Rasagiline improves freezing in a patient with primary progressive freezing gait

We herein report the case of a 84-year-old man with a 4-year history of freezing of gait (FOG) consistent with the diagnosis of primary progressive freezing gait. Single photon emission tomography (SPECT) with a radiolabeled ligand of the dopamine transporter (DAT-SPECT) showed integrity of striatal dopaminergic terminals, whereas brain perfusion SPECT disclosed multiple areas of decreased perfusion in frontal and parietal lobes, as well as in the subcortical gray nuclei of both sides. Treatment with the new irreversible monoamine oxidase B inhibitor rasagiline at standard doses resulted in a rapid, dramatic, and sustained improvement of the frequency and duration of FOG episodes. In addition, brain perfusion SPECT after treatment showed a marked increase of the activity in all cortical areas as well as in the basal ganglia and thalamus. Rasagiline may prove to be an effective and safe treatment for this disabling condition. (C) 2007 Movement Disorder Society.