Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson's disease
Identifieur interne : 001758 ( Main/Merge ); précédent : 001757; suivant : 001759Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson's disease
Auteurs : Alberto J. Espay [États-Unis] ; Joe P. Giuffrida [États-Unis] ; Robert Chen [Canada] ; Megan Payne [États-Unis] ; Filomena Mazzella [Canada] ; Emily Dunn [États-Unis] ; Jennifer E. Vaughan [États-Unis] ; Andrew P. Duker [États-Unis] ; Alok Sahay [États-Unis] ; Sang Jin Kim [Canada] ; Fredy J. Revilla [États-Unis] ; Dustin A. Heldman [États-Unis]Source :
- Movement Disorders [ 0885-3185 ] ; 2011-12.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Dopamine Agents (administration & dosage), Drug Monitoring (statistics & numerical data), Humans, Hypokinesia (drug therapy), Hypokinesia (physiopathology), KinetiSense, Levodopa (administration & dosage), MBRS, Middle Aged, Movement (drug effects), Neurologic Examination (statistics & numerical data), Neurology (statistics & numerical data), Observer Variation, Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Parkinson's disease, UPDRS, Videotape Recording, bradykinesia.
- MESH :
- chemical , administration & dosage : Dopamine Agents, Levodopa.
- drug effects : Movement.
- drug therapy : Hypokinesia, Parkinson Disease.
- physiopathology : Hypokinesia, Parkinson Disease.
- statistics & numerical data : Drug Monitoring, Neurologic Examination, Neurology.
- Aged, Aged, 80 and over, Humans, Middle Aged, Observer Variation, Videotape Recording.
Abstract
Although movement impairment in Parkinson's disease includes slowness (bradykinesia), decreased amplitude (hypokinesia), and dysrhythmia, clinicians are instructed to rate them in a combined 0–4 severity scale using the Unified Parkinson's Disease Rating Scale motor subscale. The objective was to evaluate whether bradykinesia, hypokinesia, and dysrhythmia are associated with differential motor impairment and response to dopaminergic medications in patients with Parkinson's disease. Eighty five Parkinson's disease patients performed finger‐tapping (item 23), hand‐grasping (item 24), and pronation–supination (item 25) tasks OFF and ON medication while wearing motion sensors on the most affected hand. Speed, amplitude, and rhythm were rated using the Modified Bradykinesia Rating Scale. Quantitative variables representing speed (root mean square angular velocity), amplitude (excursion angle), and rhythm (coefficient of variation) were extracted from kinematic data. Fatigue was measured as decrements in speed and amplitude during the last 5 seconds compared with the first 5 seconds of movement. Amplitude impairments were worse and more prevalent than speed or rhythm impairments across all tasks (P < .001); however, in the ON state, speed scores improved exclusively by clinical (P < 10−6) and predominantly by quantitative (P < .05) measures. Motor scores from OFF to ON improved in subjects who were strictly bradykinetic (P < .01) and both bradykinetic and hypokinetic (P < 10−6), but not in those strictly hypokinetic. Fatigue in speed and amplitude was not improved by medication. Hypokinesia is more prevalent than bradykinesia, but dopaminergic medications predominantly improve the latter. Parkinson's disease patients may show different degrees of impairment in these movement components, which deserve separate measurement in research studies. © 2011 Movement Disorder Society
Url:
- https://api.istex.fr/document/955A6ADBAD0C30FD04ED07193D86A6CD57209F9E/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3318914
DOI: 10.1002/mds.23893
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ISTEX:955A6ADBAD0C30FD04ED07193D86A6CD57209F9ELe document en format XML
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<term>Humans</term>
<term>Hypokinesia (drug therapy)</term>
<term>Hypokinesia (physiopathology)</term>
<term>KinetiSense</term>
<term>Levodopa (administration & dosage)</term>
<term>MBRS</term>
<term>Middle Aged</term>
<term>Movement (drug effects)</term>
<term>Neurologic Examination (statistics & numerical data)</term>
<term>Neurology (statistics & numerical data)</term>
<term>Observer Variation</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson's disease</term>
<term>UPDRS</term>
<term>Videotape Recording</term>
<term>bradykinesia</term>
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<term>Levodopa</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Hypokinesia</term>
