title: Temporal Characteristics of High-Frequency Lower-Limb Oscillation during Freezing of Gait in Parkinson's Disease.
abstract: A cardinal feature of freezing of gait (FOG) is high frequency (3-8 Hz) oscillation of the legs, and this study aimed to quantify the temporal pattern of lower-body motion prior to and during FOG. Acceleration data was obtained from sensors attached to the back, thighs, shanks, and feet in 14 Parkinson's disease patients performing timed-up-and-go tasks, and clinical assessment of FOG was performed by two experienced raters from video. A total of 23 isolated FOG events, defined as occurring at least 5 s after gait initiation and with no preceding FOG, were identified from the clinical ratings. The corresponding accelerometer records were analyzed within a 4 s window centered at the clinical onset of freezing. FOG-related high-frequency oscillation (an increase in power in the 3-8 Hz band >3 SD from baseline) followed a distal to proximal onset pattern, appearing at the feet, shanks, thighs, and then back over a period of 250 ms. Peak power tended to decrease as the focus of oscillation moved from feet to back. There was a consistent delay (mean 872 ms) between the onset of high frequency oscillation at the feet and clinical onset of FOG. We infer that FOG is characterized by high frequency oscillation at the feet, which progresses proximally and is mechanically damped at the torso.
authors.affiliation: Human Aerospace Laboratory, Department of Neurology, Mount Sinai School of Medicine, Box 1052, 1 Gustave L. Levy Place, New York, NY 10029, USA.
authors.forename: Don A
authors.initials: DA
authors.lastname: Yungher
authors.affiliation: Human Aerospace Laboratory, Department of Neurology, Mount Sinai School of Medicine, Box 1052, 1 Gustave L. Levy Place, New York, NY 10029, USA.
authors.forename: Tiffany R
authors.initials: TR
authors.lastname: Morris
authors.affiliation: Human Aerospace Laboratory, Department of Neurology, Mount Sinai School of Medicine, Box 1052, 1 Gustave L. Levy Place, New York, NY 10029, USA.
authors.forename: Valentina
authors.initials: V
authors.lastname: Dilda
authors.affiliation: Parkinson's Disease Research Clinic, Brain and Mind Research Institute, University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: James M
authors.initials: JM
authors.lastname: Shine
authors.affiliation: Parkinson's Disease Research Clinic, Brain and Mind Research Institute, University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Naismith
authors.affiliation: Parkinson's Disease Research Clinic, Brain and Mind Research Institute, University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Simon J G
authors.initials: SJ
authors.lastname: Lewis
authors.affiliation: Human Aerospace Laboratory, Department of Neurology, Mount Sinai School of Medicine, Box 1052, 1 Gustave L. Levy Place, New York, NY 10029, USA ; Robert and John M. Bendheim Parkinson and Movement Disorders Center, Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA.
authors.forename: Steven T
authors.initials: ST
authors.lastname: Moore
references.citation: J Neuroeng Rehabil. 2013 Feb 13;10:19
references.pmid: 23405951
references.citation: Parkinsonism Relat Disord. 2012 Jan;18(1):25-9
references.pmid: 21872523
references.citation: Neurology. 2001 Jun 26;56(12):1712-21
references.pmid: 11425939
references.citation: Mov Disord. 2006 Sep;21(9):1419-24
references.pmid: 16773644
references.citation: Mov Disord. 2005 Nov;20(11):1449-54
references.pmid: 16007641
references.citation: Brain. 2009 Nov;132(Pt 11):2947-57
references.pmid: 19759203
references.citation: Eur J Neurol. 2003 Jul;10(4):391-8
references.pmid: 12823491
references.citation: Mov Disord. 2004 Aug;19(8):871-84
references.pmid: 15300651
references.citation: J Neurol Neurosurg Psychiatry. 1996 Jul;61(1):70-4
references.pmid: 8676165
references.citation: J Comput Neurosci. 2004 May-Jun;16(3):211-35
references.pmid: 15114047
references.citation: J Neural Transm (Vienna). 2001;108(1):53-61
references.pmid: 11261746
references.citation: Mov Disord. 2011 Apr;26(5):844-51
references.pmid: 21370271
references.citation: Brain. 2002 Mar;125(Pt 3):575-83
references.pmid: 11872614
references.citation: Eur J Neurol. 2009 Feb;16(2):194-200
references.pmid: 19146640
references.citation: Brain. 2004 Jul;127(Pt 7):1650-60
references.pmid: 15128621
references.citation: Parkinsonism Relat Disord. 2009 Jun;15(5):379-82
references.pmid: 18977165
references.citation: Parkinsonism Relat Disord. 2012 Jun;18(5):572-7
references.pmid: 22445248
references.citation: Front Syst Neurosci. 2013 Oct 04;7:61
references.pmid: 24109438
references.citation: Brain. 2007 Jun;130(Pt 6):1596-607
references.pmid: 17251240
references.citation: Clin Orthop Relat Res. 1980 May;(148):192-5
references.pmid: 7379394
references.citation: Parkinsonism Relat Disord. 2013 Mar;19(3):388-90
references.pmid: 22906729
references.citation: Mov Disord. 2007 May 15;22(7):953-6
references.pmid: 17377927
references.citation: Gait Posture. 2013 Jun;38(2):326-9
references.pmid: 23332192
references.citation: JAMA. 1997 Jul 9;278(2):125-30
references.pmid: 9214527
references.citation: J Neurosci Methods. 2008 Jan 30;167(2):340-8
references.pmid: 17928063
references.citation: Neurosurgery. 2011 Dec;69(6):1248-53; discussion 1254
references.pmid: 21725254
references.citation: Exp Neurol. 2009 Feb;215(2):334-41
references.pmid: 19061889
references.citation: Neurology. 1992 Feb;42(2):333-9
references.pmid: 1736161
references.citation: Age Ageing. 1992 Jan;21(1):32-8
references.pmid: 1553857