Characterization of freezing of gait subtypes and the response of each to levodopa in Parkinson's disease
Characterization of freezing of gait subtypes and the response of each to levodopa in Parkinson's disease
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DOI：
10.1046/j.1468-1331.2003.00611.x
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发表时间：
2003-07-01
影响因子：
5.1
通讯作者：
Giladi, N
中科院分区：
文献类型：
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作者：
Schaafsma, JD;Balash, Y;Giladi, N
评估左旋多巴对“关闭”FOG患者不同的步态冻结（FOG）亚型的影响。19名帕金森病患者（12名男性，平均年龄62.0 +/- 8.4岁）在“关闭”状态下有临床意义的FOG，在“关闭”和“打开”状态下行走130米时进行录像。三个独立的观察者的特点的类型，持续时间和临床表现和量化FOG通过分析录像带。他们的综合平均得分用于统计分析。组内相关系数评估观察者间的可靠性。Wilcoxon和Friedman检验评估了FOG特征平均频率的差异。在“关闭”状态下，FOG是由转弯（63%），开始（23%），穿过狭窄的空间（12%）和到达目的地（9%）引起的。在“开”状态下，这些相应值仅为14%、4%、2%和1%（P < 0.011）。FOG最常见的表现是以非常小的步伐前进和腿部颤抖;完全运动不能是罕见的。大多数FOG发作时间< 10 s，并且在“开启”状态下往往更短。左旋多巴显著降低FOG频率（P < 0.0001）和运动不能发作次数（P < 0.001）。FOG亚型之间的区别使得能够评价独特的治疗反应。左旋多巴有助于减少“关闭”相关FOG的频率和持续时间。
To assess the effect of levodopa on distinct freezing of gait (FOG) subtypes in patients with 'off' FOG. Nineteen patients (12 men, mean age 62.0 +/- 8.4 years) with Parkinson's disease and clinically significant FOG during 'off' states were videotaped whilst walking 130 m during 'off' and 'on' states. Three independent observers characterized the type, duration, and clinical manifestations and quantified FOG by analyzing the videotapes. Their combined mean scores were used for statistical analysis. The intra-class correlation coefficient assessed inter-observer reliability. Wilcoxon and Friedman tests evaluated differences in mean frequencies of FOG characteristics. During 'off' states, FOG was elicited by turns (63%), starts (23%), walking through narrow spaces (12%) and reaching destinations (9%). These respective values were only 14, 4, 2 and 1% during 'on' states (P < 0.011). Moving forward with very small steps and leg trembling in place were the most common manifestations of FOG; total akinesia was rare. Most FOG episodes took < 10 s and tended to be shorter during 'on' states. Levodopa significantly decreased FOG frequency (P < 0.0001) and the number of episodes with akinesia (P < 0.001). Distinction amongst FOG subtypes enables evaluation of distinctive therapeutic response. Levodopa helps in reducing the frequency and duration of 'off'-related FOG.