Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson's disease
Identifieur interne : 002D55 ( Main/Corpus ); précédent : 002D54; suivant : 002D56Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson's disease
Auteurs : Alberto J. Espay ; Joe P. Giuffrida ; Robert Chen ; Megan Payne ; Filomena Mazzella ; Emily Dunn ; Jennifer E. Vaughan ; Andrew P. Duker ; Alok Sahay ; Sang Jin Kim ; Fredy J. Revilla ; Dustin A. HeldmanSource :
- Movement Disorders [ 0885-3185 ] ; 2011-12.
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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
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DOI: 10.1002/mds.23893
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Duker</name><affiliation><mods:affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</mods:affiliation></affiliation></author><author><name sortKey="Sahay, Alok" sort="Sahay, Alok" uniqKey="Sahay A" first="Alok" last="Sahay">Alok Sahay</name><affiliation><mods:affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</mods:affiliation></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><mods:affiliation>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</mods:affiliation></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><mods:affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</mods:affiliation></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><mods:affiliation>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. 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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><corpusName>wiley</corpusName><author><json:item><name>Alberto J. Espay MD, MSc</name><affiliations><json:string>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</json:string></affiliations></json:item><json:item><name>Joe P. Giuffrida PhD</name><affiliations><json:string>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio, USA</json:string></affiliations></json:item><json:item><name>Robert Chen MBBChir, MSc, FRCPC</name><affiliations><json:string>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</json:string></affiliations></json:item><json:item><name>Megan Payne MS, MBA</name><affiliations><json:string>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</json:string></affiliations></json:item><json:item><name>Filomena Mazzella BScN, RN</name><affiliations><json:string>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</json:string></affiliations></json:item><json:item><name>Emily Dunn</name><affiliations><json:string>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</json:string></affiliations></json:item><json:item><name>Jennifer E. 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Duker MD</name><affiliations><json:string>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</json:string></affiliations></json:item><json:item><name>Alok Sahay MD</name><affiliations><json:string>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</json:string></affiliations></json:item><json:item><name>Sang Jin Kim MD</name><affiliations><json:string>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</json:string></affiliations></json:item><json:item><name>Fredy J. 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Heldman PhD</name><affiliations><json:string>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>bradykinesia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>UPDRS</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MBRS</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>KinetiSense</value></json:item></subject><articleId><json:string>MDS23893</json:string></articleId><language><json:string>eng</json:string></language><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</abstract><qualityIndicators><score>5.667</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>1900</abstractCharCount><pdfWordCount>2667</pdfWordCount><pdfCharCount>17547</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>265</abstractWordCount></qualityIndicators><title>Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson's disease</title><genre><json:string>article</json:string></genre><host><volume>26</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>5</total><last>2508</last><first>2504</first></pages><issn><json:string>0885-3185</json:string></issn><issue>14</issue><subject><json:item><value>Research 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uri="https://api.istex.fr/document/955A6ADBAD0C30FD04ED07193D86A6CD57209F9E/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2011</date></publicationStmt><notesStmt><note type="content">*Funding agencies: This study was supported by the Davis Phinney Foundation for Parkinson's Disease and NIH/NINDS 7R43NS065554‐03.</note><note type="content">*Relevant conflicts of interest/financial disclosures: The Davis Phinney Foundation for Parkinson's Disease provided unrestricted support and had no role in the oversight or review of the research data or reporting.</note><note type="content">*Full financial disclosures and author roles may be found in the online version of this article.</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson's disease</title><author><persName><forename type="first">Alberto J.</forename><surname>Espay</surname></persName><roleName type="degree">MD, MSc</roleName><note type="correspondence"><p>Correspondence: Department of Neurology, University of Cincinnati, 260 Stetson St., Suite 2300 (PO Box 670525), Cincinnati, OH 45267‐0525, USA</p></note><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation></author><author><persName><forename type="first">Joe P.