Medicina Clinica, Ambulatorio Complicanze Internistiche Cerebrali, Dipartimento Universitario Clinici di Scienze Mediche Tecnologiche e Traslazionali, Università degli Studi di Trieste, Ospedale di Cattinara, Strada Fiume 447, 34149 Trieste, Italy.
Parkinsons Dis. 2011;2011:746303. doi: 10.4061/2011/746303. Epub 2011 Jul 14.
Freezing of gait is a warning sign of Parkinson's disease. One could distinguish off-freezing, which is associated with dopaminergic therapy and to its titration, and it is clinically related to wearing-off phenomenon. Differently, the on-freezing phenomenon seems to be related to a neural disruption of the frontal-parietal-basal ganglia-pontine projections; clinically, it does not respond to therapy modifications or to different drug titration. In a group of patients with on-freezing, we have detected an alteration of focusing attention, an impairment of set-shifting, in addition to poor abstract reasoning and a reduction of planning. These aspects have been even more evident, when compared with the results obtained by a group of PD patients, without freezing.
冻结步态是帕金森病的一个警告信号。人们可以区分无冻结步态,它与多巴胺能治疗及其滴定有关,并且与“开-关”现象有关。相反,冻结步态现象似乎与额顶叶-基底节-脑桥投射的神经中断有关;临床上,它对治疗方法的改变或不同药物滴定没有反应。在一组冻结步态患者中,我们发现了注意力集中能力的改变,定势转移的损害,此外还有抽象推理能力差和计划能力的降低。与一组无冻结步态的 PD 患者相比,这些方面更加明显。