Bewegungsblockaden bei Parkinsonsyndromen

Zusammenfassung

Eine der größten therapeutischen Herausforderungen bei Menschen mit fortgeschrittenen Parkinson-Syndromen sind motorische Blockaden bzw. das Freezing-Phänomen, dessen bekanntester Vertreter wohl das Gangfreezing ist. Dabei reicht die Wahrnehmung und Konzeption von motorischen Blockaden von einer Kolibristörung bis hin zum Kardinalsymptom der Parkinsonkrankheit. Der vorliegende Artikel macht sich die Mühe, diese Konzeption motorischer Blockaden bis zu den ersten Gedanken von Parkinson selbst zurück und dann im Verlauf der Geschichte weiter zu verfolgen. Es geht uns darum, zu zeigen und ein Verständnis dafür zu wecken, dass es sich bei motorischen Blockaden um einen zentralen Aspekt der Phänomenologie von Parkinson-Syndromen handelt. Pathophysiologische Grundlagen werden in ihren anerkannten klinischen Aspekten berührt, ebenso wie die klinische und forschende Erfassung. Schließlich werden sowohl die wichtigsten pharmakotherapeutischen als auch die physiotherapeutischen Ansätze in ihren Grundzügen dem Leser vorgestellt.

Abstract

One of the greatest therapeutic challenges for people with advanced Parkinson’s syndromes are motor blockades or the freezing phenomenon, the best-known representative of which is probably gait freezing. The perception and conceptualization of motor blockades ranges from a hummingbird disorder to the cardinal symptom of Parkinson’s disease. This article takes the trouble to trace this concept of motor blockades back to the first thoughts of Parkinson himself and then further in the course of history. It is also our aim to show and create an understanding of the fact that motor blockades are a central aspect of the phenomenology of Parkinson’s syndromes. Pathophysiological principles will be touched upon in their recognized clinical aspects, as well as clinical and research assessment. Finally, the most important pharmacotherapeutic and physiotherapeutic approaches are presented to the reader in their basic features.

Schlüsselwörter

Parkinson - Parkinsonkrankheit - progressive supranukleäre Paralyse - Gang - motorische Blockaden - Geschichte - Freezing

Keywords

Parkinson’s disease - progressive supranuclear paralysis - gait - motor blocks - freezing of gait - history