</forename><surname>Giuffrida</surname></persName><roleName type="degree">PhD</roleName><affiliation>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio, USA</affiliation></author><author><persName><forename type="first">Robert</forename><surname>Chen</surname></persName><roleName type="degree">MBBChir, MSc, FRCPC</roleName><affiliation>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</affiliation></author><author><persName><forename type="first">Megan</forename><surname>Payne</surname></persName><roleName type="degree">MS, MBA</roleName><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation></author><author><persName><forename type="first">Filomena</forename><surname>Mazzella</surname></persName><roleName type="degree">BScN, RN</roleName><affiliation>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</affiliation></author><author><persName><forename type="first">Emily</forename><surname>Dunn</surname></persName><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation></author><author><persName><forename type="first">Jennifer E.</forename><surname>Vaughan</surname></persName><roleName type="degree">BPhil</roleName><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation></author><author><persName><forename type="first">Andrew P.</forename><surname>Duker</surname></persName><roleName type="degree">MD</roleName><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation></author><author><persName><forename type="first">Alok</forename><surname>Sahay</surname></persName><roleName type="degree">MD</roleName><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation></author><author><persName><forename type="first">Sang Jin</forename><surname>Kim</surname></persName><roleName type="degree">MD</roleName><affiliation>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</affiliation></author><author><persName><forename type="first">Fredy J.</forename><surname>Revilla</surname></persName><roleName type="degree">MD</roleName><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation></author><author><persName><forename type="first">Dustin A.</forename><surname>Heldman</surname></persName><roleName type="degree">PhD</roleName><affiliation>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio, USA</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-12"></date><biblScope unit="volume">26</biblScope><biblScope unit="issue">14</biblScope><biblScope unit="page" from="2504">2504</biblScope><biblScope unit="page" to="2508">2508</biblScope></imprint></monogr><idno type="istex">955A6ADBAD0C30FD04ED07193D86A6CD57209F9E</idno><idno type="DOI">10.1002/mds.23893</idno><idno type="ArticleID">MDS23893</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2011</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>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</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>bradykinesia</term></item><item><term>UPDRS</term></item><item><term>MBRS</term></item><item><term>KinetiSense</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2011-04-08">Received</change><change when="2011-07-05">Registration</change><change when="2011-12">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/955A6ADBAD0C30FD04ED07193D86A6CD57209F9E/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="140"><doi origin="wiley" registered="yes">10.1002/mds.v26.14</doi><numberingGroup><numbering type="journalVolume" number="26">26</numbering><numbering type="journalIssue">14</numbering></numberingGroup><coverDate startDate="2011-12">December 2011</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="160" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.23893</doi><idGroup><id type="unit" value="MDS23893"></id></idGroup><countGroup><count type="pageTotal" number="5"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2011 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2011-04-08"></event><event type="manuscriptRevised" date="2011-06-02"></event><event type="manuscriptAccepted" date="2011-07-05"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:3.0.1 mode:FullText" date="2012-01-13"></event><event type="publishedOnlineEarlyUnpaginated" date="2011-09-23"></event><event type="publishedOnlineFinalForm" date="2011-12-14"></event><event type="firstOnline" date="2011-09-23"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">2504</numbering><numbering type="pageLast">2508</numbering></numberingGroup><correspondenceTo>Department of Neurology, University of Cincinnati, 260 Stetson St., Suite 2300 (PO Box 670525), Cincinnati, OH 45267‐0525, USA</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS23893.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="4"></count><count type="tableTotal" number="0"></count><count type="referenceTotal" number="14"></count><count type="wordTotal" number="4085"></count></countGroup><titleGroup><title type="main" xml:lang="en">Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson's disease<link href="#fn1"></link><link href="#fn2"></link><link href="#fn3"></link></title><title type="short" xml:lang="en">Bradykinesia in PD</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Alberto J.</givenNames><familyName>Espay</familyName><degrees>MD, MSc</degrees></personName><contactDetails><email>alberto.espay@uc.edu</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Joe P.</givenNames><familyName>Giuffrida</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Robert</givenNames><familyName>Chen</familyName><degrees>MBBChir, MSc, FRCPC</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Megan</givenNames><familyName>Payne</familyName><degrees>MS, MBA</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Filomena</givenNames><familyName>Mazzella</familyName><degrees>BScN, RN</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Emily</givenNames><familyName>Dunn</familyName></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Jennifer E.