Freezing of gait: moving forward on a mysterious clinical phenomenon
John G Nutt, Bastiaan R Bloem, Nir Giladi, Mark Hallett, Fay B Horak, Alice Nieuwboer, John G Nutt, Bastiaan R Bloem, Nir Giladi, Mark Hallett, Fay B Horak, Alice Nieuwboer
Abstract
Freezing of gait (FoG) is a unique and disabling clinical phenomenon characterised by brief episodes of inability to step or by extremely short steps that typically occur on initiating gait or on turning while walking. Patients with FoG, which is a feature of parkinsonian syndromes, show variability in gait metrics between FoG episodes and a substantial reduction in step length with frequent trembling of the legs during FoG episodes. Physiological, functional imaging, and clinical-pathological studies point to disturbances in frontal cortical regions, the basal ganglia, and the midbrain locomotor region as the probable origins of FoG. Medications, deep brain stimulation, and rehabilitation techniques can alleviate symptoms of FoG in some patients, but these treatments lack efficacy in patients with advanced FoG. A better understanding of the phenomenon is needed to aid the development of effective therapeutic strategies.
Conflict of interest statement
Conflicts of interest
In the past 3 years, JGN and the Oregon Health & Sciences University (OHSU) have received consulting fees from Xenoport, Impax Laboratories, Neurogen, Synosia, Neuroderm, Merck, Lilly/Medtronics, Elan, Addex, Lumbeck, Merz Pharmaceuticals, and SynAgile, and grants from the National Institutes of Health (NIH), the Veterans Administration, the National Parkinson Foundation, the Michael J Fox Foundation, the RJG Foundation, and Merck. In the past 3 years, BRB and the Radboud University Nijmegen Medical Centre have received consulting fees, travel funds, board membership fees, and grants from Boehringer Ingelheim, Teva, GlaxoSmithKline, Novartis, the Movement Disorder Society, the European Federation of Neurological Societies, Tijdschrift voor Neurolgie en Neurochiugie, the Netherlands Organisation for Scientific Research, the Michael J Fox Foundation, Prinses Beatrix Fonds, Stichting Intemationaal Parkinson Fonds, and the van Alkemade-Keuls Foundation. In the past 3 years, NG and the Sackler School of Medicine, Tel Aviv University, have received board membership fees, consulting fees, speaking fees, travel fees, and grants from the Movement Disorder Society, Teva, UCB, Schwarz Pharma, Lundbeck, Eisai, Intec Pharma, GlaxoSmithKline, Solvay, Merz, Biogen, Neuroderm, the Michael J Fox Foundation, the National Parkinson Foundation, and the Israel Science Foundation. In the past 3 years, FBH and the OHSU have received speaker fees, board membership fees, and grants from the Hong Kong Polytechnical University, the APDM Inc OHSU Hospital Innovation Fund, and NIH, MH and AN declare that they have no conflicts of interest.
Copyright © 2011 Elsevier Ltd. All rights reserved.
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Source: PubMed