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Kaniewska A, Bagińska E, Masztalewicz M, Mross K, Jankowska M, Nowacki P, Meller A, Machowska-Sempruch K, Pawlukowska W. Profile of Sensory Integration Disorders in Migraine Patients-New Perspectives of Therapy. J Clin Med 2024; 13:3928. [PMID: 38999493 PMCID: PMC11242493 DOI: 10.3390/jcm13133928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
Background: The involvement of sensory integration disorders in the pathophysiology of migraine has been suggested. This study aims to analyze the relationship between symptoms of sensory integration disorders and migraine in a broad scope, including all sensory domains, and examine its impact on migraine attacks. Methods: The study included 372 people diagnosed with migraine. The Daniel Travis Questionnaire was used to assess symptoms of sensory integration disorders and their severity across six domains. The relationships between the severity of these symptoms and headache features, as well as accompanying headache symptoms, were the subject of statistical analysis. Results: Current impairment in all sensory domains was significantly associated with headaches exacerbated by everyday life activities. A significant inverse relationship was found between the occurrence of throbbing headaches and symptoms of sensory integration disorders in terms of current sensory discrimination, current motor skills, and current emotional/social skills. Past under-responsiveness and past disturbances in emotional/social abilities were significantly associated with migraine aura. Conclusions: The severity of symptoms of sensory integration disorders affects the clinical picture of migraine. The significant association between migraine and emotional/social disorders, as well as under-responsiveness in the past, needs further research to assess whether this is a cause-and-effect relationship. There is a need for in-depth diagnostics of sensory integration disorders in migraine patients, which could be an additional target of their therapy.
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Affiliation(s)
- Agata Kaniewska
- Department of Neurology, Pomeranian Medical University, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (M.M.); (P.N.); (A.M.); (K.M.-S.); (W.P.)
| | - Ewelina Bagińska
- Doctoral School, Pomeranian Medical University, 71-210 Szczecin, Poland; (E.B.)
| | - Marta Masztalewicz
- Department of Neurology, Pomeranian Medical University, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (M.M.); (P.N.); (A.M.); (K.M.-S.); (W.P.)
| | - Krystian Mross
- Department of Neurology, Pomeranian Medical University, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (M.M.); (P.N.); (A.M.); (K.M.-S.); (W.P.)
| | - Marta Jankowska
- Doctoral School, Pomeranian Medical University, 71-210 Szczecin, Poland; (E.B.)
| | - Przemysław Nowacki
- Department of Neurology, Pomeranian Medical University, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (M.M.); (P.N.); (A.M.); (K.M.-S.); (W.P.)
| | - Agnieszka Meller
- Department of Neurology, Pomeranian Medical University, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (M.M.); (P.N.); (A.M.); (K.M.-S.); (W.P.)
| | - Karolina Machowska-Sempruch
- Department of Neurology, Pomeranian Medical University, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (M.M.); (P.N.); (A.M.); (K.M.-S.); (W.P.)
| | - Wioletta Pawlukowska
- Department of Neurology, Pomeranian Medical University, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (M.M.); (P.N.); (A.M.); (K.M.-S.); (W.P.)
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Gulberti A, Schneider TR, Galindo-Leon EE, Heise M, Pino A, Westphal M, Hamel W, Buhmann C, Zittel S, Gerloff C, Pötter-Nerger M, Engel AK, Moll CKE. Premotor cortical beta synchronization and the network neuromodulation of externally paced finger tapping in Parkinson's disease. Neurobiol Dis 2024; 197:106529. [PMID: 38740349 DOI: 10.1016/j.nbd.2024.106529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/30/2024] [Accepted: 05/10/2024] [Indexed: 05/16/2024] Open
Abstract
Parkinson's disease (PD) is characterized by the disruption of repetitive, concurrent and sequential motor actions due to compromised timing-functions principally located in cortex-basal ganglia (BG) circuits. Increasing evidence suggests that motor impairments in untreated PD patients are linked to an excessive synchronization of cortex-BG activity at beta frequencies (13-30 Hz). Levodopa and subthalamic nucleus deep brain stimulation (STN-DBS) suppress pathological beta-band reverberation and improve the motor symptoms in PD. Yet a dynamic tuning of beta oscillations in BG-cortical loops is fundamental for movement-timing and synchronization, and the impact of PD therapies on sensorimotor functions relying on neural transmission in the beta frequency-range remains controversial. Here, we set out to determine the differential effects of network neuromodulation through dopaminergic medication (ON and OFF levodopa) and STN-DBS (ON-DBS, OFF-DBS) on tapping synchronization and accompanying cortical activities. To this end, we conducted a rhythmic finger-tapping study with high-density EEG-recordings in 12 PD patients before and after surgery for STN-DBS and in 12 healthy controls. STN-DBS significantly ameliorated tapping parameters as frequency, amplitude and synchrony to the given auditory rhythms. Aberrant neurophysiologic signatures of sensorimotor feedback in the beta-range were found in PD patients: their neural modulation was weaker, temporally sluggish and less distributed over the right cortex in comparison to controls. Levodopa and STN-DBS boosted the dynamics of beta-band modulation over the right hemisphere, hinting to an improved timing of movements relying on tactile feedback. The strength of the post-event beta rebound over the supplementary motor area correlated significantly with the tapping asynchrony in patients, thus indexing the sensorimotor match between the external auditory pacing signals and the performed taps. PD patients showed an excessive interhemispheric coherence in the beta-frequency range during the finger-tapping task, while under DBS-ON the cortico-cortical connectivity in the beta-band was normalized. Ultimately, therapeutic DBS significantly ameliorated the auditory-motor coupling of PD patients, enhancing the electrophysiological processing of sensorimotor feedback-information related to beta-band activity, and thus allowing a more precise cued-tapping performance.
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Affiliation(s)
- Alessandro Gulberti
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Till R Schneider
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Edgar E Galindo-Leon
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Miriam Heise
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alessandro Pino
- Department of Aerospace Science and Technology, Politecnico di Milano, Milan, Italy
| | - Manfred Westphal
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Hamel
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simone Zittel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Monika Pötter-Nerger
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas K Engel
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian K E Moll
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Ordás CM, Alonso-Frech F. The neural basis of somatosensory temporal discrimination threshold as a paradigm for time processing in the sub-second range: An updated review. Neurosci Biobehav Rev 2024; 156:105486. [PMID: 38040074 DOI: 10.1016/j.neubiorev.2023.105486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The temporal aspect of somesthesia is a feature of any somatosensory process and a pre-requisite for the elaboration of proper behavior. Time processing in the milliseconds range is crucial for most of behaviors in everyday life. The somatosensory temporal discrimination threshold (STDT) is the ability to perceive two successive stimuli as separate in time, and deals with time processing in this temporal range. Herein, we focus on the physiology of STDT, on a background of the anatomophysiology of somesthesia and the neurobiological substrates of timing. METHODS A review of the literature through PubMed & Cochrane databases until March 2023 was performed with inclusion and exclusion criteria following PRISMA recommendations. RESULTS 1151 abstracts were identified. 4 duplicate records were discarded before screening. 957 abstracts were excluded because of redundancy, less relevant content or not English-written. 4 were added after revision. Eventually, 194 articles were included. CONCLUSIONS STDT encoding relies on intracortical inhibitory S1 function and is modulated by the basal ganglia-thalamic-cortical interplay through circuits involving the nigrostriatal dopaminergic pathway and probably the superior colliculus.
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Affiliation(s)
- Carlos M Ordás
- Universidad Rey Juan Carlos, Móstoles, Madrid, Spain; Department of Neurology, Hospital Rey Juan Carlos, Móstoles, Madrid, Spain.
| | - Fernando Alonso-Frech
- Department of Neurology, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Spain
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Ilardi CR, La Marra M, Amato R, Di Cecca A, Di Maio G, Ciccarelli G, Migliaccio M, Cavaliere C, Federico G. The "Little Circles Test" (LCT): a dusted-off tool for assessing fine visuomotor function. Aging Clin Exp Res 2023; 35:2807-2820. [PMID: 37910290 DOI: 10.1007/s40520-023-02571-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/18/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND The fine visuomotor function is commonly impaired in several neurological conditions. However, there is a scarcity of reliable neuropsychological tools to assess such a critical domain. AIMS The aim of this study is to explore the psychometric properties and provide normative data for the Visual-Motor Speed and Precision Test (VMSPT). RESULTS Our normative sample included 220 participants (130 females) aged 18-86 years (mean education = 15.24 years, SD = 3.98). Results showed that raw VMSPT scores were affected by higher age and lower education. No effect of sex or handedness was shown. Age- and education-based norms were provided. VMSPT exhibited weak-to-strong correlations with well-known neuropsychological tests, encompassing a wide range of cognitive domains of clinical relevance. By gradually intensifying the cognitive demands, the test becomes an indirect, performance-oriented measure of executive functioning. Finally, VMSPT seems proficient in capturing the speed-accuracy trade-off typically observed in the aging population. CONCLUSIONS This study proposes the initial standardization of a versatile, time-efficient, and cost-effective neuropsychological tool for assessing fine visuomotor coordination. We propose renaming the VMSPT as the more approachable "Little Circles Test" (LCT).
