BACKGROUND: This investigation examined whether aspects of attention and executive functioning differed between Parkinson's Disease (PD) patients with freezing of gait (FOG) based on responsiveness to dopamine. We also explored association of cognition with FOG severity and gait metrics. METHODS: Fifty-four individuals with PD completed the study protocol: 17 without freezing (PDC), 23 with dopa-responsive FOG (RFOG), and 14 with dopa-unresponsive (URFOG). Standardized neuropsychological tests assessed attention (focused and sustained), psychomotor speed, and set-switching (time and errors). FOG severity was measured using the new FOG Questionnaire (nFOG-Q). Metrics from timed up and go (TUG) tasks were obtained while "on" and "off" dopamine, with and without dual cognitive tasks. RESULTS: After controlling for clinical and demographic factors, analysis of covariance revealed a significant between-group difference for set-switching errors; planned contrasts revealed increased set-switching errors in URFOG relative to RFOG and PD control groups. Groups were not different in other cognitive domains. FOG severity was modestly associated with set-switching errors in RFOG but not URFOG. TUG performances while "on" were associated with set-switching errors in PD controls, and with focused attention in RFOG. CONCLUSION: PD patients with dopa-unresponsive FOG are more prone to set-switching errors than those who respond to treatment. Furthermore, executive function appears relevant to FOG severity only in patients who show dopamine response. Together, these findings suggest disruption of a common dopamine-mediated pathway for FOG and ability to monitor rules while alternating cognitive processes. Consideration of dopa-response could be useful in characterizing cohorts and treating FOG in PD.
BACKGROUND: This investigation examined whether aspects of attention and executive functioning differed between Parkinson's Disease (PD) patients with freezing of gait (FOG) based on responsiveness to dopamine. We also explored association of cognition with FOG severity and gait metrics. METHODS: Fifty-four individuals with PD completed the study protocol: 17 without freezing (PDC), 23 with dopa-responsive FOG (RFOG), and 14 with dopa-unresponsive (URFOG). Standardized neuropsychological tests assessed attention (focused and sustained), psychomotor speed, and set-switching (time and errors). FOG severity was measured using the new FOG Questionnaire (nFOG-Q). Metrics from timed up and go (TUG) tasks were obtained while "on" and "off" dopamine, with and without dual cognitive tasks. RESULTS: After controlling for clinical and demographic factors, analysis of covariance revealed a significant between-group difference for set-switching errors; planned contrasts revealed increased set-switching errors in URFOG relative to RFOG and PD control groups. Groups were not different in other cognitive domains. FOG severity was modestly associated with set-switching errors in RFOG but not URFOG. TUG performances while "on" were associated with set-switching errors in PD controls, and with focused attention in RFOG. CONCLUSION: PD patients with dopa-unresponsive FOG are more prone to set-switching errors than those who respond to treatment. Furthermore, executive function appears relevant to FOG severity only in patients who show dopamine response. Together, these findings suggest disruption of a common dopamine-mediated pathway for FOG and ability to monitor rules while alternating cognitive processes. Consideration of dopa-response could be useful in characterizing cohorts and treating FOG in PD.
Authors: Kaylena A Ehgoetz Martens; James M Shine; Courtney C Walton; Matthew J Georgiades; Moran Gilat; Julie M Hall; Alana J Muller; Jennifer Y Y Szeto; Simon J G Lewis Journal: Mov Disord Date: 2018-07 Impact factor: 10.338
Authors: Robert G Holloway; Ira Shoulson; Stanley Fahn; Karl Kieburtz; Anthony Lang; Kenneth Marek; Michael McDermott; John Seibyl; William Weiner; Bruno Musch; Cornelia Kamp; Mickie Welsh; Aileen Shinaman; Rajesh Pahwa; Lynn Barclay; Jean Hubble; Peter LeWitt; Janis Miyasaki; Oksana Suchowersky; Mark Stacy; David S Russell; Blair Ford; John Hammerstad; David Riley; David Standaert; Frederick Wooten; Stewart Factor; Joseph Jankovic; Farah Atassi; Roger Kurlan; Michel Panisset; Ali Rajput; Robert Rodnitzky; Cliff Shults; Giselle Petsinger; Cheryl Waters; Ronald Pfeiffer; Kevin Biglan; Leona Borchert; Amy Montgomery; Laura Sutherland; Carolyn Weeks; Maryan DeAngelis; Elspeth Sime; Susan Wood; Carol Pantella; Mary Harrigan; Barbara Fussell; Sandra Dillon; Barbara Alexander-Brown; Pamela Rainey; Marsha Tennis; Elke Rost-Ruffner; Diane Brown; Sharon Evans; Debra Berry; Jean Hall; Theresa Shirley; Judith Dobson; Deborah Fontaine; Brenda Pfeiffer; Alicia Brocht; Susan Bennett; Susan Daigneault; Karen Hodgeman; Carolynn O'Connell; Tori Ross; Karen Richard; Arthur Watts Journal: Arch Neurol Date: 2004-07
Authors: Emily J Henderson; Stephen R Lord; Matthew A Brodie; Daisy M Gaunt; Andrew D Lawrence; Jacqueline C T Close; A L Whone; Y Ben-Shlomo Journal: Lancet Neurol Date: 2016-01-13 Impact factor: 44.182