title: Levodopa changes the severity of freezing in Parkinson's disease.
abstract: Oral levodopa has been proposed to be one of the more effective medications to alleviate freezing of gait, but there is limited data on its efficacy. We evaluated the gait phenomenology of 20 Parkinson's disease patients with freezing of gait before and 60 min after a standardized levodopa dose using a rating scale based on the assumption that festination and akinetic freezing share a common pathophysiology. Levodopa abolished festination and freezing in 20% of patients (p < 0.0001), and reduced the freezing sum score from a median of 15 (IQR 6.75-27.5) to 3.5 (1-11.25), p < 0.001) in all but one of the remainder. Pre-dose ratings correlated with post-dose ratings, in that those patients with lower pre-dose item-scores also showed lower post-dose outcome scores. Levodopa's effect on both festination and akinetic freezing was linear, thereby supporting the concept that festination and freezing are variants on a continuity of episodic gait disorders in PD.
authors: Schön Klinik München Schwabing, Dept. of Neurology and Clinical Neurophysiology, Centre for Parkinson's Disease and Movement Disorders, Parzivalplatz 4, D-80804 München, Germany.
authors: Urban M
authors: UM
authors: Fietzek
authors: Jens
authors: J
authors: Zwosta
authors: Frauke E
authors: FE
authors: Schroeteler
authors: Kerstin
authors: K
authors: Ziegler
authors: Andres O
authors: AO
authors: Ceballos-Baumann
mesh_terms: D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001696:Biomechanical Phenomena; D003071:Cognition / Q000502:physiology; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Freezing of gait; Gait; Levodopa; Parkinson's disease