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Affiliation(s)
| | - Marco La Marra
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Raffaella Amato
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Angelica Di Cecca
- IRCCS SYNLAB SDN S.P.A., Via Emanuele Gianturco 113, 80143, Naples, Italy
| | - Girolamo Di Maio
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Miriana Migliaccio
- IRCCS SYNLAB SDN S.P.A., Via Emanuele Gianturco 113, 80143, Naples, Italy
| | - Carlo Cavaliere
- IRCCS SYNLAB SDN S.P.A., Via Emanuele Gianturco 113, 80143, Naples, Italy
| | - Giovanni Federico
- IRCCS SYNLAB SDN S.P.A., Via Emanuele Gianturco 113, 80143, Naples, Italy
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Soke F, Ozcan Gulsen E, Erkoc Ataoglu NE, Kocer B, Gulsen C, Turker D, Comoglu SS, Bora Tokcaer A. The coin rotation test: a reliable and valid test in people with Parkinson's disease. Disabil Rehabil 2023; 45:879-888. [PMID: 35263197 DOI: 10.1080/09638288.2022.2044925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To investigate: (1) the interrater, and test-retest reliability of the coin rotation test (CRT) in people with Parkinson's Disease (PwPD); (2) the minimum detectable change in the CRT; (3) the concurrent and known-groups validity of the CRT; and (4) the cut-off times that best discriminate PwPD from healthy people and functionally dependent PwPD from functionally independent PwPD. METHOD Forty-eight PwPD and 33 healthy people were included. The CRT was administered with the nine-hole peg test, Movement Disorders Society Sponsored Unified Parkinson's Disease Rating Scale, Hoehn and Yahr Scale, Parkinson's Disease Questionnaire-8, and Schwab and England Scale. RESULTS The CRT had excellent interrater and test-retest reliability. Minimal detectable changes were 5.96 and 8.23 s for the dominant and non-dominant hand, respectively. The CRT correlated with other outcome measures. Significant differences in the CRT times were found between PwPD and healthy people, and between functionally dependent PwPD and functionally independent PwPD. The cut-off times of 12.66 s on the dominant hand and 15.76 s on the non-dominant best discriminated PwPD from healthy people, while 22.99 s on the dominant hand and 23.48 s on the non-dominant best discriminated functionally dependent PwPD from functionally independent PwPD. CONCLUSIONS The CRT is a reliable, and clinically available tool for assessing manual dexterity in PwPD.Implications for rehabilitationThe coin rotation test is a reliable, valid, and clinically available tool for assessing manual dexterity in Parkinson's Disease.The minimal detectable changes of the coin rotation test are 5.96 s for dominant hand and 8.23 s for the non-dominant hand, which may useful for clinicians and researchers to detect in any true change in manual dexterity after any intervention.The coin rotation test correlated with Parkinson's Disease-specific measurement tools.The coin rotation test times may detect impaired manual dexterity between people with Parkinson's Disease and healthy people, and between functionally dependent and functionally independent in Parkinson's Disease population.
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Affiliation(s)
- Fatih Soke
- Department of Physiotherapy and Rehabilitation, Gulhane Faculty of Physiotherapy and Rehabilitation, Fatih Soke, University of Health Sciences, Ankara, Turkey
| | - Elvan Ozcan Gulsen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Elvan Ozcan Gulsen, Yuksek Ihtisas University, Ankara, Turkey
| | - Nigar Esra Erkoc Ataoglu
- Department of Neurology, Faculty of Medicine, Nigar Esra Erkoc Ataoglu, Gazi University, Ankara, Turkey
| | - Bilge Kocer
- Department of Neurology, Bilge Kocer, Diskapi Yildirim Beyazit Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Cagri Gulsen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Cagri Gulsen, Gazi University, Ankara, Turkey
| | - Duygu Turker
- Department of Physiotherapy and Rehabilitation, Gulhane Faculty of Physiotherapy and Rehabilitation, Fatih Soke, University of Health Sciences, Ankara, Turkey
| | - Selim Selcuk Comoglu
- Department of Neurology, Bilge Kocer, Diskapi Yildirim Beyazit Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ayse Bora Tokcaer
- Department of Neurology, Faculty of Medicine, Nigar Esra Erkoc Ataoglu, Gazi University, Ankara, Turkey
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Panyakaew P, Duangjino K, Kerddonfag A, Ploensin T, Piromsopa K, Kongkamol C, Bhidayasiri R. Exploring the Complex Phenotypes of Impaired Finger Dexterity in Mild-to-moderate Stage Parkinson's Disease: A Time-Series Analysis. JOURNAL OF PARKINSON'S DISEASE 2023; 13:975-988. [PMID: 37574743 PMCID: PMC10578277 DOI: 10.3233/jpd-230029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Impaired dexterity is an early motor symptom in Parkinson's disease (PD) that significantly impacts the daily activity of patients; however, what constitutes complex dexterous movements remains controversial. OBJECTIVE To explore the characteristics of finger dexterity in mild-to-moderate stage PD. METHODS We quantitatively assessed finger dexterity in 48 mild-to-moderate stage PD patients and 49 age-matched controls using a simple alternating two-finger typing test for 15 seconds. Time-series analyses of various kinematic parameters with machine learning were compared between sides and groups. RESULTS Both the more and less affected hands of patients with PD had significantly lower typing frequency and slower typing velocity than the non-dominant and the dominant hands of controls (p = 0.019, p = 0.016, p < 0.001, p < 0.001). The slope of the typing velocity decreased with time, indicating a sequence effect in the PD group. A typing duration of 6 seconds was determined sufficient to discriminate PD patients from controls. Typing error, repetition, and repetition rate were significantly higher in the more affected hands of patients with PD than in the non-dominant hand of controls (p < 0.001, p = 0.03, p < 0.001). The error rate was constant, whereas the repetition rate was steep during the initiation of typing. A predictive model of the more affected hand demonstrated an accuracy of 70% in differentiating PD patients from controls. CONCLUSION Our study demonstrated complex components of impaired finger dexterity in mild-to-moderate stage PD, namely bradykinesia with sequence effects, error, and repetition at the initiation of movement, suggesting that multiple neural networks may be involved in dexterity deficits in PD.
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Affiliation(s)
- Pattamon Panyakaew
- Chulalongkorn Centre of Excellence for Parkinson’s Disease & Related Disorders, Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Kotchakorn Duangjino
- Chulalongkorn Centre of Excellence for Parkinson’s Disease & Related Disorders, Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Apiwoot Kerddonfag
- Chulalongkorn Centre of Excellence for Parkinson’s Disease & Related Disorders, Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Teerit Ploensin
- Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Krerk Piromsopa
- Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
- Research Group on Applied Computer Engineering Technology for Medicine and Healthcare, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Chanon Kongkamol
- Department of Family and Prevention Medicine, Faculty of Medicine, Prince of Songkla University, Bangkok, Thailand
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson’s Disease & Related Disorders, Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
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Wong-Yu ISK, Ren L, Mak MKY. Impaired Hand Function and Its Association With Self-Perceived Hand Functional Ability and Quality of Life in Parkinson Disease. Am J Phys Med Rehabil 2022; 101:843-849. [PMID: 35978454 DOI: 10.1097/phm.0000000000001923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Comprehensive hand function in people with Parkinson disease (PD) has been underevaluated. The objectives were to compare self-perceived and objective hand functions of PD and controls, compare outcomes between more and less affected hand subgroups, and evaluate relationship between self-perceived and objective outcomes in subgroups. DESIGN A total of 165 PD and 82 healthy participants completed the Jebsen-Taylor Hand Function Test, Purdue Pegboard Test, grip strength test, and Manual Ability Measure-16 in a cross-sectional study. PD participants completed the Parkinson Disease Questionnaire-39. Associations between objective and self-perceived/quality of life outcomes in PD groups were analyzed, and nondominant and dominant more affected subgroups performance was compared. RESULTS PD participants had significantly worse performance in most Jebsen-Taylor Hand Function Test and all Purdue Pegboard Test items, lower Manual Ability Measure-16 scores, and poorer handgrip strength. Weak associations were found between dexterity, but not grip strength, and self-perceived functional hand ability and Parkinson Disease Questionnaire-39 scores in PD subgroups. For nondominant more affected subgroup, poorer dexterity was associated with better Parkinson Disease Questionnaire-39 Activity of Daily Living domain scores. CONCLUSION People with mild to moderate PD were shown to have poorer manual dexterity, reduced grip strength, and lower self-perceived functional hand ability than controls. Associations between dexterity and self-perceived outcomes highlight the importance of unimanual and bimanual training.
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Affiliation(s)
- Irene S K Wong-Yu
- From the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
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Söke F, OZCAN GÜLSEN ELVAN, Erkoc Ataoglu NE, Gülşen Ç, Kocer B, BORA TOKCAER A. The Reliability and Validity of the Manual Ability Measure-36 in Patients with Parkinson's Disease. TURKISH JOURNAL OF NEUROLOGY 2022. [DOI: 10.4274/tnd.2022.99836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Li J, Liu Z, Du Z, Zhu N, Qiu X, Xu X. Cortical Activation During Finger Tapping Task Performance in Parkinson's Disease Is Influenced by Priming Conditions: An ALE Meta-Analysis. Front Hum Neurosci 2021; 15:774656. [PMID: 34916919 PMCID: PMC8669914 DOI: 10.3389/fnhum.2021.774656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
The finger tapping task (FTT) is commonly used in the evaluation of dyskinesia among patients with Parkinson's disease (PD). Past research has indicated that cortical activation during FTT is different between self-priming and cue-priming conditions. To evaluate how priming conditions affect the distribution of brain activation and the reorganization of brain function, and to investigate the differences in brain activation areas during FTT between PD patients and healthy control (HC) participants, we conducted an activation likelihood estimation (ALE) meta-analysis on the existing literature. Analyses were based on data from 15 independent samples that included 181 participants with PD and 164 HC participants. We found that there was significantly more activation in the middle frontal gyrus, precentral gyrus, post-central gyrus, superior parietal lobe, inferior parietal lobule, cerebellum, and basal ganglia during FTT in PD patients than in HCs. In self-priming conditions, PD patients had less activation in the parietal lobe and insular cortex but more activation in the cerebellum than the HCs. In cue-priming conditions, the PD patients showed less activation in the cerebellum and frontal-parietal areas and more activation in the superior frontal gyrus and superior temporal gyrus than the HCs. Our study illustrates that cue-priming manipulations affect the distribution of activity in brain regions involved in motor control and motor performance in PD patients. In cue-priming conditions, brain activity in regions associated with perceptual processing and inhibitory control was enhanced, while sensory motor areas associated with attention and motor control were impaired.
