Skip to main content

Advertisement

SpringerLink
Log in

Gait freezing and speech disturbance in Parkinson’s disease

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Gait freezing and speech disturbance are disabling axial features of Parkinson’s disease (PD). However, the pathogenesis of these features remains unclear. We investigated the relation between changes in gait freezing and speech disturbance using visual and auditory cues in PD. 18 PD patients, comprising of 9 patients with freezing (PDGF) and 9 without gait freezing were studied. Patients performed a 7-m back-and-forth walk in a baseline state and with visual and auditory cues. Gait velocity, stride length and cadence were evaluated using a three-dimensional gait analysis system. For speech evaluation, patients read ten sentences in a baseline state and with visual and auditory cues. The time delay of speech initiation, speech rate and the number of repetitions per sentence were quantified. In PDGF patients, the increase in gait velocity positively correlated with the decrease in the time delay of the speech initiation. Also, the increase in the gait velocity and cadence positively correlated with the decrease in the number of repetitions per sentence. The increase in the stride length positively correlated with the increase in speech rate. Lastly, the increase in stride length positively correlated with the decrease in the number of repetitions per sentence. These findings suggest that there is a common pathomechanism of gait freezing and speech disturbance in PD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Giladi N (2001) Freezing of gait. Clinical overview. Adv Neurol 87:191–197

    CAS  PubMed  Google Scholar 

  2. Nutt JG, Bloem BR, Giladi N, Hallett M, Horak FB, Nieuwboer A (2011) Freezing of gait: moving forward on a mysterious clinical phenomenon. Lancet Neurol 10:734–744

    Article  PubMed  Google Scholar 

  3. Sethi K (2008) Levodopa unresponsive symptoms in Parkinson disease. Mov Disord 23(Suppl 3):S521–S533

    Article  PubMed  Google Scholar 

  4. Giladi N, McDermott MP, Fahn S et al (2001) Freezing of gait in PD: prospective assessment in the DATATOP cohort. Neurology 56:1712–1721

    Article  CAS  PubMed  Google Scholar 

  5. Moreau C, Ozsancak C, Blatt JL, Derambure P, Destee A, Defebvre L (2007) Oral festination in Parkinson’s disease: biomechanical analysis and correlation with festination and freezing of gait. Mov Disord 22:1503–1506

    Article  PubMed  Google Scholar 

  6. Vercruysse S, Devos H, Munks L et al (2012) Explaining freezing of gait in Parkinson’s disease: motor and cognitive determinants. Mov Disord 27:1644–1651

    Article  PubMed  Google Scholar 

  7. Cantiniaux S, Vaugoyeau M, Robert D et al (2010) Comparative analysis of gait and speech in Parkinson’s disease: hypokinetic or dysrhythmic disorders? J Neurol Neurosurg Psychiatry 81:177–184

    Article  PubMed  Google Scholar 

  8. Bartels AL, Balash Y, Gurevich T, Schaafsma JD, Hausdorff JM, Giladi N (2003) Relationship between freezing of gait (FOG) and other features of Parkinson’s: FOG is not correlated with bradykinesia. J Clin Neurosci 10:584–588

    Article  CAS  PubMed  Google Scholar 

  9. Nieuwboer A (2008) Cueing for freezing of gait in patients with Parkinson’s disease: a rehabilitation perspective. Mov Disord 23(Suppl 2):S475–S481

    Article  PubMed  Google Scholar 

  10. Debaere F, Wenderoth N, Sunaert S, Van Hecke P, Swinnen SP (2003) Internal vs external generation of movements: differential neural pathways involved in bimanual coordination performed in the presence or absence of augmented visual feedback. NeuroImage 19:764–776

    Article  PubMed  Google Scholar 

  11. Bartels AL, Leenders KL (2008) Brain imaging in patients with freezing of gait. Mov Dis Off J Mov Dis Soc 23(Suppl 2):S461–S467

    Article  Google Scholar 

  12. Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184

    Article  CAS  PubMed  Google Scholar 

  13. Giladi N, Shabtai H, Simon ES, Biran S, Tal J, Korczyn AD (2000) Construction of freezing of gait questionnaire for patients with Parkinsonism. Parkinsonism Relat Disord 6:165–170

