Treatment of Freezing of Gait in Parkinson’s Disease

Freezing of gait (FoG) is a common, debilitating disorder occurring in the majority of Parkinson’s disease (PD) patients. It is defined as the episodic inability to produce effective stepping, often triggered (and ameliorated) by environmental cues. This phenomenon can occur in isolation, but more often combined with other gait disturbances, and its response to dopamine is highly variable. The heterogeneous nature of this condition has presented challenges to elucidating its underlying pathophysiology, and its episodic and variable nature have made it difficult to establish outcome measures for clinical trials. Currently, treatment of FoG is based on maximizing its dopaminergic response and using rehabilitation techniques, as well as off-label non-dopaminergic therapies to address refractory symptoms. As with any gait disorder, a comprehensive evaluation and multidisciplinary treatment approach are recommended.