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Affiliation(s)
- Jingjing Li
- Graduate School, Wuhan Sports University, Wuhan, China
| | - Zheng Liu
- ANU College of Health and Medicine, Australian National University, Canberra, ACT, Australia
- Sydney School of Education and Social Work, University of Sydney, Sydney, NSW, Australia
| | - Zhongquan Du
- Graduate School, Wuhan Sports University, Wuhan, China
| | - Ningning Zhu
- Graduate School, Wuhan Sports University, Wuhan, China
| | - Xueqing Qiu
- Graduate School, Wuhan Sports University, Wuhan, China
| | - Xia Xu
- College of Health Science, Wuhan Sports University, Wuhan, China
- Hubei Key Laboratory of Exercise Training and Monitoring, Wuhan Sports University, Wuhan, China
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Ingram LA, Carroll VK, Butler AA, Brodie MA, Gandevia SC, Lord SR. Quantifying upper limb motor impairment in people with Parkinson's disease: a physiological profiling approach. PeerJ 2021; 9:e10735. [PMID: 33604177 PMCID: PMC7869669 DOI: 10.7717/peerj.10735] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 12/17/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Upper limb motor impairments, such as slowness of movement and difficulties executing sequential tasks, are common in people with Parkinson's disease (PD). OBJECTIVE To evaluate the validity of the upper limb Physiological Profile Assessment (PPA) as a standard clinical assessment battery in people with PD, by determining whether the tests, which encompass muscle strength, dexterity, arm stability, position sense, skin sensation and bimanual coordination can (a) distinguish people with PD from healthy controls, (b) detect differences in upper limb test domains between "off" and "on" anti-Parkinson medication states and (c) correlate with a validated measure of upper limb function. METHODS Thirty-four participants with PD and 68 healthy controls completed the upper limb PPA tests within a single session. RESULTS People with PD exhibited impaired performance across most test domains. Based on validity, reliability and feasibility, six tests (handgrip strength, finger-press reaction time, 9-hole peg test, bimanual pole test, arm stability, and shirt buttoning) were identified as key tests for the assessment of upper limb function in people with PD. CONCLUSIONS The upper limb PPA provides a valid, quick and simple means of quantifying specific upper limb impairments in people with PD. These findings indicate clinical assessments should prioritise tests of muscle strength, unilateral movement and dexterity, bimanual coordination, arm stability and functional tasks in people with PD as these domains are the most commonly and significantly impaired.
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Affiliation(s)
- Lewis A. Ingram
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Vincent K. Carroll
- NSW Health, Mid North Coast Local Health District, Coffs Harbour, New South Wales, Australia
- Parkinson’s NSW, Sydney, New South Wales, Australia
| | - Annie A. Butler
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Matthew A. Brodie
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Simon C. Gandevia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen R. Lord
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
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Yoshida N, Suzuki T, Ogahara K, Higashi T, Sugawara K. Somatosensory temporal discrimination threshold changes during motor learning. Somatosens Mot Res 2020; 37:313-319. [PMID: 33064045 DOI: 10.1080/08990220.2020.1830755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE Mechanisms underlying the somatosensory temporal discrimination threshold and its relationship with motor control have been reported; however, little is known regarding the change in temporal processing of tactile information during motor learning. We investigated the somatosensory temporal discrimination threshold changes during motor learning in a feedback-control task. MATERIALS AND METHODS We included 15 healthy individuals. The somatosensory temporal discrimination threshold was measured on the index finger. A 10-session coin rotation task was performed, with 2 min' training per session. The coin rotation scores were determined through tests (continuous coin rotation at 180° at maximum speed for 10 s). The coin rotation test score and the somatosensory temporal discrimination threshold were determined at baseline and after 5 and 10 sets of training, as follows: pre-test; training5set (1 set × 5); post-test5block; training5set (1 set × 5); and post-test10block. The coin rotation score and the somatosensory temporal discrimination threshold were compared between the tests. The latter was also compared between the right (the within-subject control) and left fingers. RESULTS The coin rotation score showed significant differences among all tests. In the somatosensory temporal discrimination threshold, there was a significant difference between the pre-test and post-test5block values, pre-test and post-test10block values of the left side and between the right and left sides in the post-test5block and the post-test10block values. CONCLUSIONS The somatosensory temporal discrimination threshold decreased along with task-performance progress following motor learning during a feedback-control task.
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Affiliation(s)
- Naoshin Yoshida
- Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Rehabilitation, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Tomotaka Suzuki
- Faculty of Health and Social Work School of Rehabilitation, Kanagawa University of Human Services, Yokosuka, Japan
| | - Kakuya Ogahara
- Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Faculty of Health and Social Work School of Rehabilitation, Kanagawa University of Human Services, Yokosuka, Japan
| | - Toshio Higashi
- Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kenichi Sugawara
- Faculty of Health and Social Work School of Rehabilitation, Kanagawa University of Human Services, Yokosuka, Japan
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Pagnussat AS, Salazar AP, Pinto C, Redivo Marchese R, Rieder CRM, Alves Filho JO, Franco AR, Kleiner AFR. Plantar stimulation alters brain connectivity in idiopathic Parkinson's disease. Acta Neurol Scand 2020; 142:229-238. [PMID: 32299120 DOI: 10.1111/ane.13253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/25/2020] [Accepted: 04/11/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Individuals with Parkinson's disease (PD) and freezing of gait (FOG) present peripheral and central sensitivity disturbances that impair motor performance. This study aimed to investigate long-term effects of plantar sensory stimulation on brain activity, brain connectivity, and gait velocity of individuals with PD and FOG. METHODS Twenty-five participants were enrolled in this clinical trial (NCT02594540). Plantar sensory stimulation was delivered using the Automated Mechanical Peripheral Stimulation therapy (AMPS). Volunteers were randomly assigned to real or placebo AMPS groups and received eight sessions of treatment. The primary outcome was brain activity (task-based fMRI-active ankle dorsi-plantar flexion). Secondary outcomes were brain connectivity (resting state-RS fMRI) and gait velocity. fMRI was investigated on the left, right, and mid-sensory motor regions, left and right basal ganglia. RESULTS No changes in brain activity were observed when task-based fMRI was analyzed. After real AMPS, RS functional connectivity between basal ganglia and sensory-related brain areas increased (insular and somatosensory cortices). Gait velocity also increased after real AMPS. A positive correlation was found between gait velocity and the increased connectivity between sensory, motor and supplementary motor cortices. CONCLUSION Plantar sensory stimulation through AMPS was not able to modify brain activity. AMPS increased the RS brain connectivity mainly in areas related to sensory processing and sensorimotor integration. Plantar stimulation could be a way to improve plantar sensitivity and consequently ameliorate gait performance. However, the mechanisms behind the way AMPS influences brain pathways are still not completely known.
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Affiliation(s)
- Aline Souza Pagnussat
- Graduate Program in Rehabilitation Sciences Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
- Movement Analysis and Rehabilitation Laboratory Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
| | - Ana Paula Salazar
- Graduate Program in Rehabilitation Sciences Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
- Movement Analysis and Rehabilitation Laboratory Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
| | - Camila Pinto
- Graduate Program in Rehabilitation Sciences Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
- Movement Analysis and Rehabilitation Laboratory Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
| | - Ritchele Redivo Marchese
- Graduate Program in Rehabilitation Sciences Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
- Movement Analysis and Rehabilitation Laboratory Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
| | - Carlos R. M. Rieder
- Graduate Program in Rehabilitation Sciences Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Porto Alegre Brazil
| | | | - Alexandre R. Franco
- Center for Biomedical Imaging and Neuromodulation Nathan S. Kline Institute for Psychiatric Research Orangeburg NY USA
- Center for the Developing Brain Child Mind Institute New York NY USA
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13
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Hejazi-Shirmard M, Taghizadeh G, Azad A, Lajevardi L, Rassafiani M. Sensory retraining improves light touch threshold of the paretic hand in chronic stroke survivors: a single-subject A-B design. Somatosens Mot Res 2020; 37:74-83. [PMID: 32162568 DOI: 10.1080/08990220.2020.1736021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Light touch, one of the primary and basic sensations, is often neglected in sensory retraining programmes for stroke survivors.Objective: This study aimed to investigate the effects of sensory retraining on the light touch threshold of the hand, dexterity and upper limb motor function of chronic stroke survivors.Methods: Five chronic stroke survivors with sensory impairment participated in this single-subject A-B design study. In baseline (A) phase, they only received standard rehabilitation. In the treatment (B) phase, they received a 6-week sensory retraining intervention in addition to standard rehabilitation. In both phases, they were evaluated every 3 days. Light touch threshold, manual dexterity and upper limb motor function were assessed using Semmes-Weinstein Monofilaments, Box-Block Test and Fugl-Meyer Assessment, respectively. Visual analysis, nonparametric Mann-Whitney U test and, c-statistic were used for assessing the changes between phases.Results: All participants indicated changes in trend or slope of the total score of light touch or both between the two phases. The results of the c-statistic also showed the statistical difference in the total score of light touch between baseline and treatment in all participants (p < 0.001). Also, the results of the c-statistic and Mann-Whitney U test supported the difference of manual dexterity and motor function of the upper limb between baseline and treatment in all participants (p < 0.001).Conclusion: Current findings showed that sensory retraining may be an effective adjunctive intervention for improving the light touch threshold of the hand, dexterity and upper limb motor function in chronic stroke survivors.