Publikationsverlauf

Artikel online veröffentlicht:
04. März 2025

• Literatur

• 1 Parkinson J. An essay on the shaking palsy. London: Whittingham and Rowland; 1817
• 2 Kempster P, Hurwitz B, Lees A. James Parkinson’s Chimera: syndrome or disease?. J R Coll Physicians Edinb 2017; 47: 190-195
• 3 Charcot J-M. On Paralysis Agitans (lecture V). In: Lectures on the Diseases of the Nervous System. London: New Sydenham Society; 1877: 129-156
• 4 Schaafsma JD, Balash Y, Gurevich T. et al. Characterization of freezing of gait subtypes and the response of each to levodopa in Parkinson’s disease. Eur J Neurol 2003; 10: 391-398
• 5 Barbeau A, Mars H, Botez MI. et al. Levodopa combined with peripheral decarboxylase inhibition in Parkinson’s disease. Can Med Assoc J 1972; 106: 1169-1174
• 6 Ambani LM, Van Woert MH. Start hesitation--a side effect of long-term levodopa therapy. N Engl J Med 1973; 288: 1113-1115
• 7 Compston A. A clinical lecture on shaking palsy. By Thomas Buzzard, MD, FRCP. (Physician to the National Hospital for the Paralyzed and Epileptic). Brain 1882; 4: 473–492 and On-off fluctuations in Parkinson’s disease. A clinical and neuropharmacological study. By RJ Hardie, AJ Lees and GM Stern. (From the Department of Neurology, University College Hospital, London WC1). Brain 1984; 107: 487–506. Brain 2008; 131: 3111-3114
• 8 Broussolle E, Trocello J-M, Woimant F. et al. Samuel Alexander Kinnier Wilson. Wilson’s disease, Queen Square and neurology. Rev Neurol (Paris) 2013; 169: 927-935
• 9 Schwab RS. Controll of two simultaniously voluntary motor acts in normals and in Parknsonism. Arch Neurol Psychiatry 1954; 72: 591
• 10 Barbeau A. Progress in understanding and treating Parkinson’s disease. Can J Neurol Sci J Can Sci Neurol 1976; 3: 81-84
• 11 Barbeau A. Six years of high-level levodopa therapy in severely akinetic parkinsonian patients. Arch Neurol 1976; 33: 333-338
• 12 Barbeau A. The clinical physiology of side effects in long-term L-DOPA therapy. Adv Neurol 1974; 5: 347-365
• 13 LeWitt PA, Fahn S. Levodopa therapy for Parkinson disease: A look backward and forward. Neurology 2016; 86: S3-S12
• 14 Marsden CD, Parkes JD. „On-off“ effects in patients with Parkinson’s disease on chronic levodopa therapy. Lancet 1976; 1: 292-296
• 15 Giladi N, McMahon D, Przedborski S. et al. Motor blocks in Parkinson’s disease. Neurology 1992; 42: 333-339
• 16 Vandenbossche J, Deroost N, Soetens E. et al. Freezing of gait in Parkinson’s disease: disturbances in automaticity and control. Front Hum Neurosci 2012; 6: 356
• 17 Compta Y, Valldeoriola F, Tolosa E. et al. Long lasting pure freezing of gait preceding progressive supranuclear palsy: a clinicopathological study. Mov Disord Off J Mov Disord Soc 2007; 22: 1954-1958
• 18 Fasano A, Herman T, Tessitore A. et al. Neuroimaging of Freezing of Gait. J Park Dis 2015; 5: 241-254
• 19 Atchison PR, Thompson PD, Frackowiak RS. et al. The syndrome of gait ignition failure: a report of six cases. Mov Disord 1993; 8: 285-292
• 20 Achiron A, Ziv I, Goren M. et al. Primary progressive freezing gait. Mov Disord 1993; 8: 293-297
• 21 Espay AJ, Fasano A, van Nuenen BFL. et al. „On“ state freezing of gait in Parkinson disease: a paradoxical levodopa-induced complication. Neurology 2012; 78: 454-457
• 22 Chee R, Murphy A, Danoudis M. et al. Gait freezing in Parkinson’s disease and the stride length sequence effect interaction. Brain J Neurol 2009; 132: 2151-2160
• 23 Fietzek UM, Stuhlinger L, Plate A. et al. Spatial constraints evoke increased number of steps during turning in Parkinson’s disease. Clin Neurophysiol Off J Int Fed Clin Neurophysiol 2017; 128: 1954-1960
• 24 Iansek R, Huxham F, McGinley J. The sequence effect and gait festination in Parkinson disease: contributors to freezing of gait?. Mov Disord 2006; 21: 1419-1424
