Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands.
Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands.
J Parkinsons Dis. 2020;10(3):1245-1248. doi: 10.3233/JPD-201997.
The relation between freezing of gait in Parkinson's disease and levodopa is complex. Here, we describe a new phenotype of freezing of gait, namely levodopa-induced freezing of gait with a biphasic pattern. Our observation supports the idea that freezing of gait might emerge because of a mismatch between cognitive/limbic loops and motor loops involved in gait control. Moreover, it underscores the importance of assessing the influence of dopaminergic medication in daily clinical practice, including objective assessment in all three dopaminergic states. The possibility of biphasic freezing will only emerge after such a comprehensive evaluation, and will have immediate therapeutic consequences.
帕金森病患者的冻结步态与左旋多巴之间的关系很复杂。在这里，我们描述了一种新的冻结步态表型，即具有双相模式的左旋多巴诱导的冻结步态。我们的观察结果支持这样一种观点，即冻结步态的出现可能是由于参与步态控制的认知/边缘回路和运动回路之间不匹配所致。此外，它强调了在日常临床实践中评估多巴胺能药物影响的重要性，包括在所有三种多巴胺能状态下进行客观评估。只有在进行了全面评估后，才会出现双相冻结的可能性，并且会立即产生治疗后果。