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Affiliation(s)
- Mahnaz Hejazi-Shirmard
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Ghorban Taghizadeh
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Akram Azad
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Laleh Lajevardi
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mehdi Rassafiani
- Occupational Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait.,Neurorehabilitation Research Center, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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14
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Bologna M, Paparella G, Fasano A, Hallett M, Berardelli A. Evolving concepts on bradykinesia. Brain 2020; 143:727-750. [PMID: 31834375 PMCID: PMC8205506 DOI: 10.1093/brain/awz344] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/02/2019] [Accepted: 09/06/2019] [Indexed: 12/20/2022] Open
Abstract
Bradykinesia is one of the cardinal motor symptoms of Parkinson's disease and other parkinsonisms. The various clinical aspects related to bradykinesia and the pathophysiological mechanisms underlying bradykinesia are, however, still unclear. In this article, we review clinical and experimental studies on bradykinesia performed in patients with Parkinson's disease and atypical parkinsonism. We also review studies on animal experiments dealing with pathophysiological aspects of the parkinsonian state. In Parkinson's disease, bradykinesia is characterized by slowness, the reduced amplitude of movement, and sequence effect. These features are also present in atypical parkinsonisms, but the sequence effect is not common. Levodopa therapy improves bradykinesia, but treatment variably affects the bradykinesia features and does not significantly modify the sequence effect. Findings from animal and patients demonstrate the role of the basal ganglia and other interconnected structures, such as the primary motor cortex and cerebellum, as well as the contribution of abnormal sensorimotor processing. Bradykinesia should be interpreted as arising from network dysfunction. A better understanding of bradykinesia pathophysiology will serve as the new starting point for clinical and experimental purposes.
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Affiliation(s)
- Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
| | | | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada
- Division of Neurology, University of Toronto, Toronto, Ontario, Canada
- Krembil Brain Institute, Toronto, Ontario, Canada
- Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
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15
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Uzochukwu JC, Stegemöller EL. Repetitive Finger Movement and Dexterity Tasks in People With Parkinson’s Disease. Am J Occup Ther 2019; 73:7303205090p1-7303205090p8. [DOI: 10.5014/ajot.2019.028738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
BACKGROUND. Little is known regarding how repetitive finger movement performance, an assessment of bradykinesia (slowness of movement), is related to fine-motor dexterity tasks in people with Parkinson’s disease (PD).
OBJECTIVE. This pilot study examined the relationship between the performance of fine-motor dexterity tasks and repetitive finger movement in people with PD.
METHOD. Forty-six participants with PD completed an acoustically cued repetitive finger movement task (1–3 Hz). Movement amplitude, movement rate difference, and coefficient of variation were obtained for each tone rate. Participants also completed a buttoning and Purdue pegboard assembly task. Buttoning time and number of assemblies were recorded.
RESULTS. A significant association was found between movement rate difference and movement rate difference coefficient of variation and buttoning performance in which higher movement rate and higher variability were associated with slower buttoning times. No significant associations between any of the repetitive finger movement outcome measures and Purdue pegboard assembly performance were revealed.
CONCLUSION. Changes in movement amplitude and movement rate may influence fine-motor dexterity tasks differently. Thus, it is important to consider the quantitative assessment of both movement rate and movement amplitude because they may indicate differential clinical applications in the treatment of people with PD.
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Affiliation(s)
- Jennifer C. Uzochukwu
- Jennifer C. Uzochukwu, MS, is Graduate Student, Department of Kinesiology, Iowa State University, Ames
| | - Elizabeth L. Stegemöller
- Elizabeth L. Stegemöller, PhD, is Assistant Professor, Department of Kinesiology, Iowa State University, Ames;
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17
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Somatosensory temporal discrimination in Parkinson’s disease, dystonia and essential tremor: Pathophysiological and clinical implications. Clin Neurophysiol 2018; 129:1849-1853. [DOI: 10.1016/j.clinph.2018.05.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/23/2018] [Accepted: 05/15/2018] [Indexed: 12/18/2022]
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18
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Avanzino L, Fiorio M, Conte A. Actual and Illusory Perception in Parkinson's Disease and Dystonia: A Narrative Review. Front Neurol 2018; 9:584. [PMID: 30079051 PMCID: PMC6062595 DOI: 10.3389/fneur.2018.00584] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/28/2018] [Indexed: 12/12/2022] Open
Abstract
Sensory information is continuously processed so as to allow behavior to be adjusted according to environmental changes. Before sensory information reaches the cortex, a number of subcortical neural structures select the relevant information to send to be consciously processed. In recent decades, several studies have shown that the pathophysiological mechanisms underlying movement disorders such as Parkinson's disease (PD) and dystonia involve sensory processing abnormalities related to proprioceptive and tactile information. These abnormalities emerge from psychophysical testing, mainly temporal discrimination, as well as from experimental paradigms based on bodily illusions. Although the link between proprioception and movement may be unequivocal, how temporal tactile information abnormalities and bodily illusions relate to motor disturbances in PD and dystonia is still a matter of debate. This review considers the role of altered sensory processing in the pathophysiology of movement disorders, focusing on how sensory alteration patterns differ between PD and dystonia. We also discuss the evidence available and the potential for developing new therapeutic strategies based on the manipulation of multi-sensory information and bodily illusions in patients with these movement disorders.
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Affiliation(s)
- Laura Avanzino
- Section of Human Physiology, Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Mirta Fiorio
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
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19
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Gating of Sensory Input at Subcortical and Cortical Levels during Grasping in Humans. J Neurosci 2018; 38:7237-7247. [PMID: 29976624 DOI: 10.1523/jneurosci.0545-18.2018] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/09/2018] [Accepted: 06/22/2018] [Indexed: 01/27/2023] Open
Abstract
Afferent input from the periphery to the cortex contributes to the control of grasping. How sensory input is gated along the ascending sensory pathway and its functional role during gross and fine grasping in humans remain largely unknown. To address this question, we assessed somatosensory-evoked potential components reflecting activation at subcortical and cortical levels and psychophysical tests at rest, during index finger abduction, precision, and power grip. We found that sensory gating at subcortical level and in the primary somatosensory cortex (S1), as well as intracortical inhibition in the S1, increased during power grip compared with the other tasks. To probe the functional relevance of gating in the S1, we examined somatosensory temporal discrimination threshold by measuring the shortest time interval to perceive a pair of electrical stimuli. Somatosensory temporal discrimination threshold increased during power grip, and higher threshold was associated with increased intracortical inhibition in the S1. These novel findings indicate that humans gate sensory input at subcortical level and in the S1 largely during gross compared with fine grasping. Inhibitory processes in the S1 may increase discrimination threshold to allow better performance during power grip.SIGNIFICANCE STATEMENT Most of our daily life actions involve grasping. Here, we demonstrate that gating of afferent input increases at subcortical level and in the primary somatosensory cortex (S1) during gross compared with fine grasping in intact humans. The precise timing of sensory information is critical for human perception and behavior. Notably, we found that the ability to perceive a pair of electrical stimuli, as measured by the somatosensory temporal discrimination threshold, increased during power grip compared with the other tasks. We propose that reduced afferent input to the S1 during gross grasping behaviors diminishes temporal discrimination of sensory processes related, at least in part, to increased inhibitory processes within the S1.
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20
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Lee SH, Lee MJ, Lyoo CH, Cho H, Lee MS. Impaired finger dexterity and nigrostriatal dopamine loss in Parkinson's disease. J Neural Transm (Vienna) 2018; 125:1333-1339. [PMID: 29971496 DOI: 10.1007/s00702-018-1901-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 06/29/2018] [Indexed: 11/28/2022]
Abstract
Impaired finger dexterity occurs in Parkinson's disease (PD) and has been considered a limb-kinetic apraxia associated with primary sensory cortical dysfunction. To study the role of nigrostriatal dopamine loss and elementary parkinsonian motor deficits in impaired finger dexterity of PD. Thirty-two right-handed untreated PD patients and 30 right-handed healthy controls were included. All patients underwent [18F] FP-CIT positron emission tomography studies. We examined the associations among unilateral coin rotation (CR) score, Unified Parkinson's Disease Rating Scale (UPDRS) subscores for bradykinesia and rigidity of the corresponding arm, and contralateral regional striatal dopamine transporter (DAT) uptake. We also measured the effect of oral levodopa dose on CR scores and UPDRS subscores. PD patients performed worse than controls on the CR task. Unilateral arm UPDRS bradykinesia scores were associated with DAT uptake in the contralateral putamen. The left CR score was associated with left arm bradykinesia and rigidity scores and DAT uptake in the right posterior putamen, whereas no such associations were found for the right CR score. There was a significant effect of handedness on the association of putamen DAT uptake with CR scores, but not with UPDRS subscores. An oral levodopa challenge improved CR scores and UPDRS subscores on both sides. Impaired finger dexterity in PD is related to elementary parkinsonian motor deficits and nigrostriatal dopamine loss. Impaired dominant hand dexterity associated with nigrostriatal dopamine loss seems to be compensated to some extent by the dominant cerebral cortex specialized for controlling precise finger movements.
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Affiliation(s)
- S H Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea
| | - M J Lee
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea
| | - C H Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea
| | - H Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea
| | - M S Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea.
