Clinical Characteristics Analysis And Clinical Study About Visual Cues With Freezing Of Gait In Wilson Disease

Wilson disease(WD)is an autosomal recessive copper metabolic disease.Whose symptoms mainly include nervous system performance and liver damage and other multi-system damage.Gait disturbance is a characteristic sign of nervous system damage and FOG were observed about 1% in WD.FOG has greatly increased the risk of falls and seriously affected the quality of daily life of patients in WD.Objective:To analysis the distribution of syndrome of deficiency and excess,in addition,analysis the correlation with the MMSE scores,UWDRS-I scores and FOGQ scores in patients with WD,in order to provide a new method for clinical intervention and rehabilitation of FOG in WD patients.Method:1.Object of study: A total of 40 patients with WD,admitted to our hospital from November 2021 to November 2022,were enrolled in our study.20 patients of WD patients respectively with(WD+FOG)and without FOG(WD-FOG).The general clinical data,including the age,gender,height and weight,of patients was collected.The patients with WD were carried out syndrome differentiation of deficiency and excess.Investigated clinical scales through MMSE,UWDRS-I,and FOGQ,To analysis cognitive function,FOG and nervous system function of WD patients.2.A wide-angle camera was used to record the whole walking process on the trail in patients with FOG in WD.The whole process of patients walking on the trail after being given four kinds of visual cues,red line,green line,red stereoscopic wood board and green stereoscopic wood board,were recorded,respectively.Quantitative analysis the effects of visual cues on FOG in WD.Result:1.This experiment has carried out a statistics of 40 cases that 20 cases respectively in WD+FOG and WD-FOG.There is no difference in subject characteristics between the two groups.2.The frequency of deficiency and excess syndrome in 40 patients with WD was,from high to low,excess syndrome,deficiency syndrome and combination of deficiency and excess syndrome.And there is no significant difference about the syndrome of deficiency and excess between WD+FOG and WD-FOG(P>0.05).3.A total of 85 episodes of FOG were observed in 20 patients with FOG in WD.There were 22 episodes between 2 second and 3 seconds,accounting for 25.9%,and is the largest proportion in this division.There were 21 episodes between 5 second and 10 seconds,accounting for24.7%,and its proportion ranked the second in this division.Besides,77 episodes were triggered in turning,accounting for 90.6% and 8 episodes were triggered in straight walking,accounting for 9.4%.4.FOG analysis(The total duration of FOG,the total number of FOG episodes and the average duration of FOG)decreased after visual clues of red line group,green line group,red stereoscopic wood board group and green stereoscopic wood board(P <0.05).But there is not statistically significant about FOG analysis(The total duration of FOG,the total number of FOG episodes and the average duration of FOG)among red line group,green line group,red stereoscopic wood board group and green stereoscopic wood board(P>0.05).5.There was no correlation is observed between FOG analysis(the total duration of FOG,the total number of FOG episodes and the average duration of FOG)and clinical scales scores(UWDRS-I,FOGQ,MMSE)in WD+FOG(P>0.05).Conclusion:1.In WD patients with FOG,the duration of FOG onset was mainly within 10 seconds,and FOG is more likely to be triggered by turning than by going straight.And there is no correlation between FOG,cognitive function,FOGQ and nervous system function.2.Visual clue can significantly improve FOG of WD patients.Red cueing and Green cueing,2D cueing and 3D cueing showed the same improvement in WD patients with FOG.