Freezing of gait in Parkinson's disease: The paradoxical interplay between gait and cognition |
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| Affiliation: | 1. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy;2. Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, United Kingdom;3. Department of Neurology and Parkinson Centre Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, The Netherlands;4. Department of Neurology, Catholic University of Sacred Heart, Rome, Italy;5. Movement Disorders Center, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, 399 Bathurst St, 7 Mc412, Toronto, Ontario M5T 2S8, Canada;1. Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, 308433, Singapore;2. Duke-NUS, Graduate Medical School, 8 College Road, 169857, Singapore;1. Department of Neurology, Oregon Health & Science University, Portland, OR, USA;2. Parkinson''s Disease Research Education and Clinical Center, Portland Veterans Affairs Medical Center, Portland, OR, USA;3. Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA;1. Service de Neurologie et Pathologie du mouvement, Hôpital Roger Salengro, CHRU de Lille, Lille, France;2. U1171, Université Lille, Lille, France;3. Service de Pharmacologie médicale, Faculté de Médecine Lille, CHRU de Lille, Lille, France;4. Service de Neuroradiologie clinique, Hôpital Roger Salengro, CHRU de Lille, Lille, France;5. Service de Médecine Nucléaire, Hôpital Roger Salengro, CHRU de Lille, Lille, France;6. Service de Biostatistiques de santé publique, CHRU de Lille, Lille, France;7. Service de Médecine Nucléaire, Centre Eugène Marquis, Rennes, France;1. Parkinson''s Disease Research Clinic, Brain and Mind Research Institute, University of Sydney, NSW, Australia;2. Centre for Human Movement Sciences, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands;3. Healthy Brain Ageing Program, Ageing Brain Centre, Brain and Mind Research Institute, University of Sydney, NSW, Australia;1. Department of Neurology and Psychiatry (Parkinson''s Centre), University “Sapienza”, Rome, Italy;2. I.R.C.C.S. Santa Lucia Foundation, Rome, Italy;3. Research Centre of Social Diseases (CIMS), University “Sapienza”, Rome, Italy |
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| Abstract: | ![]()
BackgroundFreezing of gait is a disabling episodic gait disturbance common in patients with Parkinson's disease. Recent evidences suggest a complex interplay between gait impairment and executive functions.Aim of our study was to evaluate whether specific motor conditions (sitting or walking) influence cognitive performance in patients with or without different types of freezing.MethodsEight healthy controls, eight patients without freezing, nine patients with levodopa-responsive and nine patients with levodopa-resistant freezing received a clinical and neuropsychological assessment during two randomly performed conditions: at rest and during walking.ResultsAt rest, patients with levodopa-resistant freezing performed worse than patients without freezing on tests of phonological fluency (p = 0.01). No differences among the four groups were detected during walking. When cognitive performances during walking were compared to the performance at rest, there was a significant decline of verbal episodic memory task (Rey Auditory Verbal Learning Test) in patients without freezing and with levodopa-responsive freezing. Interestingly, walking improved performance on the phonological fluency task in patients with levodopa-resistant freezing (p = 0.04).ConclusionsCompared to patients without freezing, patients with levodopa-resistant freezing perform worse when tested while seated in tasks of phonological verbal fluency. Surprisingly, gait was associated with a paradoxical improvement of phonological verbal fluency in the patients with levodopa-resistant freezing whilst walking determined a worsening of episodic memory in the other patient groups. |
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| Keywords: | Freezing of gait Parkinson's disease Executive functions Cognition Gait |
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