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Bobos P, Lalone EA, Grewal R, MacDermid JC. Do Impairments Predict Hand Dexterity After Distal Radius Fractures? A 6-Month Prospective Cohort Study. Hand (N Y) 2018; 13:441-447. [PMID: 28366013 PMCID: PMC6081776 DOI: 10.1177/1558944717701242] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The relationship of routinely measured grip and motion measures may be related to hand dexterity. This has not yet been thoroughly examined following a distal radius fracture (DRF). The purpose of this study was to investigate if impairments in range of motion (ROM) and grip strength predict hand dexterity 6 months following a DRF. METHODS Patients with DRFs were recruited from a specialized hand clinic. Hand grip was assessed with a J-Tech dynamometer; ROM was measured using standard landmarks and a manual goniometer. Multiple regression analyses were performed to identify whether potential predictors (grip, ROM, age, hand dominance, and sex) were associated with 3-month or 6-month outcomes in large- and small-object subtests of the NK dexterity test in the affected hand. RESULTS Age, sex, and arc motion for radial-ulnar deviation were significant predictors of large-object hand dexterity explaining the 23% of the variation. For small-object hand dexterity, age and flexion-extension arc motion were significant predictors explaining 11% of the variation at 3 month after the fracture (n = 391). At 6 months post injury (n = 319), grip strength, arc motion for flexion-extension, and age were found to be significant predictors of large-object dexterity explaining 34% of the variance. For the small objects, age, grip strength, sex, and arc motion of radial-ulnar deviation explained 25% of the variation. CONCLUSIONS Although this confirms that the impairments in ROM and grip that occur after a DRF can explain almost one-third of the variation in hand dexterity, it also suggests the need for dexterity testing to provide more accurate assessment.
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Affiliation(s)
- Pavlos Bobos
- Roth
- McFarlane Hand and Upper Limb
Centre Clinical Research Lab, St. Joseph’s Health Centre, Western University,
London, Ontario, Canada,Pavlos Bobos, Roth
- McFarlane Hand and Upper
Limb Centre Clinical Research Lab, St. Joseph’s Health Centre, Health and
Rehabilitation Sciences, Western University, 268 Grosvenor Street, London,
Ontario, Canada N6A 4L6.
| | - Emily A. Lalone
- Roth
- McFarlane Hand and Upper Limb
Centre Clinical Research Lab, St. Joseph’s Health Centre, Western University,
London, Ontario, Canada
| | - Ruby Grewal
- Roth
- McFarlane Hand and Upper Limb
Centre Clinical Research Lab, St. Joseph’s Health Centre, Western University,
London, Ontario, Canada
| | - Joy C. MacDermid
- Roth
- McFarlane Hand and Upper Limb
Centre Clinical Research Lab, St. Joseph’s Health Centre, Western University,
London, Ontario, Canada
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22
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Nozaki T, Asakawa T, Sugiyama K, Koda Y, Shimoda A, Mizushima T, Sameshima T, Namba H. Effect of Subthalamic Deep Brain Stimulation on Upper Limb Dexterity in Patients with Parkinson Disease. World Neurosurg 2018; 115:e206-e217. [PMID: 29654953 DOI: 10.1016/j.wneu.2018.04.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 04/03/2018] [Accepted: 04/03/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The efficacy of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on dexterity remains controversial despite its recognition as an effective strategy for Parkinson disease. The present study investigated the efficacy of STN-DBS for ameliorating bradykinesia and dexterity compared with dopaminergic medications. METHODS Part III of the Unified Parkinson's Disease Rating Scale was used for the evaluation of bradykinesia, whereas the Purdue Pegboard Test and the Box and Block test were selected for dexterity. RESULTS Our findings indicate that bradykinesia is significantly improved with both DBS and dopaminergic medication, whereas dexterity is improved only with DBS. Dopaminergic medication did not show a satisfactory efficacy on dexterity, and there was little synergistic effect of dopaminergic medication and STN-DBS for improving dexterity associated with Parkinson disease. CONCLUSIONS Our results suggest that DBS is potentially more effective than dopaminergic medications for improving dexterity. The disparities in efficacy for bradykinesia and dexterity between DBS and dopaminergic medication hint at the potential mechanisms of STN-DBS. We speculate that DBS follows at least 2 different mechanisms for improving parkinsonian symptoms: 1) the dopaminergic system, primarily for the improvement of bradykinesia and 2) the nondopaminergic system, for the improvement of dexterity. This hypothesis requires further verification and investigation.
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Affiliation(s)
- Takao Nozaki
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
| | - Tetsuya Asakawa
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
| | - Kenji Sugiyama
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yuki Koda
- Department of Rehabilitation, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Ayumi Shimoda
- Department of Rehabilitation, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Takashi Mizushima
- Department of Rehabilitation, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Tetsuro Sameshima
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Hiroki Namba
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
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Lee MS, Lee MJ, Conte A, Berardelli A. Abnormal somatosensory temporal discrimination in Parkinson’s disease: Pathophysiological correlates and role in motor control deficits. Clin Neurophysiol 2018; 129:442-447. [DOI: 10.1016/j.clinph.2017.11.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 11/13/2017] [Accepted: 11/21/2017] [Indexed: 12/14/2022]
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Dahdal P, Meyer A, Chaturvedi M, Nowak K, Roesch AD, Fuhr P, Gschwandtner U. Fine Motor Function Skills in Patients with Parkinson Disease with and without Mild Cognitive Impairment. Dement Geriatr Cogn Disord 2018; 42:127-134. [PMID: 27643700 DOI: 10.1159/000448751] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2016] [Indexed: 11/19/2022] Open
Abstract
AIMS The objective of this study was to investigate the relation between impaired fine motor skills in Parkinson disease (PD) patients and their cognitive status, and to determine whether fine motor skills are more impaired in PD patients with mild cognitive impairment (MCI) than in non-MCI patients. METHODS Twenty PD MCI and 31 PD non-MCI patients (mean age 66.7 years, range 50-84, 36 males/15 females), all right-handed, took part in a motor performance test battery. Steadiness, precision, dexterity, velocity of arm-hand movements, and velocity of wrist-finger movements were measured and compared across groups and analyzed for confounders (age, sex, education, severity of motor symptoms, and disease duration). Statistical analysis included t tests corrected for multiple testing, and a linear regression with stepwise elimination procedure was used to select significant predictors for fine motor function. RESULTS PD MCI patients performed significantly worse in precision (p < 0.05), dexterity (p < 0.05), and velocity (arm-hand movements; p < 0.05) compared to PD non-MCI patients. The fine motor function skills were confounded by age. CONCLUSIONS Fine motor skills in PD MCI patients are impaired compared to PD non-MCI patients. Investigating the relation between the fine motor performance and MCI in PD might be a relevant subject for future research.
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Affiliation(s)
- Philippe Dahdal
- Department of Neurology, University Hospital Basel, Basel, Switzerland
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Conte A, Belvisi D, Manzo N, Bologna M, Barone F, Tartaglia M, Upadhyay N, Berardelli A. Understanding the link between somatosensory temporal discrimination and movement execution in healthy subjects. Physiol Rep 2017; 4:4/18/e12899. [PMID: 27650249 PMCID: PMC5037912 DOI: 10.14814/phy2.12899] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 07/25/2016] [Indexed: 01/28/2023] Open
Abstract
The somatosensory temporal discrimination threshold (STDT) is the shortest interval at which an individual recognizes paired stimuli as separate in time. We investigated whether and how voluntary movement modulates STDT in healthy subjects. In 17 healthy participants, we tested STDT during voluntary index‐finger abductions at several time‐points after movement onset and during motor preparation. We then tested whether voluntary movement‐induced STDT changes were specific for the body segment moved, depended on movement kinematics, on the type of movement or on the intensity for delivering paired electrical stimuli for STDT. To understand the mechanisms underlying STDT modulation, we also tested STDT during motor imagery and after delivering repetitive transcranial magnetic stimulation to elicit excitability changes in the primary somatosensory cortex (S1). When tested on the moving hand at movement onset and up to 200 msec thereafter, STDT values increased from baseline, but during motor preparation remained unchanged. STDT values changed significantly during fast and slow index‐finger movements and also, though less, during passive index‐finger abductions, whereas during tonic index‐finger abductions they remained unchanged. STDT also remained unchanged when tested in body parts other than those engaged in movement and during imagined movement. Nor did testing STDT at increased intensity influence movement‐induced STDT changes. The cTBS‐induced S1 cortical changes left movement‐induced STDT changes unaffected. Our findings suggest that movement execution in healthy subjects may alter STDT processing.
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Affiliation(s)
| | | | - Nicoletta Manzo
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | | | - Francesca Barone
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Matteo Tartaglia
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Neeraj Upadhyay
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli (IS), Italy Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
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26
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Conte A, Belvisi D, Tartaglia M, Cortese FN, Baione V, Battista E, Zhu XY, Fabbrini G, Berardelli A. Abnormal Temporal Coupling of Tactile Perception and Motor Action in Parkinson's Disease. Front Neurol 2017. [PMID: 28634466 PMCID: PMC5459880 DOI: 10.3389/fneur.2017.00249] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Evidence shows altered somatosensory temporal discrimination threshold (STDT) in Parkinson’s disease in comparison to normal subjects. In healthy subjects, movement execution modulates STDT values through mechanisms of sensory gating. We investigated whether STDT modulation during movement execution in patients with Parkinson’s disease differs from that in healthy subjects. In 24 patients with Parkinson’s disease and 20 healthy subjects, we tested STDT at baseline and during index finger abductions (at movement onset “0”, 100, and 200 ms thereafter). We also recorded kinematic features of index finger abductions. Fifteen out of the 24 patients were also tested ON medication. In healthy subjects, STDT increased significantly at 0, 100, and 200 ms after movement onset, whereas in patients with Parkinson’s disease in OFF therapy, it increased significantly at 0 and 100 ms but returned to baseline values at 200 ms. When patients were tested ON therapy, STDT during index finger abductions increased significantly, with a time course similar to that of healthy subjects. Differently from healthy subjects, in patients with Parkinson’s disease, the mean velocity of the finger abductions decreased according to the time lapse between movement onset and the delivery of the paired electrical stimuli for testing somatosensory temporal discrimination. In conclusion, patients with Parkinson’s disease show abnormalities in the temporal coupling between tactile information and motor outflow. Our study provides first evidence that altered temporal processing of sensory information play a role in the pathophysiology of motor symptoms in Parkinson’s disease.
