Apraxia in Parkinson’s disease and multiple system atrophy

Uludüz, Derya; Erturk, Ozdem; Kenangil, Gülay; Özekmekçi, Sibel; Ertan, Sibel; Apaydın, Hülya; Erginöz, Ethem

doi:10.1111/j.1468-1331.2009.02905.x

Cited by 21 publications

(25 citation statements)

References 23 publications

(58 reference statements)

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“…Therefore, the finding that a similar proportion of patients fulfilled the apraxia criterion points to a good criterion validity of AST. Furthermore, well compatible with IMA, temporal-spatial errors were most commonly detected by AST, corresponding to error patterns found in apraxic PD patients in previous studies [6,7]. …”

Section: Discussionsupporting

confidence: 84%

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Short and valid assessment of apraxia in Parkinson’s disease

Vanbellingen¹,

Lungu²,

Lopez³

et al. 2012

Parkinsonism & Related Disorders

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Background Valid assessment of apraxia in usually non-apraxic Parkinson’s disease helps to delineate atypical parkinsonism frequently associated with apraxia. Furthermore, in a subgroup of late Parkinson’s disease apraxia, typically the ideomotor subtype, may gradually superimpose onto parkinsonian motor symptoms contributing to defective manual skill. Here we evaluate the utility of a brief, standardized test, the apraxia screen of TULIA (AST). Methods Seventy five Parkinson’s disease patients were tested with the AST. Parkinsonian motor deficits were measured using Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part III and difficulties in activities of daily living (ADL) by modified MDS-UPDRS part II (eating, dressing, personal hygiene, and writing). Results No association was found between the AST and MDS-UPDRS part III, indicating that AST discriminates well (discriminative validity) between apraxia and parkinsonism. Furthermore, AST was associated with ADL and Hoehn & Yahr stage (convergent validity). Conclusions AST is a short and valid test to rule out or detect apraxia in Parkinson’s disease.

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Section: Discussionsupporting

confidence: 84%

“…IMA and LKA are frequently seen in atypical parkinsonisms, such as progressive supranuclear palsy (PSP), dementia with Lewy Bodies (DLB) and as a hallmark in corticobasal degeneration (CBD) [2]. Mild IMA may even occur in some patients with Parkinson’s disease (PD) [3,4,5,6,7] and LKA may be more common than previously thought [8,9,10]. …”

Section: Introductionmentioning

confidence: 99%

Short and valid assessment of apraxia in Parkinson’s disease

Vanbellingen¹,

Lungu²,

Lopez³

et al. 2012

Parkinsonism & Related Disorders

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“…This definition is consistent with the apraxia criteria in the VDS, used as an outcome measure in this study [10]. Although the relationship between swallowing apraxia and orofacial apraxia has not been described precisely, swallowing apraxia is thought to be categorized under orofacial apraxia [16]. Orofacial apraxia is a type of ideomotor apraxia, which means that although the automatic movement of the muscles of the orofacial structures is preserved, there is a loss of ability to follow volitional movements of the muscle or imitate volitional movements [17].…”

Section: Discussionmentioning

confidence: 55%

“…Orofacial apraxia is a type of ideomotor apraxia, which means that although the automatic movement of the muscles of the orofacial structures is preserved, there is a loss of ability to follow volitional movements of the muscle or imitate volitional movements [17]. Orofacial apraxia has been reported as a symptom of MSA [16, 17]. Furthermore, orofacial apraxia in MSA is reported to be more frequent and severe than that in PD, although this has not been investigated at the MSA subtype level [16].…”

Section: Discussionmentioning

confidence: 99%

“…Orofacial apraxia has been reported as a symptom of MSA [16, 17]. Furthermore, orofacial apraxia in MSA is reported to be more frequent and severe than that in PD, although this has not been investigated at the MSA subtype level [16]. However, we should consider that it is not easy to distinguish whether the difficulty in initiating orofacial movement is caused by the orolinguopharyngeal motor deficit or by apraxia caused by a problem in the brain network, including the premotor cortex, in MSA.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics of Early Oropharyngeal Dysphagia in Patients with Multiple System Atrophy

et al. 2018

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Background/Aims: Dysphagia, a symptom of multiple system atrophy (MSA), is a major clinical concern. In this study, we investigate the characteristics of early oropharyngeal dysphagia (OD) in patients with MSA, and the differences between MSA subtypes. Methods: Patients enrolled in the study had previously been diagnosed with MSA at the clinic of the Department of Neurology, and had been referred for a videofluoroscopic swallowing study (VFSS), between 2005 and 2014, to check for dysphagia. The clinical characteristics and VFSS findings were analyzed and compared between the MSA subtypes. Results: This study enrolled 59 patients with MSA (24 men; 31 with MSA-P, 21 with MSA-C, and 7 with MSA-PC). Dysphagia symptoms were mostly limited to aspiration symptoms (90.48%) in patients with MSA-C, while difficulty in swallowing, increased mealtime, and drooling were frequent in those with MSA-P. The most common VFSS finding amongst patients was vallecular residue (n = 53, 89.8%), followed by penetration/aspiration (n = 40, 67.8%), and coating of the pharyngeal wall (n = 39, 66.1%). Comparison analysis between subtypes showed that apraxia and vallecular residue were more frequent and severe in MSA-P than in MSA-C (p = 0.033 and p = 0.010, respectively). Conclusion: Understanding early OD characteristics in patients with MSA and the differences between MSA subtypes could be helpful in managing dysphagia in patients with MSA. Several dysphagia symptoms similar to those of Parkinson disease were frequently observed in MSA-P, but not in MSA-C. A follow-up study is needed to elucidate the natural course of OD in MSA patients and the difference between MSA subtypes.

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