Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease

Autores
Perez Lloret, Santiago; Negre Pages, Laurence; Damier, Philippe; Delval, Arnaud; Derkinderen, Paul; Destée, Alain; Meissner, Wassilios G.; Schelosky, Ludwig; Tison, Francois; Rascol, Olivier
Año de publicación
2014
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
IMPORTANCE: Freezing of gait (FOG) is a common axial symptom of Parkinson disease (PD). OBJECTIVE: To determine the prevalence of FOG in a large group of PD patients, assess its relationship with quality of life and clinical and pharmacological factors, and explore its changes from the off to on conditions in patients with motor fluctuations. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional survey of 683 patients with idiopathic PD. Scores for FOG were missing in 11 patients who were not included in the analysis. Patients were recruited from referral centers and general neurology clinics in public or private institutions in France. EXPOSURE: Patients with FOG were identified as those with a score of 1 or greater on item 14 of the Unified Parkinson's Disease Rating Scale (UPDRS) in the on condition. Item 14 scores for FOG in the off condition were also collected in patients with fluctuating motor symptoms. MAIN OUTCOMES AND MEASURES: Quality of life (measured by the 39-item Parkinson's Disease Questionnaire and 36-Item Short Form Health Survey), anxiety and depression (Hospital Anxiety and Depression Scale), clinical features (UPDRS), and drug consumption. RESULTS: Of 672 PD patients, 257 reported FOG during the onstate (38.2%), which was significantly related to lower quality of life scores (P < .01). Freezing of gait was also correlated with longer PD duration (odds ratio, 1.92 [95% CI, 1.28-2.86]), higher UPDRS parts II and III scores (4.67 [3.21-6.78]), the presence of apathy (UPDRS item 4) (1.94 [1.33-2.82]), a higher levodopa equivalent daily dose (1.63 [1.09-2.43]), and more frequent exposure to antimuscarinics (3.07 [1.35-6.97]) (logistic regression). The FOG score improved from the off to on states in 148 of 174 patients with motor fluctuations (85.1%) and showed no change in 13.8%. The FOG score improved by more than 50% in 43.7% of patients. Greater improvement in the on state was observed in younger patients (r = -0.25; P < .01) with lower UPDRS II and III scores (r = -0.50; P < .01) and no antimuscarinic use (r = -0.21; P < .01). CONCLUSIONS AND RELEVANCE: Freezing of gait in PD patients correlates with poor quality of life, disease severity, apathy, and exposure to antimuscarinics. Dopaminergic therapy improved FOG in most patients with motor fluctuations, especially younger ones with less severe disease and no antimuscarinic use. This finding suggests that quality of life is impaired in PD patients with FOG and that optimizing dopaminergic therapy and avoiding antimuscarinics should be considered.
Fil: Perez Lloret, Santiago. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Farmacología; Argentina. University of Toulouse; Argentina. Inserm; Francia
Fil: Negre Pages, Laurence. LN Pharma; Francia
Fil: Damier, Philippe. Inserm; Francia. Centre Hospitalier Universitaire (CHU) Nantes; Francia
Fil: Delval, Arnaud. Centre Hospitalier Universitaire (CHU) Lille; Francia
Fil: Derkinderen, Paul. Inserm; Francia. Centre Hospitalier Universitaire (CHU) Nantes; Francia
Fil: Destée, Alain. Inserm; Francia. Centre Hospitalier Universitaire (CHU) Lille; Francia
Fil: Meissner, Wassilios G.. Centre National de la Recherche Scientifique; Francia. Centre Hospitalier Universitaire (CHU) Bordeaux; Francia. Universite de Bordeaux; Francia
Fil: Schelosky, Ludwig. Kantonsspital Münsterlingen; Suiza
Fil: Tison, Francois. Universite de Bordeaux; Francia. Centre National de la Recherche Scientifique; Francia. Centre Hospitalier Universitaire (CHU) Bordeaux; Francia
Fil: Rascol, Olivier. Inserm; Francia
Materia
Parkinson disease
Movement disorders
Quality of life
Medical Treatment
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/16126

id CONICETDig_68d4f191b2c54e8472dc20db646afa51
oai_identifier_str oai:ri.conicet.gov.ar:11336/16126
