Diversity Supplement: SCH: Context-aware Freezing of Gait mitigation in real-world setting

项目摘要 本提案是根据PA-21-071：促进卫生多样性的研究补充材料提交的。 相关研究。这一补充旨在检查神经心理学的贡献者冻结步态（FoG）， 超过50%的帕金森病（PD）患者患有FoG，以减轻FoG负担。 FoG是PD的一种常见的破坏性表现，目前尚无治愈方法或适当的药物或手术治疗 治疗，已经被定义为“短暂的、间歇性的缺失或足向前进展的显著减少， 尽管他想走路“众所周知，FoG事件经常由各种 环境和心理因素。最常见的触发因素包括开始犹豫 （步态开始时冻结），通过狭窄的空间行走，转弯犹豫（改变方向时冻结）， 接近视觉目标，双重任务，以及压力，时间敏感的情况，如进入电梯 在门关上之前每个患有PD的人在他们对这些不同的敏感性方面都是独一无二的。 触发因素，强调需要定制的治疗方法。因此，增加了对 FoG背后的可修改因素，以增加对FoG体验中个体细微差别的理解， 有正当理由虽然焦虑已经被确立为驱动FoG的重要心理机制 行为，仍然很少或没有研究神经心理因素，可能先于FoG诱导 焦虑症事实上，尽管人们知道焦虑是个体FoG行为的前兆， 虽然被诊断患有帕金森病，但对导致这种焦虑的机制知之甚少， 这是焦虑和FoG结果之间广泛联系的基础。一项新的研究表明， 客观和主观测量的睡眠与1）焦虑和2）FoG结果相关， 被诊断为PD的人为了解决关键的研究差距，这一补充将收集主观和 焦虑、睡眠和其他影响FoG结果的神经心理因素的客观指标， PD患者，以促进增加了解和告知针对减少 与这种现象有关的负担。

Project Summary This proposal is submitted in response to PA-21-071: Research Supplements to Promote Diversity in Health- Related Research. This supplement seeks to examine neuropsychological contributors to freezing of gait (FoG), which is suffered by over 50% of people living with Parkinson’s Disease (PD) in order to reduce FoG burden. FoG, a common, devastating manifestation of PD for which there is no cure or adequate medical or surgical treatment, has been defined as a “brief, episodic absence or marked reduction of forward progression of the feet, despite the intention to walk.” It is widely known that FoG episodes are frequently triggered by various environmental and psychological factors. The most commonly recognized triggers include start hesitation (freezing upon gait initiation), walking through tight quarters, turn hesitation (freezing when changing directions), approaching a visual target, dual tasking, and stressful, time-sensitive situations such as entering an elevator before the doors close. Each individual with PD is unique with regard to how sensitive they are to these various triggers, underscoring the need for customized therapeutic approaches. As such, increased understanding of modifiable factors underlying FoG for increased understanding of individual nuances in experiences of FoG is warranted. Although anxiety has been established as an important psychological mechanism driving FoG behavior, there remains little to no research on neuropsychological factors that may precede FoG-inducing anxious symptomatology. Indeed, although it is known that anxiety is a precursor to FoG behaviors in individuals diagnosed with Parkinson’s Disease, less is known about the mechanisms contributing to this anxiety and underlying the association between anxiety and FoG outcomes broadly. An emerging body of research suggests that objectively and subjectively measured sleep is associated with both 1) anxiety and 2) FoG outcomes in individuals diagnosed with PD. In order to address key research gaps, this supplement will collect subjective and objective indices of anxiety, sleep, and other neuropsychological factors that influence FoG outcomes in individuals living with PD to promote increased understanding of and inform treatment targeted toward reduced burden associated with this phenomenon.