Freezing-related perception deficits of asymmetrical walking in Parkinson's disease. (19th November 2017)

• Record Type: Journal Article
• Authors: Bekkers, Esther M.J.; Hoogkamer, Wouter; Bengevoord, Aniek; Heremans, Elke; Verschueren, Sabine M.P.; Nieuwboer, Alice
• Is Part Of: Neuroscience. Volume 364(2017)
• Page Start: 122
• Page End: 129
• Publication Date: 2017-11-19
• Subjects: CV coefficient of variation -- FOG freezing of gait -- H&Y Hoehn & Yahr staging -- LED levodopa equivalent dosage -- MDS-UPDRS Movement Disorder Society-Unified Parkinson's disease rating scale -- MMSE Mini-Mental State Examination -- MoCA Montreal Cognitive Assessment -- NFOG-Q New Freezing of Gait Questionnaire -- PD Parkinson's disease; Parkinson's disease -- freezing of gait -- split-belt walking -- perception -- gait asymmetry; Neurochemistry -- Periodicals; Neurophysiology -- Periodicals; Neurology -- Periodicals; Neurochimie -- Périodiques; Neurophysiologie -- Périodiques; Neurochemistry; Neurophysiology; Electronic journals; Periodicals; Electronic journals; 612.8
• DOI: 10.1016/j.neuroscience.2017.09.017
• Languages: English
• ISSNs: 0306-4522

Abstract

Highlights: PD patients with freezing of gait walk with more spatial asymmetry. Freezers have impaired perception of their locomotor asymmetry. Spatial gait characteristics are associated with perceptual ability. Abstract: Patients with Parkinson's disease (PD), and especially those with freezing of gait (FOG), are known to experience impairments in gait rhythmicity, symmetry, and bilateral coordination between both legs. In the current study, we investigated whether deficits in perception of gait speed between limbs were more pronounced in freezers than in non-freezers and could explain some of these gait impairments. We also assessed cognitive ability and proprioception. Twenty-five PD patients (13 freezers, 12 non-freezers) and 12 healthy controls walked on a split-belt treadmill, while the speed of one of the belts was gradually increased. Participants had to indicate the moment at which they perceived belt speeds to be different. The main outcome variables were the number of correct responses (perception accuracy) and the difference in belt speeds at the moment the participants perceived belt speeds to be different (perception threshold). In addition, gait characteristics during both split- and tied-belt walking were determined. Results showed significantly lower perception accuracy in freezers, whereas the perception threshold did not differ between groups. During tied-belt walking, freezers exhibited more asymmetrical step lengths and limb excursions than non-freezers and healthy controls. Greater step length and limb excursions were associated with better perception, whereas more variable gait was associated with more impaired perception. The results confirm the hypothesis that freezers have impaired perception of locomotor asymmetry. While proprioceptive and cognitive ability did not explain these findings, the possible causal link with the occurrence of FOG needs further corroboration.