Xiaohui Tang1, Lijia Yu1, Jingyun Yang2,3, Wenjing Guo1, Ying Liu1, Yaling Xu1, Xijin Wang1. 1. Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois. 3. Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.
Abstract
STUDY OBJECTIVES: Freezing of gait (FOG) severely impairs life quality of Parkinson disease (PD) patients. The relationship between sleep disturbance and FOG in PD remains unclear, so in this study, we aimed to investigate that relationship. METHODS: First, we assessed clinical characteristics of freezers and nonfreezers among PD patients. Next, we assessed clinical characteristics of PD patients with different PDSS1 scores (score on first item of Parkinson's Disease Sleep Scale). Finally, we prospectively followed a cohort of nonfreezers from a baseline clinical visit and to a maximum of 18 months and performed a Cox regression analysis to further investigate the relationship between PDSS1 score and FOG in PD. RESULTS: A total of 163 participants with PD were included in the baseline analysis. The freezers had significantly worse sleep compared with the nonfreezers. The proportion of freezers in the patients with low PDSS1 score (PDSS1 < 6) was significantly higher than that in the patients with high PDSS1 score (PDSS1 ≥ 6). A total of 52 nonfreezers were prospectively followed. During a maximum 18-month follow-up, FOG incidence (73%) in the PDSS1 < 6 group was significantly higher than that (24%) in the PDSS1 ≥ 6 group (P = .008). Low PDSS1 score (hazard ratio = 4.23, 95% CI 1.64-10.92, P = .003) and high levodopa equivalent daily dose (hazard ratio = 4.18, 95% CI 1.62-10.75, P = .003) were significantly associated with an increased hazard of FOG. CONCLUSIONS: Our study indicated that low PDSS1 score may be a risk indicator for the development of FOG and provided important insights into potential targets for the prevention/delay of FOG in PD.
STUDY OBJECTIVES: Freezing of gait (FOG) severely impairs life quality of Parkinson disease (PD) patients. The relationship between sleep disturbance and FOG in PD remains unclear, so in this study, we aimed to investigate that relationship. METHODS: First, we assessed clinical characteristics of freezers and nonfreezers among PD patients. Next, we assessed clinical characteristics of PD patients with different PDSS1 scores (score on first item of Parkinson's Disease Sleep Scale). Finally, we prospectively followed a cohort of nonfreezers from a baseline clinical visit and to a maximum of 18 months and performed a Cox regression analysis to further investigate the relationship between PDSS1 score and FOG in PD. RESULTS: A total of 163 participants with PD were included in the baseline analysis. The freezers had significantly worse sleep compared with the nonfreezers. The proportion of freezers in the patients with low PDSS1 score (PDSS1 < 6) was significantly higher than that in the patients with high PDSS1 score (PDSS1 ≥ 6). A total of 52 nonfreezers were prospectively followed. During a maximum 18-month follow-up, FOG incidence (73%) in the PDSS1 < 6 group was significantly higher than that (24%) in the PDSS1 ≥ 6 group (P = .008). Low PDSS1 score (hazard ratio = 4.23, 95% CI 1.64-10.92, P = .003) and high levodopa equivalent daily dose (hazard ratio = 4.18, 95% CI 1.62-10.75, P = .003) were significantly associated with an increased hazard of FOG. CONCLUSIONS: Our study indicated that low PDSS1 score may be a risk indicator for the development of FOG and provided important insights into potential targets for the prevention/delay of FOG in PD.
Authors: Tiago A Mestre; Christos Sidiropoulos; Clement Hamani; Yu-Yan Poon; Andres M Lozano; Anthony E Lang; Elena Moro Journal: Mov Disord Date: 2016-10 Impact factor: 10.338
Authors: Marta Kaminska; Victoria P Mery; Anne-Louise Lafontaine; Ann Robinson; Andrea Benedetti; Priti Gros; R John Kimoff Journal: J Clin Sleep Med Date: 2018-05-15 Impact factor: 4.062
Authors: John G Nutt; Bastiaan R Bloem; Nir Giladi; Mark Hallett; Fay B Horak; Alice Nieuwboer Journal: Lancet Neurol Date: 2011-08 Impact factor: 44.182
Authors: David P Breen; Romina Vuono; Upekshani Nawarathna; Kate Fisher; John M Shneerson; Akhilesh B Reddy; Roger A Barker Journal: JAMA Neurol Date: 2014-05 Impact factor: 18.302
Authors: Christian Schlenstedt; Martina Mancini; Jay Nutt; Amie P Hiller; Walter Maetzler; Günther Deuschl; Fay Horak Journal: Front Aging Neurosci Date: 2018-02-15 Impact factor: 5.750