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Hand Dexterity and Pyramidal Dysfunction in Friedreich Ataxia, A Finger Tapping Study
Gilles Naeije1,2, Antonin Rovai1, Massimo Pandolfo2,3
1Laboratoire de Cartographie Fonctionnelle du Cerveau, ULB Neuroscience Institute Université libre de Bruxelles (ULB) Brussels Belgium.
Movement Disorders Clinical Practice
|January 11, 2021
Summary
Finger tapping analysis in Friedreich ataxia (FRDA) reveals pyramidal dysfunction significantly impacts hand dexterity. This quantitative method offers a new clinical assessment tool for FRDA progression.
Area of Science:
- Neuroscience
- Neurology
- Biomedical Engineering
Background:
- Loss of hand dexterity is a significant disability in neurological disorders like cerebellar, pyramidal, or extrapyramidal diseases.
- Quantitative assessment of finger tapping (FT) parameters can elucidate underlying pathophysiology and serve as a clinical tool, especially when traditional scales are insufficient.
- Friedreich ataxia (FRDA) presents a complex challenge in assessing upper limb dexterity loss due to potential contributions from cerebellar, extrapyramidal, and pyramidal systems.
Purpose of the Study:
- To utilize an automated finger tapping (FT) analysis to differentiate the contributions of cerebellar, extrapyramidal, and pyramidal pathways to upper limb dexterity loss in Friedreich ataxia (FRDA).
- To correlate FT parameters with clinical assessments and motor evoked potentials (MEPs) in FRDA patients.
- To establish FT analysis as a potential quantitative outcome measure for clinical studies in FRDA.
Main Methods:
- Twenty-four FRDA patients and healthy controls performed a 90-second finger tapping task with their dominant hand.
- Automated computation of FT parameters including rate, rate variability, and amplitude, alongside linear regression analysis of movement parameters.
- Motor evoked potentials (MEPs) were measured in a subset of patients to determine central motor conduction time (CMCT).
Main Results:
- FRDA patients exhibited a slower and more regular FT rate compared to controls.
- A subgroup of FRDA patients showed FT rate slowing, which correlated with longer disease duration and higher Scale for the Assessment and Rating of Ataxia (SARA) scores.
- Patients with FT rate slowing and prolonged CMCT indicated pyramidal pathway involvement, while those with normal CMCT had a constant FT rate.
Conclusions:
- The study demonstrates significant pyramidal pathway involvement in the loss of upper limb dexterity in FRDA.
- Automated finger tapping analysis effectively distinguishes between different neurological contributions to dexterity impairment.
- This quantitative FT analysis shows promise as a valuable outcome measure for future clinical trials in FRDA.
