Unilateral Parkinson's disease, clinical and neuropathologic findings

Martinez, A. J.; Utterback, Robert A.

doi:10.1212/wnl.23.2.164

Cited by 13 publications

(4 citation statements)

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“…In contrast, the left side was lesioned only moderately. Clinical signs of PD were exhibited early as left-hand tremor and progressed over time coupled with rigidity, bradykinesia, posture and gait disturbances (Martinez and Utterback 1973).…”

Section: Environmental Toxins and Lateralitymentioning

confidence: 99%

“…However, it cannot be excluded that other factors may also account for the unilaterality in such cases. Indeed Martinez and Utterback (1973) showed damage prior to the environmental intoxication, which may have altered the ability of neurons to cope with the metabolic demand (Nikkhah et al 2001;Tang et al 2010). Therefore, environmental intoxication in almost all cases causes bilateral onset of sporadic PD.…”

Section: Environmental Toxins and Lateralitymentioning

confidence: 99%

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The significance of neuronal lateralisation in Parkinson’s disease

Riederer

Sian-Hülsmann

2012

J Neural Transm

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The destruction of the dopaminergic neurons in the substantia nigra (SN) and consequent depletion of striatal dopamine elicits the main movement deficits related to Parkinson's disease (PD). In the early stages of the illness, the motor symptoms are often exhibited asymmetrically. Thus, the onset of PD features starts on either the right or left side. The side of onset appears to determine the prognosis of the disorder and other features, such as right-side tremor dominance has a better prognosis in contrast to left-side dominant bradykinesia-rigidity. In addition, left-side onset of motor features is associated with cognitive decline. Therefore, an intricate relation appears to exist between the side of disease onset and progression/severity and other non-motor symptoms. Unilateral PD in turn corresponds to neuronal nigrostriatal degeneration in the contralateral hemisphere. Indeed positron emission tomography has demonstrated a positive correlation between symptom asymmetry and brain function (Hoorn et al. Parkinsonism Relat Disord 17:58-60, 2011), which corresponds to a unilateral pattern of degeneration. This phenomenon appears to be exclusive to PD. Additionally, the variation in motor symptom(s) dominance exhibited in the disorder conforms to the notion that PD is a spectrum disease with many sub-groups. Thus, clinical and post mortem studies on "lateralisation" may serve as a vital tool in understanding the mechanism(s) eliciting the characteristic destruction of the SN neurons. Additionally, it may be employed as a predictive indicator for the symptomology and prognosis of the illness thus allowing selective treatment strategies targeted at the pronounced hemispheric degeneration.

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Section: Environmental Toxins and Lateralitymentioning

confidence: 99%

Section: Environmental Toxins and Lateralitymentioning

confidence: 99%

The significance of neuronal lateralisation in Parkinson’s disease

Riederer

Sian-Hülsmann

2012

J Neural Transm

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“…Parkinson's disease (PD) is characterized by motor, sensory, and attentional impairments [1]–[2], and is related to a progressive degeneration of dopamine producing neurons in the substantia nigra pars compacta [3]. Motor symptoms are manifest in many laboratory-based motor tasks [4]–[5] and analogues of real-world tasks [6]–[8].…”

Section: Introductionmentioning

confidence: 99%

Music Attenuates Excessive Visual Guidance of Skilled Reaching in Advanced but Not Mild Parkinson's Disease

2009

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Parkinson's disease (PD) results in movement and sensory impairments that can be reduced by familiar music. At present, it is unclear whether the beneficial effects of music are limited to lessening the bradykinesia of whole body movement or whether beneficial effects also extend to skilled movements of PD subjects. This question was addressed in the present study in which control and PD subjects were given a skilled reaching task that was performed with and without accompanying preferred musical pieces. Eye movements and limb use were monitored with biomechanical measures and limb movements were additionally assessed using a previously described movement element scoring system. Preferred musical pieces did not lessen limb and hand movement impairments as assessed with either the biomechanical measures or movement element scoring. Nevertheless, the PD patients with more severe motor symptoms as assessed by Hoehn and Yahr (HY) scores displayed enhanced visual engagement of the target and this impairment was reduced during trials performed in association with accompanying preferred musical pieces. The results are discussed in relation to the idea that preferred musical pieces, although not generally beneficial in lessening skilled reaching impairments, may normalize the balance between visual and proprioceptive guidance of skilled reaching.

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“…Curvature of the spine is a well-recognized feature of parkinsonism (Martin, 1967). The concavity of the scoliosis is more often directed away from the side of greater rigidity (Duvoisin & Marsden, 1975).…”

Section: Discussionmentioning

confidence: 99%

Hemiparkinsonism With Infarction of the Ipsilateral Substantia Nigra

Hunter

Smith

Thomson

et al. 1978

Neuropathology Appl Neurobio

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An elderly man suffering from dementia associated with hypertension developed right-sided parkinsonism marked by rigidity and flexion. At autopsy the brain showed generalized vascular changes chiefly in the white matter, diffuse plaque and neurofibrillary tangle formation in the temporal cortex, and a discrete gliotic scar in the right substantia nigra. Hemiparkinsonism with a strictly unilateral lesion confined to the substantia nigra has, to our knowledge, not been described before, and the fact that it was ipsilateral adds to its theoretical interest.

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Unilateral Parkinson's disease, clinical and neuropathologic findings

Cited by 13 publications

References 0 publications

The significance of neuronal lateralisation in Parkinson’s disease

The significance of neuronal lateralisation in Parkinson’s disease

Music Attenuates Excessive Visual Guidance of Skilled Reaching in Advanced but Not Mild Parkinson's Disease

Hemiparkinsonism With Infarction of the Ipsilateral Substantia Nigra

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