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°) and the other as the test joint (angular range, 54° to 69°, at 3° 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° and 63°. 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. Ann Neurol 2000;47:218–228

The effect of dopamine replacement therapy on haptic sensitivity in Parkinson’s disease

“…First, it corroborates previous research showing that PD is associated with a decrease in kinaesthetic and haptic function [18,19,21,28,36]. Second, it demonstrates that the beneficial effects of levodopa on motor function can also extend to perceptual function.…”

“…There is increasing evidence that basal-ganglia-related diseases such as dystonia or Parkinson's disease (PD) are associated with perceptual deficits, such as a loss of smell, tactile discrimination, or kinaesthetic and haptic deficits [9,14,19,24,30,33,36]. These perceptual deficits become understandable knowing that many basal ganglia neurons respond to multimodal sensory afferents [27], and underline the notion that the basal ganglia-thalamo-cortical system is involved in perception.…”

Impact of Parkinson’s disease on proprioceptively based on-line movement control

“…A growing body of research demonstrates that PD patients have deficient proprioceptive processing (Klockgether et al 1995;Demirci et al 2004;Zia et al 2000;O'Suilleabhain et al 2001;Maschke et al 2003;Contreras-Vidal and Gold 2004;Mongeon et al 2009). Indeed, our own study and other previous reports have indicated that medicated and non-medicated PD patients displayed significant impairments in dynamic proprioceptive sense (O'Suilleabhain et al 2001;Contreras-Vidal and Gold 2004;Konczak et al 2007;Mongeon et al 2009).…”

“…Our findings also suggest that if vision or a visual memory of target location is available, it can be used to compensate for proprioceptive impairments. Other studies have also suggested that PD patients rely excessively on visual information to compensate for impairments in proprioceptive guidance (Zia et al 2000;Seiss et al 2003;Sacrey et al 2009). …”

“…Several studies have indicated that non-medicated and medicated PD patients show proprioceptive deficits (Klockgether et al 1995;Demirci et al 1997;Zia et al 2000;O'Suilleabhain et al 2001;Maschke et al 2003;Mongeon et al 2009). However, no study has investigated whether proprioceptively based on-line movement guidance is selectively altered in PD patients.…”