Abstract
Movement amplitude setting is affected early in Parkinson’s disease (PD), clinically manifesting as bradykinesia. Our objective was to determine if amplitude setting of upper limb bimanual movements and bipedal gait are similarly modulated in PD. 27 PD and 24 control participants were enrolled. Participants performed a bimanual anti-phase finger tapping task wearing gloves with joint angular sensors, and an instrumented gait assessment. Participants performed normal and fast paced assessments to vary motor load. PD participants were evaluated OFF (PD-OFF) and ON (PD-ON) levodopa. PD-OFF participants had smaller tap amplitude, and greater tap amplitude variability than controls in the more affected hands (all p < 0.05). Tap amplitude and stride length (p = 0.030) were correlated in PD-OFF. Tap amplitude was also correlated with motor UPDRS (p < 0.005) and bradykinesia motor (p < 0.05) and ADL (p < 0.005) UPDRS subscores. The relative amount of improvement in tap amplitude and stride length with levodopa was correlated. In PD, upper limb and gait amplitude setting are similarly scaled with motor demand and dopamine supplementation. This suggests these automated motor functions are subserved by common functional networks.
Highlights
Movement amplitude setting is affected early in Parkinson’s disease (PD), clinically manifesting as bradykinesia
Age was well matched between the PD and control groups (PD 69.3 ± 8.4 years, controls 66.5 ± 8.1 years, p = 0.228) but the gender distribution was opposite in the two groups (PD 29.6% female, controls 66.7% female, p = 0.008) as most controls were spouses of the PD participants (Table 1)
PD participants had a mean baseline Montreal Cognitive Assessment (MoCA) score that was two points lower than controls (PD 26.1 ± 3.4, controls 28.0 ± 1.7, p = 0.013) the mean score in both cases remained in the normal range for the test (≥ 26) (Table 1)
Summary
Movement amplitude setting is affected early in Parkinson’s disease (PD), clinically manifesting as bradykinesia. Parkinson’s disease affects motor function in the limbs and gait, but studies comparing unconstrained upper and lower limb function in the same participants are limited This is necessary to determine whether amplitude setting in both limbs is affected by disease and modulated by dopamine. In early PD participants, Delval and c olleagues[14] constrained finger and foot tapping movements to set metronome frequencies, but not gait speed, and found limb freezing and festination episodes before gait freezing in some participants, suggesting a break down in repetitive movements before more complex movements such as gait Both these studies were performed OFF-levodopa, and since dopamine supplementation improves some but not all motor features of P D15, determining whether. The direct kinematic relationships between finger tapping, foot tapping, and gait were not explored in these studies
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