Pathophysiology of freezing of gait and some possible treatments for it

A Technological Review of Wearable Cueing Devices Addressing Freezing of Gait in Parkinson's Disease

Freezing of gait is one of the most debilitating symptoms of Parkinson’s disease and is an important contributor to falls, leading to it being a major cause of hospitalization and nursing home admissions. When the management of freezing episodes cannot be achieved through medication or surgery, non-pharmacological methods such as cueing have received attention in recent years. Novel cueing systems were developed over the last decade and have been evaluated predominantly in laboratory settings. However, to provide benefit to people with Parkinson’s and improve their quality of life, these systems must have the potential to be used at home as a self-administer intervention. This paper aims to provide a technological review of the literature related to wearable cueing systems and it focuses on current auditory, visual and somatosensory cueing systems, which may provide a suitable intervention for use in home-based environments. The paper describes the technical operation and effectiveness of the different cueing systems in overcoming freezing of gait. The “What Works Clearinghouse (WWC)” tool was used to assess the quality of each study described. The paper findings should prove instructive for further researchers looking to enhance the effectiveness of future cueing systems.

A review of presented mathematical models in Parkinson's disease: black- and gray-box models

Parkinson's disease (PD), one of the most common movement disorders, is caused by damage to the central nervous system. Despite all of the studies on PD, the formation mechanism of its symptoms remained unknown. It is still not obvious why damage only to the substantia nigra pars compacta, a small part of the brain, causes a wide range of symptoms. Moreover, the causes of brain damages remain to be fully elucidated. Exact understanding of the brain function seems to be impossible. On the other hand, some engineering tools are trying to understand the behavior and performance of complex systems. Modeling is one of the most important tools in this regard. Developing quantitative models for this disease has begun in recent decades. They are very effective not only in better understanding of the disease, offering new therapies, and its prediction and control, but also in its early diagnosis. Modeling studies include two main groups: black-box models and gray-box models. Generally, in the black-box modeling, regardless of the system information, the symptom is only considered as the output. Such models, besides the quantitative analysis studies, increase our knowledge of the disorders behavior and the disease symptoms. The gray-box models consider the involved structures in the symptoms appearance as well as the final disease symptoms. These models can effectively save time and be cost-effective for the researchers and help them select appropriate treatment mechanisms among all possible options. In this review paper, first, efforts are made to investigate some studies on PD quantitative analysis. Then, PD quantitative models will be reviewed. Finally, the results of using such models are presented to some extent.