Clinical Features of Parkinson's Disease in Patients with Early-Onset Freezing of Gait

Hiroo Terashi; Yuki Ueta; Takeshi Taguchi; Hiroshi Mitoma; Hitoshi Aizawa

doi:10.1155/2022/4732020

Clinical Features of Parkinson's Disease in Patients with Early-Onset Freezing of Gait

Parkinsons Dis. 2022 Jul 8:2022:4732020. doi: 10.1155/2022/4732020. eCollection 2022.

Authors

Hiroo Terashi¹, Yuki Ueta¹, Takeshi Taguchi¹, Hiroshi Mitoma², Hitoshi Aizawa¹

Affiliations

¹ Department of Neurology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
² Department of Medical Education, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.

Abstract

Background: Freezing of gait (FOG) is an important symptom that can impair activities of daily living in patients with Parkinson's disease (PD). However, its pathogenic mechanism is largely unknown. The aim of the present study was to elucidate the clinical characteristics of newly diagnosed and levodopa-naïve patients with PD who present with FOG.

Methods: A total of 53 patients with untreated PD (29 men and 24 women) within 2 years of disease onset were included in the study. Using item 3 of the Freezing of Gait Questionnaire (FOG-Q), patients were classified as "freezers" and "nonfreezers" and compared for cognitive function, depressive symptoms, apathy, olfactory function, motor severity, gait parameters, and daily physical activity. We also assessed the relationship between FOG severity (total score of items 3-6 on the FOG-Q) and various clinical parameters.

Results: The FOG was reported by 8 (15%) patients with PD. The Apathy Scale score (p=0.018), Modified Hoehn and Yahr stage (p < 0.001), Unified Parkinson's Disease Rating Scale part III score (p < 0.001), and postural instability and gait disorder score (p < 0.001) were significantly higher, and the mean gait acceleration amplitude (p=0.006) was significantly lower in freezers compared to that in nonfreezers. However, there was no significant correlation between FOG severity and these clinical parameters. There was also no significant difference in cognitive function, depressive symptoms, and olfactory function between the two groups. Daily physical activity was significantly lower in freezers than that in nonfreezers.

Conclusions: Since FOG develops soon after PD onset, the study findings suggest that the FOG might be associated with the severity of apathy, motor symptoms, and in particular, gait disturbance.