Clinical Parkinsonism Related Disorders最新文献

{"title":"Blepharoclonus – a novel phenotypic association with a VAC14 variant","authors":"Karri Madhavi , Rukmini Mridula Kandadai , Sruthi Kola , Rupam Borgohain , VVSRK Prasad","doi":"10.1016/j.prdoa.2025.100386","DOIUrl":"10.1016/j.prdoa.2025.100386","url":null,"abstract":"","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"13 ","pages":"Article 100386"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns and causes of supranuclear vertical gaze palsy: A retrospective, single-institutional study in 113 patients","authors":"Daniela Kern ,&nbsp;Katharina Raber ,&nbsp;Gerit Wünsch ,&nbsp;Petra Schwingenschuh","doi":"10.1016/j.prdoa.2025.100394","DOIUrl":"10.1016/j.prdoa.2025.100394","url":null,"abstract":"<div><h3>Introduction</h3><div>Supranuclear vertical gaze palsy (SVGP) is a hallmark feature of progressive supranuclear gaze palsy (PSP). However, it can also occur in a variety of other disorders affecting the upper brainstem. The aim of this study was to provide an overview of potential etiologies of SVGP, and to characterize the associated clinical features.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data of all patients presenting with SVGP in inpatient and outpatient care in the University Hospital for Neurology Graz between January 2012 and June 2022. SVGP was diagnosed clinically by neurologists and all diagnoses were established based on clinical evaluation.</div></div><div><h3>Results</h3><div>Of the included 113 patients (66 males, 47 females; mean age: 67.5 years) the most common etiologies were Parkinsonian (n = 50) and vascular disorders (n = 43). Other underlying diagnoses were ataxia syndromes (n = 2), other neurodegenerative disorders (n = 8), autoimmune and inflammatory disorders (n = 3), lysosomal storage diseases (n = 2), neoplastic lesions (n = 2), and others (n = 2). Among Parkinsonian disorders, PSP represented the most frequent diagnosis (n = 37). All patients with downward SVGP were diagnosed with PSP and frequently exhibited additional oculomotor symptoms. In contrast, upward SVGP was more common in Parkinson’s disease (PD) (p = 0.004). Vascular lesions were located in the mesencephalon (n = 20), thalamus (n = 10), cerebellum (n = 3), and pons (n = 2) and were more commonly associated with upward SVGP (n = 35) than downward SVGP (n = 3). Similarly, other etiologies were more often linked to upward SVGP (n = 14) than downward SVGP (N = 5).</div></div><div><h3>Conclusion</h3><div>Parkinsonian and vascular disorders are the most common etiologies of SVGP, but a wide range of disorders must be considered. While upward SVGP has a broad differential diagnosis, downward SVGP is predominantly seen in patients with PSP.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"13 ","pages":"Article 100394"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motor asymmetry in Parkinson’s disease: Diagnostic thresholds based on clinical scores and DaTSCAN imaging","authors":"Philippe Voruz ,&nbsp;Julie Péron","doi":"10.1016/j.prdoa.2025.100350","DOIUrl":"10.1016/j.prdoa.2025.100350","url":null,"abstract":"<div><div>Motor asymmetry is a key feature of Parkinson’s disease that can influence disease progression and patient outcomes. However, there is currently no consensus on the best method or clear thresholds to determine motor asymmetry, which limits the ability to standardize its assessment across studies. This work aimed to determine which motor asymmetry score − standardized or non-standardized − best predicts dopaminergic damage in the putamen, as measured by DaTSCAN, and to establish clear thresholds for distinguishing symmetric from asymmetric profiles. Data from the Parkinson’s Progression Markers Initiative were utilized for the Receiver Operating Characteristic curve analysis. Both motor asymmetry scores significantly predicted dopaminergic asymmetry, with the non-standardized score showing a slightly higher predictive power (area under the curve [AUC] = 0.621, p &lt; 0.001) compared to the standardized score (AUC = 0.569, p = 0.018). For the non-standardized score, a cut-off of ± 2.50 yielded a sensitivity of 0.874 and specificity of 0.783. In contrast, the standardized score achieved a cut-off of ± 0.188, resulting in a sensitivity of 0.908 and specificity of 0.823. These findings underscore the importance of motor asymmetry in clinical evaluations of Parkinson’s disease and provide a foundation for further research aimed at refining diagnostic thresholds.