Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Mov Disord. 2010 Nov 15;25(15):2531-5. doi: 10.1002/mds.23304.
To study the influence of discriminative cutaneous sensory dysfunction on impaired finger dexterity in Parkinson's disease (PD), we evaluated 48 right-handed PD patients during a practically defined off-medication period and 24 healthy age-matched controls. With visual deprivation, a finger tapping task (FTT) was performed to assess the speed of simple repetitive finger movements and a coin rotation task (CRT) was used to assess finger dexterity. The tasks were performed with the right hand. We measured the somesthetic temporal discrimination threshold (sTDT) in the right index finger. The mean ± SD FTT score of the patient group was lower than that of the control group (24.0 ± 8.0 vs. 29.8 ± 7.8; P < 0.01). The patient group performed worse on the CRT than the control group (8.5 ± 3.5 vs. 12.6 ± 1.7; P < 0.001). The mean sTDT value of the patient group was longer than that of the control group (124.0 ± 44.8 vs. 78.1 ± 26.2 ms; P < 0.001). The CRT scores correlated with the sTDT values (Pearson's correlation coefficient = -0.43; P < 0.01), but not with the Unified Parkinson's Disease Rating Scale (UPDRS) finger bradykinesia scores or FTT scores. Multiple regression analysis showed that the sTDT values (parameter estimate = -0.03, SE = 0.01; P < 0.01), but not patient age, UPDRS finger bradykinesia score, or FTT score, affected the CRT score. Slowness of simple repetitive finger movements did not have a strong impact on the impaired manual dexterity of PD. Discriminative sensory dysfunction and consequent abnormal sensorimotor integration seem to be involved in the impaired finger dexterity of PD.
为了研究鉴别性皮肤感觉功能障碍对帕金森病(PD)患者手指灵巧度受损的影响,我们在实际停药期评估了 48 名右利手 PD 患者和 24 名年龄匹配的健康对照者。在视觉剥夺的情况下,进行手指敲击任务(FTT)以评估简单重复手指运动的速度,并用硬币旋转任务(CRT)评估手指灵巧度。任务用右手完成。我们测量了右手食指的体感时间辨别阈值(sTDT)。患者组的平均 FTT 评分低于对照组(24.0 ± 8.0 对 29.8 ± 7.8;P < 0.01)。患者组 CRT 的表现明显差于对照组(8.5 ± 3.5 对 12.6 ± 1.7;P < 0.001)。患者组的平均 sTDT 值长于对照组(124.0 ± 44.8 对 78.1 ± 26.2 ms;P < 0.001)。CRT 评分与 sTDT 值相关(Pearson 相关系数 = -0.43;P < 0.01),但与帕金森病统一评定量表(UPDRS)手指运动迟缓评分或 FTT 评分无关。多元回归分析显示,sTDT 值(参数估计=-0.03,SE=0.01;P < 0.01),而不是患者年龄、UPDRS 手指运动迟缓评分或 FTT 评分,影响 CRT 评分。简单重复手指运动的缓慢对 PD 患者受损的手动灵巧性没有很大影响。鉴别性感觉功能障碍和随之而来的异常感觉运动整合似乎与 PD 患者手指灵巧度受损有关。