Freezing phenomenon in patients with parkinsonian syndromes

TLDR

Freezing is a common symptom in parkinsonian syndromes, yet its links to specific parkinsonism etiologies and comorbid symptoms remain unexplored. The study surveyed a database to assess freezing prevalence across parkinsonism types. Among 347 non‑idiopathic parkinsonism patients, 46% experienced freezing, which correlated with disease progression (OR 1.69), was rare in drug‑induced cases (OR 0.1), common in vascular (57%) and NPH (56%) and neurodegenerative forms (45%), and associated with dementia, incontinence, and tachyphemia (OR 2.01, 1.7, 5.09).

Abstract

Abstract Freezing is a common symptom in parkinsonian syndromes, but its association with different causes of parkinsonism as well as with other symptoms has never been investigated. We conducted a database survey of the occurrence of freezing in parkinsonism. Of 347 patients with a clinical diagnosis of parkinsonism other than idiopathic Parkinson's disease and with specific data regarding freezing, 158 patients had freezing (46%). Freezing was significantly associated with progression of the disease as rated on the Hoehn & Yahr scale [odds ratio (OR), 1.69; p < 0.004]. Gender was not a risk factor for the development of freezing. Patients with drug‐induced parkinsonism were at a very low risk for developing freezing (p < 0.00001; OR, 0.1). Freezing was found in a high frequency in patients with vascular parkinsonism (57%), normal‐pressure hydrocephalus (56%), and generally in teh group of patients who had parkinsonism resulting from neurodegenerative disease (progressive supranuclear palsy, multiple system atrophy, and corticobasal ganglionic degeneration; 45%). Freezing was significantly associated with the presence of dementia, incontinence, and tachyphemia (OR, 2.01, 1.7, and 5.09, respectively).