Background. Freezing of gait (FOG) is a debilitating and incompletely understood symptom in Parkinson’s disease (PD). Objective. To determine the principal clinical factors predisposing to FOG in PD, their interactions, and associated nonmotor symptoms. Methods. 164 PD subjects were assessed in a cross-sectional retrospective study, using the MDS-UPDRS scale, MMSE, and Clinical Dementia Rating Scale. Clinical factors associated with FOG were determined using univariate analysis and nominal logistic regression. Receiver operating characteristic curves were computed, to obtain measures of sensitivity and specificity of predictors of FOG. Subgroups of patients with FOG were compared with those without FOG, based on defining aspects of their clinical phenotype. Results. Relative to non-FOG patients, those with FOG had a longer disease duration, higher PIGD and balance-gait score, higher LED, and more motor complications () and were more likely to exhibit urinary dysfunction (), cognitive impairment, hallucinations, and psychosis (). The balance-gait score and motor complications, at their optimum cutoff values, together predicted FOG with 86% accuracy. Interactions were noted between cognitive dysfunction and both the Bal-Gait score and motor complication status, cognitive impairment or dementia increasing the likelihood of FOG in subjects without motor complications (), but not in those with motor complications. Conclusions. Both disease and treatment-related factors, notably LED, influence the risk of FOG in PD, with a selective influence of cognitive dysfunction in patients with balance-gait disorder but not in those with motor fluctuations. These findings may help to inform clinical management and highlight distinct subgroups of patients with PD-FOG, which are likely to differ in their network pathophysiology.

中文翻译：

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帕金森病的步态冻结：危险因素、它们的相互作用和相关的非运动症状

背景。步态冻结 (FOG) 是帕金森病 (PD) 中一种令人衰弱且不完全理解的症状。客观。确定在 PD 中诱发 FOG 的主要临床因素、它们的相互作用和相关的非运动症状。方法。在一项横断面回顾性研究中，使用 MDS-UPDRS 量表、MMSE 和临床痴呆评定量表对 164 名 PD 受试者进行了评估。使用单变量分析和名义逻辑回归确定与 FOG 相关的临床因素。计算接收者操作特征曲线，以获得FOG预测因子的敏感性和特异性的测量值。根据临床表型的定义，将 FOG 患者亚组与非 FOG 患者进行比较。结果。与非 FOG 患者相比，FOG 患者病程更长，PIGD 和平衡步态评分更高，LED 更高，运动并发症更多。）并且更有可能表现出泌尿功能障碍（)、认知障碍、幻觉和精神病 (）。平衡步态评分和运动并发症在其最佳截止值下以 86% 的准确率共同预测 FOG。认知功能障碍与 Bal-Gait 评分和运动并发症状态、认知障碍或痴呆之间存在相互作用，增加了没有运动并发症的受试者发生 FOG 的可能性。)，但不适用于有运动并发症的患者。结论。疾病和治疗相关因素，尤其是 LED，都会影响 PD 患者的 FOG 风险，对平衡步态障碍患者的认知功能障碍有选择性影响，但对运动波动患者没有影响。这些发现可能有助于为临床管理提供信息，并突出 PD-FOG 患者的不同亚组，这些亚组的网络病理生理学可能不同。