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<front><div type="abstract" xml:lang="en">Although movement impairment in Parkinson's disease includes slowness (bradykinesia), decreased amplitude (hypokinesia), and dysrhythmia, clinicians are instructed to rate them in a combined 0–4 severity scale using the Unified Parkinson's Disease Rating Scale motor subscale. The objective was to evaluate whether bradykinesia, hypokinesia, and dysrhythmia are associated with differential motor impairment and response to dopaminergic medications in patients with Parkinson's disease. Eighty five Parkinson's disease patients performed finger‐tapping (item 23), hand‐grasping (item 24), and pronation–supination (item 25) tasks OFF and ON medication while wearing motion sensors on the most affected hand. Speed, amplitude, and rhythm were rated using the Modified Bradykinesia Rating Scale. Quantitative variables representing speed (root mean square angular velocity), amplitude (excursion angle), and rhythm (coefficient of variation) were extracted from kinematic data. Fatigue was measured as decrements in speed and amplitude during the last 5 seconds compared with the first 5 seconds of movement. Amplitude impairments were worse and more prevalent than speed or rhythm impairments across all tasks (P < .001); however, in the ON state, speed scores improved exclusively by clinical (P < 10−6) and predominantly by quantitative (P < .05) measures. Motor scores from OFF to ON improved in subjects who were strictly bradykinetic (P < .01) and both bradykinetic and hypokinetic (P < 10−6), but not in those strictly hypokinetic. Fatigue in speed and amplitude was not improved by medication. Hypokinesia is more prevalent than bradykinesia, but dopaminergic medications predominantly improve the latter. Parkinson's disease patients may show different degrees of impairment in these movement components, which deserve separate measurement in research studies. © 2011 Movement Disorder Society</div>
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<author><name sortKey="Vaughan, Jennifer E" sort="Vaughan, Jennifer E" uniqKey="Vaughan J" first="Jennifer E." last="Vaughan">Jennifer E. Vaughan</name>
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<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Duker, Andrew P" sort="Duker, Andrew P" uniqKey="Duker A" first="Andrew P." last="Duker">Andrew P. Duker</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sahay, Alok" sort="Sahay, Alok" uniqKey="Sahay A" first="Alok" last="Sahay">Alok Sahay</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kim, Sang Jin" sort="Kim, Sang Jin" uniqKey="Kim S" first="Sang Jin" last="Kim">Sang Jin Kim</name>
<affiliation wicri:level="4"><country xml:lang="fr">Canada</country>
<wicri:regionArea>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Revilla, Fredy J" sort="Revilla, Fredy J" uniqKey="Revilla F" first="Fredy J." last="Revilla">Fredy J. Revilla</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Heldman, Dustin A" sort="Heldman, Dustin A" uniqKey="Heldman D" first="Dustin A." last="Heldman">Dustin A. Heldman</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series><title level="j">Movement Disorders</title>
<title level="j" type="abbrev">Mov. Disord.</title>
<idno type="ISSN">0885-3185</idno>
<idno type="eISSN">1531-8257</idno>
<imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher>
<pubPlace>Hoboken</pubPlace>
<date type="published" when="2011-12">2011-12</date>
<biblScope unit="vol">26</biblScope>
<biblScope unit="issue">14</biblScope>
<biblScope unit="page" from="2504">2504</biblScope>
<biblScope unit="page" to="2508">2508</biblScope>
</imprint>
<idno type="ISSN">0885-3185</idno>
</series>
<idno type="istex">955A6ADBAD0C30FD04ED07193D86A6CD57209F9E</idno>
<idno type="DOI">10.1002/mds.23893</idno>
<idno type="ArticleID">MDS23893</idno>
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</seriesStmt>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>KinetiSense</term>
<term>MBRS</term>
<term>Parkinson's disease</term>
<term>UPDRS</term>
<term>bradykinesia</term>
</keywords>
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<langUsage><language ident="en">en</language>
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<front><div type="abstract" xml:lang="en">Although movement impairment in Parkinson's disease includes slowness (bradykinesia), decreased amplitude (hypokinesia), and dysrhythmia, clinicians are instructed to rate them in a combined 0–4 severity scale using the Unified Parkinson's Disease Rating Scale motor subscale. The objective was to evaluate whether bradykinesia, hypokinesia, and dysrhythmia are associated with differential motor impairment and response to dopaminergic medications in patients with Parkinson's disease. Eighty five Parkinson's disease patients performed finger‐tapping (item 23), hand‐grasping (item 24), and pronation–supination (item 25) tasks OFF and ON medication while wearing motion sensors on the most affected hand. Speed, amplitude, and rhythm were