Objective: To study interrelation of neuropsychological disturbances with severe gait impairment and postural stability in Parkinson’s disease.

Background: Clinical features of gait impairment and postural stability, mechanisms of their development at different stages of Parkinson’s disease and correlation with neuropsychological disturbances are still poorly understood.

Methods: A total of 60 PD patients, 24 men and 26 women aged from 52 to 68 years old on average – 65,3±7,8 years were examined. All patients were divided into groups with early (stage 2 by Hyun-Yar) with no postural instability, and a group of patients with advanced stages (3-4 stages by Hyun-Yar) with postural disturbances. A control group of 20 healthy individuals (9 men and 11 women), mean age – 65,7 ± 7,4 years, the level of education – 14,9 ± 4,2 years was formed. Gait impairment was assessed using the scale of Gait and Balance Scale (GABS) and Freezing of Gait Questionnaire (FOG-Q), podometry, goniometry and stabilometry. A battery of neuropsychological researches was performed.

Results: Patients with severe cognitive disturbances had a more pronounced postural instability (p<0,05), shortening the length of the steps in the normal (p<0,01) and quick (p<0,05) walking tempo and a tendency to a decrease in walking speed at a rapid walking tempo (p=0,1). Results of stabilometry showed a large square statokinezisgramma on standing with open (p<0,05) and closed p<0,05) eyes. In patients with freezing of gait (FOG) we have seen an increase in time of the Schulte test compared with patients without FOG (p<0,05). The group of patients with FOG was worse performed tests on speech activity and collecting cubes test, made more mistakes in the dynamic movements test than patients without FOG (p<0,05). We noted the correlation between the severity of gait impairment and postural stability (according GABS and stabilometry) with the severity of depression and apathy.

Conclusions: Patients with severe cognitive impairment have more pronounced postural disturbances and a tendency to more pronounced gait impairment. Intensity of gait impairment in Parkinson’s disease correlates with the severity of neuropsychological disturbances, mainly associated with frontostriatal dysfunction.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/interrelation-between-gait-impairment-with-cognitive-disturbances-in-patients-with-parkinsons-disease/