An Evaluation of Right-Sided Symptom Onset as a Predictor of Poor Parkinson’s Disease Prognosis

Abstract

Objective The current study aimed to measure and compare neurological disability in Parkinson’s disease (PD) patients with right-sided symptom onset with that in PD patients with left-sided symptom onset, using the measurements taken at their first and last visits, to determine if right-sided symptom onset was predictive of a poor PD prognosis. Methods One hundred and forty-three PD patients were included in the study. The Unified Parkinson’s Disease Rating Scale (UPDRS) and the Hoehn and Yahr Scale were used to measure neurological disability in patients at the first and last visits. The scores for the neurological disability of patients at the first and last visits were compared retrospectively relative to disease onset. Results Seventy-six PD patients had right-sided symptom onset (53%), and 67 patients had left-sided symptom onset (47%) ( p = < 0.001). The differences between the scores at the first and last visits, measured using the UPDRS and the Hoehn and Yahr Scale, were higher for PD patients with right-sided symptom onset than patients with left-sided symptom onset ( p = < 0.001, p = < 0.002, respectively). Similarly, the UPDRS Part II and Part III values, used to evaluate motor function, were higher in PD patients with right-sided symptom onset as compared to those with left-sided symptom onset at the first and last visits ( p = < 0.001). Conclusion Right-sided symptom onset was predictive of a poor prognosis in PD patients at follow-up.

Exploring Asymmetric Fine Motor Impairment Trends in Early Parkinson's Disease via Keystroke Typing

“…Clinically, this could indicate a worse clinical prognosis for D-PD, consistent with previously published literature. 11,12,25 Heinrichs-Graham et al used magnetoencephalography to evaluate the relationship between symptom asymmetry and the laterality of neural activity, also concluding that the ND-PD group presented healthier oscillatory neural activity patterns than the D-PD group.…”

“…Scharoun et al 4 found right‐handed D‐PD increased non‐dominant hand usage, potentially switching hand preference as the disease progresses. Some research suggests D‐PD has a more debilitating effect on hand performance than ND‐PD, 10 while other studies report faster motor progression for ND‐PD 4,5 or D‐PD 11,12 . Quantifying asymmetrical motor impairment could help clinicians confirm PD diagnosis, refine prognosis, and design personalized rehabilitation plans.…”

Hypoglycemia caused subacute ischemia in the left caudate nucleus in a patient with hemiballismus-hemichorea

“…Our patient had right-lateralized hemichorea-hemiballismus as a result of a lesion occurring in the left caudate nucleus head caused by hypoglycemia. It is also claimed that the left hemisphere was more vulnerable to the pathophysiological processes than the right hemisphere and the prognosis of Parkinson’s patients with clinical symptoms from the left hemisphere is significantly worse [ 9 ].…”