In a nutshell
This study reviewed the effectiveness of non-surgical or pharmacological treatments for freezing of gait (FOG) in patients with Parkinson's disease (PD).
Some background
FOG is a brief inability to step forward when trying to walk. It is a common PD symptom caused by the loss of abilities of brain cells. FOG increases the risk of falls which affects the quality of life of these patients. Currently, there is no effective treatment for FOG. Dopaminergic treatment such as levodopa improves only a limited number of FOG cases.
The outcomes associated with treatments such as methylphenidate and injections of botulinum toxin are inconclusive. The effectiveness of treatment with deep brain stimulation (DBS) is limited. It is important to research other non-surgical and non-pharmacological treatments for FOG in patients with PD.
Methods & findings
This study reviewed information from 35 different studies. Treatments for FOG were evaluated in these studies. A total of 1003 patients with PD and FOG were included.
Non-pharmacological therapies are divided into 2 groups. Those therapies that seek a long-lasting effect and those that aim to achieve a brief effect to overcome the FOG event. These include transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and automated mechanical peripheral stimulation (AMPS). TDCS uses electrodes placed on the head to stimulate with a low dose of current regions of the brain. RTMS uses magnetic fields to stimulate brain cells and AMPS increases the function of brain cells by stimulation in the nerves of the feet.
Therapies with short-term effects use different types of senses, such as seeing or hearing (visual or auditory cueing). These therapies can also use proprioceptive stimulation. This consists of the ability to sense the body in terms of position or movement.
The bottom line
This study concluded that a wide range of non-pharmacological and non-surgical treatments has appeared in recent years with promising results.
Published By :
Movement disorders: official journal of the Movement Disorder Society
Date :
Nov 26, 2019
