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The impact of freezing of gait on functional dependency in Parkinson’s disease with regard to motor phenotype

AuthorsSantos-García, Diego; Deus Fonticoba, T. de; Suárez-Castro. Ester; Aneiros Díaz, A.; Feal Panceiras, M. J.; Paz González, J. M.; García-Sancho, Carlos; Jesús Maestre, Silvia; Mir, Pablo CSIC ORCID; Planellas, Lluís; García-Caldentey, Juan; Caballol, Nuria; Legarda, Inés; Hernández-Vara, J.; González-Aramburu, Isabel; Ávila-Rivera, María A.; Catalán, M. J.; Nogueira, V.; Álvarez-Sauco, María; Vela-Desojo, Lydia; Escalante, Sonia; Cubo, Esther; Sánchez Alonso, P.; Alonso Losada, G.; López-Ariztegui, Nuria; Martinez-Martin, Pablo
KeywordsActivities of daily living
Functional dependency
Parkinson’s disease
Issue DateOct-2020
CitationNeurological Sciences 41: 2883-2892 (2020)
AbstractBackground and objective: Freezing of gait (FOG) is a disabling symptom more frequent in Parkinson’s disease (PD) patients with postural instability gait difficulty (PIGD) phenotype. The aim of this study was to determine the prevalence of self-reported FOG in a large group of PD patients as well as assess its relationship with functional dependency with regard to motor phenotype. Methods: The data correspond to the baseline evaluation of the COPPADIS-2015 study. Patients with FOG were identified as those with a score of 1 or greater on item-3 of the freezing of gait questionnaire (FOG-Q). Functional dependency was defined as a Schwab and England (S&E) ADL scale score less than 80%. PIGD and non-PIGD (tremor dominant + indeterminate) groups were considered regarding to motor phenotype. Results: Among the 689 PD patients (62.6 ± 8.9 years old, 59.8% males), 240 reported FOG (34.8%), whereas 63 presented functional dependency (9.1%). A total of 22.1% of patients with FOG presented functional dependency vs. only 2.2% of those without FOG (p < 0.0001). FOG was related to functional dependency (OR = 3.470; 95%CI 1.411–8.530; p = 0.007) after adjustment to age, gender, disease duration, daily equivalent levodopa dose, comorbidity (number of non-antiparkinsonian drugs/day), motor status (UPDRS-III), PIGD phenotype, motor complications (UPDRS-IV), NMS burden (NMSS total score), cognition (PD-CRS), and mood (BDI-II). However, according to motor phenotype, FOG was related to functional dependency only in PIGD patients (OR = 7.163; 95%CI 1.206–42.564; p = 0.030). Conclusions: Self-reported FOG is associated with functional dependency in PIGD but not in non-PIGD motor phenotype patients.
Publisher version (URL)http://dx.doi.org/10.1007/s10072-020-04404-7
Identifiersdoi: 10.1007/s10072-020-04404-7
e-issn: 1590-3478
issn: 1590-1874
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