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帕金森病中的冻结步态与运动功能不对称有关吗?

Is freezing of gait in Parkinson's disease related to asymmetric motor function?

作者信息

Plotnik Meir, Giladi Nir, Balash Yacov, Peretz Chava, Hausdorff Jeffrey M

机构信息

Movement Disorders Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

出版信息

Ann Neurol. 2005 May;57(5):656-63. doi: 10.1002/ana.20452.

Abstract

Freezing of gait (FOG) is a disabling phenomenon common in patients with advanced Parkinson's disease (PD). The cause of FOG is unclear. The objective of this study was to explore a novel hypothesis stating that FOG is related to asymmetric motor performance. We compared PD patients that experience FOG episodes (PD+FOG) with PD patients that do not (PD-FOG) and studied the relationship of FOG to asymmetry in gait and in rhythmic hand movement performance to determine whether potential FOG-related gait asymmetry is unique to walking or whether it is systemic. Subjects were tested in an "off" (unmedicated) and again in an "on" (medicated) state. Gait was more asymmetric in PD+FOG than in PD-FOG during "off" state (p = 0.005) and during "on" (p = 0.016). Rhythmicity of foot swing in one leg was correlated with the other leg in PD-FOG but not in PD+FOG. There was no difference in asymmetry in performance of rhythmic hand movements between the two groups. No correlation was found between asymmetry of clinical symptoms and gait asymmetry. Taken together, the results of this study suggest that bilateral uncoordinated gait and marked gait asymmetry, but not asymmetry in motor performance in general, are associated with FOG.

摘要

冻结步态(FOG)是晚期帕金森病(PD)患者中常见的致残现象。FOG的病因尚不清楚。本研究的目的是探索一种新的假说,即FOG与不对称运动表现有关。我们将经历FOG发作的PD患者(PD+FOG)与未经历FOG发作的PD患者(PD-FOG)进行比较,并研究FOG与步态和有节奏手部运动表现不对称之间的关系,以确定潜在的与FOG相关的步态不对称是步行所特有的,还是全身性的。受试者在“关”(未服药)状态下进行测试,然后在“开”(服药)状态下再次测试。在“关”状态下(p=0.005)和“开”状态下(p=0.016),PD+FOG患者的步态比PD-FOG患者更不对称。在PD-FOG患者中,一条腿的足部摆动节律与另一条腿相关,但在PD+FOG患者中则不然。两组之间有节奏手部运动表现的不对称性没有差异。未发现临床症状的不对称性与步态不对称性之间存在相关性。综上所述,本研究结果表明,双侧不协调步态和明显的步态不对称与FOG有关,但一般运动表现的不对称性与FOG无关。

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