Gait and attentional performance in freezers under methylphenidate
Gait & Posture. 2015-02-01; 41(2): 384-388
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Delval A(1), Moreau C(2), Bleuse S(3), Guehl D(4), Bestaven E(4), Guillaud E(4), Dujardin K(2), Defebvre L(2), Devos D(5).
(1)Lille University, France; EA 1046, Department of Clinical Neurophysiology,
Lille University Medical Center, France. Electronic address:
(2)Lille University, France; EA 1046, Department of Neurology and Movement
Disorders, Lille University Medical Center, France.
(3)Lille University, France; EA 1046, Department of Clinical Neurophysiology,
Lille University Medical Center, France.
(4)Bordeaux 2 University, UMR 5293, Bordeaux, France.
(5)Lille University, France; EA 1046, Department of Neurology and Movement
Disorders, Lille University Medical Center, France; EA 1046, Department of
Pharmacology, Lille University Medical Center, France.
BACKGROUND: Attentional resources appear to be involved in the occurrence of FoG.
The Parkgait study recently reported that methylphenidate reduces gait
hypokinesia and freezing of gait (FoG) in advanced PD patients receiving STN-DBS
in the off-dopaminergic drug condition. Methylphenidate is considered to improve
attention. The primary objective of the present ancillary study was to determine
whether methylphenidate reduced the interference between a cognitive task and
gait in patients with FoG. The study’s secondary objective was to compare
attentional performance in methylphenidate-treated and placebo-treated patients.
METHODS: A total of 24 patients (from two centers) were included in the study.
Patients were randomly assigned 1:1 to a three-month course of methylphenidate
(1mg/kg/day) or placebo. Patients were assessed after an acute L-dopa challenge.
The primary outcome criterion was the stride length ratio ((dual-task stride
length minus free gait stride length)/free gait stride length). Trials with FoG
episodes were excluded from the analysis. Secondary outcomes included changes in
reaction times for computerized attention tasks and FoG severity.
RESULTS: When comparing patients receiving methylphenidate with those receiving
placebo, we did not observe any significant differences in the interaction
between the dual task and gait or in attentional performance.
CONCLUSION: As in the main Parkgait study, methylphenidate did not reduce gait
hypokinesia in patients receiving dopaminergic treatment. Our present results
suggest that the reduction in the number of FoG episodes previously observed in
patients on methylphenidate was neither due to interaction between a dual-task
and gait nor an increase in attentional performance.
Copyright © 2014 Elsevier B.V. All rights reserved.