Mild Parkinsonian Signs: A Systematic Review of Clinical, Imaging, and Pathological Associations

Buchanan, Sarah M; Richards, Marcus; Schott, Jonathan M.; Schrag, Anette

doi:10.1002/mds.28777

Cited by 20 publications

(20 citation statements)

References 111 publications

(421 reference statements)

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“…The wearable motion sensor allowed us to obtain a more objective assessment of motor symptoms in PD, and a breakdown of the upper limb bradykinesia score into a rating of the speed, amplitude, and rhythm of the movements (Table 1). A recent review paper of mild parkinsonian signs suggested that mild motor changes in the elderly population in the form of a slightly higher MDS-UPDRS-III score in the absence of comorbidities could be an indicator of an increased risk for PD [69]. The mean total MDS-UPDRS-III score for our control cohort was 2.29 points.…”

Section: Discussionmentioning

confidence: 76%

Rate control deficits during pinch grip and ankle dorsiflexion in early-stage Parkinson’s disease

Chung

Knight²,

Bower³

et al. 2023

PLoS ONE

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Background Much of our understanding of the deficits in force control in Parkinson’s disease (PD) relies on findings in the upper extremity. Currently, there is a paucity of data pertaining to the effect of PD on lower limb force control. Objective The purpose of this study was to concurrently evaluate upper- and lower-limb force control in early-stage PD and a group of age- and gender-matched healthy controls. Methods Twenty individuals with PD and twenty-one healthy older adults participated in this study. Participants performed two visually guided, submaximal (15% of maximum voluntary contractions) isometric force tasks: a pinch grip task and an ankle dorsiflexion task. PD were tested on their more affected side and after overnight withdrawal from antiparkinsonian medication. The tested side in controls was randomized. Differences in force control capacity were assessed by manipulating speed-based and variability-based task parameters. Results Compared with controls, PD demonstrated slower rates of force development and force relaxation during the foot task, and a slower rate of relaxation during the hand task. Force variability was similar across groups but greater in the foot than in the hand in both PD and controls. Lower limb rate control deficits were greater in PD with more severe symptoms based on the Hoehn and Yahr stage. Conclusions Together, these results provide quantitative evidence of an impaired capacity in PD to produce submaximal and rapid force across multiple effectors. Moreover, results suggest that force control deficits in the lower limb may become more severe with disease progression.

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Section: Discussionmentioning

confidence: 76%

Rate control deficits during pinch grip and ankle dorsiflexion in early-stage Parkinson’s disease

Chung

Knight²,

Bower³

et al. 2023

PLoS ONE

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“…Apart from future risk of PD, SP has also been found to be associated with future dementia, particularly in the elderly population 2 and with cerebrovascular disease 26 . We adjusted for both factors in our analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Mild abnormalities in movement may be seen as part of normal aging and during the early stages of a number of neurodegenerative conditions, including Parkinson's disease (PD). 1,2 Different terms have been used to describe these signs including sub-threshold parkinsonism (SP), mild parkinsonian signs and soft or mild extrapyramidal signs. The progression of PD is gradual and slow.…”

Section: Introductionmentioning

confidence: 99%

The Emergence and Progression of Motor Dysfunction in Individuals at Risk of Parkinson's Disease

et al. 2023

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BackgroundPREDICT‐PD is a United Kingdom population‐based study aiming to stratify individuals for future Parkinson's disease (PD) using a risk algorithm.MethodsA randomly selected, representative sample of participants in PREDICT‐PD were examined using several motor assessments, including the motor section of the Movement Disorder Society‐Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS)‐III, at baseline (2012) and after an average of 6 years of follow‐up. We checked for new PD diagnoses in participants seen at baseline and examined the association between risk scores and incident sub‐threshold parkinsonism, motor decline (increasing ≥5 points in MDS‐UPDRS‐III) and single motor domains in the MDS‐UPDRS‐III. We replicated analyses in two independent datasets (Bruneck and Parkinson's Progression Markers Initiative [PPMI]).ResultsAfter 6 years of follow‐up, the PREDICT‐PD higher‐risk group (n = 33) had a greater motor decline compared with the lower‐risk group (n = 95) (30% vs. 12.5%, P = 0.031). Two participants (both considered higher risk at baseline) were given a diagnosis of PD during follow‐up, with motor signs emerging between 2 and 5 years before diagnosis. A meta‐analysis of data from PREDICT‐PD, Bruneck, and PPMI showed an association between PD risk estimates and incident sub‐threshold parkinsonism (odds ratio [OR], 2.01 [95% confidence interval (CI), 1.55–2.61]), as well as new onset bradykinesia (OR, 1.69 [95% CI, 1.33–2.16]) and action tremor (OR, 1.61 [95% CI, 1.30–1.98]).ConclusionsRisk estimates using the PREDICT‐PD algorithm were associated with the occurrence of sub‐threshold parkinsonism, including bradykinesia and action tremor. The algorithm could also identify individuals whose motor examination experience a decline over time. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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“…As some patients already had mild motor symptoms 46 (two or more UPDRS III items with a score of 1 or an item with a score of 2 or higher), they might represent a later stage of the prodromal phase. 47 Another notable…”

Section: Discussionmentioning

confidence: 99%

Monitoring Substantia Nigra Degeneration Using Free Water Imaging across Prodromal and Clinical Parkinson's Disease

et al. 2023

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A BS TRACT: Background: Substantia nigra (SN) free water has been suggested as a good surrogate marker in Parkinson's disease (PD). However, its usefulness for diagnosing prodromal PD (pPD) and monitoring disease progression warrants further validation. Objective: The aim was to investigate SN free water values across prodromal and clinical stages of PD. Methods: Four groups were enrolled in this study: 48 healthy controls (HC), 43 pPD patients, 50 de novo PD (dnPD) patients, and 49 medicated PD (mPD) patients. Based on diffusion tensor images, free water maps were calculated, and SN free water values were extracted from the anterior SN (ASN) and posterior SN (PSN). The SN free water values were compared among the four groups, and associations between free water and clinical symptoms were explored. The distinguishing power of PSN free water was evaluated using the receiver operating characteristic curve analysis. Followup was performed for 14 pPD patients.Results: PSN free water in the pPD group was significantly higher than that in the HC group and significantly lower than that in the dnPD group. Surprisingly, the mPD group showed decreased PSN free water compared to the dnPD group. There was a positive correlation between motor symptoms and PSN free water in the pPD and dnPD groups. Longitudinal analysis showed a significant increase in PSN free water in pPD patients over time. Conclusions: The PSN free water increased from prodromal to early clinical stages, but the trend might be reversed in late disease stages. This biphasic trend should be considered when applying this marker in future studies.

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Mild Parkinsonian Signs: A Systematic Review of Clinical, Imaging, and Pathological Associations

Cited by 20 publications

References 111 publications

Rate control deficits during pinch grip and ankle dorsiflexion in early-stage Parkinson’s disease

Rate control deficits during pinch grip and ankle dorsiflexion in early-stage Parkinson’s disease

The Emergence and Progression of Motor Dysfunction in Individuals at Risk of Parkinson's Disease

Monitoring Substantia Nigra Degeneration Using Free Water Imaging across Prodromal and Clinical Parkinson's Disease

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