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson diseasePerez Lloret, SantiagoNegre Pages, LaurenceDamier, PhilippeDelval, ArnaudDerkinderen, PaulDestée, AlainMeissner, Wassilios G.Schelosky, LudwigTison, FrancoisRascol, OlivierParkinson diseaseMovement disordersQuality of lifeMedical Treatmenthttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3IMPORTANCE: Freezing of gait (FOG) is a common axial symptom of Parkinson disease (PD). OBJECTIVE: To determine the prevalence of FOG in a large group of PD patients, assess its relationship with quality of life and clinical and pharmacological factors, and explore its changes from the off to on conditions in patients with motor fluctuations. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional survey of 683 patients with idiopathic PD. Scores for FOG were missing in 11 patients who were not included in the analysis. Patients were recruited from referral centers and general neurology clinics in public or private institutions in France. EXPOSURE: Patients with FOG were identified as those with a score of 1 or greater on item 14 of the Unified Parkinson's Disease Rating Scale (UPDRS) in the on condition. Item 14 scores for FOG in the off condition were also collected in patients with fluctuating motor symptoms. MAIN OUTCOMES AND MEASURES: Quality of life (measured by the 39-item Parkinson's Disease Questionnaire and 36-Item Short Form Health Survey), anxiety and depression (Hospital Anxiety and Depression Scale), clinical features (UPDRS), and drug consumption. RESULTS: Of 672 PD patients, 257 reported FOG during the onstate (38.2%), which was significantly related to lower quality of life scores (P < .01). Freezing of gait was also correlated with longer PD duration (odds ratio, 1.92 [95% CI, 1.28-2.86]), higher UPDRS parts II and III scores (4.67 [3.21-6.78]), the presence of apathy (UPDRS item 4) (1.94 [1.33-2.82]), a higher levodopa equivalent daily dose (1.63 [1.09-2.43]), and more frequent exposure to antimuscarinics (3.07 [1.35-6.97]) (logistic regression). The FOG score improved from the off to on states in 148 of 174 patients with motor fluctuations (85.1%) and showed no change in 13.8%. The FOG score improved by more than 50% in 43.7% of patients. Greater improvement in the on state was observed in younger patients (r = -0.25; P < .01) with lower UPDRS II and III scores (r = -0.50; P < .01) and no antimuscarinic use (r = -0.21; P < .01). CONCLUSIONS AND RELEVANCE: Freezing of gait in PD patients correlates with poor quality of life, disease severity, apathy, and exposure to antimuscarinics. Dopaminergic therapy improved FOG in most patients with motor fluctuations, especially younger ones with less severe disease and no antimuscarinic use. This finding suggests that quality of life is impaired in PD patients with FOG and that optimizing dopaminergic therapy and avoiding antimuscarinics should be considered.Fil: Perez Lloret, Santiago. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Farmacología; Argentina. University of Toulouse; Argentina. Inserm; FranciaFil: Negre Pages, Laurence. LN Pharma; FranciaFil: Damier, Philippe. Inserm; Francia. Centre Hospitalier Universitaire (CHU) Nantes; FranciaFil: Delval, Arnaud. Centre Hospitalier Universitaire (CHU) Lille; FranciaFil: Derkinderen, Paul. Inserm; Francia. Centre Hospitalier Universitaire (CHU) Nantes; FranciaFil: Destée, Alain. Inserm; Francia. Centre Hospitalier Universitaire (CHU) Lille; FranciaFil: Meissner, Wassilios G.. Centre National de la Recherche Scientifique; Francia. Centre Hospitalier Universitaire (CHU) Bordeaux; Francia. Universite de Bordeaux; FranciaFil: Schelosky, Ludwig. Kantonsspital Münsterlingen; SuizaFil: Tison, Francois. Universite de Bordeaux; Francia. Centre National de la Recherche Scientifique; Francia. Centre Hospitalier Universitaire (CHU) Bordeaux; FranciaFil: Rascol, Olivier. Inserm; FranciaAmer Medical Assoc2014-07info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/16126Perez Lloret, Santiago; Negre Pages, Laurence; Damier, Philippe; Delval, Arnaud; Derkinderen, Paul; et al.; Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease; Amer Medical Assoc; JAMA Neurology; 71; 7; 7-2014; 884-8902168-61492168-6157enginfo:eu-repo/semantics/altIdentifier/doi/10.1001/jamaneurol.2014.753info:eu-repo/semantics/altIdentifier/url/http://jamanetwork.com/journals/jamaneurology/fullarticle/1871698info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:45:33Zoai:ri.conicet.gov.ar:11336/16126instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:45:33.485CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease
title Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease
spellingShingle Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease
Perez Lloret, Santiago
Parkinson disease
Movement disorders
Quality of life
Medical Treatment
title_short Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease
title_full Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease
title_fullStr Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease
title_full_unstemmed Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease
title_sort Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease
dc.creator.none.fl_str_mv Perez Lloret, Santiago
Negre Pages, Laurence
Damier, Philippe
Delval, Arnaud
Derkinderen, Paul
Destée, Alain
Meissner, Wassilios G.
