Fleminger S
Department of Psychiatry, Institute of Psychiatry, London, UK.
Brain. 1992 Oct;115 ( Pt 5):1459-80. doi: 10.1093/brain/115.5.1459.
Patients with depressive motor retardation, neuroleptic induced parkinsonism or Parkinson's disease were tested on movement tasks requiring control of simultaneous movements. This was in order to determine whether these three groups of patients, who all show slowing of movements, also share the distinctive impairment of simultaneous movement control that is observed in Parkinson's disease. Though all three patient groups showed equivalent slowing on the motor tasks that were studied, the patterns of impairment were different. Only the patients with parkinsonism, either neuroleptic induced or from Parkinson's disease, showed additional slowing of a rapid ballistic elbow flexion movement when it was performed simultaneously with a rapid squeeze of the ipsilateral hand. Only patients with parkinsonism showed a significant increase in dual task interference on a bimanual bead and tapper task, compared with controls. The bead and tapper interference in patients with depressive motor retardation was between that of controls and parkinsonism. Having a bimanual skill had a large effect on the subjects' dual task interference on this task. The measures of dual task interference for the two tasks did not correlate with one another; difficulty running simultaneous motor programs does therefore not explain the interference that is observed when tapping is performed while the other hand simultaneously performs a dextrous motor task. Only patients with parkinsonism showed increased fatigue on the tapping task. The patients with depressive motor retardation did have elevated scores on a clinical rating of parkinsonism. Nevertheless there are clearly defined differences between the movement disorder observed in patients with depression, and that observed in in parkinsonism. The patterns of impairments in patients with neuroleptic parkinsonism were very similar to those of Parkinson's disease.
对患有抑郁性运动迟缓、抗精神病药物所致帕金森综合征或帕金森病的患者进行了需要控制同时进行的运动任务的测试。目的是确定这三组均表现出运动迟缓的患者是否也存在帕金森病中所观察到的同时运动控制的独特损伤。尽管所有三组患者在所研究的运动任务中均表现出同等程度的运动迟缓，但损伤模式有所不同。只有患有帕金森综合征的患者，无论是抗精神病药物所致还是帕金森病患者，在快速弹道式屈肘运动与同侧手部快速挤压同时进行时，该屈肘运动会出现额外的迟缓。与对照组相比，只有患有帕金森综合征的患者在双手珠子和敲击任务中的双重任务干扰显著增加。抑郁性运动迟缓患者的珠子和敲击干扰程度介于对照组和帕金森综合征患者之间。具备双手技能对受试者在此任务中的双重任务干扰有很大影响。这两项任务的双重任务干扰测量值彼此不相关；因此，难以同时运行运动程序并不能解释在一只手同时执行精细运动任务时进行敲击时所观察到的干扰。只有患有帕金森综合征的患者在敲击任务中表现出疲劳增加。抑郁性运动迟缓患者在帕金森综合征临床评分上确实得分较高。然而，抑郁症患者所观察到的运动障碍与帕金森综合征患者所观察到的运动障碍之间存在明确的差异。抗精神病药物所致帕金森综合征患者的损伤模式与帕金森病患者非常相似。