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100350"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to dose extended-release carbidopa-levodopa capsules (IPX203, CREXONT®) in patients with Parkinson’s disease","authors":"Robert A. Hauser ,&nbsp;Yasar Torres-Yaghi ,&nbsp;Stanley Fisher ,&nbsp;Ghazal Banisadr","doi":"10.1016/j.prdoa.2025.100357","DOIUrl":"10.1016/j.prdoa.2025.100357","url":null,"abstract":"<div><div>IPX203 (CREXONT®) is a novel, oral, extended-release (ER) carbidopa-levodopa (CD-LD) formulation, designed to rapidly achieve LD plasma concentrations similar to immediate-release (IR) CD-LD and to maintain LD concentrations for a longer duration than other oral CD-LD products. In the pivotal phase 3 clinical trial, IPX203 provided superior clinical benefit with fewer doses than IR CD-LD. Since the plasma concentration profile of IPX203 is different from that of IR LD, converting patients treated with IR LD to IPX203 requires a conversion strategy. In the pivotal phase 3 trial, patients on IR CD-LD were converted to IPX203 based on the most frequent single dose of the patient’s stable dosing regimen of IR CD-LD. IPX203 was initially administered 3 times per day for most patients. Further titration was then undertaken based on clinical response, and patients were dosed 2 to 4 times per day. Of 589 patients previously treated with IR CD-LD, 506 patients completed the conversion to IPX203; the mg conversion ratio for individual doses was 2.8 at the beginning of the dose-conversion period and 2.9 after titration to clinical response, with the majority of IPX203 patients (84%) dosed 3 times per day.</div></div><div><h3>Objective</h3><div>To provide guidance on dosing of IPX203 (CREXONT®) in clinical practice.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"13 ","pages":"Article 100357"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head tremor in Parkinson´s Disease, clinical Associations and response to therapy","authors":"José Fidel Baizabal-Carvallo ,&nbsp;Marlene Alonso-Juarez ,&nbsp;Robert Fekete","doi":"10.1016/j.prdoa.2025.100328","DOIUrl":"10.1016/j.prdoa.2025.100328","url":null,"abstract":"<div><h3>Background</h3><div>Tremor is frequently observed in patients with Parkinsońs disease (PD). Tremor most commonly affects the upper limbs but may also affect the axial muscles in PD. Head tremor (HT) is usually identified in patients with essential tremor (ET) and cervical dystonia (CD), but rarely reported in PD.</div></div><div><h3>Objectives Methods</h3><div>We aimed to assess the frequency, clinical features, correlates, and underlying mechanisms of HT in PD.</div></div><div><h3>Results</h3><div>Among 229 patients with PD, we identified 19 (8.3 %) of patients with HT. There were 11 males and 8 females with a median age at evaluation of 62.0 years. Five patients had slight, ten had mild and four had moderately severe HT. Yes-yes HT was the most common type. HT was associated with PD in 13 patients, eight of them had severe tremor-dominant presentation. In 3 patients there were signs suggesting underlying ET, while 3 patients had CD. Complete resolution of HT was observed with levodopa and/or deep brain stimulation (DBS) in patients with PD only, but inconsistent improvement was observed with comorbid ET or CD. Longer evolution time since PD onset (<em>P</em> = 0.024), rest tremor (<em>P</em> = 0.001) and CD (<em>P</em> = 0.003) were independently associated with HT in the multivariate analysis.