Abstract
Freezing of gait (FoG) is a common, debilitating disorder occurring in the majority of Parkinson’s disease (PD) patients. It is defined as the episodic inability to produce effective stepping, often triggered (and ameliorated) by environmental cues. This phenomenon can occur in isolation, but more often combined with other gait disturbances, and its response to dopamine is highly variable. The heterogeneous nature of this condition has presented challenges to elucidating its underlying pathophysiology, and its episodic and variable nature have made it difficult to establish outcome measures for clinical trials. Currently, treatment of FoG is based on maximizing its dopaminergic response and using rehabilitation techniques, as well as off-label non-dopaminergic therapies to address refractory symptoms. As with any gait disorder, a comprehensive evaluation and multidisciplinary treatment approach are recommended.
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Moreau C, Delval A, Defebvre L, Dujardin K, Duhamel A, Petyt G, et al. Methylphenidate for gait hypokinesia and freezing in patients with Parkinson’s disease undergoing subthalamic stimulation: a multicentre, parallel, randomised, placebo-controlled trial. Lancet Neurol. 2012;11(7):589–96.
Morita H, Hass CJ, Moro E, Sudhyadhom A, Kumar R, Okun MS. Pedunculopontine nucleus stimulation: where are we now and what needs to be done to move the field forward? Front Neurol. 2014;5:243. Pubmed Central PMCID: 4255598.
Nieuwboer A, Giladi N. Characterizing freezing of gait in Parkinson’s disease: models of an episodic phenomenon. Mov Disord. 2013;28(11):1509–19.
Nonnekes J, Snijders AH, Nutt JG, Deuschl G, Giladi N, Bloem BR. Freezing of gait: a practical approach to management. Lancet Neurol. 2015;14(7):768–78.
Nutt JG, Bloem BR, Giladi N, Hallett M, Horak FB, Nieuwboer A. Freezing of gait: moving forward on a mysterious clinical phenomenon. Lancet Neurol. 2011;10(8):734–44. Epub 2011/07/23. eng.
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Revuelta, G.J. (2019). Treatment of Freezing of Gait in Parkinson’s Disease. In: Reich, S., Factor, S. (eds) Therapy of Movement Disorders. Current Clinical Neurology. Humana, Cham. https://doi.org/10.1007/978-3-319-97897-0_8
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DOI: https://doi.org/10.1007/978-3-319-97897-0_8
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