FREEZING OF GAIT, BRADYKINESIA & PARKINSONS DISEASE

步态冻结、运动迟缓

• 批准号: 7366526
• 负责人: JEFFREY M HAUSDORFF
• 金额: $ 0.81万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-01 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7366526
• 关键词: FREEZING; GAIT; BRADYKINESIA; PARKINSONS; DISEASE

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The pathophysiology of freezing of gait (FOG) and its relationship to other Parkinsonian symptoms is unclear. To gain insight into these motor disturbances, we assessed the relationship between FOG and other Parkinsonian features in Parkinson's disease (PD) and the response to levodopa. 19 PD patients with clinically significant FOG at "off" state were assessed while in "off" state, 12 hours after taking their anti-Parkinsonian medications, and while in "on" state, about 1 hour after their regular morning levodopa dose. Assessments included the Unified Parkinson's disease Rating Scale (UPDRS) and a 130 meter, videotaped walk. Three observers independently viewed the videotapes and scored FOG frequency. Parkinsonian features were analyzed by grouping together related UPDRS items. Inter-observer and intra-class reliability between the three observers were evaluated by Pearson and Friedman tests. Pearson correlation coefficients were used to assess the relationships between FOG and other Parkinsonian features. There was a high level of agreement between the three observers (R=0.7). FOG frequency was not correlated with severity of any other Parkinsonian features at "off" and only with speech and writing severity indexes at "on". FOG frequency was significantly decreased by levodopa treatment. This decrement was strongly correlated with improvement of tremor (R=0.80) and speech (R=0.62) indexes. No correlation was found between the response of FOG to levodopa and improvement in rigidity, bradykinesia, or balance indexes. Levodopa treatment decreases FOG frequency in PD patients. FOG is apparently an independent motor symptom of PD, caused by a paroxysmal pathology that is different from that responsible for bradykinesia, rigidity or postural instability. Ongoing research is aimed at understanding the mechanism of this characteristic gait disorder in PD.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。步态冻结（FOG）的病理生理学及其与其他帕金森病症状的关系尚不清楚。为了深入了解这些运动障碍，我们评估了FOG和帕金森病（PD）的其他帕金森特征以及对左旋多巴的反应之间的关系。19名在“关闭”状态下具有临床显著FOG的PD患者在“关闭”状态下（服用抗帕金森病药物后12小时）和“开启”状态下（常规早晨左旋多巴剂量后约1小时）进行评估。评估包括统一帕金森氏病评定量表（UNITED Parkinson's disease Rating Scale，简称UNITED PADRS）和130米步行录像。三名观察员独立观看录像带并对FOG频率进行评分。帕金森病的特征进行了分析，分组在一起相关的ADAPRS项目。三个观察员之间的观察员和类内的可靠性进行了评价皮尔逊和弗里德曼检验。Pearson相关系数用于评估FOG与其他帕金森病特征之间的关系。三名观察员之间的一致性较高（R=0.7）。FOG频率与任何其他帕金森病特征的严重程度在“关”时不相关，而仅与“开”时的言语和书写严重程度指数相关。FOG频率显著降低左旋多巴治疗。这种减少与震颤（R=0.80）和言语（R=0.62）指数的改善密切相关。FOG对左旋多巴的反应与僵硬、运动迟缓或平衡指数的改善之间没有相关性。左旋多巴治疗可降低PD患者的FOG频率。FOG显然是PD的一种独立的运动症状，由与运动迟缓、僵硬或姿势不稳定不同的阵发性病理引起。正在进行的研究旨在了解PD中这种特征性步态障碍的机制。