    Article  PubMed  Google Scholar 

  14. Fhan S, Elton RL, committee. amotUd (1987) Unified Parkinson’s Disease Rating Scale In: Fahn S, Marsden CD, Goldstein M, DB C (eds). Macmillan Healthcare Information, Florham Park, pp 153–163

  15. Wook KY (2006) A normative study of the Korean-mini mental state examination (K-MMSE) in the elderly. Korean J Psychol 25:1–12

    Google Scholar 

  16. Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442

    Article  CAS  PubMed  Google Scholar 

  17. Fenelon G, Mahieux F, Huon R, Ziegler M (2000) Hallucinations in Parkinson’s disease: prevalence, phenomenology and risk factors. Brain 123:733–745

    Article  PubMed  Google Scholar 

  18. Lee JY, Dong Woo L, Cho SJ et al (2008) Brief screening for mild cognitive impairment in elderly outpatient clinic: validation of the Korean version of the Montreal Cognitive Assessment. J Geriatr Psychiatry Neurol 21:104–110

    Article  PubMed  Google Scholar 

  19. Hof AL (1996) Scaling gait data to body size. Gait Posture 4:222–223

    Article  Google Scholar 

  20. Willems AM, Nieuwboer A, Chavret F et al (2006) The use of rhythmic auditory cues to influence gait in patients with Parkinson’s disease, the differential effect for freezers and non-freezers, an explorative study. Disabil Rehabil 28:721–728

    Article  CAS  PubMed  Google Scholar 

  21. Bang DH, Jeon YY, Yang DG, Kil SK, Kwon M, Lee SM (2008) Development of a reading training software offering visual–auditory cue for patients with motor speech disorder. J Biomed Eng Res 29:307–315

    Google Scholar 

  22. Kwon M, Kim H, Choi SS, Na DL, Lee K-H (1998) A study for analyzing spontaneous speech for Korean adults with CIU scoring system. Korean J Commun Disord 3:35–49

    Google Scholar 

  23. Lyoo CH, Aalto S, Rinne JO, Lee KO, Oh SH, Chang JW, Lee MS (2007) Different cerebral cortical areas influence the effect of subthalamic nucleus stimulation on parkinsonian motor deficits and freezing of gait. Mov Disord 22:2176–2182

    Article  PubMed  Google Scholar 

  24. Shine JM, Matar E, Ward PB et al (2013) Exploring the cortical and subcortical functional magnetic resonance imaging changes associated with freezing in Parkinson’s disease. Brain 136:1204–1215

    Article  PubMed  Google Scholar 

  25. Snijders AH, Leunissen I, Bakker M et al (2011) Gait-related cerebral alterations in patients with Parkinson’s disease with freezing of gait. Brain 134:59–72

    Article  PubMed  Google Scholar 

  26. Tessitore A, Amboni M, Cirillo G et al (2012) Regional gray matter atrophy in patients with Parkinson disease and freezing of gait. AJNR 33:1804–1809

    Article  CAS  PubMed  Google Scholar 

  27. Tessitore A, Amboni M, Esposito F et al (2012) Resting-state brain connectivity in patients with Parkinson’s disease and freezing of gait. Parkinsonism Relat Disord 18:781–787

    Article  PubMed  Google Scholar 

  28. Kostic VS, Agosta F, Pievani M et al (2012) Pattern of brain tissue loss associated with freezing of gait in Parkinson disease. Neurology 78:409–416

    Article  CAS  PubMed  Google Scholar 

  29. Shine JM, Naismith SL, Lewis SJ (2011) The pathophysiological mechanisms underlying freezing of gait in Parkinson’s disease. J Clin Neurosci 18:1154–1157

    Article  CAS  PubMed  Google Scholar 

  30. Amboni M, Cozzolino A, Longo K, Picillo M, Barone P (2008) Freezing of gait and executive functions in patients with Parkinson’s disease. Mov Disord 23:395–400

