Freezing in Parkinson's disease: A spatiotemporal motor disorder beyond gait
Freezing in Parkinson's disease: A spatiotemporal motor disorder beyond gait
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DOI：
10.1002/mds.24015
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发表时间：
2012-02-01
影响因子：
8.6
通讯作者：
Nieuwboer, Alice
中科院分区：
文献类型：
--
作者：
Vercruysse, Sarah;Spildooren, Joke;Nieuwboer, Alice
步态冻结（FOG）是帕金森氏病的一个失能问题，难以治疗。我们测试的假设，受损的节奏和幅度控制是一种常见的机制冻结，也存在于其他节奏的任务。因此，我们比较了上肢运动、下肢运动和FOG过程中冻结发作的发生率和时空分布。11个冰柜，12个非冰柜，和11个控制进行了有节奏的双边手指运动任务。评估运动速度、幅度和协调模式的触发效果。回归斜率和频谱分析解决了冻结事件固有的空间和时间的运动学变化。FOG问卷评分显着预测上肢冻结的严重程度，目前在9个冰柜，和脚冻结，目前在8个冰柜。与步态相似，小幅度运动倾向于触发上肢冻结，这之前是加速运动和强烈的幅度崩溃。上肢冻结功率谱是宽带的，包括在冻结带（38 Hz）的能量增加。与FOG相反，单侧上肢冻结是常见的，主要发生在疾病优势侧。研究结果强调，一个核心的运动问题的基础冻结，可以影响各种运动效应器。这种缺陷可能起源于疾病主导的身体一侧，并干扰重复肢体运动期间的幅度和时间调节。这些结果可能会改变目前关于冻结起源的想法，因为它不仅仅是步态失败。(C)2011年运动障碍协会
Freezing of gait (FOG) is an incapacitating problem in Parkinson's disease that is difficult to manage therapeutically. We tested the hypothesis that impaired rhythm and amplitude control is a common mechanism of freezing which is also present during other rhythmic tasks. Therefore, we compared the occurrence and spatiotemporal profiles of freezing episodes during upper limb motion, lower limb motion, and FOG. Eleven freezers, 12 non-freezers, and 11 controls performed a rhythmic bilateral finger movement task. The triggering effect of movement speed, amplitude, and coordination pattern was evaluated. Regression slopes and spectral analysis addressed the spatial and temporal kinematic changes inherent to freezing episodes. The FOG Questionnaire score significantly predicted severity of upper limb freezing, present in 9 freezers, and of foot freezing, present in 8 freezers. Similar to gait, small-amplitude movements tended to trigger upper limb freezing, which was preceded by hastened movement and a strong amplitude breakdown. Upper limb freezing power spectra were broadband, including increased energy in the freeze band (38 Hz). Contrary to FOG, unilateral upper limb freezing was common and occurred mainly on the disease-dominant side. The findings emphasize that a core motor problem underlies freezing which can affect various movement effectors. This deficit may originate on the disease-dominant body side and interfere with amplitude and timing regulation during repetitive limb movements. These results may shift current thinking on the origins of freezing as being not exclusively a gait failure. (C) 2011 Movement Disorder Society