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Freezing of gait in Parkinson's disease: from pathophysiology to emerging therapies

    Alberto Cucca

    *Author for correspondence:

    E-mail Address: cucca.alberto@libero.it

    Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, New York, NY 10016, USA

    Department of Medicine, Surgery & Health Sciences, University of Trieste, Clinica Neurologica, Trieste, Italy

    ,
    Milton C Biagioni

    Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, New York, NY 10016, USA

    ,
    Jori E Fleisher

    Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, New York, NY 10016, USA

    ,
    Shashank Agarwal

    Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, New York, NY 10016, USA

    ,
    Andre Son

    Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, New York, NY 10016, USA

    ,
    Pawan Kumar

    Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, New York, NY 10016, USA

    ,
    Miroslaw Brys

    Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, New York, NY 10016, USA

    &
    Alessandro Di Rocco

    Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, New York, NY 10016, USA

    Published Online:https://doi.org/10.2217/nmt-2016-0018

    Freezing of gait (FOG) is ‘an episodic inability to generate effective stepping in the absence of any known cause other than parkinsonism or high level gait disorders’. FOG is one of the most disabling symptoms in Parkinson's disease, especially in its more advanced stages. Early recognition is important as FOG is related to higher fall risk and poorer prognosis. Although specific treatments are still elusive, there have been recent advances in the development of new therapeutic approaches. The aim of this review is to present the latest knowledge regarding the phenomenology, pathogenesis, diagnostic assessment and conventional treatment of FOG in Parkinson's disease. A review of the evidence supporting noninvasive brain stimulation will follow to highlight the potential of these strategies.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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