    Article  PubMed  Google Scholar 

  31. Naismith SL, Shine JM, Lewis SJ (2010) The specific contributions of set-shifting to freezing of gait in Parkinson’s disease. Mov Disord 25:1000–1004

    Article  PubMed  Google Scholar 

  32. Amboni M, Barone P, Picillo M et al (2010) A two-year follow-up study of executive dysfunctions in Parkinsonian patients with freezing of gait at on-state. Mov Disord 25:800–802

    Article  PubMed  Google Scholar 

  33. Almeida QJ, Lebold CA (2010) Freezing of gait in Parkinson’s disease: a perceptual cause for a motor impairment? J Neurol Neurosurg Psychiatry 81:513–518

    Article  CAS  PubMed  Google Scholar 

  34. Giladi N, Huber-Mahlin V, Herman T, Hausdorff JM (2007) Freezing of gait in older adults with high level gait disorders: association with impaired executive function. J Neural Transm 114:1349–1353

    Article  CAS  PubMed  Google Scholar 

  35. Huang C, Tang C, Feigin A et al (2007) Changes in network activity with the progression of Parkinson’s disease. Brain 130:1834–1846

    Article  PubMed  Google Scholar 

  36. Huang C, Mattis P, Tang C, Perrine K, Carbon M, Eidelberg D (2007) Metabolic brain networks associated with cognitive function in Parkinson’s disease. NeuroImage 34:714–723

    Article  PubMed  Google Scholar 

  37. Assmus A, Marshall JC, Ritzl A, Noth J, Zilles K, Fink GR (2003) Left inferior parietal cortex integrates time and space during collision judgments. NeuroImage 20(Suppl 1):S82–S88

    Article  PubMed  Google Scholar 

  38. Collette F, Olivier L, Van der Linden M et al (2005) Involvement of both prefrontal and inferior parietal cortex in dual-task performance. Brain Res Cogn Brain Res 24:237–251

    Article  PubMed  Google Scholar 

  39. Sidaway B, Anderson J, Danielson G, Martin L, Smith G (2006) Effects of long-term gait training using visual cues in an individual with Parkinson disease. Phys Ther 86:186–194

    PubMed  Google Scholar 

  40. Wu T, Hallett M (2005) A functional MRI study of automatic movements in patients with Parkinson’s disease. Brain 128:2250–2259

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We express our gratitude to Dr. Nir Giladi for generously allowing us to use the translated versions of the Gait and Falls Questionnaire and the Freezing of Gait Questionnaire. This work was supported by the 2012 Inje University Research Grant.

Author information

Authors and Affiliations

  1. Department of Neurology, Inje University Ilsan-Paik Hospital, Goyang, Korea

    Hee Kyung Park

  2. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-dong, Songpa-gu, Seoul, 138-736, Korea

    Hee Kyung Park, Miseon Kwon, Jae-Hong Lee & Sun Ju Chung

  3. Department of Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jong Yoon Yoo

  4. Department of Rehabilitation Medicine, Dong-A University of Hospital, Busan Ulsan Regional Cardiocerebrovascular center, Busan, Korea

    Sook Joung Lee

  5. College of Nursing, Chonbuk National University, Jeonju, Korea

    Sung Reul Kim

  6. Department of Health Screening and Promotion Center, Asan Medical Center, Seoul, Korea

    Mi Jung Kim

  7. Department of Neurology, Cheongshim International Medical Center, Gapyeong-gun, Korea

    Myoung C. Lee

  8. Department of Electronic Engineering, Inha University, Incheon, Korea

    Sang Min Lee

Authors
  1. Hee Kyung Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jong Yoon Yoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Miseon Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jae-Hong Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sook Joung Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sung Reul Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mi Jung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Myoung C. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Sang Min Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Sun Ju Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sun Ju Chung.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Park, H.K., Yoo, J.Y., Kwon, M. et al. Gait freezing and speech disturbance in Parkinson’s disease. Neurol Sci 35, 357–363 (2014). https://doi.org/10.1007/s10072-013-1519-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-013-1519-1

Keywords

Search

Navigation