</div></div><div><h3>Conclusions</h3><div>HT was identified in 8.3% of patients with PD. It associated with longer evolution since PD onset, the severity of rest tremor and presence of CD. HT is observed in the context of PD only, particularly in those with severe tremor-dominant presentation, comorbid ET or CD. Most patients improve with dopaminergic therapy or DBS.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100328"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a 24-week yoga intervention on choriocapillaris density in Parkinson’s disease","authors":"Lei Wan ,&nbsp;Andrew Hoover ,&nbsp;Giovana Rosa Gameiro ,&nbsp;Amanda Virgets ,&nbsp;Kylie J. Martinez ,&nbsp;Joseph Signorile ,&nbsp;Hong Jiang ,&nbsp;Jianhua Wang","doi":"10.1016/j.prdoa.2025.100360","DOIUrl":"10.1016/j.prdoa.2025.100360","url":null,"abstract":"<div><h3>Introduction</h3><div>Parkinson’s disease (PD) involves systemic microvascular dysfunction, with choriocapillaris density (CCD) potentially reflecting it. This study examined whether a 24-week yoga intervention alters CCD in PD and whether responses differ by disease duration, severity, or intervention style.</div></div><div><h3>Methods</h3><div>Fifteen PD patients completed a supervised 24-week yoga program involving two Hatha-based styles. CCD was measured using 3 × 3 mm macular optical coherence tomography angiography (OCTA) centered on 2.5-mm foveal region. Clinical assessments included disease duration, Hoehn and Yahr (H&amp;Y) stage, and Montreal Cognitive Assessment (MoCA), conducted at baseline and after intervention. Correlation, stratified, and subgroup analyses were performed.</div></div><div><h3>Results</h3><div>No significant change in CCD was observed at the group level (62.9 % ± 3.9 % vs. 62.9 % ± 3.2 %; P &gt; 0.05). Baseline CCD was inversely correlated with disease duration and H&amp;Y stage (ρ = −0.71, P = 0.003). Patients with shorter disease duration (&lt;5 years) or early-stage PD (H&amp;Y stage 1) showed significant CCD reductions (ΔCCD = −4.7 %, P = 0.003; ΔCCD = −4.3 %, P = 0.002), whereas those with longer duration or advanced stage (H&amp;Y 2–3) exhibited mild increases (ΔCCD = +2.3 %, ΔCCD = +2.8 %). Baseline CCD was inversely correlated with ΔCCD (ρ = −0.77, P &lt; 0.001). CCD did not differ between the YogaCue and Hatha Yoga groups at baseline, follow-up, or in ΔCCD (P &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>These findings provide preliminary evidence that CCD responses to yoga vary with disease stage but not intervention style, suggesting a potential role for CCD as a vascular marker to inform individualized rehabilitation in PD.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"13 ","pages":"Article 100360"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic dysfunction in progressive supranuclear Palsy: A retrospective study","authors":"Yichun Wang ,&nbsp;Manqing Xie ,&nbsp;Dan Xu ,&nbsp;Yanhong Wang ,&nbsp;Han Wang","doi":"10.1016/j.prdoa.2025.100310","DOIUrl":"10.1016/j.prdoa.2025.100310","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to investigate the characteristics of autonomic dysfunction in progressive supranuclear palsy (PSP) compared to Parkinson’s disease (PD) and multiple system atrophy-parkinsonian type (MSA-P).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 128 patients who underwent multidisciplinary team (MDT) intervention at Peking Union Medical College Hospital between March 31, 2021, and November 22, 2023. A total of 16 PSP, 27 MSA-P, and 11 PD patients were included. Autonomic dysfunction was assessed using the SCOPA-AUT scale and medical record data, analyzed with IBM SPSS Statistics 26.