From: Freezing of gait in Parkinson’s disease: pathophysiology, risk factors and treatments
Main findings | Participants | Assessment | Follow-up duration | FOG define | Ref |
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CSF Aβ42 was a predictor of FOG in patients with early PD. PIGD score, caudate DAT uptake, and CSF Aβ42 together could predict FOG within 4 years after diagnosis of PD (AUC = 0.755). | PPMI database (393 early do novo PD without FOG at baseline) | CSF (Aβ42, α-synuclein, t-tau, p-tau, Aβ42/ t-tau); motor; non-motor (olfactory, sleep, cognition, depression, anxiety, autonomic function); DAT imaging (striatal region) | Median 4.0 years | MDS-UPDRS item 2.13 or item 3.11 ≥ 1 | [16] |
DAT uptakes in the caudate nucleus and putamen predicted the development of FOG. Male sex, higher PIGD score, and lower MoCA score were also significant predictors of FOG. | PPMI data (390 early do novo PD without FOG at baseline) | DAT imaging (striatal region); motor; cognition | Median 4.0 years | MDS-UPDRS item 2.13 or item 3.11 ≥ 1 | [17] |
FOGQ total score and the anxiety score were the strongest predictors, and using only these two factors could significantly predict FOG in the next 15 months with 82% accuracy. | 221 PD in which 88 patients had FOG at baseline | Motor; non-motor (cognition, anxiety, depression, sleep); medication use | Mean 14 months | FOGQ item 3 ≥ 1 | [18] |
Depressive, gait speed and UPDRS-III (off vs. on) were the independent predictors of future FOG. | 57 PD patients without FOG at baseline | Motor; non-motor (sleep, cognition, autonomic, depression, and others); medication use | Mean 5 years | NFOGQ (item1 = 1) and objective observation | [19] |
Increased risk: Onset of PD with a gait disorder; higher scores of rigidity, postural instability, bradykinesia and speech; and longer disease duration; absence of tremor. Decreased risk: Deprenyl treatment | DATATOP data (800 early PD in which 57 patients had FOG at study entry) | Motor; non-motor (speech, cognition, depression); initial symptoms | Mean 14 ± 5 months | UPDRS II-item14 ≥ 1 | [20] |
Motor fluctuations, higher levodopa dose were independent risk factors; none of the cardinal features independently predicted FOG. | 232 PD without FOG at baseline | Motor and motor complication; non-motor (psychosis (UPDRS I item2, hallucinations or delusions), cognition); medication use | 12 years | UPDRS II-item14 ≥ 1 | [21] |
Lower education, akinetic-rigid style, not using dopamine receptor agonists, sleep disorders (insomnia); cognitive disturbances were predictors of FOG. | 248 early PD without FOG at baseline | Motor; non-motor (anxiety; depression); medication use; | 3 years | FOGQ item 3 ≥ 1 and objective observation | [22] |
Longer disease duration, visuospatial function deterioration, onset in lower limbs, presence of festination, falls, and hallucinations were independent predictors of FOG. | 225 PD without FOG at baseline | Motor (including festination and fall); non-motor (anxiety, depression, cognition); medication use; | 3 years | FOGQ item 3 ≥ 1 and objective observation | [23] |
Baseline processing speed, learning and daytime sleepiness were predictive of FOG. | PPMI database (50 PD + FOG, and 50 PD-FOG at the fourth year) | Motor; non-motor (cognition, anxiety, depression, sleep) | 4 years | MDS-UPDRS item 2.13 ≥ 1 | [24] |
A more severe depletion of presynaptic dopamine (low 123I-FP-CIT binding in the putamen and striatum) in early PD predicted FOG | 41 early PD without FOG at baseline | Motor (including falls) and motor complication; DAT imaging (striatal region); medication use | 9.51 ± 3.18 years | UPDRS II-item14 ≥ 1 | [25] |
PD group with moderate to severe WMH showed a higher risk of developing FOG (HR, 3.29; 95% CI, 1.79–6.05; P < 0.001) than the PD patients with minimal WMH. | 268 patients with de novo PD without FOG | MRI WMH; motor (UPDRS-III, phenotype); non-motor (olfactory, cognition, depression) DAT imaging; medication; vascular risk factors | > 3 years | Inquiry and observation | [26] |