Schelosky, Ludwig
Tison, Francois
Rascol, Olivier
author Perez Lloret, Santiago
author_facet Perez Lloret, Santiago
Negre Pages, Laurence
Damier, Philippe
Delval, Arnaud
Derkinderen, Paul
Destée, Alain
Meissner, Wassilios G.
Schelosky, Ludwig
Tison, Francois
Rascol, Olivier
author_role author
author2 Negre Pages, Laurence
Damier, Philippe
Delval, Arnaud
Derkinderen, Paul
Destée, Alain
Meissner, Wassilios G.
Schelosky, Ludwig
Tison, Francois
Rascol, Olivier
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Parkinson disease
Movement disorders
Quality of life
Medical Treatment
topic Parkinson disease
Movement disorders
Quality of life
Medical Treatment
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv IMPORTANCE: Freezing of gait (FOG) is a common axial symptom of Parkinson disease (PD). OBJECTIVE: To determine the prevalence of FOG in a large group of PD patients, assess its relationship with quality of life and clinical and pharmacological factors, and explore its changes from the off to on conditions in patients with motor fluctuations. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional survey of 683 patients with idiopathic PD. Scores for FOG were missing in 11 patients who were not included in the analysis. Patients were recruited from referral centers and general neurology clinics in public or private institutions in France. EXPOSURE: Patients with FOG were identified as those with a score of 1 or greater on item 14 of the Unified Parkinson's Disease Rating Scale (UPDRS) in the on condition. Item 14 scores for FOG in the off condition were also collected in patients with fluctuating motor symptoms. MAIN OUTCOMES AND MEASURES: Quality of life (measured by the 39-item Parkinson's Disease Questionnaire and 36-Item Short Form Health Survey), anxiety and depression (Hospital Anxiety and Depression Scale), clinical features (UPDRS), and drug consumption. RESULTS: Of 672 PD patients, 257 reported FOG during the onstate (38.2%), which was significantly related to lower quality of life scores (P < .01). Freezing of gait was also correlated with longer PD duration (odds ratio, 1.92 [95% CI, 1.28-2.86]), higher UPDRS parts II and III scores (4.67 [3.21-6.78]), the presence of apathy (UPDRS item 4) (1.94 [1.33-2.82]), a higher levodopa equivalent daily dose (1.63 [1.09-2.43]), and more frequent exposure to antimuscarinics (3.07 [1.35-6.97]) (logistic regression). The FOG score improved from the off to on states in 148 of 174 patients with motor fluctuations (85.1%) and showed no change in 13.8%. The FOG score improved by more than 50% in 43.7% of patients. Greater improvement in the on state was observed in younger patients (r = -0.25; P < .01) with lower UPDRS II and III scores (r = -0.50; P < .01) and no antimuscarinic use (r = -0.21; P < .01). CONCLUSIONS AND RELEVANCE: Freezing of gait in PD patients correlates with poor quality of life, disease severity, apathy, and exposure to antimuscarinics. Dopaminergic therapy improved FOG in most patients with motor fluctuations, especially younger ones with less severe disease and no antimuscarinic use. This finding suggests that quality of life is impaired in PD patients with FOG and that optimizing dopaminergic therapy and avoiding antimuscarinics should be considered.
