Objective: To investigate the role of components of working memory updating in freezing of gait phenomenon Parkinson’s Disease

Background: The role of cognitive deficits has been stressed on for freeing of gait phenomenon since Lewis and Barker’s(2009) pathophysiological model of freezing of gait in Parkinson’s Disease. Working memory is known to be affected in patients with Parkinson’s Disease experiencing freezing of gait (Hall et al., 2014), and the specific demands of updating working memory have been known to influence gait and movement (Johannsen et al., 2013). Therefore, this study investigates different components of working memory updating, viz. retrieval, transformation, and substitution, and their role in the Freezing of Gait phenomenon.

Method: A sample of 45 participants was recruited, including 15 elderly patients of Parkinson’s Disease with Freezing of Gait (FOG),15 patients without freezing of gait(NFOG), and 15 matched healthy controls(HC) (60-85yrs). Montreal Cognitive Assessment was performed to rule out dementia and cognitive impairment, and the New Freezing of Gait questionnaire was used to screen and categorize the FOG and NFOG group. Computerized retrieval, transformation, and substitution assessments were administered to the participants, and their accuracy and reaction times were recorded.

Results: Multivariate ANOVA revealed a significant difference among the groups at F(2,42)= 9.975, p=.01. for transformation reaction time. Post hoc analysis revealed significant differences between  with FOG( M=  77.43, SD= 7.06) and NFOG(M= 83.44, SD= 3.96) and with HC(M= 84.44, SD= 7.03), both significant at <.01 level.

For the substitution component, accuracy differed between the groups at F(2,42)= 8.245, p= .01. and significant differences between FOG( M= 64.56, SD= 10.26) and NFOG(M= 71.56, SD= 8.76) and the HC group (M= 74.00, SD= 6.54) were found at less than <.01 level of significance.

Conclusion: Working the memory updating deficit is implied among the group experiencing freezing of gait. Transformation gives a new value to existing information by assigning an operation, and substitution replaces the old information with new information, which is essential to maintain the accuracy of updating. This research will help in better understanding of this phenomenon will and, therefore, lead to better management of this phenomenon, the patients and caregivers.

References: Hall, J. M., Shine, J. M., Walton, C. C., Gilat, M., Kamsma, Y. P. T., Naismith, S. L., & Lewis, S. J. G. (2014). Early phenotypic differences between Parkinson’s disease patients with and without freezing of gait. Parkinsonism & Related Disorders, 20(6), 604-607.

Johannsen, L., Li, K. Z., Chechlacz, M., Bibi, A., Kourtzi, Z., & Wing, A. M. (2013). Functional neuroimaging of the interference between working memory and the control of periodic ankle movement timing. Neuropsychologia, 51(11), 2142-2153.

Lewis, S. J., & Barker, R. A. (2009). A pathophysiological model of freezing of gait in Parkinson’s disease. Parkinsonism & related disorders, 15(5), 333-338.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-underside-of-parkinsons-disease-a-working-memory-updating-failure-in-freezing-of-gait/