Terashi Hiroo, Ueta Yuki, Taguchi Takeshi, Mitoma Hiroshi, Aizawa Hitoshi
Department of Neurology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
Department of Medical Education, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
Parkinsons Dis. 2022 Jul 8;2022:4732020. doi: 10.1155/2022/4732020. eCollection 2022.
Freezing of gait (FOG) is an important symptom that can impair activities of daily living in patients with Parkinson's disease (PD). However, its pathogenic mechanism is largely unknown. The aim of the present study was to elucidate the clinical characteristics of newly diagnosed and levodopa-naïve patients with PD who present with FOG.
A total of 53 patients with untreated PD (29 men and 24 women) within 2 years of disease onset were included in the study. Using item 3 of the Freezing of Gait Questionnaire (FOG-Q), patients were classified as "freezers" and "nonfreezers" and compared for cognitive function, depressive symptoms, apathy, olfactory function, motor severity, gait parameters, and daily physical activity. We also assessed the relationship between FOG severity (total score of items 3-6 on the FOG-Q) and various clinical parameters.
The FOG was reported by 8 (15%) patients with PD. The Apathy Scale score (=0.018), Modified Hoehn and Yahr stage ( < 0.001), Unified Parkinson's Disease Rating Scale part III score ( < 0.001), and postural instability and gait disorder score ( < 0.001) were significantly higher, and the mean gait acceleration amplitude (=0.006) was significantly lower in freezers compared to that in nonfreezers. However, there was no significant correlation between FOG severity and these clinical parameters. There was also no significant difference in cognitive function, depressive symptoms, and olfactory function between the two groups. Daily physical activity was significantly lower in freezers than that in nonfreezers.
Since FOG develops soon after PD onset, the study findings suggest that the FOG might be associated with the severity of apathy, motor symptoms, and in particular, gait disturbance.
冻结步态（FOG）是帕金森病（PD）患者日常生活活动受损的一个重要症状。然而，其致病机制在很大程度上尚不清楚。本研究的目的是阐明新发且未服用左旋多巴的PD患者出现FOG的临床特征。
本研究纳入了53例疾病发作2年内未接受治疗的PD患者（29例男性和24例女性）。使用步态冻结问卷（FOG-Q）的第3项，将患者分为“冻结者”和“非冻结者”，并比较其认知功能、抑郁症状、淡漠、嗅觉功能、运动严重程度、步态参数和日常身体活动。我们还评估了FOG严重程度（FOG-Q第3-6项的总分）与各种临床参数之间的关系。
8例（15%）PD患者报告有FOG。与非冻结者相比，冻结者的淡漠量表评分（=0.018）、改良Hoehn和Yahr分期（<0.001）、帕金森病统一评分量表第三部分评分（<0.001）以及姿势不稳和步态障碍评分（<0.001）显著更高，平均步态加速度幅度（=0.006）显著更低。然而，FOG严重程度与这些临床参数之间无显著相关性。两组在认知功能、抑郁症状和嗅觉功能方面也无显著差异。冻结者的日常身体活动明显低于非冻结者。
由于FOG在PD发病后不久就出现，研究结果表明FOG可能与淡漠、运动症状尤其是步态障碍的严重程度有关。
