[Posture and gait modulation using sensory or attentional cues in Parkinson's disease. A possible approach to the mechanism of episodic freezing].
Parkinsonian patients have difficulties for walking as well as for adapting their posture following a voluntary or automatic movement that will disturb their equilibrium. Furthermore, in Parkinson's disease, the patients can suffer for motor blockades (or freezing) in which the movement is like frozen during its execution. These motor blockades can occur during gait initiation, turning round, as well as during the walking through apertures or small passages, but with a high variability as inter-individual as intra-individual. Cognitive, attentional or sensory stimulation--especially visual information--can interact directly on these motor blockades, either positively inhibiting them or negatively inducing them. The different modulation factors of locomotion as well as posture, in Parkinsonian patient and in healthy elderly, and the special case of the motor blockades in Parkinsonian patients are reviewed here. We also examine the effects of L-DOPA with respect to each of these factors. In the conclusion, the modulation of gait, posture, and freezing are discussed in term of mechanisms involved or hypothesis recently proposed.
Darmon
A
A
UPRES 2199, Physiopathologie du Système Nerveux et du Muscle, CHU La Timone, Marseille.
Azulay
J P
JP
Pouget
J
J
Blin
O
O
D000222:Adaptation, Physiological; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D001288:Attention; D015928:Cognitive Behavioral Therapy; D003463:Cues; D005684:Gait; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D010300:Parkinson Disease / Q000188:drug therapy; D011187:Posture; D011596:Psychomotor Disorders / Q000628:therapy*
D000978:Antiparkinson Agents; D007980:Levodopa