Motor laterality asymmetry and nonmotor symptoms in Parkinson's disease

Abstract

Abstract:Background: In patients with Parkinson's disease (PD), asymmetric motor signs provide an interesting model to evaluate whether asymmetric nigrostriatal degeneration can affect neuropsychological function and other nonmotor symptoms (NMS). This study was designed to evaluate the predominant laterality of motor symptoms and its relationship with cognition and other NMS in idiopathic PD. Methods: Nationwide, longitudinal, and multicenter study (ELEP Registry) using outpatients with PD. Left PD (LPD) and right PD (RPD) was defined based on the motor signs on the SCOPA-motor scale. To include the clinical spectrum of asymmetric PD patients, we considered two groups of patients with mild-moderate and extreme asymmetry. Predominant LPD or RPD with mild-moderate versus extreme asymmetry were compared using the following scales: cognition, psychosis (Parkinson Psychosis Rating Scale), anxiety/depression, sleep (and autonomic dysfunction at baseline and 1 year later. Nonparametric tests were used for comparison. Results: One hundred fortynine PD patients (74 RPD and 75 LPD) with mild-moderate asymmetry and 90 (47 RPD and 43 LPD) with extreme asymmetry and a mean age of 64.5 (10.4) years were included. Extreme RPD had higher Parkinson Psychosis Rating Scale scores over time (P 5 0.005) compared with LPD, but no significant differences were observed between LPD and RPD in terms of other NMS. Conclusions: These findings suggest that damage to left-hemisphere plays a disproportionately greater role in PD-related psychosis over time. In contrast, motor laterality does not consistently affect other NMS, suggesting that NMS are related to a more widespread brain disorder.2009 Movement Disorder Society

The significance of neuronal lateralisation in Parkinson’s disease

“…Similarly, the neuropsychological decline observed in PD exhibits a marked variation ranging from mild/no-cognitive deficits to frank dementia, thus suggesting that motor lateralisation does not consistently affect non-motor symptoms (Cubo et al 2010). Additionally, the right-sided symptoms are related to verbal deficits while in contrast the left-sided signs were associated to spatial deficits (Blonder et al 1989).…”

Clinical Correlates of Apathy in Patients Recently Diagnosed with Parkinson’s Disease: The ANIMO Study

“…It is well known that the motor symptoms of PD are mainly due to progressive asymmetric degeneration of nigral dopaminergic neurons [26] . Since this is an observational study, we cannot preclude more conclusions, but it seems that the PD left hemisphere may be dominant in mood and apathy, in contrast to previous findings, where apathy was a prominent feature of a dysfunction in the right prefrontal pathway [27] .…”

“…The presence and severity of motor impairment was assessed during the 'on state' using the motor subscale of the Unified Parkinson Disease Rating Scale (UPDRSm) [9] , and the Hoehn and Yahr stage [10] . The UPDRSm provided the following scores: bradykinesia-rigidity score (sum of the bradykinesia plus rigidity items), tremor score (sum of the postural and rest tremor items), axial score (sum of the gait, postural stability, facial expression, and speech items), and total score [11] . We also asked the neurologists to supply medical information related to these patients, including age, gender, educational level, marital status, environment (urban vs. rural area), employment status, and medications.…”

Bilateral Distribution of Oxytocinase Activity in the Medial Prefrontal Cortex of Spontaneously Hypertensive Rats with Experimental Hemiparkinsonism

“…In the early stages, PD patients exhibit cognitive and behavioral impairments unrelated to the motor symptoms, and involving frontal lobe dysfunction (Brück et al, 2004;Farina et al, 1994;Zgaljardic et al, 2006). They are the result of damage of a specific hemisphere (Cubo et al, 2010). In addition, hemiparkinsonism has been associated with asymmetrical cognitive changes (Huber et al, 1992;Piacentini et al, 2010).…”