rated using the Modified Bradykinesia Rating Scale. Quantitative variables representing speed (root mean square angular velocity), amplitude (excursion angle), and rhythm (coefficient of variation) were extracted from kinematic data. Fatigue was measured as decrements in speed and amplitude during the last 5 seconds compared with the first 5 seconds of movement. Amplitude impairments were worse and more prevalent than speed or rhythm impairments across all tasks (P < .001); however, in the ON state, speed scores improved exclusively by clinical (P < 10−6) and predominantly by quantitative (P < .05) measures. Motor scores from OFF to ON improved in subjects who were strictly bradykinetic (P < .01) and both bradykinetic and hypokinetic (P < 10−6), but not in those strictly hypokinetic. Fatigue in speed and amplitude was not improved by medication. Hypokinesia is more prevalent than bradykinesia, but dopaminergic medications predominantly improve the latter. Parkinson's disease patients may show different degrees of impairment in these movement components, which deserve separate measurement in research studies. © 2011 Movement Disorder Society</div>
</front>
</TEI>
</ISTEX>
<PMC><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Differential Response of Speed, Amplitude, and Rhythm to Dopaminergic Medications in Parkinson’s Disease</title>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Giuffrida, Joe P" sort="Giuffrida, Joe P" uniqKey="Giuffrida J" first="Joe P." last="Giuffrida">Joe P. Giuffrida</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name>
<affiliation wicri:level="4"><nlm:aff id="A3">Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Payne, Megan" sort="Payne, Megan" uniqKey="Payne M" first="Megan" last="Payne">Megan Payne</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mazzella, Filomena" sort="Mazzella, Filomena" uniqKey="Mazzella F" first="Filomena" last="Mazzella">Filomena Mazzella</name>
<affiliation wicri:level="4"><nlm:aff id="A3">Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Dunn, Emily" sort="Dunn, Emily" uniqKey="Dunn E" first="Emily" last="Dunn">Emily Dunn</name>
<affiliation wicri:level="2"><nlm:aff id="A1">UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Vaughan, Jennifer E" sort="Vaughan, Jennifer E" uniqKey="Vaughan J" first="Jennifer E." last="Vaughan">Jennifer E. Vaughan</name>
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<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Duker, Andrew P" sort="Duker, Andrew P" uniqKey="Duker A" first="Andrew P." last="Duker">Andrew P. Duker</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sahay, Alok" sort="Sahay, Alok" uniqKey="Sahay A" first="Alok" last="Sahay">Alok Sahay</name>
<affiliation wicri:level="2"><nlm:aff id="A1">UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kim, Sang Jin" sort="Kim, Sang Jin" uniqKey="Kim S" first="Sang Jin" last="Kim">Sang Jin Kim</name>
<affiliation wicri:level="4"><nlm:aff id="A3">Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Revilla, Fredy J" sort="Revilla, Fredy J" uniqKey="Revilla F" first="Fredy J." last="Revilla">Fredy J. Revilla</name>
<affiliation wicri:level="2"><nlm:aff id="A1">UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Heldman, Dustin A" sort="Heldman, Dustin A" uniqKey="Heldman D" first="Dustin A." last="Heldman">Dustin A. Heldman</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
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<idno type="pmid">21953789</idno>
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<idno type="wicri:Area/PubMed/Corpus">001029</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Differential Response of Speed, Amplitude, and Rhythm to Dopaminergic Medications in Parkinson’s Disease</title>
<author><name sortKey="Espay, Alberto J" sort="Espay, Alberto J" uniqKey="Espay A" first="Alberto J." last="Espay">Alberto J. Espay</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Giuffrida, Joe P" sort="Giuffrida, Joe P" uniqKey="Giuffrida J" first="Joe P." last="Giuffrida">Joe P. Giuffrida</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name>
<affiliation wicri:level="4"><nlm:aff id="A3">Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Payne, Megan" sort="Payne, Megan" uniqKey="Payne M" first="Megan" last="Payne">Megan Payne</name>
<affiliation wicri:level="2"><nlm:aff id="A1">UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mazzella, Filomena" sort="Mazzella, Filomena" uniqKey="Mazzella F" first="Filomena" last="Mazzella">Filomena Mazzella</name>
<affiliation wicri:level="4"><nlm:aff id="A3">Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Dunn, Emily" sort="Dunn, Emily" uniqKey="Dunn E" first="Emily" last="Dunn">Emily Dunn</name>
