The role of gait rhythmicity and bilateral coordination of stepping in the pathophysiology of freezing of gait in Parkinson's disease

Meir Plotnik*, Jeffrey M. Hausdorff

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Freezing of gait (FOG) is a disabling episodic gait disturbance that is common among patients with Parkinson's disease (PD). In this review, we describe a new approach for understanding the mechanisms underlying this puzzling phenomenon. We propose that impairments in the ongoing regulation of gait, even during periods in which freezing is not present, set the stage for the occurrence of a FOG episode. More specifically, three "interictal" walking attributes are associated with FOG: gait rhythmicity, gait asymmetry, and bilateral dyscoordination of left-right stepping. Gait is less rhythmic, more asymmetric, and less coordinated among PD patients with FOG, when compared with PD patients without FOG. We describe the relationship between these changes and other features of patients with FOG and discuss whether these gait changes may predispose to FOG or if they also cause FOG, perhaps, when they are altered beyond a certain threshold or exacerbated by another trigger.

Original languageEnglish
Pages (from-to)S444-S450
JournalMovement Disorders
Volume23
Issue numberSUPPL. 2
DOIs
StatePublished - 2008

Funding

FundersFunder number
National Institute on AgingP60AG008812, R01AG014100
National Center for Research ResourcesP41RR013622
Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentR01HD039838

    Keywords

    • Bilateral coordination
    • Freezing of gait
    • Gait asymmetry
    • Gait rhythmicity
    • Parkinson's disease

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