Obstacle circumvention and eye coordination during walking to least and most affected side in people with Parkinson’s disease

Abstract Background Non-immersive video games are currently being used as technological rehabilitation tools for individuals with Parkinson’s disease (PD). The aim of this feasibility study was to evaluate the effectiveness of the Leap Motion Controller® (LMC) system used with serious games designed for the upper limb (UL), as well as the levels of satisfaction and compliance among patients in mild-to-moderate stages of the disease. Methods A non-probabilistic sampling of non-consecutive cases was performed. 23 PD patients, in stages II-IV of the Hoehn & Yahr scale, were randomized into two groups: an experimental group (n = 12) who received treatment based on serious games designed by the research team using the LMC system for the UL, and a control group (n = 11) who received a specific intervention for the UL. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, as well as satisfaction and compliance, were assessed in both groups pre-treatment and post-treatment. Results Within the experimental group, significant improvements were observed in all post-treatment assessments, except for Box and Blocks test for the less affected side. Clinical improvements were observed for all assessments in the control group. Statistical intergroup analysis showed significant improvements in coordination, speed of movements and fine motor dexterity scores on the more affected side of patients in the experimental group. Conclusions The LMC system and the serious games designed may be a feasible rehabilitation tool for the improvement of coordination, speed of movements and fine UL dexterity in PD patients. Further studies are needed to confirm these preliminary findings.

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V92 Acceleration of syllable repetition in Parkinson’s disease depends on the more affected side – Evidence for a differential role of the basal ganglia in motor speech performance?

Basal Ganglia ◽

10.1016/j.baga.2011.01.012 ◽

2011 ◽

Vol 1 (1) ◽

pp. 16

Author(s):

A. Flasskamp ◽

U. Schlegel ◽

S. Skodda

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Basal Ganglia ◽

Motor Speech ◽

Affected Side ◽

Syllable Repetition ◽

Speech Performance

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Decreased Dopamine Transporter Binding Ipsilateral to the Clinically More Affected Side in Parkinson's disease: Which Side to Take?

Journal of Neurology & Neurophysiology ◽

10.4172/2155-9562.1000361 ◽

2016 ◽

Vol 07 (02) ◽

Author(s):

Nurit Birman ◽

Mordechai Lorberboym

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dopamine Transporter ◽

Affected Side

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“Striatal Hand Signs” and early diagnosis of Parkinson’s Disease: The “Monkey-Wrench Sign”

10.5327/1516-3180.228 ◽

2021 ◽

Author(s):

Igor de Lima e Teixeira ◽

Vanessa Pereira de Alencar Souza ◽

Caroline Zorzenon ◽

Beatriz Azevedo dos Anjos Godke Veiga ◽

Vanderci Borges ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Onset ◽

Ulnar Deviation ◽

Advanced Parkinson’S Disease ◽

Metacarpophalangeal Joints ◽

Affected Side ◽

Hand Deformities ◽

Distal Interphalangeal ◽

Striatal Hand

Background: Striatal hand signs, first described by Charcot, are reported in 10% of advanced Parkinson’s Disease patients as flexion of the metacarpophalangeal joints, extension of proximal interphalangeal joints, flexion of distal interphalangeal joints and ulnar deviation. Another deformation is the metacarpophalangeal joints flexion and thumb medialization (U shaped - “Monkey-Wrench sign”). We believe that mild hand deformities are present in earlier phases of the disease and may help the diagnosis of PD. Objectives: To identify hand deformities in PD patient. Methods: We evaluated 36 PD patients, according to UKPDS Brain Bank Diagnostic Criteria, side of onset, disease duration, severity by UPDRS part III - left/ right side, hand deformities and the “monkey-wrench sign”. Results: We had 14 patients 10 years. 2/3 had left side onset. 33 patients (91.67%) presented the “Monkey- Wrench sign”, unilaterally or asymmetrically, and it was present in all PD patients > 4 years of disease onset, but it was present only in 78.6% less than 4 years. The “MW” sign was easily detected in the more affected side, with a mean UPDRS score of 31.1 on the side of striatal hand signs compared to the mean score of 24.7 on the less affected side. Conclusions: Striatal hand deformities and the “Monkey-Wrench” sign may be useful to diagnosis PD, if unilateral or asymmetrical signs, as well as, it could be used to differentiate between tremors of PD and other etiologies, in a more visual way.

