Towards closed-loop deep brain stimulation for freezing of gait in Parkinson’s disease

Freezing of gait (FOG) is a highly debilitating symptom of advanced Parkinson's disease (PD) during which patients experience a sudden inability to take a step while walking, turning or when attempting to initiate gait, often resulting in falls (Nutt et al. 2011). FOG has a complex and heterogeneous pathophysiology whereby the impaired habitual control of gait in PD becomes vulnerable to interference from consecutive processing across motor, cognitive and limbic cortico-striatal circuits in the absence of striatal dopamine, whilst the ability to apply executive control over gait diminishes as a result of progressing extra-nigral neuropathology (Bohnen and Jahn 2013; Lewis and Shine 2016).

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