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Affiliation(s)
- Antonella Conte
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | | | - Matteo Tartaglia
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | | | - Viola Baione
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Emanuele Battista
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Xiao Y Zhu
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy.,Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Giovanni Fabbrini
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
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27
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Hwang S, Song CS. Relationship between manual dexterity and the unified parkinson's disease rating scale-motor exam. J Phys Ther Sci 2017; 28:3403-3406. [PMID: 28174461 PMCID: PMC5276770 DOI: 10.1589/jpts.28.3403] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 08/20/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to examine the relationships between manual
dexterity and the Unified Parkinson’s Disease Rating Scale-Motor Exam as a clinical tool
for quantifying upper extremity function in persons with Parkinson’s disease. [Subjects
and Methods] Thirty-two persons with idiopathic Parkinson’s disease participated in this
study. This study measured two clinical outcomes, the box-and-block test and the Unified
Parkinson’s Disease Rating Scale-Motor Exam, to investigate the relationships between
manual dexterity and the Unified Parkinson’s Disease Rating Scale-Motor Exam. [Results]
The box-and-block test on the more affected side was positive relationship with the
box-and-block test on the less affected side. The Unified Parkinson’s Disease Rating
Scale-motor exam score had a negative correlation with the box-and-block test results for
both sides. [Conclusion] A positive association was noted between manual dexterity and
motor function in patients with idiopathic Parkinson disease. The results of this study
suggest that the box-and-block test and the Unified Parkinson’s Disease Rating Scale-Motor
Exam are good clinical measures that quantify upper extremity function and are necessary
for the accurate evaluation of patients and to plan intervention strategies.
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Affiliation(s)
- Sujin Hwang
- Department of Physical Therapy, Division of Health Science, Baekseok University, Republic of Korea
| | - Chiang-Soon Song
- Department of Occupational Therapy, College of Health Science, Chosun University, Republic of Korea
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28
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Lee MJ, Son JS, Lee JH, Kim SJ, Lyoo CH, Lee MS. Impact of Prolonged Temporal Discrimination Threshold on Finger Movements of Parkinson's Disease. PLoS One 2016; 11:e0167034. [PMID: 27893840 PMCID: PMC5125668 DOI: 10.1371/journal.pone.0167034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 11/08/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Sensory information is essential for the precise control of movement. Patients with Parkinson's disease (PD) have higher-order sensory dysfunctions including prolonged temporal discrimination threshold (TDT). However, the impact of prolonged TDT on parkinsonian motor deficits is uncertain. METHODS This study includes 33 PD patients and 24 healthy controls. TDT values were measured in the index finger. Using coin rotation task (CRT), dexterous finger movement was assessed. Using an inertial sensor, the speed, amplitude, and frequency of finger tapping were measured. The impact of prolonged index finger TDT on two different finger movements was analyzed using the general estimating equation. RESULTS Compared to healthy controls, TDT was prolonged in the PD patients. There was no impact of TDT on mean values or decrement for amplitude and speed, as well as mean values, decrement and variability of tapping frequency. However, prolonged TDT had a significant impact on the variability in amplitude (B = 436.905 × 10-4, Wald χ2 = 9.140, p = 0.014) and speed (B = 425.655 × 10-4, Wald χ2 = 9.876, p = 0.014) of finger tapping. There was a marginal correlation between TDT and CRT. In addition, CRT correlated with variability in amplitude and speed of finger tapping. CONCLUSION In PD, cutaneous temporal discriminative sensory dysfunction appears to be related to increased variabilities in the speed and amplitude of fast repetitive finger movements and disturbed finger dexterity.
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Affiliation(s)
- M. J. Lee
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Republic of Korea
| | - J. S. Son
- Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, Illinois, United States of America
| | - J. H. Lee
- Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Yangsan, Republic of Korea
| | - S. J. Kim
- Department of Neurology, Busan Baik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - C. H. Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - M. S. Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- * E-mail:
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29
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Somatosensory temporal discrimination threshold in Parkinson’s disease parallels disease severity and duration. Clin Neurophysiol 2016; 127:2985-2989. [DOI: 10.1016/j.clinph.2016.06.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/18/2016] [Accepted: 06/29/2016] [Indexed: 11/22/2022]
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30
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Suppa A, Bologna M, Conte A, Berardelli A, Fabbrini G. The effect of L-dopa in Parkinson’s disease as revealed by neurophysiological studies of motor and sensory functions. Expert Rev Neurother 2016; 17:181-192. [DOI: 10.1080/14737175.2016.1219251] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Antonio Suppa
- Department of Neurology and Psychiatry, Sapienza University of Rome and Neuromed Institute IRCCS, Pozzilli, Italy
| | - Matteo Bologna
- Department of Neurology and Psychiatry, Sapienza University of Rome and Neuromed Institute IRCCS, Pozzilli, Italy
| | - Antonella Conte
- Department of Neurology and Psychiatry, Sapienza University of Rome and Neuromed Institute IRCCS, Pozzilli, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, Sapienza University of Rome and Neuromed Institute IRCCS, Pozzilli, Italy
| | - Giovanni Fabbrini
- Department of Neurology and Psychiatry, Sapienza University of Rome and Neuromed Institute IRCCS, Pozzilli, Italy
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Foki T, Vanbellingen T, Lungu C, Pirker W, Bohlhalter S, Nyffeler T, Kraemmer J, Haubenberger D, Fischmeister FPS, Auff E, Hallett M, Beisteiner R. Limb-kinetic apraxia affects activities of daily living in Parkinson's disease: a multi-center study. Eur J Neurol 2016; 23:1301-7. [PMID: 27132653 DOI: 10.1111/ene.13021] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/22/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Impaired dexterity (fine hand movements) is often present in Parkinson's disease (PD), even at early to moderate disease stages. It has a detrimental impact on activities of daily living (ADL) such as buttoning, contributing to reduced quality of life. Limb-kinetic apraxia, a loss of the ability to make precise, independent but coordinated finger and hand movements, may contribute to impaired dexterity even more than bradykinesia per se. However, the impact of limb-kinetic apraxia on ADL remains controversial. Our aim was to identify the strongest predictor of buttoning and unbuttoning in PD. It was hypothesized that coin rotation (a surrogate of limb-kinetic apraxia) represents the most important determinant. METHODS Sixty-four right-handed, early to moderate PD patients were recruited from three movement disorder centers (Hoehn andYahr stages 1-3). Buttoning, unbuttoning and coin rotation (right and left hand) represented the target tasks. Motor impairment was assessed according to the Unified Parkinson's Disease Rating Scale. RESULTS Multiple linear regression analysis showed that coin rotation with the right hand was the only significant predictor of buttoning (P < 0.001) and unbuttoning (P = 0.002). Notably, measures of bradykinesia or overall motor impairment did not represent significant predictors. CONCLUSIONS Constituting the novel key finding, limb-kinetic apraxia seems to be particularly relevant for ADL requiring dexterity skills in PD, even at early to moderate disease stages. Our results prompt research into the pathophysiological background and therapeutic options to treat limb-kinetic apraxia. The simple coin rotation test provides valuable information about ADL-related dexterity skills.
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Affiliation(s)
- T Foki
- Department of Neurology, Medical University of Vienna, Vienna, Austria.,MR Center of Excellence, Medical University of Vienna, Vienna, Austria
| | - T Vanbellingen
- Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, University Hospital Bern, Bern, Switzerland.,Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland
| | - C Lungu
- Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - W Pirker
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - S Bohlhalter
- Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, University Hospital Bern, Bern, Switzerland.,Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland
| | - T Nyffeler
- Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, University Hospital Bern, Bern, Switzerland.,Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland
| | - J Kraemmer
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - D Haubenberger
- Department of Neurology, Medical University of Vienna, Vienna, Austria.,Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - F Ph S Fischmeister
- Department of Neurology, Medical University of Vienna, Vienna, Austria.,MR Center of Excellence, Medical University of Vienna, Vienna, Austria
| | - E Auff
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - M Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - R Beisteiner
- Department of Neurology, Medical University of Vienna, Vienna, Austria.,MR Center of Excellence, Medical University of Vienna, Vienna, Austria
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32
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Gerstenberger J, Bauer A, Helmschrodt C, Richter A, Richter F. The novel adaptive rotating beam test unmasks sensorimotor impairments in a transgenic mouse model of Parkinson's disease. Behav Brain Res 2016; 304:102-10. [PMID: 26880341 DOI: 10.1016/j.bbr.2016.02.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 02/08/2016] [Accepted: 02/11/2016] [Indexed: 10/22/2022]
Abstract
Development of disease modifying therapeutics for Parkinson's disease (PD), the second most common neurodegenerative disorder, relies on availability of animal models which recapitulate the disease hallmarks. Only few transgenic mouse models, which mimic overexpression of alpha-synuclein, show dopamine loss, behavioral impairments and protein aggregation. Mice overexpressing human wildtype alpha-synuclein under the Thy-1 promotor (Thy1-aSyn) replicate these features. However, female mice do not exhibit a phenotype. This was attributed to a potentially lower transgene expression located on the X chromosome. Here we support that female mice overexpress human wildtype alpha-synuclein only about 1.5 fold in the substantia nigra, compared to about 3 fold in male mice. Since female Thy1-aSyn mice were shown previously to exhibit differences in corticostriatal communication and synaptic plasticity similar to their male counterparts we hypothesized that female mice use compensatory mechanisms and strategies to not show overt motor deficits despite an underlying endophenotype. In order to unmask these deficits we translated recent findings in PD patients that sensory abnormalities can enhance motor dysfunction into a novel behavioral test, the adaptive rotating beam test. We found that under changing sensory input female Thy1-aSyn mice showed an overt phenotype. Our data supports that the integration of sensorimotor information is likely a major contributor to symptoms of movement disorders and that even low levels of overexpression of human wildtype alpha-synuclein has the potential to disrupt processing of these information. The here described adaptive rotating beam test represents a sensitive behavioral test to detect moderate sensorimotor alterations in mouse models.
