Freezing of Gait Early in Parkinson: Atypical versus Typical Parkinson Disorders (P6.067)

Objective: Freezing of Gait Early in Parkinson: Atypical versus Typical Parkinson Disorders Background: Freezing of gait (FOG) is an episodic, often dramatic, gait pattern characterized by an abrupt inability to walk, in which the patient’s feet appear to be “stuck,” while the upper body often continues to move. The events preceding and during a freezing episode are characterized by a decrease in postural stability, a decrease in step length, a decrease in range of movement of the hips, knees, and ankles,, and an increase in fall risk. Design/Method: 850 patients were examined at Muhammad Ali Parkinson Center (MAPC) with a diagnosis of Parkinson’s disease (PD) over a period of 18 months. Results: Among 850 patients, 212 patients (25[percnt]), had had PD for < 5 years, and 27 of these (12.7[percnt]) had freezing of gait (FOG). Among the 850 patients 40 patients, 4.7 [percnt] of the total, had atypical parkinsonism. Among these 40 patients, all of whom had had symptoms for ≤ 5 years, 12 had FOG. FOG improved with levodopa treatment in 21/27 patients with typical PD, but FOG did not improve with levodopa in the 12 patients with atypical PD. Although FOG appears to be a problem in locomotion, our results suggest that impaired postural stability rather than impaired locomotion is the main problem, and balance training rather than gait training is more likely to be helpful in patients with FOG. Conclusion: Primary progressive freezing of gait (PPFG) is viewed as arising from a disconnection between the frontal lobes and basal ganglia. In three patients with PPFG, whose FOG did not respond to levodopa, DaTscans revealed an absence of presynaptic dopamine in the basal ganglia. Disclosure: Dr. Deep has nothing to disclose. Dr. Lieberman has nothing to disclose. Dr. Dhall has received personal compensation for activities with UCB Pharma, Impax Pharmaceuticals, and Teva Neuroscience. Dr. Tran has nothing to disclose. Dr. Liu has nothing to disclose.