Poor dopaminergic response of impaired dexterity in Parkinson's disease: Bradykinesia or limb kinetic apraxia?
Identifieur interne : 000D06 ( Main/Exploration ); précédent : 000D05; suivant : 000D07Poor dopaminergic response of impaired dexterity in Parkinson's disease: Bradykinesia or limb kinetic apraxia?
Auteurs : Andreas Gebhardt [Suisse] ; Tim Vanbellingen [Suisse] ; Fabio Baronti [Suisse] ; Bernd Kersten [Suisse] ; Stephan Bohlhalter [Suisse]Source :
- Movement Disorders [ 0885-3185 ] ; 2008-09-15.
English descriptors
Abstract
Patients with Parkinson's disease (PD) often show impaired manual dexterity even when being only minimally bradykinetic, suggesting that they may have limb kinetic apraxia (LKA), that is, a loss of fine motor skill not explained by elemental motor deficits. To explore this dissociation, we investigated the differential dopaminergic responsiveness of dexterity and bradykinesia in PD. Twelve patients with PD (4 women, age 64.4 ± 8.3, mean + SD) and 12 matched healthy controls (64.8 ± 8.9) were tested twice in ON vs. OFF and 1st vs. 2nd trial, respectively. A coin rotation (CR) task was applied to assess dexterity and a finger tapping (FT) task to assess bradykinesia. Performance was followed by video recording and analyzed by measuring the frequency of CR and FT during three 10‐second periods. Statistical analysis was done by a mixed factorial design with group (PD vs. controls) as between‐subject factor and medication (ON‐ vs. OFF‐state or 1st vs. 2nd trial), task (FT vs. CR), and handedness (dominant vs. nondominant) as within‐subject factors. In patients with PD, regardless of hand involved, dopaminergic treatment only mildly improved CR performance, in contrast to the strong increase in FT scores (up to the level of controls), as demonstrated by the significant triple interaction of the factors group, medication, and task (F1,22 = 7.9, P = 0.01; η2 = 0.26). Furthermore, CR scores were considerably lower, both in OFF and ON, than in normal controls, pointing to a substantial impairment of dexterity in PD (P < 0.001). In conclusion, impaired manual dexterity showing significantly diminished response to dopaminergic treatment suggests that dextrous deficits in PD are related to LKA rather than bradykinesia. © 2008 Movement Disorder Society
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DOI: 10.1002/mds.22199
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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="2008-09-15">2008-09-15</date><biblScope unit="volume">23</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1701">1701</biblScope><biblScope unit="page" to="1706">1706</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">55A59F1DCBC1FB3B940A337E8C9583B0AC35B191</idno><idno type="DOI">10.1002/mds.22199</idno><idno type="ArticleID">MDS22199</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>coin rotation</term><term>finger tapping</term><term>limb kinetic apraxia</term><term>premotor cortex</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Patients with Parkinson's disease (PD) often show impaired manual dexterity even when being only minimally bradykinetic, suggesting that they may have limb kinetic apraxia (LKA), that is, a loss of fine motor skill not explained by elemental motor deficits. To explore this dissociation, we investigated the differential dopaminergic responsiveness of dexterity and bradykinesia in PD. Twelve patients with PD (4 women, age 64.4 ± 8.3, mean + SD) and 12 matched healthy controls (64.8 ± 8.9) were tested twice in ON vs. OFF and 1st vs. 2nd trial, respectively. A coin rotation (CR) task was applied to assess dexterity and a finger tapping (FT) task to assess bradykinesia. Performance was followed by video recording and analyzed by measuring the frequency of CR and FT during three 10‐second periods. Statistical analysis was done by a mixed factorial design with group (PD vs. controls) as between‐subject factor and medication (ON‐ vs. OFF‐state or 1st vs. 2nd trial), task (FT vs. CR), and handedness (dominant vs. nondominant) as within‐subject factors. In patients with PD, regardless of hand involved, dopaminergic treatment only mildly improved CR performance, in contrast to the strong increase in FT scores (up to the level of controls), as demonstrated by the significant triple interaction of the factors group, medication, and task (F1,22 = 7.9, P = 0.01; η2 = 0.26). Furthermore, CR scores were considerably lower, both in OFF and ON, than in normal controls, pointing to a substantial impairment of dexterity in PD (P < 0.001). In conclusion, impaired manual dexterity showing significantly diminished response to dopaminergic treatment suggests that dextrous deficits in PD are related to LKA rather than bradykinesia. © 2008 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Suisse</li></country><region><li>Canton de Berne</li></region><settlement><li>Berne</li></settlement><orgName><li>Université de Berne</li></orgName></list><tree><country name="Suisse"><noRegion><name sortKey="Gebhardt, Andreas" sort="Gebhardt, Andreas" uniqKey="Gebhardt A" first="Andreas" last="Gebhardt">Andreas Gebhardt</name></noRegion><name sortKey="Baronti, Fabio" sort="Baronti, Fabio" uniqKey="Baronti F" first="Fabio" last="Baronti">Fabio Baronti</name><name sortKey="Bohlhalter, Stephan" sort="Bohlhalter, Stephan" uniqKey="Bohlhalter S" first="Stephan" last="Bohlhalter">Stephan Bohlhalter</name><name sortKey="Kersten, Bernd" sort="Kersten, Bernd" uniqKey="Kersten B" first="Bernd" last="Kersten">Bernd Kersten</name><name sortKey="Vanbellingen, Tim" sort="Vanbellingen, Tim" uniqKey="Vanbellingen T" first="Tim" last="Vanbellingen">Tim Vanbellingen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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