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The poorly understood pathophysiology of freezing of gait presents challenges for early prediction and therapeutic intervention. This prospective study investigated whether eye movement abnormalities, specifically in the anti-saccade paradigm, could predict freezing of gait onset in Parkinson's disease patients over a two-year follow-up period. We analysed longitudinal data from the Ontario Neurodegenerative Disease Research Initiative, focusing on Parkinson's disease patients without freezing of gait at baseline who underwent comprehensive clinical evaluations and eye movement recordings. Anti-saccade reaction time and error ratio, combined with clinical measures including right upper extremity rigidity, demonstrated significant predictive value for freezing of gait development within two years. These findings suggest that eye movement deficits and upper limb rigidity emerge years before freezing of gait onset, indicating a prodromal phase in freezing of gait pathogenesis. The predictive relationship between these measures supports the hypothesis of shared neural substrates, potentially involving the mesencephalic locomotor region, in the development of both oculomotor dysfunction and gait freezing episodes.<\/jats:p>","DOI":"10.1093\/braincomms\/fcaf402","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T13:21:40Z","timestamp":1760448100000},"source":"Crossref","is-referenced-by-count":3,"title":["The relation of eye movements to the occurrence of freezing of gait in Parkinson\u2019s disease"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4038-0904","authenticated-orcid":false,"given":"Juan","family":"Fernandez-Ruiz","sequence":"first","affiliation":[{"name":"Departamento de Fisiolog\u00eda, Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Ciudad de Mexico CP 04510 ,","place":["M\u00e9xico"]},{"name":"Instituto de Neuroetolog\u00eda, Universidad Veracruzana , Xalapa, CP 91190 Veracruz ,","place":["M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9966-4047","authenticated-orcid":false,"given":"Heidi C","family":"Riek","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience Studies, Queen\u2019s University , Kingston, ON , , K7L 3N6","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4074-6646","authenticated-orcid":false,"given":"Donald C","family":"Brien","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience Studies, Queen\u2019s University , Kingston, ON , , K7L 3N6","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C","family":"Coe","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience Studies, Queen\u2019s University , Kingston, ON , , K7L 3N6","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Grimes","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, University of Ottawa , Ottawa, ON , , K1Z 8L6","place":["Canada"]},{"name":"Ottawa Hospital Research Institute Departmen of Medicine, , Ottawa, ON , , K1H 8L6","place":["Canada"]},{"name":"Brain and Mind Research Institute, University of Ottawa , Ottawa, ON , , K1H 8M5","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony E","family":"Lang","sequence":"additional","affiliation":[{"name":"Edmond J. 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