Ehgoetz Martens Kaylena A, Peterson Daniel S, Almeida Quincy J, Lewis Simon J G, Hausdorff Jeffrey M, Nieuwboer Alice
Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
College of Health Solutions, Arizona State University, Arizona, USA; Phoenix Veterans Affairs Medical Centre, Arizona, USA.
Neurosci Biobehav Rev. 2020 Sep;116:350-364. doi: 10.1016/j.neubiorev.2020.06.026. Epub 2020 Jun 27.
Over the past decade, non-motor related symptoms and provocative contexts have offered unique opportunities to gain insight into the potential mechanisms that may underpin freezing of gait (FOG) in Parkinson's disease (PD). While this large body of work has informed several theoretical models, to date, few are capable of explaining behavioural findings across multiple domains (i.e. cognitive, sensory-perceptual and affective) and in different behavorial contexts. As such, the exact nature of these interrelationships and their neural basis remain quite enigmatic. Here, the non-motor, behavioural evidence for cognitive, sensory-perceptual and affective contributors to FOG are reviewed and synthesized by systematically examining (i) studies that manipulated contextual environments that provoke freezing of gait, (ii) studies that uncovered factors that have been proposed to contribute to freezing, and (iii) studies that longitudinally tracked factors that predict the future development of freezing of gait. After consolidating the evidence, we offer a novel perspective for integrating these multi-faceted behavioural patterns and identify key challenges that warrant consideration in future work.
在过去十年中，与非运动相关的症状和激发情境为深入了解帕金森病（PD）中可能导致冻结步态（FOG）的潜在机制提供了独特的机会。尽管大量研究工作为几种理论模型提供了依据，但迄今为止，很少有模型能够解释多个领域（即认知、感觉-知觉和情感）以及不同行为情境下的行为结果。因此，这些相互关系的确切性质及其神经基础仍然相当神秘。在此，通过系统地审查以下方面对认知、感觉-知觉和情感因素导致FOG的非运动行为证据进行了综述和综合：（i）操纵激发冻结步态的情境环境的研究；（ii）揭示已被提出导致冻结的因素的研究；（iii）纵向跟踪预测冻结步态未来发展的因素的研究。在整合证据之后，我们提出了一个整合这些多方面行为模式的新视角，并确定了未来工作中值得考虑的关键挑战。
