Objective: To analyze the association between motor, attentional and non-planning impulsivity and freezing of gait in people with PD

Background: Freezing of gait is a disabling feature of Parkinson’s disease (PD) as it reduces mobility, increases the risk of falls, and negatively affects health-related quality of life¹.Impulsivity is a multifaceted concept that encompasses behaviors characterized by inadequate planning, premature execution, excessive risk-taking, or a lack of situational appropriateness, often leading to unfavorable consequences².Although some studies have demonstrated its association with freezing of gait, the relationship between different sub-traits of impulsivity and freezing of gait has not been explored in people with PD³.

Method: The Mini Mental State Examination (MMSE) was performed, followed by sociodemographic and clinical data including disease severity (MDS-UPDRS motor examination and Hoehn and Yahr [H&Y]), disability (MDS-UPDRS Motor Aspects of Daily Life Experiences – M-EVD), impulsivity (Barratt Impulsiveness Scale 11 – BIS-11) and freezing of gait (freezing of gait questionnaire -FOG-Q).The BIS-11 is a self-report tool used to assess the personality construct of impulsivity.The questionnaire consists of 30 items that are scored on a four-point scale (1–4) and that taps into three sub-traits: motor impulsivity, attentional impulsivity, and non-planning impulsivity.Total impulsivity is calculated as the sum of all items. Higher scores on the BIS-11 indicate greater impulsivity.The FOG-Q has 6 questions and the total score ranges from 0-24, with higher scores indicating more severity of freezing of gait.Pearson correlation was used to identify the association between the variables.

Results: Among the 130 participants enrolled in this study, 76 (58.5%) were male, the mean age was 63.6 (9.9) years, disease duration was 7.13 (4.38) years, median HY was 2.5 (2-2.6), mean MDS-UPDRS motor examination was 32.6 (14.5) and MDS-UPDRS M-EVD was 12 (7.5-15). BIS-11 had a mean of 61.825 (9.32) points. 61 (47.7%) individuals had freezing of gait and the median FOG-Q was 4 (2-10).A direct correlation was found between freezing of gait and both attentional (r = .300; p = .001) and non-planning impulsivity (r = .253; p = .004) and.

Conclusion: Although a causal relationship cannot be established, our results suggest that impulsivity may impact freezing of gait and should be assessed in people with PD.

References: 1.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 Aug;10(8):734-44.
2. Smulders K, Esselink RA, Cools R, Bloem BR. Trait impulsivity is associated with the risk of falls in Parkinson’s disease. PLoS One. 2014 Mar 7;9(3):e91190.
3.GILADI N, Nieuwboer A. Understanding and treating freezing of gait in parkinsonism, proposed working definition, and setting the stage. Mov Disord.2018;23 Suppl 2:S423-5.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/association-between-trait-impulsivity-and-freezing-of-gait-in-people-with-parkinsons-disease/