Case Report: Levodopa Challenge Test is Important in Identifying Dopamine-induced Freezing of Gait in Patient with Parkinson's Disease

Overview

Journal Front Hum Neurosci

Specialty Neurology

Date 2024 Sep 19

PMID 39296915

Authors

Shan-Shan Xu

Shi-Guo Zhu

Cheng-Xiang Yuan

Guo-Ling Zeng

Xiao-Tian Li

Rong-Pei Liu

Shi-Shi Huang

Xiong Zhang

Jian-Yong Wang

Affiliations

Soon will be listed here.

Abstract

Introduction: Freezing of gait (FOG) is a disabling and heterogeneous symptom in patients with Parkinson's disease (PD). Among them, dopamine-induced FOG is rare and difficult to identify. The treatment of dopamine-induced FOG is complex.

Case Presentation: We herein presented a case of PD patient who complicated with refractory FOG. It was identified as dopamine-induced FOG during levodopa challenge test. Her symptoms were alleviated after we reduced the total equivalent dosage of levodopa.

Conclusion: Our report emphasizes the importance of levodopa challenge test in identifying different types of FOG, which is very important for further adjusting treatment.

References

Nonnekes J, Bereau M, Bloem B . Freezing of Gait and Its Levodopa Paradox. JAMA Neurol. 2019; 77(3):287-288. DOI: 10.1001/jamaneurol.2019.4006. View

Gao C, Liu J, Tan Y, Chen S . Freezing of gait in Parkinson's disease: pathophysiology, risk factors and treatments. Transl Neurodegener. 2020; 9:12. PMC: 7161193. DOI: 10.1186/s40035-020-00191-5. View

Falla M, Cossu G, Di Fonzo A . Freezing of gait: overview on etiology, treatment, and future directions. Neurol Sci. 2022; 43(3):1627-1639. DOI: 10.1007/s10072-021-05796-w. View

Mirelman A, Bonato P, Camicioli R, Ellis T, Giladi N, Hamilton J . Gait impairments in Parkinson's disease. Lancet Neurol. 2019; 18(7):697-708. DOI: 10.1016/S1474-4422(19)30044-4. View

Zhang W, Gao C, Tan Y, Chen S . Prevalence of freezing of gait in Parkinson's disease: a systematic review and meta-analysis. J Neurol. 2021; 268(11):4138-4150. DOI: 10.1007/s00415-021-10685-5. View

Jansen J, Capato T, Darweesh S, Barbosa E, Donders R, Bloem B . Exploring the levodopa-paradox of freezing of gait in dopaminergic medication-naïve Parkinson's disease populations. NPJ Parkinsons Dis. 2023; 9(1):130. PMC: 10492797. DOI: 10.1038/s41531-023-00575-0. View

Factor S . The clinical spectrum of freezing of gait in atypical parkinsonism. Mov Disord. 2008; 23 Suppl 2:S431-8. DOI: 10.1002/mds.21849. View

Nonnekes J, Snijders A, Nutt J, Deuschl G, Giladi N, Bloem B . Freezing of gait: a practical approach to management. Lancet Neurol. 2015; 14(7):768-78. DOI: 10.1016/S1474-4422(15)00041-1. View

Giladi N, McDermott M, Fahn S, Przedborski S, Jankovic J, Stern M . Freezing of gait in PD: prospective assessment in the DATATOP cohort. Neurology. 2001; 56(12):1712-21. DOI: 10.1212/wnl.56.12.1712. View

10.

Barbeau A . Long-term side-effects of levodopa. Lancet. 1971; 1(7695):395. DOI: 10.1016/s0140-6736(71)92226-4. View

11.

Kalia L, Lang A . Parkinson's disease. Lancet. 2015; 386(9996):896-912. DOI: 10.1016/S0140-6736(14)61393-3. View

12.

Schaafsma J, Balash Y, Gurevich T, Bartels A, Hausdorff J, Giladi N . Characterization of freezing of gait subtypes and the response of each to levodopa in Parkinson's disease. Eur J Neurol. 2003; 10(4):391-8. DOI: 10.1046/j.1468-1331.2003.00611.x. View

13.

Espay A, Fasano A, van Nuenen B, Payne M, Snijders A, Bloem B . "On" state freezing of gait in Parkinson disease: a paradoxical levodopa-induced complication. Neurology. 2012; 78(7):454-7. PMC: 3466608. DOI: 10.1212/WNL.0b013e3182477ec0. View

14.

Ehgoetz Martens K, Shine J, Walton C, Georgiades M, Gilat M, Hall J . Evidence for subtypes of freezing of gait in Parkinson's disease. Mov Disord. 2018; 33(7):1174-1178. DOI: 10.1002/mds.27417. View

15.

Nieuwboer A, Giladi N . Characterizing freezing of gait in Parkinson's disease: models of an episodic phenomenon. Mov Disord. 2013; 28(11):1509-19. DOI: 10.1002/mds.25683. View

16.

Hu Z, Zhu S, Huang J, Chen J, Huang S, Liu R . Carpets with visual cues can improve gait in Parkinson's disease patients: may be independent of executive function. Eur J Med Res. 2023; 28(1):530. PMC: 10652558. DOI: 10.1186/s40001-023-01472-1. View

17.

Lewis S, Barker R . A pathophysiological model of freezing of gait in Parkinson's disease. Parkinsonism Relat Disord. 2008; 15(5):333-8. DOI: 10.1016/j.parkreldis.2008.08.006. View

18.

Lamberti P, Armenise S, Castaldo V, De Mari M, Iliceto G, Tronci P . Freezing gait in Parkinson's disease. Eur Neurol. 1997; 38(4):297-301. DOI: 10.1159/000113398. View