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Disordered axial movement in Parkinson's disease
M J Steiger1, P D Thompson, C D Marsden
1University Department of Clinical Neurology, Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
Journal of Neurology, Neurosurgery, and Psychiatry
|December 1, 1996
Summary
Axial motor impairments in Parkinson's disease, like turning in bed, often worsen with disease duration. However, this study found that these movements significantly improve after levodopa treatment, even in later disease stages.
Area of Science:
- Neurology
- Movement Disorders
Background:
- Axial motor impairments are common in Parkinson's disease (PD) and may be levodopa-resistant.
- These impairments can significantly impact daily living and disability.
Purpose of the Study:
- To investigate the responsiveness of turning in bed to dopaminergic stimulation in Parkinson's disease patients.
- To compare turning ability with other axial motor functions and their response to levodopa.
Main Methods:
- Assessed turning in bed in 36 PD patients (Hoehn and Yahr stages 1-5) before and after levodopa.
- Correlated turning with gait, postural stability, rising from a chair, bradykinesia, and rigidity.
- Analyzed the impact of disease duration and age at onset.
Main Results:
- 19 out of 36 patients failed to turn in bed in the "off" state, associated with gait, postural, and other axial impairments.
- Turning in bed, gait, postural stability, rising, bradykinesia, and rigidity all significantly improved after levodopa.
- Improvements were noted across different disease stages and durations.
Conclusions:
- Turning in bed and other axial motor functions in Parkinson's disease can be dopamine-responsive.
- Levodopa therapy can restore turning ability and improve other axial symptoms, even in advanced PD.
- Axial motor control may remain responsive to dopaminergic therapy, challenging previous assumptions.