title: Postural sensory correlates of freezing of gait in Parkinson's disease.
abstract: BACKGROUND
  To elucidate the unique patterns of postural sensory deficits contributing to freezing of gait (FOG) in patients with Parkinson's disease (PD) and to identify postural sensory modalities that correlate with FOG severity.
  
  
  METHODS
  Twenty-five PD patients with FOG, 22 PD patients without FOG, and 26 age-matched controls were evaluated using a sensory organization test and clinical measures including the Unified Parkinson's Disease Rating Scale motor score, Montreal Cognitive Assessment, Frontal Assessment Battery, Activities-specific Balance Confidence, Beck Anxiety Inventory, Beck Depression Inventory, and Berg Balance Scale. Multivariable logistic regression analysis was performed for posturographic parameters and possible confounders to determine postural sensory contributors to FOG. We also correlated FOG severity, measured using a New Freezing of Gait Questionnaire, with posturographic parameters.
  
  
  RESULTS
  PD patients with FOG showed worse postural sensory processing compared with those without FOG. In particular, the inability to use the vestibular information (odds ratio [OR] 1.447; 95% confidential interval [CI]: 1.120, 1.869) and poor control over the perturbed somatosensory inputs (OR 2.904; 95% CI: 1.028, 8.202) significantly contributed to FOG. Among PD patients with FOG, FOG severity was correlated with higher reliance on visual information (ρ = -0.432, p = 0.039).
  
  
  CONCLUSIONS
  Postural sensory deficits involving specific sensory modalities are strongly associated with FOG. Quantitative measurement of postural sensory deficits in PD patients with FOG may provide a better understanding of pathomechanisms of FOG and increase the efficacy of sensory cueing strategies for alleviating FOG, by more accurately identifying suitable patients for rehabilitative therapies.
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea. Electronic address: nana1880@hanmail.net.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Huh
authors.affiliation: Center for Robotics Research, Korea Institute of Science and Technology, Seoul, South Korea. Electronic address: sh@kist.re.kr.
authors.forename: Seonhong
authors.initials: S
authors.lastname: Hwang
authors.affiliation: Center for Robotics Research, Korea Institute of Science and Technology, Seoul, South Korea. Electronic address: khk@kist.re.kr.
authors.forename: Keehoon
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea. Electronic address: wonho.chung@samsung.com.
authors.forename: Won-Ho
authors.initials: WH
authors.lastname: Chung
authors.affiliation: Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea. Electronic address: genian.youn@samsung.com.
authors.forename: Jinyoung
authors.initials: J
authors.lastname: Youn
authors.affiliation: Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea. Electronic address: jinwhan.cho@samsung.com.
authors.forename: Jin Whan
authors.initials: JW
authors.lastname: Cho
mesh_terms: D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology; D011434:Proprioception / Q000502:physiology
keywords: Freezing of gait; Parkinson's disease; Postural sensory deficits; Vestibular impairment