Frazzitta Giuseppe, Ferrazzoli Davide, Maestri Roberto, Rovescala Roberta, Guaglio Gabriele, Bera Rossana, Volpe Daniele, Pezzoli Gianni
Department of Parkinson Disease and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Gravedona ed Uniti, Italy; Fondazione Europea Ricerca Biomedica (FERB), "S.Isidoro" Hospital, Trescore Balneario, Italy.
Department of Parkinson Disease and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Gravedona ed Uniti, Italy.
PLoS One. 2015 Mar 25;10(3):e0121251. doi: 10.1371/journal.pone.0121251. eCollection 2015.
Muscular weakness is a frequent cause of instability that contributes to falls in Parkinson's disease (PD). Isokinetic dynamometry is a method of muscle assessment useful to measure the muscular strength giving a quantification of the weakness, but only few studies about isokinetic assessment were performed in PD. The aims of the study were to evaluate the muscle strength in PD and to investigate the differences in patients affected on the right and left side.
Knee flexor and extensor muscles strength was assessed using an isokinetic dynamometer in 25 patients in stage 3 H&Y and in 15 healthy controls. Subjects were tested in both legs at three fixed angular velocities: 90°/s, 120°/s, 180°/s.
Considering the whole population of Parkinsonians, no difference in strength was observed with respect to controls. Considering the side, patients affected on the right side showed a clear tendency to be weaker than patients affected on the left side and controls.
PD patients affected on the right side, but not those affected on the left side, had a reduction in muscle strength as compared to controls. We postulate a central origin deficit in muscle strength in PD. It is known that dopamine transporter binding is more severely reduced in the left posterior putamen and our results suggest that the control of the muscle strength in PD is linked to the right-left hemispheric asymmetry of the functional organization of basal ganglia and with their connections to cortical motor and pre-motor areas.
肌肉无力是导致帕金森病（PD）患者跌倒的不稳定状态的常见原因。等速肌力测试是一种用于评估肌肉力量的方法，有助于量化肌肉无力，但关于PD患者等速肌力评估的研究较少。本研究的目的是评估PD患者的肌肉力量，并调查左右侧受累患者之间的差异。
使用等速肌力测试仪对25例H&Y 3期患者和15名健康对照者的膝部屈肌和伸肌力量进行评估。受试者在双腿上以三种固定角速度进行测试：90°/秒、120°/秒、180°/秒。
就帕金森病患者总体而言，与对照组相比，未观察到力量差异。就左右侧而言，右侧受累患者明显比左侧受累患者和对照组更虚弱。
与对照组相比，右侧受累的PD患者肌肉力量降低，而左侧受累患者则未出现这种情况。我们推测PD患者肌肉力量不足源于中枢。已知左侧后壳核中多巴胺转运体结合减少更为严重，我们的结果表明，PD患者肌肉力量的控制与基底神经节功能组织的左右半球不对称及其与皮质运动和运动前区的连接有关。
