Freezing of Gait in Multiple System Atrophy

Huaguang Yang; Weiyin Vivian Liu; Shanshan Wang; Wenbin Yang; Changsheng Liu; Zhi Wen; Lanhua Hu; Jinxia Guo; Guoguang Fan; Xiaoguang Luo; Yunfei Zha

doi:10.3389/fnagi.2022.833287

Freezing of Gait in Multiple System Atrophy

Front Aging Neurosci. 2022 Apr 8:14:833287. doi: 10.3389/fnagi.2022.833287. eCollection 2022.

Authors

Affiliations

¹ Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, China.
² MR Research, GE Healthcare, Beijing, China.
³ Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China.
⁴ Department of Neurology, The First Affiliated Hospital of South University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China.

Abstract

Background and purpose: Freezing of gait (FOG) is a common gait disturbance phenomenon in multiple system atrophy (MSA) patients. The current investigation assessed the incidence FOG in a cross-sectional clinical study, and clinical correlations associated with it.

Methods: Ninety-nine MSA patients from three hospitals in China were consecutively enrolled in the study. Eight patients were subsequently excluded from the analysis due to incomplete information. The prevalence of FOG symptoms in the MSA cohort was determined, and clinical manifestations in MSA patients with and without FOG were assessed.

Results: Of 91 MSA patients, 60 (65.93%) exhibited FOG. The incidence of FOG increased with disease duration and motor severity and was correlated with modified Hoehn and Yahr (H-Y) stages [odds ratio (OR), 0.54; 95% confidence interval (CI), 0.33-3.92], longer disease duration (OR, 0.54, 95% CI, 0.37-0.78), higher Unified Multiple System Atrophy Rating Scale (UMSARS) score (OR, 0.96, 95% CI, 0.93-0.99), MSA-cerebellum subtype (OR, 2.99, 95% CI, 1.22-7.33), levodopa-equivalent dose (LDED) (OR, 0.998, 95% CI, 0.997-1.00), and higher Scale for the Assessment and Rating of Ataxia (SARA) score (OR, 0.80, 95% CI, 0.72-0.89) (logistic regression). Motor dysfunction was significantly positively associated with lower quality of life scores (p < 0.01).

Conclusion: FOG is a common symptom in MSA patients and it is correlated with poor quality of life, disease progression and severity, levodopa-equivalent dose, and cerebellum impairment.

Keywords: epidemiological investigation; freezing of gait; multiple system atrophy; prevalence; risk factors.