Shaikh Aasef G
Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44110, USA.
Movement Disorders Center, University Hospitals Case Medical Center, Cleveland, OH, USA.
Neurol Sci. 2017 May;38(5):855-863. doi: 10.1007/s10072-017-2852-6. Epub 2017 Feb 22.
Parkinson's disease, the most common cause of parkinsonism is often difficult to distinguish from its second most common etiology due to exposure to dopamine receptor blocking agents such as antiemetics and neuroleptics. Dual axis accelerometry was used to quantify tremor in 158 patients with parkinsonism; 62 had Parkinson's disease and 96 were clinically diagnosed with dopamine receptor blocking agent-induced parkinsonism. Tremor was measured while subjects rested arms (resting tremor), outstretched arms in front (postural tremor), and reached a target (kinetic tremor). Cycle-by-cycle analysis was performed to measure cycle duration, oscillation amplitude, and inter-cycle variations in the frequency. Patients with dopamine receptor blocker induced parkinsonism had lower resting and postural tremor amplitude. There was a substantial increase of kinetic tremor amplitude in both disorders. Postural and resting tremor in subjects with dopamine receptor blocking agent-induced parkinsonism was prominent in the abduction-adduction plane. In contrast, the Parkinson's disease tremor had equal amplitude in all three planes of motion. Tremor frequency was comparable in both groups. Remarkable variability in the width of the oscillatory cycles suggested irregularity in the oscillatory waveforms in both subtypes of parkinsonism. Quantitative tremor analysis can distinguish Parkinson's disease from dopamine receptor blocking agent-induced parkinsonism.
帕金森病是帕金森综合征最常见的病因，由于接触多巴胺受体阻断剂（如止吐药和抗精神病药），它往往难以与第二常见的病因相区分。采用双轴加速度计对158例帕金森综合征患者的震颤进行量化；其中62例患有帕金森病，96例临床诊断为多巴胺受体阻断剂所致帕金森综合征。在受试者手臂休息（静止性震颤）、向前伸展手臂（姿势性震颤）以及触及目标时（运动性震颤）测量震颤。进行逐周期分析以测量周期持续时间、振荡幅度以及频率的周期间变化。多巴胺受体阻断剂所致帕金森综合征患者的静止性和姿势性震颤幅度较低。两种疾病的运动性震颤幅度均显著增加。多巴胺受体阻断剂所致帕金森综合征患者的姿势性和静止性震颤在内收 - 外展平面较为突出。相比之下，帕金森病的震颤在所有三个运动平面的幅度相同。两组的震颤频率相当。振荡周期宽度的显著变异性表明两种帕金森综合征亚型的振荡波形均不规则。定量震颤分析可将帕金森病与多巴胺受体阻断剂所致帕金森综合征区分开来。
