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OFF-Period Purposeless Groaning in Parkinsonism
Vikash Agarwal1, Jeyalakshmi Rajan2, Norlisah Ramli3
1Division of Neurology and the Mah Pooi Soo and Tan Chin Nam Centre for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Neurology, Gleneagles Global Health City, Chennai, Tamil Nadu, India.
Neurology India
|July 22, 2022
Summary
Purposeless groaning, a nonmotor symptom, can manifest during medication OFF-periods in Parkinson's disease (PD). This case highlights its disruptive nature and potential impact on caregivers.
Area of Science:
- Neurology
- Movement Disorders
Background:
- Purposeless groaning is a known phenomenon in progressive supranuclear palsy and advanced Parkinson's disease (PD).
- It is typically associated with motor symptoms or advanced stages of neurodegenerative diseases.
Observation:
- This report details a unique case of significant purposeless groaning in a patient with moderately advanced PD.
- The groaning occurred specifically during medication OFF-periods, identified as a nonmotor phenomenon.
Findings:
- The patient's groaning constituted approximately 40% of their OFF-period duration, as documented in their PD diary.
- This phenomenon was corroborated by family reports and direct clinical observation.
Implications:
- OFF-period purposeless groaning in PD, though rare, can be highly distressing and increase caregiver burden.
- Potential pathophysiological mechanisms involve disinhibition and perseveration within the cingulo-periaqueductal circuit, warranting further investigation.
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