Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom.
Mov Disord. 2011 Jun;26(7):1266-73. doi: 10.1002/mds.23684. Epub 2011 Mar 25.
Patients diagnosed with Parkinson's disease on clinical grounds who subsequently turn out to have normal dopamine transporter imaging have been referred to as SWEDDs (scans without evidence of dopaminergic deficits). Despite having clinical features similar to those of Parkinson's disease, these patients seem to have different pathophysiology, prognosis, and treatment requirements. In this study we determined the similarities and differences in the gaits of SWEDDs and Parkinson's disease patients to investigate whether walking patterns can distinguish these entities. We used 3-D motion capture to analyze the gaits of 11 SWEDDs patients (who had unilateral or asymmetric upper limb tremor with a rest component), 12 tremor-dominant Parkinson's disease patients, and 13 healthy control participants. In common with Parkinson's disease patients, SWEDDs patients had a slow gait mainly because of a small stride length, as well as a reduced arm swing. However, several abnormal features of posture and gait in Parkinson's disease were normal in SWEDDs. Thus, SWEDDs patients had normal trunk and elbow posture, normal stride length variability, and normal bilateral step-phase coordination, all of which were abnormal in Parkinson's disease patients. We also searched for signs of ataxic movements during normal and tandem walking, but found no evidence that ataxic gait was a general feature in SWEDDs. These findings could aid the clinician in identification of potential tremulous SWEDDs cases. © 2011 Movement Disorder Society.
临床上诊断为帕金森病但随后多巴胺转运体成像正常的患者被称为 SWEDDs（扫描无多巴胺能缺陷）。尽管这些患者具有与帕金森病相似的临床特征，但它们似乎具有不同的病理生理学、预后和治疗需求。在这项研究中，我们确定了 SWEDDs 和帕金森病患者步态的相似点和不同点，以研究行走模式是否可以区分这些实体。我们使用 3-D 运动捕捉技术分析了 11 名 SWEDDs 患者（单侧或不对称上肢震颤伴有休息成分）、12 名震颤为主的帕金森病患者和 13 名健康对照参与者的步态。与帕金森病患者一样，SWEDDs 患者的步态缓慢，主要是因为步幅较小，手臂摆动减少。然而，帕金森病中几个异常的姿势和步态特征在 SWEDDs 中是正常的。因此，SWEDDs 患者的躯干和肘部姿势正常，步长变异性正常，双侧步相协调正常，而这些在帕金森病患者中都是异常的。我们还在正常和串联行走期间寻找共济失调运动的迹象，但没有发现共济失调步态是 SWEDDs 的一般特征的证据。这些发现可以帮助临床医生识别潜在的震颤 SWEDDs 病例。© 2011 运动障碍学会。
