Predictors of onset of gait freezing in Parkinson's disease
What is it about?
In this prospective study, people with Parkinson's disease who had not yet developed gait freezing were followed-up for two years and assessed each year. To investigate the most sensitive markers of the onset of gait freezing, participants performed walking, turning, balance tasks and repetitive hand and foot movements besides extensive neuro-psychological testing. Markers of developing gait freezing were investigated and a predictive model was built using pre-conversion information. Difficulties during repetitive hand and foot movements as well as walking asymmetry were predictive of conversion. Cognitive and autonomic disturbances were reported pre-conversion although cognitive performance was not more impaired. These results provide novel insights into specific motor deficits predicting conversion to gait freezing.
Why is it important?
This is the first time objective measures of motor performance have been assessed in a prospective manner in relationship to freezing of gait. These results provide specific therapeutic targets to investigate whether improving these would delay or possibly prevent the onset of gait freezing in Parkinson's disease. Further, the predictive model showed that a commonly used clinical scale contained information that could predict the onset of gait freezing, which may be quickly developed into a screening tool for risk assessment and early intervention.