<affiliation wicri:level="2"><nlm:aff id="A1">UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Vaughan, Jennifer E" sort="Vaughan, Jennifer E" uniqKey="Vaughan J" first="Jennifer E." last="Vaughan">Jennifer E. Vaughan</name>
<affiliation wicri:level="2"><nlm:aff id="A1">UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Duker, Andrew P" sort="Duker, Andrew P" uniqKey="Duker A" first="Andrew P." last="Duker">Andrew P. Duker</name>
<affiliation wicri:level="2"><nlm:aff id="A1">UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sahay, Alok" sort="Sahay, Alok" uniqKey="Sahay A" first="Alok" last="Sahay">Alok Sahay</name>
<affiliation wicri:level="2"><nlm:aff id="A1">UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kim, Sang Jin" sort="Kim, Sang Jin" uniqKey="Kim S" first="Sang Jin" last="Kim">Sang Jin Kim</name>
<affiliation wicri:level="4"><nlm:aff id="A3">Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Revilla, Fredy J" sort="Revilla, Fredy J" uniqKey="Revilla F" first="Fredy J." last="Revilla">Fredy J. Revilla</name>
<affiliation wicri:level="2"><nlm:aff id="A1">UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Heldman, Dustin A" sort="Heldman, Dustin A" uniqKey="Heldman D" first="Dustin A." last="Heldman">Dustin A. Heldman</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Movement Disorders</title>
<idno type="ISSN">0885-3185</idno>
<idno type="eISSN">1531-8257</idno>
<imprint><date when="2011">2011</date>
</imprint>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Dopamine Agents (administration & dosage)</term>
<term>Drug Monitoring (statistics & numerical data)</term>
<term>Humans</term>
<term>Hypokinesia (drug therapy)</term>
<term>Hypokinesia (physiopathology)</term>
<term>Levodopa (administration & dosage)</term>
<term>Middle Aged</term>
<term>Movement (drug effects)</term>
<term>Neurologic Examination (statistics & numerical data)</term>
<term>Neurology (statistics & numerical data)</term>
<term>Observer Variation</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Videotape Recording</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Dopamine Agents</term>
<term>Levodopa</term>
</keywords>
<keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Movement</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Hypokinesia</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Hypokinesia</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Drug Monitoring</term>
<term>Neurologic Examination</term>
<term>Neurology</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Humans</term>
<term>Middle Aged</term>
<term>Observer Variation</term>
<term>Videotape Recording</term>
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<front><div type="abstract" xml:lang="en"><p id="P1">Although movement impairment in Parkinson’s disease includes slowness (bradykinesia), decreased amplitude (hypokinesia), and dysrhythmia, clinicians are instructed to rate them in a combined 0–4 severity scale using the Unified Parkinson’s Disease Rating Scale motor subscale. The objective was to evaluate whether bradykinesia, hypokinesia, and dysrhythmia are associated with differential motor impairment and response to dopaminergic medications in patients with Parkinson’s disease. Eighty five Parkinson’s disease patients performed finger-tapping (item 23), hand-grasping (item 24), and pronation–supination (item 25) tasks OFF and ON medication while wearing motion sensors on the most affected hand. Speed, amplitude, and rhythm were rated using the Modified Bradykinesia Rating Scale. Quantitative variables representing speed (root mean square angular velocity), amplitude (excursion angle), and rhythm (coefficient of variation) were extracted from kinematic data. Fatigue was measured as decrements in speed and amplitude during the last 5 seconds compared with the first 5 seconds of movement. Amplitude impairments were worse and more prevalent than speed or rhythm impairments across all tasks (<italic>P</italic>
< .001); however, in the ON state, speed scores improved exclusively by clinical (<italic>P</italic>
< 10<sup>−6</sup>
) and predominantly by quantitative (<italic>P</italic>
< .05) measures. Motor scores from OFF to ON improved in subjects who were strictly bradykinetic (<italic>P</italic>
< .01) and both bradykinetic and hypokinetic (<italic>P</italic>
< 10<sup>−6</sup>
), but not in those strictly hypokinetic. Fatigue in speed and amplitude was not improved by medication. Hypokinesia is more prevalent than bradykinesia, but dopaminergic medications predominantly improve the latter. Parkinson’s disease patients may show different degrees of impairment in these movement components, which deserve separate measurement in research studies.</p>
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