Prevalence and predictors of freezing of gait in people with Parkinson’s disease

Abstract Background Identifying the risk factors of freezing of gait (FOG) is essential in the management of Parkinson’s disease (PD). This study aimed to identify the clinical and radiological predictors of FOG in Egyptian people with PD (PwPD). The gait of 91 PwPD was evaluated using new freezing of gait questionnaire (NFOG-Q), Berg balance scale (BBS), ten-meter walking test and time up and go test. Also, patients were assessed by total and sub-scores of MDS-UPDRS, Schwab and England (S&E-ADL), Hoehn and Yahr (H&Y), Beck depression inventory (BDI), non-motor symptoms scale (NMSS), and PD questionnaire 39 (PDQ-39). White matter hyperintensities in the MRI brain were evaluated using the Fazekas and Scheltens scales. Results The prevalence of FOG was 63.7%. Compared to non-FOG patients, patients with FOG had significantly higher disease duration, MDS-UPDRS total, sub-scores and H&Y ( p < 0.001). Patients with FOG had worse S&E-ADL, gait parameters ( p < 0.001), NMSS ( p = 0.041), BDI and PDQ-39 scores ( p < 0.001). Worse FOG-Off was associated with longer duration, higher levodopa equivalent daily dosage (LEDD), worse motor and nonmotor parameters, slower gait speed and worse quality of life. In predictive modelling, significant predictors of FOG included LEDD, postural instability-gait disorder-Off, S&E-ADL-Off, BBS-Off, MoCA naming score, and total NMSS. Conclusions Factors associated with FOG include disease duration, LEDD, motor symptom severity, gait characteristics, and cognitive impairment,—while white matter load does not appear to be a contributing factor. These findings highlight the importance of a comprehensive, multidisciplinary approach to FOG management.