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Affiliation(s)
- Julia Gerstenberger
- Institute of Pharmacology, Pharmacy and Toxicology, Department of Veterinary Medicine, Leipzig University, An den Tierkliniken 15, 04103 Leipzig, Germany.
| | - Anne Bauer
- Institute of Pharmacology, Pharmacy and Toxicology, Department of Veterinary Medicine, Leipzig University, An den Tierkliniken 15, 04103 Leipzig, Germany.
| | - Christin Helmschrodt
- Institute of Pharmacology, Pharmacy and Toxicology, Department of Veterinary Medicine, Leipzig University, An den Tierkliniken 15, 04103 Leipzig, Germany.
| | - Angelika Richter
- Institute of Pharmacology, Pharmacy and Toxicology, Department of Veterinary Medicine, Leipzig University, An den Tierkliniken 15, 04103 Leipzig, Germany.
| | - Franziska Richter
- Institute of Pharmacology, Pharmacy and Toxicology, Department of Veterinary Medicine, Leipzig University, An den Tierkliniken 15, 04103 Leipzig, Germany.
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33
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Gee LE, Chen N, Ramirez-Zamora A, Shin DS, Pilitsis JG. The effects of subthalamic deep brain stimulation on mechanical and thermal thresholds in 6OHDA-lesioned rats. Eur J Neurosci 2015; 42:2061-9. [PMID: 26082992 DOI: 10.1111/ejn.12992] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/08/2015] [Accepted: 06/11/2015] [Indexed: 12/21/2022]
Abstract
Chronic pain is a major complaint for up to 85% of Parkinson's disease patients; however, it often not identified as a symptom of Parkinson's disease. Adequate treatment of motor symptoms often provides analgesic effects in Parkinson's patients but how this occurs remains unclear. Studies have shown both Parkinson's patients and 6-hydroxydopamine-lesioned rats exhibit decreased sensory thresholds. In humans, some show improvements in these deficits after subthalamic deep brain stimulation, while others report no change. Differing methods of testing and response criteria may explain these varying results. We examined this effect in 6-hydroxydopamine-lesioned rats. Sprague-Dawley rats were unilaterally implanted with subthalamic stimulating electrodes in the lesioned right hemisphere and sensory thresholds were tested using von Frey, tail-flick and hot-plate tests. Tests were done during and off subthalamic stimulation at 50 and 150 Hz to assess its effects on sensory thresholds. The 6-hydroxydopamine-lesioned animals exhibited lower mechanical (left paw, P < 0.01) and thermal thresholds than shams (hot plate, P < 0.05). Both 50 and 150 Hz increased mechanical (left paw; P < 0.01) and thermal thresholds in 6-hydroxydopamine-lesioned rats (hot-plate test: 150 Hz, P < 0.05, 50 Hz, P < 0.01). Interestingly, during von Frey testing, low-frequency stimulation provided a more robust improvement in some 6OHDA lesioned rats, while in others, the magnitude of improvement on high-frequency stimulation was greater. This study shows that subthalamic deep brain stimulation improves mechanical allodynia and thermal hyperalgesia in 6-hydroxydopamine-lesioned animals at both high and low frequencies. Furthermore, we suggest considering using low-frequency stimulation when treating Parkinson's patients where pain remains the predominant complaint.
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Affiliation(s)
- Lucy E Gee
- Center for Neuroscience and Neuropharmacology, Albany Medical College, Albany, NY, USA.,Department of Neurosurgery, AMC Neurosurgery Group, Albany Medical Center, 47 New Scotland Ave, MC 10, Physicians Pavilion, 1st Floor, Albany, NY, 12208, USA
| | - Nita Chen
- Center for Neuroscience and Neuropharmacology, Albany Medical College, Albany, NY, USA
| | | | - Damian S Shin
- Center for Neuroscience and Neuropharmacology, Albany Medical College, Albany, NY, USA
| | - Julie G Pilitsis
- Center for Neuroscience and Neuropharmacology, Albany Medical College, Albany, NY, USA.,Department of Neurosurgery, AMC Neurosurgery Group, Albany Medical Center, 47 New Scotland Ave, MC 10, Physicians Pavilion, 1st Floor, Albany, NY, 12208, USA
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34
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Does the cerebellum intervene in the abnormal somatosensory temporal discrimination in Parkinson's disease? Parkinsonism Relat Disord 2015; 21:789-92. [DOI: 10.1016/j.parkreldis.2015.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 04/06/2015] [Accepted: 04/07/2015] [Indexed: 11/24/2022]
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35
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Lee HM, Koh SB. Many Faces of Parkinson's Disease: Non-Motor Symptoms of Parkinson's Disease. J Mov Disord 2015; 8:92-7. [PMID: 26090081 PMCID: PMC4460545 DOI: 10.14802/jmd.15003] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 01/28/2015] [Accepted: 02/12/2015] [Indexed: 12/21/2022] Open
Abstract
Parkinson’s disease (PD) is a multi-systemic disorder that is characterized by a combination of motor and non-motor symptoms (NMS). The dopaminergic neurodegeneration of PD is involved in the genesis of NMS, but other conditions and side effects of levodopa are also associated with NMS. NMS can develop at all stage of PD and rapid eyeball movement sleep behavior disorder (RBD), constipation, depression, and olfactory dysfunction are considered prodromal signs of PD. Many NMS related with motor deficits and cognitive dysfunction. Some NMS including olfactory dysfunction, RBD and abnormal stereopsis are associated with presence of other NMS of PD. In addition, several NMS can be helpful to differentiate between idiopathic PD and other parkinsonian disorders. Early recognition and management of NMS in PD patients is important for preserving quality of life.
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Affiliation(s)
- Hye Mi Lee
- Department of Neurology, Korea University College of Medicine at Guro Hospital, Seoul, Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University College of Medicine at Guro Hospital, Seoul, Korea
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36
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Foki T, Pirker W, Geißler A, Haubenberger D, Hilbert M, Hoellinger I, Wurnig M, Rath J, Lehrner J, Matt E, Fischmeister F, Trattnig S, Auff E, Beisteiner R. Finger dexterity deficits in Parkinson's disease and somatosensory cortical dysfunction. Parkinsonism Relat Disord 2015; 21:259-65. [DOI: 10.1016/j.parkreldis.2014.12.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/22/2014] [Accepted: 12/27/2014] [Indexed: 01/17/2023]
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37
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Doty RL, Gandhi SS, Osman A, Hurtig HI, Pawasarat I, Beals E, Chung I, Dubroff J, Newberg A, Ying GS, Leon-Sarmiento FE. Point pressure sensitivity in early stage Parkinson's disease. Physiol Behav 2014; 138:21-7. [PMID: 25447476 DOI: 10.1016/j.physbeh.2014.09.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 08/03/2014] [Accepted: 09/30/2014] [Indexed: 01/22/2023]
Abstract
A number of sensory changes occur in the earliest stages of Parkinson's disease (PD), some of which precede the expression of the classic motor phenotype by years (e.g., olfactory dysfunction). Whether point pressure sensitivity (PPS), a cutaneous measure of light touch mediated by myelinated Aβ fibers, is altered in early PD is not clear. Prior studies on this point are contradictory and are based on non-forced-choice threshold tests that confound the sensitivity measure with the response criterion. While α-synuclein pathology, a defining feature of PD, is present in the skin of PD patients, it is restricted to unmyelinated nerve fibers, suggesting PPS may be spared in this disease. We determined PPS thresholds using a state-of-the-art forced-choice staircase threshold test paradigm in 29 early stage PD patients and 29 matched controls at 11 body sites: the center of the forehead and the left and right forearms, index fingers, palms, medial soles of the feet, and plantar halluces. The patients were tested, in counterbalanced sessions, both on and off dopamine-related medications (DRMs). PPS was not influenced by PD and did not correlate with DRM l-DOPA equivalents, scores on the Unified Parkinson's Disease Rating Scale, side of the major motor disturbances, or SPECT imaging of the striatal dopamine transporter, as measured by technetium-99m TRODAT. However, PPS thresholds were lower on the left than on the right side of the body (p=0.008) and on the upper extremities relative to the toes and feet (ps<0.0001). Positive correlations were evident among the thresholds obtained across all body sectors, even though disparate regions of the body differed in terms of absolute sensitivity. This study indicates that PPS is not influenced in early stage PD regardless of whether patients are on or off DRMs.
