Towards the Prevention of Freezing of Gait in Parkinson's Disease

Despite optimal management, freezing of gait (FOG) remains a disabling complication of Parkinson's disease (PD), contributing substantially to falls, loss of independence and reduced quality of life. This highlights the pressing need for a shift towards preventive approaches, aiming to postpone or even prevent its development. In this narrative review, we examine potential avenues for the secondary prevention of FOG. We discuss how FOG might be prevented specifically, by targeting modifiable risk factors that seem associated with the development of FOG. Examples of potentially effective strategies here include vascular prophylaxis and perhaps avoidance of pulsatile levodopa administration. Secondary prevention efforts also include generic disease-modifying strategies, including pleiotropic interventions such as exercise and nutrition, targeting either persons in the prodromal disease phase or persons with clinically manifest PD, who are still free from FOG. We conclude by discussing future avenues towards FOG prevention.