Mirror movements in Parkinson's disease: An under-appreciated clinical sign
Payel Chatterjee1, Rebecca Banerjee1, Supriyo Choudhury2
1Department of Neurology and RGC Research Centre, Institute of Neurosciences, Kolkata, India.
Introduction:
Mirror movements (MM) have been previously reported in patients with Parkinson's disease (PD). Despite being potentially relevant in PD, MM as a neurological sign have remained less recognized. In this study we critically evaluated the characteristic features of MM and their attributes among a cohort of PD patients from a tertiary care center of eastern part of India.
Methods:
In this analytical cross-sectional study, 70 patients with PD were evaluated using Unified Parkinson's Disease Rating Scale (UPDRS) and a previously used scale to score MM in the OFF and ON phases of l-Dopa therapy. MM was video-recorded for 4 motor tasks (finger- tapping, hand-movement, pronation-supination, rapid ankle-flexion-extension) and scored for the MM attributes i.e. amplitude, distribution and proportion.
Results:
A vast majority of PD patients (95.7%) exhibited MM and there was a trend of higher MM score with lesser severity of disease affection. Marked differences in amplitude, distribution and proportion of MM in the upper and lower limbs were evident in response to l-Dopa therapy in certain motor tasks. In addition, less involved limbs exhibited higher MM and the MM scores were higher for lower limb tasks in the ON phase.
Conclusions:
The high prevalence of MM in PD patients and its correlation to disease severity echoed previous studies across the globe. In addition, this study provides evidence for a differential response of MM attributes to l-Dopa. To our knowledge, this is the first study that characterized MM in a cohort of PD patients from India. Our findings suggest the significance of MM as a clinical neurological sign in PD.
Insights
Mirror movements (MM) are common in Parkinson's disease (PD) patients, affecting 95.7% in this study. These movements showed differential responses to l-Dopa therapy, suggesting their significance as a clinical sign.
Area of Science:
- Neurology
- Movement Disorders
Background:
- Mirror movements (MM) are observed in Parkinson's disease (PD) but remain under-recognized.
- This study investigates the characteristics of MM in Indian PD patients.
Purpose of the Study:
- To critically evaluate the features and attributes of mirror movements (MM) in a cohort of Parkinson's disease (PD) patients.
- To assess the impact of l-Dopa therapy on MM characteristics.
Main Methods:
- An analytical cross-sectional study involving 70 PD patients.
- Evaluation using the Unified Parkinson's Disease Rating Scale (UPDRS) and a dedicated MM scoring scale.
- Video-recording of motor tasks and scoring of MM attributes (amplitude, distribution, proportion) in OFF and ON l-Dopa phases.
Main Results:
- A high prevalence of MM (95.7%) was observed in PD patients.
- MM scores showed a trend towards higher values in less severe disease.
- Differential responses in MM amplitude, distribution, and proportion were noted with l-Dopa, particularly in lower limb tasks during the ON phase.
Conclusions:
- The high prevalence and correlation with disease severity align with global findings.
- This study provides novel evidence of differential MM attribute responses to l-Dopa.
- Highlights the significance of MM as a clinical neurological sign in Parkinson's disease, particularly in the Indian population.
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