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[123I]β-CIT SPECT imaging of dopamine and serotonin transporters in Parkinson’s disease and multiple system atrophy

Nuklearmedizin ◽

10.1055/s-0038-1623903 ◽

2003 ◽

Vol 42 (01) ◽

pp. 31-38 ◽

Cited By ~ 31

Author(s):

Th. Brücke ◽

P. Odin ◽

D. J. Brooks ◽

H. Kolbe ◽

P. Gielow ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Multiple System Atrophy ◽

Yahr Stage ◽

Advanced Parkinson’S Disease ◽

Affected Side ◽

Duration Of Disease ◽

Definition Of ◽

Mesial Frontal Cortex

Summary Aims: Definition of the regional pattern of dopamine transporter (DAT) dysfunction in advanced Parkinson’s disease (PD) and evaluation of a potential correlation between DAT binding and symptoms; elucidation of the role of DAT imaging in the differential diagnosis of PD and multiple system atrophy (MSA); assessment and comparison of serotonin transporter (SERT) binding in PD and MSA. Methods: [123I]ß-CIT SPECT was performed in 14 patients with advanced PD, 10 with moderate MSA and 20 healthy persons. Specific to nonspecific tracer binding ratios (V3’’) were calculated via ROI analysis of uptake images at 4 h (SERT binding) and 24 h (DAT binding) p. i. Results: In PD bilateral reduction of striatal DAT binding (63-70%) was seen. The caudate ipsilateral to the clinically predominantly affected side showed relatively the least impairment. Significant correlations (r = -0.54 to -0.64) between DAT binding and Hoehn and Yahr stage, UPDRS-scores and duration of disease were found. In MSA DAT binding was less reduced (40-48%) targeting the putamen contralateral to the side of clinical predominance. Significantly lower SERT binding was observed in PD midbrain and MSA hypothalamus compared to controls – and in MSA relative to PD mesial frontal cortex. Conclusions: In advanced PD striatal DAT binding is markedly reduced with the least reduction in caudate ipsilateral to the clinically predominantly affected side. In moderate MSA with asymmetrical symptoms DAT dysfunction is predominant in the contralateral putamen, a pattern seen in early PD. The reduction of SERT in the midbrain area of PD patients suggests additional tegmental degeneration while in MSA the serotonergic system seems to be more generally affected.

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Quantitative lateralized measures of bradykinesia at different stages of Parkinson's disease: The role of the less affected side

Movement Disorders ◽

10.1002/mds.22741 ◽

2009 ◽

Vol 24 (13) ◽

pp. 1991-1997 ◽

Cited By ~ 22

Author(s):

Stephanie Louie ◽

Mandy Miller Koop ◽

Anna Frenklach ◽

Helen Bronte-Stewart

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Affected Side

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Bilateral Repetitive Transcranial Magnetic Stimulation With the H-Coil in Parkinson's Disease: A Randomized, Sham-Controlled Study

Frontiers in Neurology ◽

10.3389/fneur.2020.584713 ◽

2021 ◽

Vol 11 ◽

Author(s):

Francesca Spagnolo ◽

Mario Fichera ◽

Raffaella Chieffo ◽

Gloria Dalla Costa ◽

Marco Pisa ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Transcranial Magnetic Stimulation ◽

High Frequency ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Safety And Efficacy ◽

Affected Side ◽

End Of Treatment ◽

Updrs Part

Background: Pilot open-label application of high-frequency repetitive transcranial magnetic stimulation (rTMS) with H-coil in Parkinson's Disease (PD) have shown promising results.Objective: To evaluate safety and efficacy of high-frequency rTMS with H-coil in PD in a double-blind, placebo-controlled, randomized study.Methods: Sixty patients with PD were randomized into 3 groups: M1-PFC (real stimulation on primary motor-M1 and pre-frontal cortices-PFC), M1 (real rTMS on M1, sham on PFC), Sham (apparent stimulation). Primary outcome was baseline-normalized percent improvement in UPDRS part III OFF-therapy at the end of treatment (12 rTMS sessions, 4 weeks). Secondary outcomes were improvement in UPDRS part III sub-scores, timed tests, and neuropsychological tests. Statistical analysis compared improvement following real and sham stimulation at the end of the protocol using either a t-test or a Mann-Whitney test.Results: All patients tolerated the treatment and concluded the study. One patient from M1-PFC group was excluded from the analysis due to newly discovered uncontrolled diabetes mellitus. No serious adverse effect was recorded. At the end of treatment, patients receiving real rTMS (M1-PFC and M1 combined) showed significantly greater improvement compared to sham in UPDRS part III total score (p = 0.007), tremor subscore (p = 0.011), and lateralized sub-scores (p = 0.042 for the more affected side; p = 0.012 for the less affected side). No significant differences have been oserved in safety and efficacy outcomes between the two real rTMS groups. Notably, mild, not-distressing and transient dyskinesias occurred in 3 patients after real rTMS in OFF state.Conclusions: The present findings suggest that high-frequency rTMS with H-coil is a safe and potentially effective procedure and prompt larger studies for validation as add-on treatment in PD.

