Apraxia in Parkinson's disease and multiple system atrophy
D Uluduz1, O Ertürk, G Kenangil
1Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
European Journal of Neurology
|January 7, 2010
Summary
Parkinson's disease (PD) and multiple system atrophy (MSA) patients show impaired praxis function, particularly in sequential tasks. Ideomotor and ideational apraxia may be features of MSA and PD, unrelated to PD motor symptoms.
Area of Science:
- Neuroscience
- Neurology
- Movement Disorders
Background:
- Praxis function, the ability to perform learned motor actions, can be affected in neurodegenerative diseases.
- Parkinson's disease (PD) and multiple system atrophy (MSA) are distinct neurodegenerative disorders with overlapping motor symptoms.
- Understanding praxis deficits in PD and MSA is crucial for accurate diagnosis and management.
Purpose of the Study:
- To compare praxis function between patients with Parkinson's disease (PD) and multiple system atrophy (MSA).
- To identify specific praxis deficits, including ideomotor apraxia (IMA) and ideational apraxia (IDA), in these patient groups.
- To explore the relationship between praxis function and motor symptoms in PD.
Main Methods:
- The study included 19 patients with PD, 16 patients with probable MSA, and 25 age-matched healthy controls.
- The Mayo Clinic praxis test battery was used, assessing pantomime (IMA) and sequential tasks (IDA).
- Cognitive and mood assessments included the Standardized Mini Mental Test (MMSE), Hamilton Depression (HAM-D), and Anxiety (HAM-A) Scales.
Main Results:
- Patients with PD and MSA demonstrated significantly lower mean total praxis scores compared to controls.
- Patients with PD showed significant impairments in upper extremity transitive performances and sequential tasks.
- Praxis scores were substantially worse in the MSA group, who also exhibited poorer MMSE, HAM-D, and HAM-A scores compared to controls. PD patients only had worse HAM-A scores.
Conclusions:
- Ideomotor apraxia (IMA) and ideational apraxia (IDA) may be present in multiple system atrophy (MSA) and, to a lesser extent, in Parkinson's disease (PD).
- These praxis deficits appear to be independent of the primary motor features of Parkinson's disease.
- Praxis testing may aid in differentiating between MSA and PD, especially when cognitive and mood symptoms are also considered.
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