The specific contributions of set-shifting to freezing of gait in Parkinson's disease

2010 ◽  
Vol 25 (8) ◽  
pp. 1000-1004 ◽  
Author(s):  
Sharon L. Naismith ◽  
James M. Shine ◽  
Simon J.G. Lewis
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Set Shifting

scholarly journals A Cross-Sectional Study of Set Shifting Impairments and Falling in Individuals with and without Parkinson’s Disease

2017 ◽  
Author(s):  
J. Lucas McKay ◽  
Kimberly C. Lang ◽  
Lena H. Ting ◽  
Madeleine E. Hackney
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Function ◽  
Freezing Of Gait ◽  
Cross Sectional Study ◽  
Set Shifting ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk

AbstractINTRODUCTION. Individuals with Parkinson’s disease (PD) are at increased risk for falls, and exhibit deficits in executive function, including Set Shifting, which can be measured as the difference between parts B and A of the Trailmaking Test. METHODS. We conducted a cross-sectional study using baseline data of PD patients with and without freezing of gait (FOG) (n=69) and community-dwelling neurologically-normal older adults (NON-PD) (n=84) who had volunteered to participate in clinical rehabilitation research. Multivariate logistic regression analyses were performed to determine associations between Set Shifting, PD, and faller status, as determined by ≥1 self-reported falls in the previous 6 months, after adjusting for demographic and cognitive factors and clinical disease characteristics. RESULTS. Impaired Set Shifting was associated with previous falls after controlling for age, sex, overall cognitive function, PD, FOG, and PD disease duration (OR=1.29 [1.03-1.60]; P=0.02). In models controlling for age, sex, and overall cognitive function, PD was associated with increased fall prevalence among the study sample (OR=4.15 [95% CI 1.65-10.44], P<0.01) and FOG was associated with increased fall prevalence among the PD sample (OR=3.63 [1.22-10.80], P=0.02). Although the strongest associations between Set Shifting and falling were observed among PD without FOG (OR=2.11) compared to HOA (OR=1.14) and PD with FOG (OR=1.46) in a multivariate model that allowed for interaction between set shifting and PD status, there was insufficient evidence to reject the null hypothesis of no interaction. CONCLUSIONS. Set Shifting is associated with previous falls in non-demented older adults with and without PD.HighlightsIndividuals with PD are at increased risk for falls, although causes are unclear.Impaired Set Shifting was associated with falls in older adults with and without PD.Associations were strongest among those with PD but without freezing of gait.

scholarly journals The On-Freezing Phenomenon: Cognitive and Behavioral Aspects

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Rita Moretti ◽  
Paola Torre ◽  
Rodolfo M. Antonello ◽  
Francesca Esposito ◽  
Giuseppe Bellini
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Basal Ganglia ◽  
Freezing Of Gait ◽  
Warning Sign ◽  
Abstract Reasoning ◽  
Set Shifting ◽  
Dopaminergic Therapy ◽  
Behavioral Aspects ◽  
Wearing Off

Freezing of gait is a warning sign of Parkinson's disease. One could distinguish off-freezing, which is associated with dopaminergic therapy and to its titration, and it is clinically related to wearing-off phenomenon. Differently, the on-freezing phenomenon seems to be related to a neural disruption of the frontal-parietal-basal ganglia-pontine projections; clinically, it does not respond to therapy modifications or to different drug titration. In a group of patients with on-freezing, we have detected an alteration of focusing attention, an impairment of set-shifting, in addition to poor abstract reasoning and a reduction of planning. These aspects have been even more evident, when compared with the results obtained by a group of PD patients, without freezing.

scholarly journals Context-Dependent Behavior in Parkinson’s Disease With Freezing of Gait

2019 ◽  
Vol 33 (12) ◽  
pp. 1040-1049
Author(s):  
Ya-Yun Lee ◽  
Chun-Hwei Tai ◽  
Beth E. Fisher
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Motor Task ◽  
Context Dependency ◽  
Superior Performance ◽  
Set Shifting ◽  
Sequence Context ◽  
Dependent Behavior ◽  
Context Dependent

