The Association Between Clinical Characteristics and Motor Symptom Laterality in Patients With Parkinson's Disease.

Sha Zhu,Ruxin Gu,Jingde Dong,Jun Yan,Yu Bai,Bo Shen,Jun Zhu,Li Zhang,Pingyi Xu,Min Zhong,Xu Jiang,Zhuang Wu,Yang Pan

doi:10.3389/fneur.2021.663232

Abstract

Background and Purpose: The unilateral onset and persistent asymmetry of motor symptoms are important characteristics of Parkinson's disease (PD). By using scales and wearable sensors, this study explored whether motor symptom laterality could affect non-motor symptom and gait performance.Methods: A total of 130 right-handed patients with PD were enrolled in our study and were divided into two groups according to the side of predominant motor symptom presentation by using the Unified Parkinson's Disease Rating Scale part III. We measured the non-motor symptoms with the Non-motor symptoms Scale, sleep quality with the Parkinson's Disease Sleep Scale and Pittsburgh sleep quality index, cognitive function with the Mini-mental State Examination and Montreal Cognitive Assessment, quality of life with the Parkinson's Disease Questionnaire-39, and the severity of anxiety and depression with the Hamilton Anxiety Scale and Hamilton Depression Scale, respectively. All participants underwent the instrumented stand and walk test, and gait data were collected using a set of JiBuEn gait analysis system.Results: We observed that left-dominant symptom PD patients (LPD) were associated with a greater impairment of sleep quality than right-dominant symptom PD patients (RPD). We found no difference between LPD and RPD in terms of gait performance. However, compared with the severe asymmetry RPD patients (RPD-S), severe asymmetry LPD patients (LPD-S) showed a shorter stride length and decreased range of motion of hip joints.Conclusions: In this study, LPD was associated with a more severe sleep-related dysfunction than RPD. In addition, LPD-S exhibited more gait impairments than RPD-S. Considering that motor symptom laterality may affect the non-motor symptom and gait performance, it should be taken into account when evaluating and treating PD patients.

Highlights

Parkinson’s disease (PD) is a common neurodegenerative disease, which is mainly characterized by movement disorders, including bradykinesia, resting tremor, rigidity, and postural instability [1]
White matter integrity has remarkably changed in right-dominant symptom PD patients (RPD), but not in left-dominant symptom PD patients (LPD), indicating that LPD may be related to a better prognosis than RPD [7]
To measure the degree of clinical laterality, we employed the following two groups [14]: [1] mild right asymmetry defined as the total score of right bradykinesia, tremor, and rigidity divided by the left side total score >1 and

Summary

Introduction

Parkinson’s disease (PD) is a common neurodegenerative disease, which is mainly characterized by movement disorders, including bradykinesia, resting tremor, rigidity, and postural instability [1]. The UPDRS III score is a widely used clinical examination to evaluate motor function in PD, it only partially reflects the motor function in daily life and suffers from intra- and inter-rater reliability [8, 9]. It is very limited for quantitative information on gait impairment. This study aimed to explore the effect of motor symptom laterality on gait characteristics of PD patients by using wearable devices and assessing patients’ non-motor symptoms. The unilateral onset and persistent asymmetry of motor symptoms are important characteristics of Parkinson’s disease (PD). By using scales and wearable sensors, this study explored whether motor symptom laterality could affect non-motor symptom and gait performance

Objectives

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Results

Conclusion