Jason Scott

Do you have a plan for management of freezing of gait (FOG) in Parkinson's? I think about 5 things when constructing a PLAN. Check out the new paper by Tosserams, Fasano, Bloem, Nonnekes and colleagues in Nature Reviews Neurology. Key Points: - Freezing of gait is one of the most disabling symptoms in Parkinson’s. - It is one of the most frustrating for patients and caregivers alike. - People may describe it as feeling like their feet are glued to the floor, and FOG increases fall risk, anxiety, and loss of independence. My Take: I urge our community to take a step forward with more coordinated plans for FOG in Parkinson's. FOG in Parkinson’s: Why do we need a plan? This paper offers us a clear, comprehensive, pathophysiology-driven framework to build a person specific plan. An important point that resonates for me: FOG isn’t one thing, it’s many things. It demands listening, with a personalized, evolving approach. It must addresses motor and non-motor factors that may underpin the manifestation. Here are 5 key things I consider when treating freezing of gait (FOG): 1- Classify the type of FOG – Is it OFF-state, pseudo-ON, or dopamine-unresponsive? Your treatment will hinge on this. 2- Optimize dopamine – Tailor medications carefully, and consider infusion or DBS if or when appropriate. 3- Use non-drug strategies – Physical therapy, cueing, and gait training. These can be powerful, especially early in disease. 4- Treat the whole person. Anxiety, cognition, and sleep all interact with FOG. Addressing these features matters. 5- Think prevention: Exercise, balance training, and early identification. Can we delay FOG or treat the person more effectively so it does not emerge? Listen and optimize plans at every visit even if FOG is not present. Let’s turn these insights into action. BRAVO to the authors. Don't be nolens volens – willy-nilly about freezing of gait (FOG). nature.com/articles/s41582-0… #Parkinsons #FOG #FreezingOfGait #Neurology #DBS #Gait #MovementDisorders #ParkinsonsPlan #NeuroRehab #NeuroInnovation @ParkinsonDotOrg @FixelInstitute