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Affiliation(s)
- Richard L Doty
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Shifa S Gandhi
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Allen Osman
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Howard I Hurtig
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ian Pawasarat
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Evan Beals
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Inna Chung
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacob Dubroff
- Department of Radiology, Division of Nuclear Medicine and Clinical Molecular Imaging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew Newberg
- Myrna Brind Center of Integrative Medicine, Thomas Jefferson University, Philadelphia, PA USA
| | - Gui-Shang Ying
- Department of Ophthalmology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Fidias E Leon-Sarmiento
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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38
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Hubel KA, Reed B, Yund EW, Herron TJ, Woods DL. Computerized measures of finger tapping: effects of hand dominance, age, and sex. Percept Mot Skills 2014; 116:929-52. [PMID: 24175464 DOI: 10.2466/25.29.pms.116.3.929-952] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Computerized measures of digit tapping rate were obtained over 3 successive, 10-sec. periods in the right and left index fingers, from a community sample of 1,519 participants (ages 18 to 65 years; 607 men, 912 women). Differences between the dominant and non-dominant hands were found for tapping rate, movement initiation, and button down times, and the decline in tapping rate over the successive, 10-sec. periods. Declines were found in tapping rate in older participants in association with increased intertap variability. Men had higher tapping rates than women in all age ranges. The computerized finger tapping test is an efficient and precise measure of tapping speed and kinetics of potential utility in research and clinical studies of motor performance.
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Affiliation(s)
- Kerry A Hubel
- Human Cognitive Neurophysiology Laboratory, VANCHCS, Martinez, CA 94553, USA
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Hubel KA, Yund EW, Herron TJ, Woods DL. Computerized measures of finger tapping: reliability, malingering and traumatic brain injury. J Clin Exp Neuropsychol 2013; 35:745-58. [PMID: 23947782 DOI: 10.1080/13803395.2013.824070] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We analyzed computerized finger tapping metrics in four experiments. Experiment 1 showed tapping-rate differences associated with hand dominance, digits, sex, and fatigue that replicated those seen in a previous, large-scale community sample. Experiment 2 revealed test-retest correlations (r = .91) that exceeded those reported in previous tapping studies. Experiment 3 investigated subjects simulating symptoms of traumatic brain injury (TBI); 62% of malingering subjects produced abnormally slow tapping rates. A tapping-rate malingering index, based on rate-independent tapping patterns, provided confirmatory evidence of malingering in 48% of the subjects with abnormal tapping rates. Experiment 4 compared tapping in 24 patients with mild TBI (mTBI) and a matched control group; mTBI patients showed slowed tapping without evidence of malingering. Computerized finger tapping measures are reliable measures of motor speed, useful in detecting subjects performing with suboptimal effort, and are sensitive to motor abnormalities following mTBI.
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Affiliation(s)
- Kerry A Hubel
- a Human Cognitive Neurophysiology Laboratory , Martinez Clinic , Martinez , CA , USA
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Abstract
SUMMARY Apraxia is a cognitive-motor disorder affecting gestural communication and tool use, and is seen in various neurodegenerative disorders. Apraxia is a major feature of the corticobasal syndrome associated with nonlevodopa-responsive, typically asymmetric parkinsonism. Mild apraxia may also be seen in Parkinson’s disease, at least in later stages of the disease. Furthermore, patients with Alzheimer’s disease or posterior cortical atrophy are prone to develop apraxia during their disease course. However, apraxia may be difficult to dissect from other motor (e.g., dystonia and bradykinesia in corticobasal syndrome) or cognitive (e.g., dysexecutive or semantic memory deficits in Alzheimer’s disease) dysfunction. Therefore, the ecological significance of apraxia in neurodegenerative disorders may not always be obvious. Although treatment protocols for apraxia have been developed in stroke, there is little information on the management of apraxia in neurodegenerative disorders. Owing to their progressive nature, benefits from therapeutic interventions are certainly limited, although some capacity of motor learning may be preserved, at least in earlier disease stages. In advanced cases, management of apraxia should focus on compensatory measures, for instance, on adapting the patient’s environment to their needs, particularly when related to safety and comfort.
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Affiliation(s)
- Stephan Bohlhalter
- Neurology & Neurorehabilitation Center, Department of Internal Medicine, Luzerner Kantonsspital & Department of Clinical Research, University of Bern, 6000 Luzern 16, Switzerland
| | - Francois Osiurak
- Laboratoire d’Etude des Mécanismes Cognitifs (EA 3082), Université Lyon 2, Lyon, France
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Hubel KA, Reed B, Yund EW, Herron TJ, Woods DL. COMPUTERIZED MEASURES OF FINGER TAPPING: EFFECTS OF HAND DOMINANCE, AGE, AND SEX1,2. Percept Mot Skills 2013. [DOI: 10.2466/25.29.pms.116.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gorniak SL, Machado AG, Alberts JL. Force coordination during bimanual task performance in Parkinson's disease. Exp Brain Res 2013; 229:261-71. [PMID: 23811728 PMCID: PMC10103102 DOI: 10.1007/s00221-013-3608-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 06/04/2013] [Indexed: 10/26/2022]
Abstract
We investigated within- and between-hand grip-load force coordination in medically managed Parkinson's disease (PD) patients during bimanual tasks involving realistic actions. Increased grip force production and evidence of bradykinesia were expected in PD patients. Force coordination indices were also expected to be reduced in PD, due to impaired anticipatory force control. Increased grip force, bradykinesia, and abnormal load force production were exhibited in PD patients as compared to healthy controls. Indices of between-hand load force coordination, but not between-hand grip force coordination, were reduced in PD patients. Discrepancies in the strength of within-hand force coordination with respect to hand action were also noted in PD patients. Increased grip force production, in conjunction with abnormal load force production, may result in reduced fine motor control in PD patients during daily activities. Integrating quantitative analyses of realistic motor function in clinic may assist clinicians in evaluating the effectiveness of medical intervention in PD patients.
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Affiliation(s)
- Stacey L Gorniak
- Department of Health and Human Performance, University of Houston, Houston, TX 77204-6015, USA.
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Norman KE, Héroux ME. Measures of fine motor skills in people with tremor disorders: appraisal and interpretation. Front Neurol 2013; 4:50. [PMID: 23717299 PMCID: PMC3650669 DOI: 10.3389/fneur.2013.00050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 04/24/2013] [Indexed: 12/04/2022] Open
Abstract
People with Parkinson's disease, essential tremor, or other movement disorders involving tremor have changes in fine motor skills that are among the hallmarks of these diseases. Numerous measurement tools have been created and other methods devised to measure such changes in fine motor skills. Measurement tools may focus on specific features - e.g., motor skills or dexterity, slowness in movement execution associated with parkinsonian bradykinesia, or magnitude of tremor. Less obviously, some tools may be better suited than others for specific goals such as detecting subtle dysfunction early in disease, revealing aspects of brain function affected by disease, or tracking changes expected from treatment or disease progression. The purpose of this review is to describe and appraise selected measurement tools of fine motor skills appropriate for people with tremor disorders. In this context, we consider the tools' content - i.e., what movement features they focus on. In addition, we consider how measurement tools of fine motor skills relate to measures of a person's disease state or a person's function. These considerations affect how one should select and interpret the results of these tools in laboratory and clinical contexts.
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Affiliation(s)
- Kathleen E. Norman
- School of Rehabilitation Therapy, Queen’s UniversityKingston, ON, Canada
- Centre for Neuroscience Studies, Queen’s UniversityKingston, ON, Canada
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Abstract
BACKGROUND Abnormal somatosensory processing may contribute to motor impairments observed in Parkinson's disease (PD). Dopaminergic medications have been shown to alter somatosensory processing such that tactile perception is improved. In PD, it remains unclear whether the temporal sequencing of tactile stimuli is altered and if dopaminergic medications alter this perception. METHODS Somatosensory tactile perception was investigated using temporal order judgment in patients with Parkinson's disease on and off dopaminergic medications and in aged-matched healthy controls. Measures of temporal order judgment were acquired using computer controlled stimulation to digits 2 and 3 on the right hand and subjects were required to determine which stimuli occurred first. Two experimental tasks were compared, temporal order judgment without and with synchronization whereby digits 2 and 3 were vibrated synchronously in advance of the temporal order judgment sequence of stimuli. RESULTS Temporal order judgment in PD patients of and on medications were similar to controls. Temporal order judgment preceded by synchronous vibration impaired tactical acuity in controls and in PD patients off medications to similar degrees, but this perceptual impairment by synchronous vibration was not present in PD patients on medications. CONCLUSIONS These findings suggest that dopamine in PD reduces cortico-cortical connectivity with SI and this leads to changes in tactical sensitivity.
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Impaired finger dexterity in Parkinson's disease is associated with praxis function. Brain Cogn 2011; 77:48-52. [PMID: 21775040 DOI: 10.1016/j.bandc.2011.06.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 06/03/2011] [Accepted: 06/20/2011] [Indexed: 01/19/2023]
Abstract
A controversial concept suggests that impaired finger dexterity in Parkinson's disease may be related to limb kinetic apraxia that is not explained by elemental motor deficits such as bradykinesia. To explore the nature of dexterous difficulties, the aim of the present study was to assess the relationship of finger dexterity with ideomotor praxis function and parkinsonian symptoms. Twenty-five patients with Parkinson's disease participated in the study. Their left and right arms were tested independently. Testing was done in an OFF and ON state as defined by a modified version of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Finger dexterity was assessed by a coin rotation (CR) task and ideomotor praxis using a novel test of upper limb apraxia (TULIA), in which the patients were requested to imitate and pantomime 48 meaningless, as well as communicative and tool-related gestures. Coin rotation significantly correlated with TULIA irrespective of the motor state and arm involved, but not with the MDS-UPDRS. This association was significantly influenced by Hoehn and Yahr stage. The strong association of finger dexterity with praxis function but not the parkinsonian symptoms indicates that impaired finger dexterity in Parkinson's disease may be indeed apraxic in nature, yet, predominantly in advanced stages of the disease when cortical pathology is expected to develop. The findings are discussed within a cognitive-motor model of praxis function.
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