Objective: To assess the effect of levodopa on dual-tasking in situations triggering freezing of gait (FOG) in Parkinson’s disease (PD).

Background: The frequency and severity of FOG in PD is associated with several situations including starting to walk, turning, walking through narrow places, reaching one’s intended destination, as well as performing dual tasks while walking. Levodopa has been shown to improve FOG in up to 60% of patients, however its effects on FOG during different dual-task levels and situations are not clear.

Methods: Six PD patients with FOG (PD-FOG) and 6 without FOG (PD-nFOG) enrolled in the Center for Neurodegeneration and Translational Neuroscience were included in the preliminary analyses. Total and individual FOG assessment scores consisting of ratings during four situations (start walking, turn 360° clockwise, turn 360° counter clockwise, walk through door) with three dual-task levels (walk [1]; walk & carry tray [2]; walk, carry tray & perform mental calculations [3]) were assessed with levodopa off and on. Total score and time, as well as individual scores during different dual-tasking levels were compared between groups and levodopa states within each group.

Results: Demographics and disease features while levodopa off were matched between groups [table 1]. Levodopa improved MDS-UPDRS Part III scores in both groups [table 1]. Although the degree of improvement by levodopa was not significantly different between groups, there was more improvement of MDS-UPDRS Part III scores in PD-nFOG. PD-FOG had higher scores and were slower on all levels in the FOG assessment compared to PD-nFOG, with and without levodopa [figures 1-2]. Levodopa shortened the time to complete each level in PD-nFOG, but did not have a significant effect on the PD-FOG [figures 1-2]. Total and individual FOG assessment scores improved with levodopa in both groups, but the improvement was not statistically significant.

Conclusions: Levodopa improved the time to complete the FOG assessment in PD-nFOG but not PD-FOG. FOG scores were not significantly improved by levodopa. Overall, levodopa does not have a major impact on dual-tasking. With a bigger sample, more reliable results will be acquired. More effective treatment approaches are required for the management of PD-FOG.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/levodopa-effect-on-dual-tasking-in-freezing-of-gait-in-parkinsons-disease/