Neurological Sciences

, Volume 38, Issue 3, pp 509–510 | Cite as

Preserved ability to cycle in patient with progressive supranuclear palsy–parkinsonism

  • Danira Bažadona
  • Vladimir MiletićEmail author
Letter to the Editor

Differentiation between Parkinson’s disease (PD) and atypical parkinsonism still presents an open issue. Although many attempts have been made to identify specific clinical tests to discriminate the two, making the right diagnosis is challenging [1]. Freezing of gait (FOG) is common phenomenon in patients with PD and various atypical parkinsonism. However, despite severe FOG, patients with PD retain ability to cycle in contrast to patients with atypical parkinsonism [2]. Hence, the “bicycle sign” or loss of cycling abilities was recently suggested as a new red flag and highly specific sign indicative for atypical parkinsonism [3]. Here, we report a patient with progressive supranuclear palsy–parkinsonism (PSP-P) phenotype with maintained and prolonged ability to ride a bicycle.

A 57-year-old man was admitted to our movement disorders unit in 2012 because of two-year history of generalized slowness and difficulties in gait initiation associated with sudden stops while walking, but...


Parkinson's disease Atypical parkinsonism Cycling ability Freezing of gait 


Compliance with ethical standards

Conflict of interest

The authors state that they have no conflict of interest.

Written informed consent for the usage of supplementary videos was obtained from the patient.

Supplementary material

Supplementary material 1 Supplementary video file 1 The video demonstrates patient with difficulties in gait initiation and freezing of gait. Movements of low amplitude and high frequency without decrement can be observed during figer-tap test; slow vertical saccades, especially when looking downward can be observed. (MP4 145784 kb)

Supplementary material 2 Supplementary video file 2 The video demonstrates patient cycling without difficulties. Written informed consent for the usage of supplementary videos was obtained from the patient. (MP4 66174 kb)


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Copyright information

© Springer-Verlag Italia 2016

Authors and Affiliations

  1. 1.Department of Neurology, Referral Center for Movement DisordersUniversity Hospital Center ZagrebZagrebCroatia

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