Freezing of gait subtypes have different Parkinson's disease
Freezing of gait subtypes have different Parkinson's disease
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DOI：
10.1016/j.parkreldis.2014.09.023
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发表时间：
2014-12-01
影响因子：
4.1
通讯作者：
Goldstein, F. C.
中科院分区：
文献类型：
--
作者：
Factor, S. A.;Scullin, M. K.;Goldstein, F. C.
背景资料：步态冻结（FOG）是帕金森病（PD）患者的一个主要问题，因为它是福尔斯的主要原因，并与生活质量差有关。病理生理学尚不清楚，但假设其与认知异常有关;特别是执行和视觉空间功能障碍。然而，以前的结果是不一致的。目的：探讨左旋多巴无反应型FOG与执行功能和视空间功能障碍的关系。方法：对135例PD患者进行FOG问卷、运动功能量表、综合认知成套测验和幻觉量表的测试。分析比较了无反应（n = 16），响应（n = 20）和无FOG（n = 99）subtypes.Results：无反应亚型有一个显着老年人的发病年龄PD比响应组（p = 0.03），并有更差的运动评分（p = 0.003）比无FOG组。与无FOG组相比，有反应组的病程较长（p =.002）。无反应FOG组的视觉空间能力（p = 0.001）和执行功能（p = 0.02）明显低于无反应和有反应的FOG亚组。后两组无显著差异。响应FOG组与hallowings.Conclusion的存在：除了药理学差异，无响应FOG与涉及额纹状体通路的执行和视觉空间功能障碍，而响应FOG与暗示参与后皮质区域的幻觉。FOG的进一步研究和治疗应包括适当的亚型分类。(C)2014爱思唯尔有限公司版权所有。
Background: Freezing of gait (FOG) is a major concern for Parkinson's disease (PD) patients because it is a leading cause of falls and is associated with poor quality of life. The pathophysiology is unknown but it is hypothesized that it relates to cognitive abnormalities; particularly executive and visuospatial dysfunction. However, prior results have been discrepant. Pharmacologic subtypes of FOG include those that are responsive and unresponsive to levodopa.Objective: To determine whether executive and visuospatial dysfunction are associated specifically with the levodopa unresponsive subtype of FOG.Methods: 135 PD subjects completed a single assessment included FOG questionnaire, UPDRS motor scale, comprehensive cognitive battery and measure of hallucinations. Analyses compared unresponsive (n = 16), responsive (n = 20) and no FOG (n = 99) subtypes.Results: The unresponsive subtype had a significantly older age of onset of PD than the responsive group (p =.03) and had worse motor scores (p =.003) than the no FOG group. Longer disease duration was associated with the responsive group compared to the no FOG group (p =.002). The unresponsive FOG group had significantly poorer visuospatial ability (p =.001) and executive functioning (p =.02) than both the no and responsive FOG subgroups. These latter groups were not significantly different. The responsive FOG group was associated with the presence of hallucinations.Conclusion: Aside from pharmacological differences, unresponsive FOG is associated with executive and visuospatial dysfunction implicating frontostriatal pathways while responsive FOG is associated with hallucinations suggesting involvement of posterior cortical regions. Further study and treatment of FOG should include appropriate subtype classification. (C) 2014 Elsevier Ltd. All rights reserved.