Fenney Alison, Jog Mandar S, Duval Christian
Département de Kinanthropologie, Université du Québec à Montréal, C.P. 8888, Succursale Centre-Ville, Montréal, Québec, Canada H3C 3P8.
Clin Neurol Neurosurg. 2008 Feb;110(2):160-7. doi: 10.1016/j.clineuro.2007.10.010. Epub 2007 Dec 3.
Clinical observations have noted variability in amplitude of levodopa-induced dyskinesias (LID) in Parkinson's disease (PD) and chorea in Huntington's disease (HD) during the day. However, no studies have examined whether both the amplitude and body location (motor topography) of whole-body involuntary movement (WBIM) varied over short periods of time (seconds or minutes), which may have a distinct and significant effect on how disruptive these WBIM may be. The present study quantified the variability of WBIM amplitude and motor topography in patients with PD having LID and in patients with HD having chorea.
WBIM was quantified using the MotionMonitor magnetic motion tracker system. Five patients in each group were tested in two conditions: sitting and standing.
WBIM increased from sitting to standing, more so in choreic patients. WBIM varied from 17% to 102% of total WBIM amplitude. Chorea tended to present with greater variability than LID in absolute terms in the standing condition, but not when the mean WBIM amplitude was taken into consideration. Motor topography of WBIM also varied more in the HD group, but mostly in the seated condition where more limbs were free to move. Neither group expressed any laterality of involuntary movement, with amplitude being equally distributed on both sides of the body.
Results show significant short-term variability in amplitude of chorea and LID, as well as, variability in location of these involuntary movements, illustrating the complexity of the adaptations required to live and be active with involuntary movements such as HD chorea or PD dyskinesias.
临床观察发现,帕金森病(PD)患者左旋多巴诱发的异动症(LID)以及亨廷顿舞蹈病(HD)患者舞蹈症的幅度在一天中存在变异性。然而,尚无研究探讨全身不自主运动(WBIM)的幅度和身体部位(运动地形图)是否会在短时间内(数秒或数分钟)发生变化,而这可能对这些WBIM的干扰程度产生独特且显著的影响。本研究对患有LID的PD患者和患有舞蹈症的HD患者WBIM的幅度和运动地形图变异性进行了量化。
使用MotionMonitor磁运动跟踪系统对WBIM进行量化。每组5名患者在两种状态下接受测试:坐姿和站姿。
从坐姿到站姿,WBIM增加,舞蹈症患者增加得更多。WBIM占WBIM总幅度的17%至102%。在站姿下,舞蹈症在绝对值上的变异性往往比异动症更大,但在考虑WBIM平均幅度时并非如此。HD组中WBIM的运动地形图变化也更大,但主要是在坐姿下,此时更多肢体可以自由活动。两组均未表现出不自主运动的任何偏向性,幅度在身体两侧均匀分布。
结果显示舞蹈症和异动症的幅度在短期内存在显著变异性,以及这些不自主运动的位置变异性,说明了在患有诸如HD舞蹈症或PD异动症等不自主运动的情况下,为了生活和活动所需要适应的复杂性。