Bartels A L, Balash Y, Gurevich T, Schaafsma J D, Hausdorff J M, Giladi N
Department of Neurology, Tel-Aviv University, Tel-Aviv, Israel.
J Clin Neurosci. 2003 Sep;10(5):584-8. doi: 10.1016/s0967-5868(03)00192-9.
The pathophysiology of freezing of gait (FOG) is unclear.
To assess the relationships between FOG and other parkinsonian features in Parkinson's disease (PD), focusing on levodopa effects.
Nineteen PD patients with significant FOG in "off" were assessed while "off" and "on". Three observers independently viewed videotapes of a 130-m walk and scored FOG frequency. The Unified Parkinson's disease Rating Scale was used to evaluate clinical state.
FOG frequency was not correlated with other parkinsonian features in "off" and only with speech and writing in "on". Levodopa significantly decreased FOG frequency (p<0.001). This reduction was strongly correlated with improvement of tremor (R=0.80, p<0.01) and speech (R=0.62, p<0.05), but not with improvement in rigidity, bradykinesia, or balance.
Levodopa decreases FOG in PD. FOG is apparently an independent motor symptom, caused by a paroxysmal pathology that is different from that responsible for bradykinesia, rigidity or postural instability.
冻结步态(FOG)的病理生理学尚不清楚。
评估帕金森病(PD)中FOG与其他帕金森病特征之间的关系,重点关注左旋多巴的作用。
对19例在“关”期有明显FOG的PD患者在“关”期和“开”期进行评估。三名观察者独立观看130米步行的录像带,并对FOG频率进行评分。采用统一帕金森病评定量表评估临床状态。
FOG频率在“关”期与其他帕金森病特征无关,仅在“开”期与言语和书写有关。左旋多巴显著降低FOG频率(p<0.001)。这种降低与震颤改善(R=0.80,p<0.01)和言语改善(R=0.62,p<0.05)密切相关,但与强直、运动迟缓或平衡改善无关。
左旋多巴可降低PD患者的FOG。FOG显然是一种独立的运动症状,由一种阵发性病理改变引起,该病理改变不同于导致运动迟缓、强直或姿势不稳的病理改变。