</givenNames><familyName>Vaughan</familyName><degrees>BPhil</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Andrew P.</givenNames><familyName>Duker</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Alok</givenNames><familyName>Sahay</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Sang Jin</givenNames><familyName>Kim</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au11" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Fredy J.</givenNames><familyName>Revilla</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au12" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Dustin A.</givenNames><familyName>Heldman</familyName><degrees>PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio, USA</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="CA" type="organization"><unparsedAffiliation>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">bradykinesia</keyword><keyword xml:id="kwd3">UPDRS</keyword><keyword xml:id="kwd4">MBRS</keyword><keyword xml:id="kwd5">KinetiSense</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>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 (<i>P</i> < .001); however, in the ON state, speed scores improved exclusively by clinical (<i>P</i> < 10<sup>−6</sup>) and predominantly by quantitative (<i>P</i> < .05) measures. Motor scores from OFF to ON improved in subjects who were strictly bradykinetic (<i>P</i> < .01) and both bradykinetic and hypokinetic (<i>P</i> < 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. © 2011 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p><b>Funding agencies:</b> This study was supported by the Davis Phinney Foundation for Parkinson's Disease and NIH/NINDS 7R43NS065554‐03.</p></note><note xml:id="fn2"><p><b>Relevant conflicts of interest/financial disclosures:</b> The Davis Phinney Foundation for Parkinson's Disease provided unrestricted support and had no role in the oversight or review of the research data or reporting.</p></note><note xml:id="fn3"><p>Full financial disclosures and author roles may be found in the online version of this article.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Bradykinesia in PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Alberto J.</namePart><namePart type="family">Espay</namePart><namePart type="termsOfAddress">MD, MSc</namePart><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation><description>Correspondence: Department of Neurology, University of Cincinnati, 260 Stetson St., Suite 2300 (PO Box 670525), Cincinnati, OH 45267‐0525, USA</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Joe P.</namePart><namePart type="family">Giuffrida</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Robert</namePart><namePart type="family">Chen</namePart><namePart type="termsOfAddress">MBBChir, MSc, FRCPC</namePart><affiliation>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Megan</namePart><namePart type="family">Payne</namePart><namePart type="termsOfAddress">MS, MBA</namePart><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Filomena</namePart><namePart type="family">Mazzella</namePart><namePart type="termsOfAddress">BScN, RN</namePart><affiliation>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Emily</namePart><namePart type="family">Dunn</namePart><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jennifer E.</namePart><namePart type="family">Vaughan</namePart><namePart type="termsOfAddress">BPhil</namePart><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Andrew P.</namePart><namePart type="family">Duker</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alok</namePart><namePart type="family">Sahay</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sang Jin</namePart><namePart type="family">Kim</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Fredy J.</namePart><namePart type="family">Revilla</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Dustin A.</namePart><namePart type="family">Heldman</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Division of Movement Disorders, Great Lakes NeuroTechnologies Inc., Cleveland, Ohio, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2011-12</dateIssued><dateCaptured encoding="w3cdtf">2011-04-08</dateCaptured><dateValid encoding="w3cdtf">2011-07-05</dateValid><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">4</extent><extent unit="references">14</extent><extent unit="words">4085</extent></physicalDescription><abstract 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</abstract><note type="content">*Funding agencies: This study was supported by the Davis Phinney Foundation for Parkinson's Disease and NIH/NINDS 7R43NS065554‐03.</note><note type="content">*Relevant conflicts of interest/financial disclosures: The Davis Phinney Foundation for Parkinson's Disease provided unrestricted support and had no role in the oversight or review of the research data or reporting.</note><note type="content">*Full financial disclosures and author roles may be found in the online version of this article.</note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>bradykinesia</topic><topic>UPDRS</topic><topic>MBRS</topic><topic>KinetiSense</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>26</number></detail><detail type="issue"><caption>no.</caption><number>14</number></detail><extent unit="pages"><start>2504</start><end>2508</end><total>5</total></extent></part></relatedItem><identifier type="istex">955A6ADBAD0C30FD04ED07193D86A6CD57209F9E</identifier><identifier type="DOI">10.1002/mds.23893</identifier><identifier type="ArticleID">MDS23893</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2011 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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