Higher-level gait disorders: An open frontier


  • John G. Nutt MD

    Corresponding author
    1. Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
    • Correspondence to: Dr. John G. Nutt, Oregon Health and Science University, Department of Neurology, 3181 SW Sam Jackson Park Road, OP 32, Portland, OR 97239, USA; nuttj@ohsu.edu

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  • Relevant conflicts of interest/financial disclosures: Nothing to report.


The term higher-level gait disorders (HLGD) defines a category of balance and gait disorders that are not explained by deficits in strength, tone, sensation, or coordination. HLGD are characterized by various combinations of disequilibrium and impaired locomotion. A plethora of new imaging techniques are beginning to determine the neural circuits that are the basis of these disorders. Although a variety of neurodegenerative and other pathologies can produce HLGD, the most common cause appears to be microvascular disease that causes white-matter lesions and thereby disrupts balance/locomotor circuits. © 2013 International Parkinson and Movement Disorder Society