</div></div><div><h3>Results</h3><div>SCOPA-AUT revealed varying degrees of autonomic dysfunction across all groups. The total SCOPA-AUT score was lower in PSP (16.88 ± 6.70) than in MSA-P (23.33 ± 8.80) (p = 0.019), but not significantly different from PD (18.64 ± 9.80). All five SCOPA-AUT subscales were affected in PSP, though significant differences were found only in urinary control (p = 0.006) and urinary storage (p = 0.008) scores between PSP and MSA-P. Orthostatic hypotension was clinically identified in 7.7 % of PSP, 66.7 % of MSA-P, and 27.3 % of PD patients, with a significant difference between PSP and MSA-P (p &lt; 0.001). Residual urine volume in MSA-P (137.5 [75.5–190.25] mL) was significantly higher than in PD (34.5 [1.50–60.00] mL, p &lt; 0.001) and PSP (9.95 [1.13–56.25] mL, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Our findings indicate that PSP presents with various forms of autonomic dysfunction, as assessed by SCOPA-AUT, with similarities to both MSA-P and PD. Objective measures, such as orthostatic blood pressure assessments and residual urine ultrasound, can provide additional insights into autonomic dysfunction in PSP.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100310"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Feasibility of Serial Lumbar Punctures: Long-term Results from the Parkinson’s Progression Markers Initiative","authors":"William Barbosa ,&nbsp;Ruth B Schneider ,&nbsp;Seung Ho Choi ,&nbsp;Micah J Marshall ,&nbsp;David-Erick Lafontant ,&nbsp;Chelsea Caspell-Garcia ,&nbsp;Christopher S Coffey ,&nbsp;Jason Ross ,&nbsp;Andrew Siderowf ,&nbsp;Kenneth Marek ,&nbsp;Tanya Simuni ,&nbsp;on behalf of The Parkinson’s Progression Markers Initiative (PPMI)","doi":"10.1016/j.prdoa.2025.100385","DOIUrl":"10.1016/j.prdoa.2025.100385","url":null,"abstract":"<div><h3>Background</h3><div>Cerebrospinal fluid (CSF) serves an essential role in biomarker research. New Parkinson’s disease (PD) classifications incorporate CSF α-synuclein status into trial design. This study evaluated the safety and feasibility of serial CSF collection in participants enrolled in the Parkinson’s Progression Markers Initiative (PPMI).</div></div><div><h3>Methods</h3><div>PPMI participants were evaluated over 13-years with lumbar punctures (LPs) occurring annually from baseline through year five and biennially thereafter. Adverse events and compliance, defined as percentage of LPs with CSF collection, were assessed at baseline and upon follow up. Logistic regression and generalized linear mixed effects models were used to calculate odds ratios and 95% confidence intervals for predictors of baseline and longitudinal LP success.</div></div><div><h3>Results</h3><div>3479 participants (PD: n = 1412, prodromal: n = 1768, healthy control: n = 299) were analyzed. 3360 attempted at least one LP with 29.5 % experiencing an adverse event (1.3 % severe). Baseline compliance was 90 %. From baseline to year five, percent change in compliance decreased by 39.4 % in the PD cohort, 41.4 % in the prodromal cohort, and 27.8 % in the healthy control cohort. Predictive variables of baseline LP success included fewer years since diagnosis (PD: OR 0.82, 0.76–0.89), lower BMI (prodromal: OR 0.92, 0.89–0.94), and site location U.S. vs. non-U.S. (PD: OR 1.5, 1.03–2.18, healthy control: OR 3.6, 1.22–10.64). Baseline LP success was the best predictor of longitudinal success (OR 7.82, 5.74–10.65).</div></div><div><h3>Conclusions</h3><div>Lumbar punctures were safe in PD research participants over a 13-year period. Compliance was high over the first three years, but further investigation is warranted to improve long term success.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"13 ","pages":"Article 100385"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-based peroneal electrical transcutaneous NeuroModulation (peroneal eTNM®) in Parkinson’s disease as “add-on” treatment – Results of a pilot study","authors":"Petra Bártová ,&nbsp;Eva Augste ,&nbsp;Filip Strouhal ,&nbsp;Jan Krhut ,&nbsp;Martin Slovák ,&nbsp;Roman V. Dvorak ,&nbsp;Lukáš Peter ,&nbsp;Martin Schmidt ,&nbsp;David Školoudík","doi":"10.1016/j.prdoa.2025.100321","DOIUrl":"10.1016/j.prdoa.2025.100321","url":null,"abstract":"<div><h3>Introduction</h3><div>Currently, there is no causal cure for Parkinson’s disease (PD), and medications and other therapeutic procedures only allow for the reduction of symptoms. Noninvasive neuromodulation is among the potentially promising treatments for PD patients. The present pilot study aimed to evaluate the safety and efficacy of peroneal electrical Transcutaneous NeuroModulation (peroneal eTNM®) in the treatment of PD symptoms with a particular emphasis on disease-related quality of life.