Clinical predictors of freezing of gait in patients with Parkinson's disease: A systematic review

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-03-12 DOI:10.1016/j.clineuro.2025.108848

Sohaila Alshimemeri, Abdulrahman alhayssoni, Reema Hazazi

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引用次数: 0

Abstract

Background

Freezing of gait (FOG) is a debilitating motor symptom of Parkinson’s disease (PD) that markedly impacts patients’ quality of life. This review aims to identify clinical predictors of FOG to facilitate early prediction and future interventions.

Methods

A systematic review adhering to PRISMA guidelines was conducted. Comprehensive searches in PubMed, EBSCO, and Web of Science yielded 1761 records. After removing duplicates, 1558 records were screened by title and abstract, and 92 full-text articles were assessed. Nine studies met the inclusion criteria and were qualitatively synthesized.

Results

Our systematic review indicates that higher baseline MDS-UPDRS scores, which reflect greater disease severity, alongside elevated doses and early use of levodopa, are predictive of FOG in patients with PD. Additionally, higher Postural Instability and Gait Disorder (PIGD) scores, motor fluctuations, and lower limb disease onset further increase the risk of FOG. Other factors associated with an increased risk of FOG include older age, longer disease duration, anxiety, hyposmia, cognitive deficits, and sleep disorders. Furthermore, decreased step initiation duration when using visual cues serves as a predictor for the development of FOG. Early treatment with amantadine, selegiline, and dopamine agonists may help reduce the risk of developing FOG.

Conclusion

A combination of motor and non-motor factors predicts the development of FOG. Understanding FOG predictors is crucial for developing future therapeutics and personalized management plans, enabling targeted interventions and improved outcomes.

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背景步态冻结（FOG）是帕金森病（PD）的一种使人衰弱的运动症状，严重影响患者的生活质量。本综述旨在确定 FOG 的临床预测因素，以便进行早期预测和未来干预。通过对 PubMed、EBSCO 和 Web of Science 的全面检索，共获得 1761 条记录。去除重复内容后，根据标题和摘要筛选出 1558 条记录，并对 92 篇全文进行了评估。结果我们的系统综述表明，较高的基线MDS-UPDRS评分反映了疾病的严重程度，同时左旋多巴剂量的增加和早期使用也是预测PD患者FOG的因素。此外，较高的姿势不稳定性和步态障碍（PIGD）评分、运动波动和下肢发病也会进一步增加FOG的风险。其他与 FOG 风险增加相关的因素包括年龄较大、病程较长、焦虑、嗅觉减退、认知障碍和睡眠障碍。此外，在使用视觉线索时，起步持续时间缩短也是发生 FOG 的一个预测因素。结论综合运动和非运动因素可预测 FOG 的发生。了解 FOG 的预测因素对于开发未来的治疗方法和个性化管理计划至关重要，有助于采取有针对性的干预措施和改善预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.