Freezing of Gait in Parkinson's Disease: Invasive and Noninvasive Neuromodulation

Objective: To conduct a systematic review evaluating the effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life among individuals with Parkinson’s disease. Data sources: A systematic search of PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, and Physiotherapy Evidence Database was carried out to identify eligible papers published up to December 10, 2020. Review methods: Literature selection, data extraction, and methodological quality assessment were independently performed by two investigators. Publication bias was determined by funnel plot and Egger’s regression test. “Trim and fill” analysis was performed to adjust any potential publication bias. Results: Seventeen studies involving 598 participants were included in this meta-analysis. Music-based movement therapy significantly improved motor function (Unified Parkinson’s Disease Rating Scale motor subscale, MD = −5.44, P = 0.002; Timed Up and Go Test, MD = −1.02, P = 0.001), balance (Berg Balance Scale, MD = 2.02, P < 0.001; Mini-Balance Evaluation Systems Test, MD = 2.95, P = 0.001), freezing of gait (MD = −2.35, P = 0.039), walking velocity (MD = 0.18, P < 0.001), and mental health (SMD = −0.38, P = 0.003). However, no significant effects were observed on gait cadence, stride length, and quality of life. Conclusion: The findings of this study show that music-based movement therapy is an effective treatment approach for improving motor function, balance, freezing of gait, walking velocity, and mental health for patients with Parkinson’s disease.

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Attention switching deficit in patients of Parkinson’s disease who experience freezing of gait

Applied Neuropsychology Adult ◽

10.1080/23279095.2021.1951268 ◽

2021 ◽

pp. 1-12

Author(s):

Moulika Mandal ◽

Azizuddin Khan

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Freezing Of Gait ◽

Attention Switching

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1 Application of neural network to detect freezing of gait in patients with Parkinson’s disease

Soft Computing ◽

10.1515/9783110628616-001 ◽

2020 ◽

pp. 1-12

Keyword(s):

Neural Network ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Freezing Of Gait

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Use of Botulinum Neurotoxin in Parkinson’s Disease: A Critical Appraisal

Toxins ◽

10.3390/toxins13020087 ◽

2021 ◽

Vol 13 (2) ◽

pp. 87

Author(s):

Wolfgang H. Jost

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Botulinum Neurotoxin ◽

Critical Appraisal ◽

Freezing Of Gait ◽

Sufficient Data ◽

Pisa Syndrome ◽

Focal Hyperhidrosis ◽

Detrusor Hyperactivity ◽

Important Indication

For well over 30 years, the botulinum neurotoxin (BoNT) has been used for a large number of indications, some of which however have not been licensed. Admittedly, approval varies in many countries and this permits a large spectrum for evaluation. Thus, BoNT is used for patients with Parkinson’s disease (PD) and other Parkinson’s syndromes (PS) in varying degrees of frequency. We have to distinguish between (1) indications that are either approved or (2) those not approved, (3) indications that might be a result of PS and (4) finally those which appear independent of PS. The most important indication for BoNT in PS patients is probably sialorrhea, for which approval has been granted in the majority of countries. Cervical dystonia is a frequent symptom in PS, with anterocollis as a specific entity. A further indication is blepharospasm in the different forms, especially the inhibition of eyelid opening in atypical PS. The use of BoNT in cases of camptocormia, the Pisa syndrome and neck rigidity is still a matter of debate. In dystonia of the extremities BoNT can be recommended, especially in dystonia of the feet. One well-known indication, for which however sufficient data are still lacking, involves treating tremor with BoNT. As to autonomic symptoms: Focal hyperhidrosis and detrusor hyperactivity can be mentioned, in this last case BoNT has already been approved. A number of further but rare indications such as freezing-of-gait, dyskinesia, and dysphagia will be discussed and evaluated.

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Thalamic morphology predicts the onset of freezing of gait in Parkinson’s disease

npj Parkinson s Disease ◽

10.1038/s41531-021-00163-0 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Nicholas D’Cruz ◽

Griet Vervoort ◽

Sima Chalavi ◽

Bauke W. Dijkstra ◽

Moran Gilat ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Resting State ◽

Freezing Of Gait ◽

Study Entry ◽

Resting State Functional Connectivity ◽

Behavioral Correlates ◽

Local Volume ◽

Linear Evolution ◽

Risk Of Falls

AbstractThe onset of freezing of gait (FOG) in Parkinson’s disease (PD) is a critical milestone, marked by a higher risk of falls and reduced quality of life. FOG is associated with alterations in subcortical neural circuits, yet no study has assessed whether subcortical morphology can predict the onset of clinical FOG. In this prospective multimodal neuroimaging cohort study, we performed vertex-based analysis of grey matter morphology in fifty-seven individuals with PD at study entry and two years later. We also explored the behavioral correlates and resting-state functional connectivity related to these local volume differences. At study entry, we found that freezers (N = 12) and persons who developed FOG during the course of the study (converters) (N = 9) showed local inflations in bilateral thalamus in contrast to persons who did not (non-converters) (N = 36). Longitudinally, converters (N = 7) also showed local inflation in the left thalamus, as compared to non-converters (N = 36). A model including sex, daily levodopa equivalent dose, and local thalamic inflation predicted conversion with good accuracy (AUC: 0.87, sensitivity: 88.9%, specificity: 77.8%). Exploratory analyses showed that local thalamic inflations were associated with larger medial thalamic sub-nuclei volumes and better cognitive performance. Resting-state analyses further revealed that converters had stronger thalamo-cortical coupling with limbic and cognitive regions pre-conversion, with a marked reduction in coupling over the two years. Finally, validation using the PPMI cohort suggested FOG-specific non-linear evolution of thalamic local volume. These findings provide markers of, and deeper insights into conversion to FOG, which may foster earlier intervention and better mobility for persons with PD.

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