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Early phenotypic differences between Parkinson’s disease patients with and without freezing of gait.

I recently spoke at a meeting for the Harris County Parkinsons Foundation and I discussed the science behind different phenotypes wihing Parkinsosns that explain why some people have freezing gait and oher do not. I also found it very interesting that there was a connection between the freezers and the hallucinatory symptoms.

Parkinsonism Relat Disord. 2014 Mar 12. pii: S1353-8020(14)00081-9. doi: 10.1016/j.parkreldis.2014.02.028. [Epub ahead of print]

Early phenotypic differences between Parkinson’s disease patients with and without freezing of gait.

Hall JM(1), Shine JM(2), Walton CC(2), Gilat M(2), Kamsma YP(3), Naismith SL(4),  Lewis SJ(2).

Author information:  (1)Parkinson’s Disease Research Clinic, Brain and Mind Research Institute, University of Sydney, NSW, Australia; Centre for Human Movement Sciences, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: julie.hall@sydney.edu.au. (2)Parkinson’s Disease Research Clinic, Brain and Mind Research Institute, University of Sydney, NSW, Australia. (3)Centre for Human Movement Sciences, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands. (4)Healthy Brain Ageing Program, Ageing Brain Centre, Brain and Mind Research Institute, University of Sydney, NSW, Australia.

BACKGROUND: Previous studies have associated freezing of gait in Parkinson’s disease with the presence of specific phenotypic features such as mood disturbances, REM sleep behavior disorder and selective cognitive impairments. However, it is not clear whether these features are present in the earlier stages of the disease or simply represent a more general pattern of progression. To investigate this issue, the current study evaluated motor, cognitive, affective and autonomic features as well as REM sleep behavior disorder in Parkinson’s disease patients in the early stages of the condition. METHODS: Thirty-eight freezers and fifty-three non-freezers with disease duration of fewer than five years and a Hoehn and Yahr stage of less than three were included in this study. The groups were matched on a number of key disease features including age, disease duration, motor severity and dopamine dose equivalence. Furthermore, patients were assessed on measures of motor, cognitive, affective and autonomic features, as well as REM sleep behavior disorder. RESULTS: Compared to non-freezers, patients with freezing of gait had significantly more non-tremor symptoms and a selective impairment on executive functions, such as set-shifting ability and working memory. Freezers and non-freezers did not differ on measures of tremor, autonomic function, REM sleep  behavior disorder, mood or more general cognition. CONCLUSION: These results suggest the pathophysiological mechanisms underlying freezing of gait in the early clinical stages of Parkinson’s disease are likely to be related to specific changes in the frontostriatal pathways rather than being due to brainstem or more diffuse neuropathology.

Copyright © 2014. Published by Elsevier Ltd.

PMID: 24679901  [PubMed – as supplied by publisher]

Dr. Abraham Lieberman, PT, DPT
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