Balancing between the two: Are freezing of gait and postural instability in Parkinson's disease connected?

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:94

Review

Bekkers, E. M. J.^1,2  Dijkstra, B. W.¹  Heremans, E.¹  Verschueren, S. M. P.³  Bloem, B. R.²  Nieuwboer, A.¹ 

[1] Katholieke Univ Leuven, Dept Rehabil Sci, Neuromotor Rehabil Res Grp, Tervuursevest 101,Box 1501, B-3001 Leuven, Belgium

[2] Radboud Univ Nijmegen, Med Ctr, Donders Inst Brain Cognit & Behav, Dept Neurol,Parkinson Ctr Nijmegen ParC, Reinier Postlaan 4, NL-6525 GC Nijmegen, Netherlands

[3] Katholieke Univ Leuven, Dept Rehabil Sci, Res Grp Musculoskeletal Res, Tervuursevest 101, B-3001 Leuven, Belgium

关键词: Parkinson's disease;    Freezing of gait;    Postural control;    Posturography;   

DOI  :  10.1016/j.neubiorev.2018.08.008

来源: Elsevier

【 摘 要 】

Postural instability and freezing of gait (FoG) are key features of Parkinson's disease (PD) closely related to falls. Growing evidence suggests that co-existing postural deficits could influence the occurrence and severity of FoG. To date, the exact nature of this interrelationship remains largely unknown. We analyzed the complex interaction between postural instability and gait disturbance by comparing the findings available in the posturo-graphic literature between patients with and without FoG. Results showed that FoG and postural instability are intertwined, can influence each other behaviorally and may coincide neurologically. The most common FoG-related postural deficits included weight-shifting impairments, and inadequate scaling and timing of postural responses most apparent at forthcoming postural changes under time constraints. Most likely, a negative cycle of combined and more severe postural deficits in people with FoG will enhance postural stability breakdown. As such, the wide brain network deficiencies involved in FoG may also concurrently influence postural stability. Future work needs to examine whether training interventions targeting both symptoms will have extra clinical benefits on fall frequency.

【 授权许可】

Free