Joint position sense is impaired by Parkinson's disease

Abstract

The abilities of Parkinson's disease (PD) patients, taking routine medication, and of control subjects, to discriminate bilateral differences in the static angular positions of the two elbow joints were studied during passive (subject relaxed) and active (subject contracting to hold position) conditions. On each trial, one of the subject's elbows served as the reference joint (angle 60 degrees) and the other as the test joint (angular range, 54 degrees to 69 degrees, at 3 degree intervals). Subjects, with eyes closed, were required to discriminate the relative angles of the two elbows. In Experiments 1 (passive condition) and 2 (active condition), parkinsonians (n = 12) gave significantly fewer correct responses, pooled across sides, than did controls (n = 12), both in total scores across all angles and at individual test angles of 57 degrees and 63 degrees. In Experiment 3 (passive condition), derivation of conventional psychophysical variables indicated that both the difference limen (DL; threshold) and Weber ratio (WR; discriminatory sensitivity, independent of absolute stimulus values; same as DL/PSE) values of patients (n = 6) were significantly larger than those of controls (n = 6), in the absence of a significant difference between groups in the point of subjective equality (PSE). Our results provide clear evidence of a quantitative impairment of joint position sense in PD patients.

Dopaminergic contributions to distance estimation in Parkinson's disease: A sensory-perceptual deficit?

“…There are a number of potential explanations for the greater movement errors that were seen during the walking condition. First, proprioceptive processing of the upper limbs has been found to be impaired in PD (Keijsers et al, 2005;Klockgether et al, 1995;Rickards & Cody, 1997;Zia et al, 2000). When investigating PD movements (i.e., pointing or walking) in complete darkness, thus relying solely on proprioceptive information, previous studies have found reliable error in PD similar to what was seen in the current study and have concluded that these errors were a result of proprioceptive deficits (Almeida et al, 2005;Jacobs & Horak, 2006;Keijsers et al, 2005;Mongeon et al, 2009).…”

“…Proprioceptive deficits are well documented in PD (Klockgether, Borutta, Rapp, Spieker, & Dichgans, 1995;Schneider, Diamond, & Markham, 1987;Zia, Cody, & O'Boyle, 2000), although similar to visual perception, their contribution to movement impairments remains unclear. Studies have shown that individuals with PD have abnormal processing of sensory information, specifically proprioceptive inputs (Klockgether et al, 1995;Rickards & Cody, 1997;Schneider et al, 1987;Zia et al, 2000).…”

“…Studies have shown that individuals with PD have abnormal processing of sensory information, specifically proprioceptive inputs (Klockgether et al, 1995;Rickards & Cody, 1997;Schneider et al, 1987;Zia et al, 2000). Abnormal vibration-induced movement errors have been observed in PD during joint flexion-extension tasks (Rickards & Cody, 1997;Schrader et al, 2008), and PET imaging studies of passive finger vibration have demonstrated a reduction in sensory evoked brain activations in the cortical (parietal and frontal) and subcortical (BG) areas of the brain (Boecker et al, 1999a).…”

“…Abnormal vibration-induced movement errors have been observed in PD during joint flexion-extension tasks (Rickards & Cody, 1997;Schrader et al, 2008), and PET imaging studies of passive finger vibration have demonstrated a reduction in sensory evoked brain activations in the cortical (parietal and frontal) and subcortical (BG) areas of the brain (Boecker et al, 1999a). During limb position tasks, individuals with PD make more errors then healthy control participants when required to identify the occurrence and/or direction of passive movements (Schneider et al, 1987) as well as demonstrating greater errors in matching static limb position, detecting limb displacements, or using the lower limbs to estimate the size of an object (Martens & Almeida, 2011;O'Suilleabhain, Bullard, & Dewey, 2001;Zia et al, 2000). Similarly, tasks involving reaching and pointing to remembered targets have found that PD patients exhibit significantly large errors when locating the original target (Keijsers, Admiraal, Cools, Bloem, & Gielen, 2005;Klockgether et al, 1995), especially when patients are unable to see their hand (Mongeon, Blanchet, & Messier, 2009) or in the complete absence of visual information (Keijsers et al, 2005).…”

Proprioception in Parkinson's disease is acutely depressed by dopaminergic medications

“…Zia et al recently showed abnormal proprioception in treated patients with Parkinson's disease 8. These findings complimented previous research which indicated that kinaesthesia is deficient in Parkinson's disease, again primarily among patients receiving dopaminergic medications 5…”