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Glucocerebrosidase Mutations and Motor Reserve in Parkinson’s Disease

Journal of Parkinson s Disease ◽

10.3233/jpd-212758 ◽

2021 ◽

pp. 1-10

Author(s):

Seok Jong Chung ◽

Phil Hyu Lee ◽

Young H. Sohn ◽

Yun Joong Kim

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Motor Deficits ◽

Dopamine Depletion ◽

Affected Side ◽

Disease Rating ◽

Individual Capacity ◽

The Individual ◽

Gba Mutations

Background: The concept of motor reserve explains the individual differences in motor deficits despite similar degrees of nigrostriatal dopamine depletion in Parkinson’s disease (PD). Objective: To investigate glucocerebrosidase (GBA) variants as potential determinants of motor reserve for exploratory purposes. Methods: A total of 408 patients with drug-naïve PD were enrolled from the Parkinson’s Progression Markers Initiative cohort database. All patients underwent SPECT dopamine transporter (DAT) scans and had results for Sanger sequencing of GBA. Parkinsonian motor deficits were assessed using the Movement Disorders Society Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS-III). We compared MDS-UPDRS-III scores while adjusting for DAT availability in the putamen (i.e., motor reserve) between the PD groups according to the presence of GBA mutations. Results: Fifty-four (13.2%) patients carried GBA mutations. PD patients with GBA mutations were younger than those without mutations. There were no significant differences in sex, disease duration, years of education, and striatal DAT availability between the PD groups. PD patients with GBA mutations had higher MDS-UPDRS-III scores for the less affected side than those without mutations, despite similar levels of DAT availability in the contralateral putamen. The MDS-UPDRS-III sub-scores of the more affected side did not differ between the two PD groups. Conclusion: The results of this study demonstrated the detrimental effect of GBA variants on individual capacity to cope with PD-related pathologies, with different impacts depending on the motor laterality.

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Relationship between neuromelanin and dopamine terminals within the Parkinson’s nigrostriatal system

Brain ◽

10.1093/brain/awz120 ◽

2019 ◽

Vol 142 (7) ◽

pp. 2023-2036 ◽

Cited By ~ 10

Author(s):

Antonio Martín-Bastida ◽

Nicholas P Lao-Kaim ◽

Andreas Antonios Roussakis ◽

Graham E Searle ◽

Yue Xing ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Substantia Nigra ◽

Dopamine Transporter ◽

Substantia Nigra Pars Compacta ◽

Control Group ◽

Post Mortem ◽

Significant Relationships ◽

Affected Side

Abstract Parkinson’s disease is characterized by the progressive loss of pigmented dopaminergic neurons in the substantia nigra and associated striatal deafferentation. Neuromelanin content is thought to reflect the loss of pigmented neurons, but available data characterizing its relationship with striatal dopaminergic integrity are not comprehensive or consistent, and predominantly involve heterogeneous samples. In this cross-sectional study, we used neuromelanin-sensitive MRI and the highly specific dopamine transporter PET radioligand, 11C-PE2I, to assess the association between neuromelanin-containing cell levels in the substantia nigra pars compacta and nigrostriatal terminal density in vivo, in 30 patients with bilateral Parkinson’s disease. Fifteen healthy control subjects also underwent neuromelanin-sensitive imaging. We used a novel approach taking into account the anatomical and functional subdivision of substantia nigra into dorsal and ventral tiers and striatal nuclei into pre- and post-commissural subregions, in accordance with previous animal and post-mortem studies, and consider the clinically asymmetric disease presentation. In vivo, Parkinson’s disease subjects displayed reduced neuromelanin levels in the ventral (−30 ± 28%) and dorsal tiers (−21 ± 24%) as compared to the control group [F(1,43) = 11.95, P = 0.001]. Within the Parkinson’s disease group, nigral pigmentation was lower in the ventral tier as compared to the dorsal tier [F(1,29) = 36.19, P < 0.001] and lower in the clinically-defined most affected side [F(1,29) = 4.85, P = 0.036]. Similarly, lower dopamine transporter density was observed in the ventral tier [F(1,29) = 76.39, P < 0.001] and clinically-defined most affected side [F(1,29) = 4.21, P = 0.049]. Despite similar patterns, regression analysis showed no significant association between nigral pigmentation and nigral dopamine transporter density. However, for the clinically-defined most affected side, significant relationships were observed between pigmentation of the ventral nigral tier with striatal dopamine transporter binding in pre-commissural and post-commissural striatal subregions known to receive nigrostriatal projections from this tier, while the dorsal tier correlated with striatal projection sites in the pre-commissural striatum (P < 0.05, Benjamini-Hochberg corrected). In contrast, there were no statistically significant relationships between these two measures in the clinically-defined least affected side. These findings provide important insights into the topography of nigrostriatal neurodegeneration in Parkinson’s disease, indicating that the characteristics of disease progression may fundamentally differ across hemispheres and support post-mortem data showing asynchrony in the loss of neuromelanin-containing versus tyrosine hydroxylase positive nigral cells.

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