.0-43.1%). Disease duration and severity are both the clinical features associated with the FOG. The highest FOG prevalence rate in PD patients was seen in patients with disease durations ≥ 10 years, at 70.8%, followed that of PD patients with disease durations ≥ 5 years (53.3%), and PD patients with disease durations < 5 years (22.4%). FOG presented in 28.4% of PD patients with Hoehn and Yahr staging (H&Y) score ≤ 2.5, and in 68.4% of PD patients with H&Y score ≥ 2.5.ConclusionThis meta-analysis confirms that the prevalence of FOG in PD is considerable, and highlights the need for accurate identification of FOG in PD.

Highlights

The prevalence rates of freezing of gait (FOG) in Parkinson’s disease (PD) vary widely, ranging from 14.0 to 55.1%
All potential studies reporting the prevalence of FOG in PD patients were read in full for eligibility and 188 articles were excluded for the following reasons: prevalence of FOG in PD was not mentioned (n = 94), there may be an insufficient description of a random or consecutive design of patient recruitment (n = 51), the publications stemmed from the same database or duplicate articles (n = 31), the population included had only neuroleptic-induced PD or PD with only dual-task difficulties (n = 4), or the full text was not found (n = 8)
In terms of the level of severity, FOG presented in 28.4% of PD patients with Hoehn and Yahr staging (H&Y) score ≤ 2.5, and in 68.4% of PD patients with H&Y score > 2.5 (Table 4)

Summary

Introduction

The prevalence rates of freezing of gait (FOG) in Parkinson’s disease (PD) vary widely, ranging from 14.0 to 55.1%. Our aim is to calculate the overall prevalence of FOG in all PD patients with different disease durations and severities. Parkinson’s disease (PD) is a neurodegenerative disease primarily characterized by rigidity, bradykinesia, and resting tremor; the freezing of gait (FOG) is a common and disabling symptom in PD [1,2,3]. FOG proposes major risks for falls, and leading to disability to patients, making the efficient identification of it important [7]. The prevalence of FOG in PD patients that are reported in the literature vary widely, ranging from 14.0 to 55.1% [8, 9]. Up to 86.5% of advanced PD patients experience FOG [10], and up to 37.8% of early PD patients have the FOG as defined by a validated scale (2020) 6:17

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