title: Lack of maintenance of gait pattern as measured by instrumental methods suggests psychogenic gait.
abstract: Fluctuation is a common feature of all psychogenic gait disorder (PGD) patterns. Whether this fluctuation involves only the degree of impairment or whether it affects the gait pattern itself remains an interesting question. We hypothesize that, on repeated measurements, both normal and abnormal gait may present quantitative differences while maintaining their basic underlying pattern; conversely, in psychogenic gait, the basic pattern appears not to be preserved. Using an optoelectronic system, data acquired from 19 normal subjects and 66 patients were applied to train a neural network (NN) and subsequently classify gait patterns into four different groups (normal, ataxic, spastic-paraparetic and parkinsonian). Five patients who fulfilled clinical criteria for psychogenic gait and six controls were then prospectively evaluated on two separate occasions, three months apart. Normal controls and ataxic, parkinsonian or spastic patients were correctly identified by the NN, and categorized within the corresponding groups at baseline as well as at a three-month follow-up evaluation. NN analysis showed that after three months, no PGD patient preserved the gait pattern detected at baseline, even though this finding was not clinically apparent. Modification of gait pattern detected by repeated kinematic measurement and NN analysis could suggest the presence of PGD, particularly in difficult-to-diagnose cases.
authors.affiliation: Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research, FLENI, Buenos Aires, Argentina. mmerello@fleni.org.ar
authors.forename: Marcelo
authors.initials: M
authors.lastname: Merello
authors.forename: Diego
authors.initials: D
authors.lastname: Ballesteros
authors.forename: Malco
authors.initials: M
authors.lastname: Rossi
authors.forename: Julieta
authors.initials: J
authors.lastname: Arena
authors.forename: Marcos
authors.initials: M
authors.lastname: Crespo
authors.forename: Andres
authors.initials: A
authors.lastname: Cervio
authors.forename: Carolina
authors.initials: C
authors.lastname: Cuello Oderiz
authors.forename: Alberto
authors.initials: A
authors.lastname: Rivero
authors.forename: Daniel
authors.initials: D
authors.lastname: Cerquetti
authors.forename: Marcelo
authors.initials: M
authors.lastname: Risk
authors.forename: Jorge
authors.initials: J
authors.lastname: Balej
mesh_terms: D001696:Biomechanical Phenomena; D004581:Electronics / Q000295:instrumentation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000175:diagnosis* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016571:Neural Networks, Computer; D011446:Prospective Studies; D011602:Psychophysiologic Disorders; D016138:Walking / Q000502:physiology