Drug intervention for freezing of gait resistant to dopaminergic therapy: A pilot study

Freezing of gait (FOG) is observed in patients with various diseases and remains difficult to treat when unresponsive to dopaminergic treatment. In this paper, we report the results of drug intervention in the treatment of FOG in patients with progressive supranuclear palsy (PSP) and pure akinesia (PA). The effects of four drugs (donepezil vs droxidopa and amantadine vs selegiline) were investigated by crossover design. Two PSP patients and seven PA patients participated in these studies. Except for one patient who participated only in the amantadine vs droxidopa study, all patients participated in all studies. In PA patients, average Japanese FOG questionnaire (JFOGO) scores significantly decreased, following administration of donepezil, droxidopa and amantadine. These results suggest that cholinergic, noradrenergic and glutamatergic neuronal dysfunctions participate in FOG development in PA patients.