Kishore Asha, Espay Alberto J, Marras Connie, Al-Khairalla Thamer, Arenovich Tamara, Asante Abena, Miyasaki Janis, Lang Anthony E
Division of Neurology, Department of Medicine, Toronto Western Hospital, Toronto, Ontario, Canada.
Mov Disord. 2007 Feb 15;22(3):328-33. doi: 10.1002/mds.21238.
Patients with Parkinson's disease (PD) have an impaired ability to perform two different simultaneous bimanual tasks. The differential effects of unilateral versus bilateral identical tasks on the bradykinesia scores of the more and less affected limbs in PD have not been examined. Twenty-seven patients with early and asymmetric PD underwent blinded, videotaped assessment, independently for each limb, using the bradykinesia items of the Unified Parkinson's Disease Rating Part III, Motor subscale (mUPDRS) and a Modified Bradykinesia Rating Scale (MBRS), which assessed amplitude, speed, and rhythm of movements. We found that the score for finger tapping in mUPDRS and MBRS, the score of amplitude of finger tapping in MBRS, and the lateralized scores of mUPDRS (sum of Items 23 to 25) of the most affected side significantly improved during the bimanual task. The improvement was associated with longer duration of illness, higher total scores in mUPDRS, and higher lateralized bradykinesia scores of the most affected side. There was a simultaneous deterioration of the lateralized bradykinesia scores in MBRS (sum of Items 23 to 25) and Item 25 of mUPDRS (rapid alternating movements) of the least affected side in bimanual tasks. In conclusion, identical bimanual tasks facilitate movement of the most affected side in early asymmetric PD at the cost of motor degradation in the least affected side. This observation also highlights the need to perform tasks of bradykinesia in one limb at a time for best accuracy.
帕金森病（PD）患者执行两种不同的同时双手任务的能力受损。尚未研究单侧与双侧相同任务对PD中受影响程度较高和较低肢体的运动迟缓评分的差异影响。27例早期非对称性PD患者接受了盲法录像评估，使用统一帕金森病评定量表第三部分运动亚量表（mUPDRS）的运动迟缓项目和改良运动迟缓评定量表（MBRS），分别对每个肢体独立进行评估，MBRS评估运动的幅度、速度和节奏。我们发现，在双手任务期间，mUPDRS和MBRS中的手指轻敲评分、MBRS中手指轻敲幅度评分以及最受影响侧的mUPDRS侧化评分（第23至25项之和）显著改善。这种改善与病程较长、mUPDRS总分较高以及最受影响侧较高的侧化运动迟缓评分相关。在双手任务中，最不受影响侧的MBRS侧化运动迟缓评分（第23至25项之和）和mUPDRS的第25项（快速交替运动）同时恶化。总之，相同的双手任务以最不受影响侧的运动退化为代价，促进了早期非对称性PD中最受影响侧的运动。这一观察结果也凸显了每次仅对一个肢体进行运动迟缓任务以获得最佳准确性的必要性。
