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Freezing of gait in idiopathic normal pressure hydrocephalus.
Kihlstedt, Carl-Johan; Malm, Jan; Fasano, Alfonso; Bäckström, David.
Afiliación
  • Kihlstedt CJ; Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden.
  • Malm J; Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden.
  • Fasano A; Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada.
  • Bäckström D; Division of Neurology, University of Toronto, Toronto, ON, Canada.
Fluids Barriers CNS ; 21(1): 22, 2024 Mar 08.
Article en En | MEDLINE | ID: mdl-38454478
ABSTRACT

BACKGROUND:

Reports of freezing of gait (FoG) in idiopathic normal pressure hydrocephalus (iNPH) are few and results are variable. This study's objective was to evaluate the frequency of FoG in a large cohort of iNPH patients, identify FoG-associated factors, and assess FoG's responsiveness to shunt surgery.

METHODS:

Videotaped standardized gait protocols with iNPH patients pre- and post-shunt surgery (n = 139; median age 75 (71-79) years; 48 women) were evaluated for FoG episodes by two observers (Cohens kappa = 0.9, p < 0.001). FoG episodes were categorized. Mini-mental state examination (MMSE) and MRI white matter hyperintensities (WMH) assessment using the Fazekas scale were performed. CSF was analyzed for Beta-amyloid, Tau, and Phospho-tau. Patients with and without FoG were compared.

RESULTS:

Twenty-two patients (16%) displayed FoG at baseline, decreasing to seven (8%) after CSF shunt surgery (p = 0.039). The symptom was most frequently exhibited during turning (n = 16, 73%). Patients displaying FoG were older (77.5 vs. 74.6 years; p = 0.029), had a slower walking speed (0.59 vs. 0.89 m/s; p < 0.001), a lower Tinetti POMA score (6.8 vs. 10.8; p < 0.001), lower MMSE score (21.3 vs. 24.0; p = 0.031), and longer disease duration (4.2 vs. 2.3 years; p < 0.001) compared to patients not displaying FoG. WMH or CSF biomarkers did not differ between the groups.

CONCLUSIONS:

FoG is occurring frequently in iNPH patients and may be considered a typical feature of iNPH. FoG in iNPH was associated with higher age, longer disease duration, worse cognitive function, and a more unstable gait. Shunt surgery seems to improve the symptom.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Parkinson / Trastornos Neurológicos de la Marcha / Hidrocéfalo Normotenso Límite: Aged / Female / Humans Idioma: En Revista: Fluids Barriers CNS Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Parkinson / Trastornos Neurológicos de la Marcha / Hidrocéfalo Normotenso Límite: Aged / Female / Humans Idioma: En Revista: Fluids Barriers CNS Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido