Hall, J.M. (Julie Mae) (2013) Early phenotypic differences between Parkinson's disease patients with anwithout freezing of gait. thesis, Human Movement Sciences.
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Abstract
Previous studies have associated Freezing of Gait (FOG) in Parkinson's disease with the presence of specific phenotypic features, such as autonomic dysfunction, sleep and mood disturbances and cognitive impairment. However, it is not clear from these studies whether or not these features are present early in the course of the disease. To investigate this issue, the current study evaluated motor, cognitive, affective and autonomic functions in ninety-one Parkinson's disease patients with disease duration of less than five years and disease severity of lower than stage III of the Hoehn and Yahr rating scale. Clinical assessment confirmed that thirty-eight patients had FOG whereas fifty-three did not. Significantly, these two groups were matched on a number of key disease features, including age, disease duration, disease severity and dopamine dose equivalence. However, compared to non-freezers, patients with FOG had significantly more non-tremor features and had greater impairment of executive functions, such as set-shifting ability, working memory and phonemic verbal fluency. These results suggest that rather than either a targeted pathology of the brainstem or a more diffuse destruction of neural architecture over the course of the disease, the pathophysiological mechanism of FOG is more likely to be related to damage to fronto-striatal pathways that underlie executive dysfunction. Furthermore, these relationships suggest that potential therapeutic strategies to improve executive dysfunction in Parkinson's disease may also improve FOG.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | 1 Centre for Human Movement Sciences, University Medical Cen and Groningen, Groningen |
| Supervisor name: | Parkinson's Disease Research Clinic, Brain and Mind Research and Sydney, NSW |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:51 |
| Last Modified: | 25 Jun 2020 10:51 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1242 |
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