Gait Parameters Across Parkinson’s Disease Patients Treated With Psychotropics

Congratulations Drs. Martinez-Ramirez, Wolf, Almeida & Okun on the publication of “Gait Parameters Across Parkinson’s Disease Patients Treated With Psychotropics,”  which was published in the April issue of Neurology


Objective: To compare GAITrite® parameters between Parkinson’s disease patients on psychotropics and those without psychotropics.

Background: Parkinson’s disease patients have an increased risk of falls resulting in important consequences. We previously reported that antidepressants were the only class of psychotropics independently associated with falls. However, how these drugs affect gait parameters is still unknown.

Design/Methods: A cross-sectional study was performed including 193 Parkinson’s disease patients who completed the GAITRite® analysis during the period of January to November 2013. The cohort was divided into four groups: not on psychotropics (n=54), on psychotropics other than antidepressants (n=67), on antidepressants only (n=20), and on antidepressants and other antipsychotics (n=52). GAITRite® parameters were compared and analyzed.

Results: The cohort included 193 Parkinson’s disease patients, 68% male, mean age of 67.7 years (SD=10.2) and mean disease duration of 7.9 years (SD=4.8). Mean UPDRS part III “off” medication state was 26.4 (SD=11.8); 91% were on levodopa, 33% on dopamine agonists. The mean PDQ-39 score was 167.1 (SD=132.5). After controlling for age, disease duration and UPDRS III score, cadence was significantly lower on those only on antidepressants when compared to those on psychotropics other than antidepressants (103.92 c/m vs. 107.63 c/m, df(4), F=3.01, p=0.025); step time was significantly higher on those on antidepressants only compared to those on psychotropics other than antidepressants (0.59 sec vs. 0.56 sec, df(4), F=3.01, p=0.017); and stance time was also significantly higher on same groups (0.79 sec vs. 0.0.73 sec, df(4), F=4.1, p=0.008). No significant differences were observed when comparing groups with those not on psychotropics.

Conclusions: Our results suggest that use of antidepressants seem to reduce cadence while increasing step time and stance time in our cohort. However, these gait parameters changes cannot be directly related to cause of falls. Other factors not studied need to be considered.