Objective: We conducted a prospective hospital based cohort study to investigate the incidence of Freezing of gait (FOG) and variables associated with onset of FOG in Japanese Parkinson’s disease (PD) patients．

Background: FOG is one of the motor symptoms that disable and affect the quality of life of PD patients. There have been few studies examining the longitudinal course of FOG in PD patients.

Methods: 133 idiopathic PD patients were enrolled at baseline evaluation and followed prospectively over one year. The Japanese version of New Freezing of Gait Questionnaire (NFOG-Q) was administered to evaluate FOG, which has a cutoff for a gait freezer at ≥1 points. Hoehn-Yahr stage (HY stage), Unified Parkinson’s Disease Rating Scale (UPDRS) part 3, Levodopa equivalent daily dose (LEDD), cognitive function including the Mini Mental State Examination (MMSE), the Japanese version of Montreal Cognitive Assessment (MoCA-J) and the Frontal Assessment Battery (FAB), and non-motor symptoms including depression, apathy, fatigue and sleep disorders were also assessed.

Results: At baseline, 77 patients (57%) had FOG with a mean age of the freezer of 69.9 (SD: 9.2) years, mean disease duration of 7.5 (5. 6) years and a mean HY stage of 2.4(0.87). At the follow-up evaluation (mean follow-up duration was 12.7 (2.8) months), prevalence of FOG increased to 62% of patients. Twelve patients who were non-freezer at baseline developed FOG (incident freezer), while six patients who were freezers at baseline became non-freezers. Compared to the non-freezer group, the age at evaluation was significantly higher and the FAB score at baseline was significantly lower in the incident freezer group. There were no significant differences in UPDRS part 3 and HY stage at baseline between the two groups. At the follow-up evaluation, the scores of UPDRS part 3 and HY stage were significantly higher in the incident freezer group compared to the non-freezer group. While the tremor sub-score of UPDRS did not change, the sub-scores of bradykinesia, rigidity and postural instability gait difficulty (PIGD) were significantly worsened in the incident freezer group.

Conclusions: Although the etiology of FOG in PD remains uncertain, our study indicates that in addition to frontal lobe dysfunction, motor exacerbation may contribute to the occurrence of FOG in PD patients.

References: 1) Nieuwboer A, et al. Reliability of the new freezing of gait questionnaire: agreement between patients with Parkinson‘s disease and their carers. Gait Posture. 2009 Nov; 30(4):459–63. 2) Forsaa EB, et al. A 12-year population-based study of freezing of gait in Parkinson’s disease. Parkinsonism Relat Disord. 2015 Mar; 21(3):254–8

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/longitudinal-study-of-freezing-of-gait-in-patients-with-parkinsons-disease/