Background. Context-dependent behavior is a phenomenon in which people demonstrate superior performance in the context where a motor task was originally learned, but show poorer performance in an unfamiliar context. Previous studies found that people with Parkinson’s disease (PD) demonstrated greater context-dependency than nondisabled adults. Moreover, the frontostriatal circuit appeared to play a role in mediating context-dependent behavior. Neuroimaging studies showed that people with PD and freezing of gait (FoG) had difficulty recruiting the frontostriatal circuit when performing a set-shifting task, known to be mediated by this neural network. Objective. This study aimed to investigate whether individuals with PD and FoG (PD + FoG) would be more context-dependent than those without FoG (PD − FoG). Furthermore, the association between context-dependent behavior and set-shifting ability would be determined. Methods. Sixteen individuals with PD + FoG, 15 participants with PD − FoG, and 15 nondisabled adults (Control) were recruited. The participants practiced 3 numerical sequences, each associated with a specific context. One day following practice, the participants were tested under 2 conditions: the sequence-context associations remained the same as practice or were changed. Set-shifting ability was measured by the Trail Making Test (TMT). Results. Compared to the PD − FoG group, the PD + FoG group showed a greater decrement in normalized motor performance when the sequence-context associations were changed. Context-dependency correlated with the TMT in the PD − FoG group but not in the PD + FoG or Control groups. Conclusion. While people with PD + FoG appeared to be more context-dependent than individuals without FoG, a relationship between context-dependent behavior and set-shifting existed only in those without FoG.

Attentional set-shifting deficits correlate with the severity of freezing of gait in Parkinson's disease

2013 ◽  
Vol 19 (3) ◽  
pp. 388-390 ◽  
Author(s):  
J.M. Shine ◽  
S.L. Naismith ◽  
N.C. Palavra ◽  
S.J.G. Lewis ◽  
S.T. Moore ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Set Shifting ◽  
Attentional Set ◽  
Attentional Set Shifting

Attentional Set-Shifting in Parkinson’s Disease Patients with Freezing of Gait-Acquisition and Discrimination Set Learning Deficits at the Background?

2014 ◽  
Vol 20 (9) ◽  
pp. 929-936 ◽  
Author(s):  
Elka Stefanova ◽  
Milica Ječmenica Lukić ◽  
Ljubomir Žiropadja ◽  
Vladana Marković ◽  
Tanja Stojković ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Real Life ◽  
Attrition Rate ◽  
Stop Signal Task ◽  
Set Shifting ◽  
Neuropsychological Battery ◽  
Attentional Set ◽  
Attentional Set Shifting

AbstractCognitive loading aggravates the freezing of gait (FoG), which is observed in approximately 50% of patients with Parkinson’s disease (PD) in the advanced stages. To investigate whether a specific pattern of executive deficits, that is, attentional set-shifting and/or inhibitory control, are associated with FoG in PD, 30 PD patients with FoG (PD-FoG+) and 36 PD patients without FoG (PD-FoG−) and 22 control healthy subjects were examined with a comprehensive neuropsychological battery. Intra-Extra Dimensional Set shifting Test (IED) and Stop Signal Task (SST), selected from the Cambridge Automated Neuropsychological Battery (CANTAB battery), were administered to analyze set-shifting and motor inhibition, respectively. The IED task was significantly sensitive for differentiating between PD-FoG+ and PD-FoG− groups (p<.01), as well Adenbrook’s clock drawing task (p=.033). By contrast, no differences emerged on any aspect of the SST task and other cognitive tasks. The attrition rate during the IED task showed that the problem in the PD-FoG+ group appeared at the pre-ID level, on the discrimination-learning set; the 32% PD-FoG+ subjects did not achieve the ID level of the task in comparison to negligible 4% of the PD-FoG− patients (p=.011). The logistic regression analysis, indicated the higher the IED stage successfully completed, the less likely presence of FoG in PD subjects. These results demonstrate that the complex cognitive–motor interplay might be responsible for FoG in PD and have had real life implication for the patients. (JINS, 2014, 20, 1–8)

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