• 25 Fahn S. The freezing phenomenon in parkinsonism. Adv Neurol 1995; 67: 53-63
• 26 Critchley EM. Speech disorders of Parkinsonism: a review. J Neurol Neurosurg Psychiatry 1981; 44: 751-758
• 27 Höglinger GU, Respondek G, Stamelou M. et al. Clinical diagnosis of progressive supranuclear palsy: The movement disorder society criteria. Mov Disord Off J Mov Disord Soc 2017; 32: 853-864
• 28 Goetz CG, Tilley BC, Shaftman SR. et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord 2008; 23: 2129-2170
• 29 Snijders AH, Haaxma CA, Hagen YJ. et al. Freezer or non-freezer: clinical assessment of freezing of gait. Parkinsonism Relat Disord 2012; 18: 149-154
• 30 Ziegler K, Schroeteler F, Ceballos-Baumann AO. et al. A new rating instrument to assess festination and freezing gait in Parkinsonian patients. Mov Disord Off J Mov Disord Soc 2010; 25: 1012-1018
• 31 Fietzek UM, Zwosta J, Schroeteler FE. et al. Levodopa changes the severity of freezing in Parkinson’s disease. Parkinsonism Relat Disord 2013; 19: 894-896
• 32 Fietzek UM, Schroeteler FE, Ziegler K. et al. Randomized cross-over trial to investigate the efficacy of a two-week physiotherapy programme with repetitive exercises of cueing to reduce the severity of freezing of gait in patients with Parkinson’s disease. Clin Rehabil 2014; 28: 902-911
• 33 Goh L, Paul SS, Canning CG. et al. The Ziegler Test Is Reliable and Valid for Measuring Freezing of Gait in People With Parkinson Disease. Phys Ther 2022; 102: pzac122
• 34 Salomon A, Gazit E, Ginis P. et al. A machine learning contest enhances automated freezing of gait detection and reveals time-of-day effects. Nat Commun 2024; 15: 4853
• 35 Zampogna A, Borzì L, Rinaldi D. et al. Unveiling the Unpredictable in Parkinson’s Disease: Sensor-Based Monitoring of Dyskinesias and Freezing of Gait in Daily Life. Bioeng Basel Switz 2024; 11: 440
• 36 Fahn S. Levodopa in the treatment of Parkinson’s disease. J Neural Transm Suppl 2006; 1-15
• 37 Bartels AL, Balash Y, Gurevich T. et al. Relationship between freezing of gait (FOG) and other features of Parkinson’s: FOG is not correlated with bradykinesia. J Clin Neurosci 2003; 10: 584-588
• 38 Fahn S, Oakes D, Shoulson I. et al. Levodopa and the progression of Parkinson’s disease. N Engl J Med 2004; 351: 2498-2508
• 39 Rascol O, Brooks DJ, Korczyn AD. et al. A five-year study of the incidence of dyskinesia in patients with early Parkinson’s disease who were treated with ropinirole or levodopa. 056 Study Group. N Engl J Med 2000; 342: 1484-1491
• 40 Parkinson Study Group CALM Cohort Investigators. Long-term effect of initiating pramipexole vs levodopa in early parkinson disease. Arch Neurol 2009; 66: 563-570
• 41 Rascol O, Brooks DJ, Melamed E. et al. Rasagiline as an adjunct to levodopa in patients with Parkinson’s disease and motor fluctuations (LARGO, Lasting effect in Adjunct therapy with Rasagiline Given Once daily, study): a randomised, double-blind, parallel-group trial. Lancet 2005; 365: 947-954
• 42 Ferreira JJ, Lees A, Rocha J-F. et al. Opicapone as an adjunct to levodopa in patients with Parkinson’s disease and end-of-dose motor fluctuations: a randomised, double-blind, controlled trial. Lancet Neurol 2015;
• 43 Steiger MJ, Thompson PD, Marsden CD. Disordered axial movement in Parkinson’s disease. J Neurol Neurosurg Psychiatry 1996; 61: 645-648
• 44 Narabayashi H, Kondo T, Yokochi F. et al. Clinical effects of L-threo-3,4-dihydroxyphenylserine in cases of parkinsonism and pure akinesia. Adv Neurol 1987; 45: 593-602
• 45 Narabayashi H. Akinesia in parkinsonism – clinical and pharmacological analysis of parkinsonian symptoms. Bull Mém Académie R Médecine Belg 1984; 139: 309-320
