Freezing of gait and dementia in parkinsonism: A retrospective case-control study

Brain Behav. 2019 Jun;9(6):e01247. doi: 10.1002/brb3.1247. Epub 2019 May 9.

Abstract

Objectives: To support the cognitive model of Freezing of Gait (FoG) we investigated FoG in a cohort of patients with Dementia with Lewy Bodies (DLB).

Materials and methods: We assessed FoG frequency in 19 DLB patients compared to 19 control PD patients within 2 years from symptom onset and with at least 5 years follow-up. The two groups were matched by age and motor presentation at onset, severity of parkinsonism and disease duration. The presence and severity of FoG was identified as those with a score of 1 or greater on subitem 14 of the Unified Parkinson's Disease Rating Scale Part II (UPDRS II).

Results: At T0, 68.4% DLB and 10.5% PD patients experienced FoG ≥1. The prevalence of FoG increased with disease progression (94.7% DLB and 47.3% PD subjects had FoG ≥1 at T5). DLB also showed a more severe FoG (FoG ≥2) than PD (21% vs. 0% at T0 and 52.6% vs. 10.5% at T5), consistently with previous studies reporting FoG prevalence in DLB.

Conclusion: This is the first study looking specifically at FoG in DLB, identifying it as a frequent and early feature of DLB and emphasizing the crucial role of cognitive impairment in the occurrence of this mysterious phenomenon.

Keywords: Parkinson's disease; Parkinsonism; dementia with lewy bodies; freezing of gait.

MeSH terms

  • Aged
  • Case-Control Studies
  • Cohort Studies
  • Dementia / etiology*
  • Dementia / physiopathology*
  • Female
  • Follow-Up Studies
  • Gait Disorders, Neurologic / etiology*
  • Gait Disorders, Neurologic / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / complications*
  • Parkinson Disease / physiopathology*
  • Parkinson Disease / psychology
  • Retrospective Studies
  • Severity of Illness Index