Associação entre impulsividade, ansiedade e congelamento da marcha em pessoas com doença de Parkinson: estudo transversal

Abstract

Introduction: Freezing of gait, being highly disabling, stands out among the motor symptoms of Parkinson's disease (PD), as it reduces mobility and increases the risk of falls. Among the non-motor symptoms of PD, impulsivity and anxiety are common and have a negative impact on the quality of life of patients and caregivers. Although some studies have demonstrated their association with freezing of gait, the relationship between these non-motor symptoms and freezing of gait in people with PD still needs to be further investigated. Objective: To analyze the association between impulsivity and anxiety and freezing of gait in people with Parkinson's disease. Methods: This is a cross-sectional study conducted with participants recruited from the Outpatient Clinic for Movement Disorders and Parkinson's Disease of the Roberto Santos General Hospital, Salvador, Bahia, Brazil. The Mini Mental State Examination (MMSE) was performed, followed by the recording of sociodemographic and clinical data, including the severity of the disease through the MDS-UPDRS and Hoehn and Yahr (H&Y) motor examination, disability through the MDS-UPDRS M-EVD (Motor Aspects of Daily Living Experiences), impulsivity with the Barratt Impulsivity Scale 11 (BIS 11), anxiety with the State-Trait Anxiety Inventory (STAI) and the severity of freezing of gait through the Freezing of Gait Questionnaire (FOG-Q). Results: Among the 130 participants in this study, 76 (58.5%) were male, mean age was 63.6 (± 9.9) years, disease duration was 7.13 (± 4.38) years, median H&Y 2.5 (2-2.6), mean MDS-UPDRS, motor examination 32.6 (± 14.5) and MDS-UPDRS M-EVD 12 (7.5-15) points, BIS-11 with 61.25 (± 9.32) points, STAI state with 35.86 (8.6) points and STAI trait with 35.86 (± 8.6). Freezing of gait occurred in 61 (47.7%) participants and the median FOG-Q was 4 (2-10). A direct correlation was found between attentional and non-planning impulsivity and freezing of gait (r=0.300, p=0.001), (r= 0.253, p= 0.004), and between trait and state anxiety and severity of freezing of gait (r=0.363, p= <0.001), (r= 0.274, p= 0.002), respectively. Conclusion: although cause and effect conclusions cannot be drawn from this association, it is suggested that impulsivity and anxiety may influence freezing of gait in people with PD.