パーキンソン病におけるすくみ足と両下肢協調運動障害

概要

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Freezing of gait is observed in quiet a few neurological diseases but has been raised a main and disabling neurological sign in Parkinson's disease (PD). In this mini-review, studies concerning freezing of gait in PD are reviewed and a hypothesis that the freezing of gait phenomenon in PD originates from interlimb incoordination are introduced. Pathogenesis of the freezing of gait phenomenon remains unknown, but some hypotheses have been raised: (1) Rhythmical contraction of anterior tibial muscles are prohibited, (2) Postural changes to initiate gait are disturbed, (3) Reciprocal inhibition in the spinal cord is disturbed due to abnormal descending commands from the central nervous system. Based on experiments conducted using a special type of ergometer (strength ergo 240W), Abe et al observed interlimb incoordination in PD patients with freezing of gait during pedaling. In addition, Plotnik et al. observed asymmetrical lower limb movements during walking and considered that PD patients with freezing of gait might have interlimb incoordination. These studies may support a hypothesis that freezing of gait in PD originates from interlimb incoordination.
2006-05-18