Fil: Perez Lloret, Santiago. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Farmacología; Argentina. University of Toulouse; Argentina. Inserm; Francia
Fil: Negre Pages, Laurence. LN Pharma; Francia
Fil: Damier, Philippe. Inserm; Francia. Centre Hospitalier Universitaire (CHU) Nantes; Francia
Fil: Delval, Arnaud. Centre Hospitalier Universitaire (CHU) Lille; Francia
Fil: Derkinderen, Paul. Inserm; Francia. Centre Hospitalier Universitaire (CHU) Nantes; Francia
Fil: Destée, Alain. Inserm; Francia. Centre Hospitalier Universitaire (CHU) Lille; Francia
Fil: Meissner, Wassilios G.. Centre National de la Recherche Scientifique; Francia. Centre Hospitalier Universitaire (CHU) Bordeaux; Francia. Universite de Bordeaux; Francia
Fil: Schelosky, Ludwig. Kantonsspital Münsterlingen; Suiza
Fil: Tison, Francois. Universite de Bordeaux; Francia. Centre National de la Recherche Scientifique; Francia. Centre Hospitalier Universitaire (CHU) Bordeaux; Francia
Fil: Rascol, Olivier. Inserm; Francia
description IMPORTANCE: Freezing of gait (FOG) is a common axial symptom of Parkinson disease (PD). OBJECTIVE: To determine the prevalence of FOG in a large group of PD patients, assess its relationship with quality of life and clinical and pharmacological factors, and explore its changes from the off to on conditions in patients with motor fluctuations. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional survey of 683 patients with idiopathic PD. Scores for FOG were missing in 11 patients who were not included in the analysis. Patients were recruited from referral centers and general neurology clinics in public or private institutions in France. EXPOSURE: Patients with FOG were identified as those with a score of 1 or greater on item 14 of the Unified Parkinson's Disease Rating Scale (UPDRS) in the on condition. Item 14 scores for FOG in the off condition were also collected in patients with fluctuating motor symptoms. MAIN OUTCOMES AND MEASURES: Quality of life (measured by the 39-item Parkinson's Disease Questionnaire and 36-Item Short Form Health Survey), anxiety and depression (Hospital Anxiety and Depression Scale), clinical features (UPDRS), and drug consumption. RESULTS: Of 672 PD patients, 257 reported FOG during the onstate (38.2%), which was significantly related to lower quality of life scores (P < .01). Freezing of gait was also correlated with longer PD duration (odds ratio, 1.92 [95% CI, 1.28-2.86]), higher UPDRS parts II and III scores (4.67 [3.21-6.78]), the presence of apathy (UPDRS item 4) (1.94 [1.33-2.82]), a higher levodopa equivalent daily dose (1.63 [1.09-2.43]), and more frequent exposure to antimuscarinics (3.07 [1.35-6.97]) (logistic regression). The FOG score improved from the off to on states in 148 of 174 patients with motor fluctuations (85.1%) and showed no change in 13.8%. The FOG score improved by more than 50% in 43.7% of patients. Greater improvement in the on state was observed in younger patients (r = -0.25; P < .01) with lower UPDRS II and III scores (r = -0.50; P < .01) and no antimuscarinic use (r = -0.21; P < .01). CONCLUSIONS AND RELEVANCE: Freezing of gait in PD patients correlates with poor quality of life, disease severity, apathy, and exposure to antimuscarinics. Dopaminergic therapy improved FOG in most patients with motor fluctuations, especially younger ones with less severe disease and no antimuscarinic use. This finding suggests that quality of life is impaired in PD patients with FOG and that optimizing dopaminergic therapy and avoiding antimuscarinics should be considered.
publishDate 2014
dc.date.none.fl_str_mv 2014-07
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/16126
Perez Lloret, Santiago; Negre Pages, Laurence; Damier, Philippe; Delval, Arnaud; Derkinderen, Paul; et al.; Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease; Amer Medical Assoc; JAMA Neurology; 71; 7; 7-2014; 884-890
2168-6149
2168-6157
url http://hdl.handle.net/11336/16126
identifier_str_mv Perez Lloret, Santiago; Negre Pages, Laurence; Damier, Philippe; Delval, Arnaud; Derkinderen, Paul; et al.; Prevalence, determinants, and effect on quality of life of freezing of gait in Parkinson disease; Amer Medical Assoc; JAMA Neurology; 71; 7; 7-2014; 884-890
2168-6149
2168-6157
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1001/jamaneurol.2014.753
info:eu-repo/semantics/altIdentifier/url/http://jamanetwork.com/journals/jamaneurology/fullarticle/1871698
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Amer Medical Assoc
publisher.none.fl_str_mv Amer Medical Assoc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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