Background

Gait disturbance is one of the most common symptoms among patients with idiopathic Parkinson’s disease (IPD). Nevertheless, Parkinson’s disease subtype clustering according to gait characteristics has not been thoroughly investigated.

Research question

The aim of this study was to identify subgroups according to gait pattern among patients with IPD.

Methods

This study included 88 patients with IPD who underwent ¹⁸F-fluorinated-N-3-fluoropropyl-2-β-carboxymethoxy-3-β-4-iodophenyl-nortropane positron emission tomography (¹⁸F-FP-CIT PET) and three-dimensional gait analysis (3DGA) between January 1, 2014 and December 31, 2016. We performed cluster analysis using temporal-spatial gait variables (gait speed, stride length, cadence, and step width) and divided patients into four subgroups. The kinematic and kinetic gait variables in 3DGA were compared among the four subgroups. Furthermore, we compared the uptake patterns of striatum among the four subgroups using ¹⁸F-FP-CIT PET.

Results

The patients were clustered into subgroups based on gait hypokinesia and cadence compensation. Group 1 had decreased stride length compensating with increased cadence. Group 2 had decreased stride length without cadence compensation and wider step width. Group 3 had relatively spared stride length with decreased cadence. Group 4 had spared stride length and cadence. The uptake of posterior putamen was significantly decreased in Group 3 compared with Group 4.

Significance

Gait hypokinesia and cadence can help to classify gait patterns in IPD patients. Our subgroups may reflect the different gait patterns in IPD patients.

中文翻译：

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使用定量步态分析和18F-FP-CIT正电子发射断层显像对相应的局部区域纹状体摄取进行表征，对特发性帕金森病亚组进行表征。

背景

步态障碍是特发性帕金森病（IPD）患者中最常见的症状之一。然而，根据步态特征进行的帕金森氏病亚型聚集尚未得到彻底研究。

研究问题

这项研究的目的是根据IPD患者的步态模式识别亚组。

方法

该研究包括88例IPD患者，他们接受了¹⁸ F-氟化-N-3-氟丙基-2-β-羧基甲氧基-3-β-4-碘苯基-降冰片正电子发射断层显像（¹⁸ F-FP-CIT PET）和三于2014年1月1日至2016年12月31日进行三维步态分析（3DGA）。我们使用时空步态变量（步态速度，步幅，步频和步幅）进行聚类分析，并将患者分为四个亚组。在四个子组中比较了3DGA中的运动步态和动力学步态变量。此外，我们使用¹⁸ F-FP-CIT PET比较了四个亚组中纹状体的摄取模式。

结果

根据步态运动障碍和节奏补偿将患者分为亚组。第1组步幅减少，但步频增加。第2组的步幅减小，没有节奏补偿，步幅增大。第三组的步幅相对较宽，步频降低。第4组的步幅和步调不遗余力。与第4组相比，第3组中后壳的摄取明显减少。

意义

步态运动障碍和节奏可以帮助对IPD患者的步态模式进行分类。我们的亚组可能反映了IPD患者的不同步态模式。