Movement and reaction times and fine coordination tasks following pallidotomy

Abstract

The effect of a unilateral, microelectrode‐guided lesion in the globus pallidum internum (GPi) was evaluated in 41 patients (21 women) with moderately advanced Parkinson's disease (PD). The mean age was 60.3 ± 9.0 years (range, 40–74) and the mean symptom duration was 14.7 ± 5.3 years (range, 4–25). In addition to clinical ratings, movement time (MT) and reaction time (RT) tests were performed at baseline and 3 months after surgery during the “practically defined off” state (more than 12 hours after the last dose of levodopa). Improvement occurred bilaterally with more robust and statistically significant improvement on the contralateral side in all RT tests. Simple reaction time (SRT) improved by 14.5% (p < 0.001) and the choice reaction time (CRT) by 12.2% (p < 0.001) when the arm contralateral to the pallidotomy side was tested. There was a trend toward improvement in the ipsilateral arm. The MT, determined by repetitive movement between two adjacent targets, improved by 24% contralaterally (p < 0.0001) and by 12% ipsilaterally (p < 0.005). In addition, the Purdue Pegboard (PP) test scores, used to evaluate hand dexterity, improved on the contralateral side by 35.5% (p < 0.0002) but there was no statistically significant ipsilateral improvement. To the extent that MT and RT are quantitative measures of bradykinesia, our study provides evidence that this parkinsonian feature improves after pallidotomy.

The influence of interval versus continuous exercise on thermoregulation, torso hemodynamics, and finger dexterity in the cold

“…Volunteers maintained bare hands throughout the protocol. For testing, they picked up the pegs one by one ) and placed them sequentially (Jankovic et al 1999) into the board from top to bottom as fast as possible. Each test lasted 30 s; the total score was the number of pegs for the dominant hand portion and pairs of pegs for the bimanual portion (Tiffin and Asher 1948).…”

Neuropsychologic assessment of patients for movement disorder surgery

“…While straightforward finger tapping does not add much to the assessment, requiring patients to tap "automatically" while carrying out a distractor task with the other hand (such as coin sorting) allows the evaluation of the capacity to maintain an internally driven motor program under divided attention (see references 3 and 87). Objective measurement of postoperative motor capacity may be done clinically with the UPDRS and blind ratings 88,89 or experimentally [90][91][92] (see reference 93 for a thorough discussion of this topic).…”

Development of an Objective Motor Score for Monitoring the Progression and Severity of Parkinson's Disease

“…Additionally, the Purdue pegboard test and UPDRS were scored. Significant improvement in movement time and reaction time tests was shown when comparing pre/post pallidotomy results for both contralateral and ipsilateral hands [46].…”