• 46 Quinn NP, Perlmutter JS, Marsden CD. Acute administration of DS ThreoDOPS does not affect the freezing phenomenon in parkinsonian patients. Neurology 1984; 34: 149
• 47 Devos D, Krystkowiak P, Clement F. et al. Improvement of gait by chronic, high doses of methylphenidate in patients with advanced Parkinson’s disease. J Neurol Neurosurg Psychiatry 2007; 78: 470-475
• 48 Espay AJ, Dwivedi AK, Payne M. et al. Methylphenidate for gait impairment in Parkinson disease: a randomized clinical trial. Neurology 2011; 76: 1256-1262
• 49 Moreau C, Delval A, Defebvre L. et al. Methylphenidate for gait hypokinesia and freezing in patients with Parkinson’s disease undergoing subthalamic stimulation: a multicentre, parallel, randomised, placebo-controlled trial. Lancet Neurol 2012; 11: 589-596
• 50 Verhagen Metman L, Del Dotto P, van den Munckhof P. et al. Amantadine as treatment for dyskinesias and motor fluctuations in Parkinson’s disease. Neurology 1998; 50: 1323-1326
• 51 Giladi N. Medical treatment of freezing of gait. Mov Disord 2008; 23 (Suppl. 2) S482-8
• 52 Yarnall A, Rochester L, Burn DJ. The interplay of cholinergic function, attention, and falls in Parkinson’s disease. Mov Disord Off J Mov Disord Soc 2011; 26: 2496-2503
• 53 Pahapill PA, Lozano AM. The pedunculopontine nucleus and Parkinson’s disease. Brain 2000; 123 Pt 9 1767-1783
• 54 Thevathasan W, Coyne TJ, Hyam JA. et al. Pedunculopontine nucleus stimulation improves gait freezing in Parkinson disease. Neurosurgery 2011; 69: 1248-1253 discussion 1254
• 55 Thevathasan W, Cole MH, Graepel CL. et al. A spatiotemporal analysis of gait freezing and the impact of pedunculopontine nucleus stimulation. Brain J Neurol 2012; 135: 1446-1454
• 56 Litvinenko IV, Odinak MM, Mogil’naya VI. et al. Efficacy and safety of galantamine (reminyl) for dementia in patients with Parkinson’s disease (an open controlled trial). Neurosci Behav Physiol 2008; 38: 937-945
• 57 Cosentino C, Putzolu M, Mezzarobba S. et al. One cue does not fit all: A systematic review with meta-analysis of the effectiveness of cueing on freezing of gait in Parkinson’s disease. Neurosci Biobehav Rev 2023; 150: 105189
• 58 Goh L, Canning CG, Song J. et al. The effect of rehabilitation interventions on freezing of gait in people with Parkinson’s disease is unclear: a systematic review and meta-analyses. Disabil Rehabil 2023; 45: 3199-3218
• 59 Gilat M, Ginis P, Zoetewei D. et al. A systematic review on exercise and training-based interventions for freezing of gait in Parkinson’s disease. Npj Park Dis 2021; 7: 81
• 60 Herman T, Barer Y, Bitan M. et al. A meta-analysis identifies factors predicting the future development of freezing of gait in Parkinson’s disease. NPJ Park Dis 2023; 9: 158
• 61 Ginis P, Nackaerts E, Nieuwboer A. et al. Cueing for people with Parkinson’s disease with freezing of gait: A narrative review of the state-of-the-art and novel perspectives. Ann Phys Rehabil Med 2018; 61: 407-413
• 62 Nonnekes J, Ružicka E, Nieuwboer A. et al. Compensation Strategies for Gait Impairments in Parkinson Disease: A Review. JAMA Neurol 2019; 76: 718
• 63 Tosserams A, Bloem BR, Nonnekes J. Compensation Strategies for Gait Impairments in Parkinson’s Disease: From Underlying Mechanisms to Daily Clinical Practice. Mov Disord Clin Pract 2023; 10
• 64 Tosserams A, de Vries NM, Bloem BR. et al. Multidisciplinary Care to Optimize Functional Mobility in Parkinson Disease. Clin Geriatr Med 2020; 36: 159-172
• 65 Tosserams A, Wit L, Sturkenboom IHWM. et al. Perception and Use of Compensation Strategies for Gait Impairment by Persons With Parkinson Disease. Neurology 2021; 97: e1404-e1412
• 66 Walton CC, Shine JM, Hall JM. et al. The major impact of freezing of gait on quality of life in Parkinson’s disease. J Neurol 2015; 262: 108-115