背景:步态冻结(FOG)是特发性帕金森病(IPD)患者最虚弱的症状之一。视觉提示可以缓解FOG症状。然而,对于可以从视觉线索中获益的患者特征,目前尚无共识.因此,我们根据视觉提示的有效性检查了IPD患者特征的差异.
方法:通过步态实验,我们调查了雾霾发生的次数,平均每集FOG周期,FOG持续时间在总步态周期中的比例,10名因IPD而被诊断为FOG的参与者的无FOG期步态时空参数。随后,他们的临床特征和纹状体多巴胺活性转运体可用性之间的差异从纹状体的六个亚区通过将它们分为两组基于三个减少率:发生数,每集的平均持续时间,通过使用激光鞋进行视觉提示,可以改善FOG持续时间在总步态周期中的比例。还使用Spearman相关性分析研究了这三种还原率与其他FOG相关参数之间的关系。
结果:根据与FOG相关的三个减少率,小组分配是相同的,这也与基线自我报告的FOG严重程度评分(新的步态冻结问卷)有关:FOG越严重,对视觉提示的反应越差。通过视觉提示,反应较好的组表现出较低的新FOG问卷总分的特征,前和后壳核的多巴胺活性转运蛋白可用性更高,在没有提示的情况下,每次发作的FOG平均持续时间较短。使用Spearman相关性分析重复了这些结果。
结论:对于IPD后的FOG症状,当NFOGQ总评分较低且壳核的DAT较高时,通过视觉提示进行步态辅助可能更有效。通过这项研究,我们证明了临床和纹状体多巴胺能条件,以选择更有可能从激光鞋的视觉提示中受益的患者,这些发现导致需要对IPD患者进行FOG的早期诊断。
背景:ClinicalTrials.gov标识符:NCT05080413。2021年9月14日注册。
BACKGROUND: Freezing of gait (FOG) is one of the most debilitating symptoms in patients with idiopathic Parkinson\'s disease (IPD). Visual cues can relieve FOG symptoms. However, there is no consensus on patient characteristics that can benefit from visual cues. Therefore, we examined the differences in IPD patient characteristics according to the effectiveness of visual cueing.
METHODS: Through gait experiments, we investigated the number of FOG occurrences, average FOG period per episode, proportion of FOG duration in the total gait cycles, and FOG-free period gait spatiotemporal parameters in ten participants diagnosed with FOG due to IPD. Subsequently, the differences between their clinical characteristics and striatal dopamine active transporter availability from six subregions of the striatum were compared by dividing them into two groups based on the three reduction rates: occurrence numbers, mean durations per episode, and proportion of FOG duration in the total gait cycles improved by visual cueing using laser shoes. The relationships among these three reduction rates and other FOG-related parameters were also investigated using Spearman correlation analyses.
RESULTS: According to the three FOG-related reduction rates, the group assignments were the same, which was also related to the baseline self-reported FOG severity score (New Freezing of Gait Questionnaire): the more severe the FOG, the poorer the response to the visual cueing. By visual cueing, the better response group demonstrated the characteristics of lower new FOG questionnaire total scores, higher dopamine active transporter availability of the anterior and posterior
putamen, and shorter mean duration of FOG per episode in the absence of cueing. These results were replicated using Spearman correlation analyses.
CONCLUSIONS: For FOG symptoms following IPD, gait assistance by visual cueing may be more effective when the total NFOGQ score is lower and the DAT of
putamen is higher. Through this study, we demonstrated clinical and striatal dopaminergic conditions to select patients who may be more likely to benefit from visual cueing with laser shoes, and these findings lead to the need for early diagnosis of FOG in patients with IPD.
BACKGROUND: ClinicalTrials.gov identifier: NCT05080413. Registered on September 14, 2021.