Stegemöller Elizabeth L, Uzochukwu Jennifer, Tillman Mark D, McFarland Nikolaus R, Subramony S H, Okun Michael S, Hass Chris J
Department of Kinesiology, Iowa State University, 235 Forker, Ames, IA 50011 USA ; Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, USA ; Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, McKnight Brain Institute, Gainesville, USA.
Department of Kinesiology, Iowa State University, 235 Forker, Ames, IA 50011 USA.
J Clin Mov Disord. 2015 Feb 16;2:6. doi: 10.1186/s40734-014-0015-y. eCollection 2015.
Differentiating movement disorders is critical for appropriate treatment, prognosis, and for clinical trials. In clinical trials this is especially important as effects can be diluted by inclusion of inappropriately diagnosed participants. In early disease duration phases, disorders often have overlapping clinical features, such as impairments in repetitive finger movement, making diagnosis challenging. The purpose of this pilot study was to examine and compare repetitive finger movement performance in participants diagnosed with idiopathic Parkinson's disease, Progressive Supranuclear Palsy, and spinocerebellar ataxias.
Participants completed an unconstrained index finger flexion/extension movement (i.e. finger tap) in time with an incremental acoustic tone. Measures of movement rate, movement amplitude, and coefficient of variation were compared among groups.
Significant differences between groups were revealed for movement rate at faster tone rates. Participants with Parkinson's disease tended to tap faster than the tone rate while participants with Progressive Supranuclear Palsy and spinocerebellar ataxia tended to tap slower. No significant differences were revealed for movement amplitude, but participants with spinocerebellar ataxia demonstrated greater variance in amplitude than participants with Parkinson's disease.
Quantitative analysis of repetitive finger movement performance at faster rates may be helpful to differentiate Parkinson's Disease, Progressive Supranuclear Palsy and spinocerebellar ataxia.
区分运动障碍对于恰当的治疗、预后评估以及临床试验至关重要。在临床试验中，这一点尤为重要，因为不恰当诊断的参与者纳入可能会稀释疗效。在疾病早期阶段，各种障碍往往具有重叠的临床特征，例如重复性手指运动受损，这使得诊断具有挑战性。这项初步研究的目的是检查和比较被诊断为特发性帕金森病、进行性核上性麻痹和脊髓小脑共济失调的参与者的重复性手指运动表现。
参与者随着递增的音调及时完成无约束的食指屈伸运动（即手指敲击）。比较了各组之间的运动速率、运动幅度和变异系数测量值。
在较快音调速率下，各组之间的运动速率存在显著差异。帕金森病参与者的敲击速度往往比音调速率快，而进行性核上性麻痹和脊髓小脑共济失调参与者的敲击速度往往较慢。运动幅度方面未发现显著差异，但脊髓小脑共济失调参与者的幅度变异比帕金森病参与者更大。
对较快速率下的重复性手指运动表现进行定量分析可能有助于区分帕金森病、进行性核上性麻痹和脊髓小脑共济失调。