</div></div><div><h3>Methods</h3><div>Twelve patients with clinically established Parkinsońs disease (8 males; mean age 59.5 ± 11.6 years) were enrolled. In addition to state-of-the-art background pharmacotherapy for PD, patients were treated with peroneal eTNM® daily for 30 min for 6 weeks followed by 6 weeks of follow-up without stimulation. The primary endpoint was safety and tolerability, the secondary endpoint was the response of the condition on the ’add-on’ peroneal eTNM®.</div></div><div><h3>Results</h3><div>Peroneal eTNM® proved to be feasible for home treatment in the PD population. Treatment-related adverse events were not reported throughout the study. Along with an excellent safety profile, peroneal eTNM® showed considerable positive trends in terms of improvement in quality of life as measured by EQ-5D-5L questionnaire. There was a definitive trend toward a reduction in Section III of the Unified Parkinson’s Disease Rating Scale showing positive changes in tremor-related items. At the end of the study, 50 % of the patients were considered clinical responders.</div></div><div><h3>Conclusions</h3><div>Larger and more rigorously designed studies are needed to validate the utility and position of peroneal eTNM® in the treatment of patients with PD.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100321"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of augmented reality cueing strategies on freezing of gait: The ELIMINATE FoG trial","authors":"Brendan Baugher ,&nbsp;Ryan Kaya ,&nbsp;Claire Sonneborn ,&nbsp;Kenneth B. Baker ,&nbsp;Hubert H. Fernandez ,&nbsp;Nathaniel Szewczyk ,&nbsp;Jay L. Alberts ,&nbsp;James Liao","doi":"10.1016/j.prdoa.2025.100332","DOIUrl":"10.1016/j.prdoa.2025.100332","url":null,"abstract":"<div><h3>Background</h3><div>Freezing of gait (FoG) is a treatment-resistant symptom of Parkinson disease (PD). Augmented reality (AR) cues have been investigated as a therapy for FoG, with inconclusive results from a limited array of AR constructs.</div></div><div><h3>Objectives</h3><div>Compare four modalities of a novel AR cue to physical and no-cue controls.</div></div><div><h3>Methods</h3><div>Presence of FoG in PD was required; exclusion criteria included dementia, severe vision loss, and significant gait-disrupting comorbidities. Participants completed six walking tasks, featuring different cueing conditions in a crossover fashion, in a holographic hallway displayed by an AR headset. A conventional physical cue was presented first, followed by other conditions in randomized order (<em>hand-controlled</em> AR cue, <em>observer-controlled</em> AR cue, <em>eye-controlled</em> AR cue, <em>constant</em> AR cue, no-cue control). Primary outcomes were FoG duration and incidence, manually annotated. Secondary outcomes included survey questions and gait parameters derived from IMUs.</div></div><div><h3>Results</h3><div>Thirty-six participants completed testing. The <em>observer-controlled</em> AR cue produced lower FoG duration than the no-cue, physical, and <em>hand-controlled</em> AR cue conditions (N = 36, p ≤ 0.006, Wilcoxon effect size (WES) ≥ 0.46). The <em>constant</em> cue reduced FoG incidence compared to all other conditions (N = 36, p ≤ 0.016, WES ≥ 0.40). Participants’ preferred AR cues decreased FoG duration (N = 28, p ≤ 0.004, WES ≥ 0.48) and incidence (N = 28, p ≤ 0.022, WES ≥ 0.38) compared to controls. Differences in kinematic outcomes were negligible. Survey results indicated receptiveness toward AR cueing, with diversity in preferred cue activation modalities. No significant adverse events occurred.</div></div><div><h3>Conclusions</h3><div>AR cueing decreased FoG incidence and duration compared to controls. Efficacy of discrete cueing modalities likely depends on user intrinsic factors, such as preference.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100332"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}