title: Freezing of gait: moving forward on a mysterious clinical phenomenon.
abstract: Freezing of gait (FoG) is a unique and disabling clinical phenomenon characterised by brief episodes of inability to step or by extremely short steps that typically occur on initiating gait or on turning while walking. Patients with FoG, which is a feature of parkinsonian syndromes, show variability in gait metrics between FoG episodes and a substantial reduction in step length with frequent trembling of the legs during FoG episodes. Physiological, functional imaging, and clinical-pathological studies point to disturbances in frontal cortical regions, the basal ganglia, and the midbrain locomotor region as the probable origins of FoG. Medications, deep brain stimulation, and rehabilitation techniques can alleviate symptoms of FoG in some patients, but these treatments lack efficacy in patients with advanced FoG. A better understanding of the phenomenon is needed to aid the development of effective therapeutic strategies.
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA. nuttj@ohsu.edu
authors.forename: John G
authors.initials: JG
authors.lastname: Nutt
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
authors.forename: Nir
authors.initials: N
authors.lastname: Giladi
authors.forename: Mark
authors.initials: M
authors.lastname: Hallett
authors.forename: Fay B
authors.initials: FB
authors.lastname: Horak
authors.forename: Alice
authors.initials: A
authors.lastname: Nieuwboer
mesh_terms: D000818:Animals; D001479:Basal Ganglia / Q000473:pathology / Q000502:physiology*; D005625:Frontal Lobe / Q000473:pathology / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D020734:Parkinsonian Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy