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Excessive Hand Force in Parkinson's Disease with Levodopa-Induced Dyskinesias
A DGReview of :"Force overflow and levodopa-induced dyskinesias in Parkinson's disease"
Brain
04/16/2002
By David Ball
Levodopa-induced dyskinesias (LID) and grip force excess in patients with Parkinson's disease could well share common pathophysiological mechanisms related to motor fluctuations.
This is the view of a team of researchers at the Department of Neurology of the Christian-Albrechts Universität Kiel, Germany, who found force excess only in subjects with LID and motor fluctuations.
Their study of 23 Parkinson's disease patients with LID and 10 without LID, who were compared with age matched healthy controls, assessed the relationship of motor complications of levodopa therapy with force co-ordination of the hand.
Dyskinesias in those on the drug therapy was found to have a close relationship with the overshooting of forces. Assessments on and off levodopa were made using the motor score of the Unified Parkinson's Disease Rating Scale, a dyskinesia score and force in a grip-lift paradigm.
The force involved in pressing down the object before lifting by patients with Parkinson's disease + LID was seen to be significantly increased by levodopa (by 61 percent).
Compared with the off-drug condition, the on-state showed an overshooting of peak grip force by 51 percent (P < 0.05) and of static grip force by 45 percent, whereas no excessive force was seen in Parkinson's disease - LID.
While peak grip force in on-state was found to be 140 percent higher in Parkinson's disease + LID compared with Parkinson's disease - LID, static grip force increased by 138 percent (P < 0.01) between the groups.
A strong correlation was found between the severity of peak dose dyskinesias and grip force in on-state (r = 0.79 with peak force).
There was no apparent correlation between forces and the motor score as well as with the daily dose of dopaminergic medication.
Brain, April 2002, Vol. 125, No. 4, 871-879.
"Force overflow and levodopa-induced dyskinesias in Parkinson's disease"
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