Doorway-provoked freezing of gait in Parkinson's disease

摘要: Freezing of gait in Parkinson’s disease can be difficult to study the laboratory. Here we investigate use a variable-width doorway provoke freeze behavior together with new objective methods measure it. With this approach compare effects anti-parkinsonian treatments (medications and deep-brain stimulation subthalamic nucleus) on freezing other impairments. Ten ‘‘freezers’’ 10 control participants were studied. Whole-body kinematics measured while walked at preferred speed each 4 conditions (no door present, width 100%, 125%, 150% shoulder width) treatment states (offmeds/offstim, offmeds/onstim,onmeds/offstim, onmeds/onstim). no doorway, group showed characteristic disturbances including slow speed, short steps, variable step timing. Treatments improved these disturbances. The slowed further doorways by an amount inversely proportional width, suggesting visuomotor dysfunction. This was not either alone. Finally, freeze-like events successfully provoked near their prevalence significantly increased narrower doorways. These defined clinically 2 criteria that correlated well clinical ratings. risk reduced medication but stimulation. Freeze replicable experimental setting using paradigm,and objectively definitions introduced here. differential highlight complexity Parkinsonian disorders management.