Objective: to determine the potential differences in gait characteristics between PD-GBA carriers and non-carriers (idiopathic Parkinson’s disease (iPD)), both mutually and in relation to MSA-P.

Background: Gait and balance difficulties are cardinal features of parkinsonian disorders, yet these mobility deficits vary greatly across patients. There are only a few studies dealing with quantitative gait parameters analysis in PD and MSA-P, that can provide valuable information about subtle gait alterations, especially in the early phases of the diseases.

Recent studies have shown that PD-GBA carriers have clinical presentations that closely resemble MSA-P, making the differential diagnosis even more challenging.

Method: We enrolled 24 patients with iPD and 11 with PD-GBA, and 12 with MSA-P. The severity of motor, psychiatric, and cognitive symptoms were accessed with appropriate scales in all 3 groups. All subjects underwent GAITRite to objectively measure gait, at “basic gait condition”, as well as for three additional test conditions, described in the methods. We compared the results of gait analysis among 3 groups in all test conditions and performed a correlation analysis of gait parameters with clinical characteristics.

Results: After on average 3.5 years of disease duration, GBA carriers and non-carriers differ neither in clinical parameters nor in subtle gait parameters. However, patients in the early phase of MSA-P differ from both PD patient groups, not just in motor and cognitive parameters of the disease, but also in gait assessment. Differences in spatial abnormalities of gait parameters are obvious in the early phases of investigated parkinsonian disorders, mainly expressed through the shortening of step length and its increased variability in MSA-P, while no differences were found in temporal gait parameters. While the step length in early PD is not correlated with any of the motor and cognitive symptoms, the step length and its variation in MSA-P is under the influence of multiple factors, and most consistently depends on disease duration. In addition, step length in early MSA-P is also affected by motor, cognitive, and mood disturbances, but only in dual-task situations.

Conclusion: Our data suggest that genetic status does not influence gait pattern in early PD and that there are gait parameters that could discriminate early MSA-P from PD and, therefore, provide objective research outcomes.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/characterization-of-gait-variability-of-early-parkinsons-disease-and-multiple-system-atrophy/