Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea.
Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea.
J Neural Transm (Vienna). 2018 Sep;125(9):1333-1339. doi: 10.1007/s00702-018-1901-5. Epub 2018 Jul 3.
Impaired finger dexterity occurs in Parkinson's disease (PD) and has been considered a limb-kinetic apraxia associated with primary sensory cortical dysfunction. To study the role of nigrostriatal dopamine loss and elementary parkinsonian motor deficits in impaired finger dexterity of PD. Thirty-two right-handed untreated PD patients and 30 right-handed healthy controls were included. All patients underwent [F] FP-CIT positron emission tomography studies. We examined the associations among unilateral coin rotation (CR) score, Unified Parkinson's Disease Rating Scale (UPDRS) subscores for bradykinesia and rigidity of the corresponding arm, and contralateral regional striatal dopamine transporter (DAT) uptake. We also measured the effect of oral levodopa dose on CR scores and UPDRS subscores. PD patients performed worse than controls on the CR task. Unilateral arm UPDRS bradykinesia scores were associated with DAT uptake in the contralateral putamen. The left CR score was associated with left arm bradykinesia and rigidity scores and DAT uptake in the right posterior putamen, whereas no such associations were found for the right CR score. There was a significant effect of handedness on the association of putamen DAT uptake with CR scores, but not with UPDRS subscores. An oral levodopa challenge improved CR scores and UPDRS subscores on both sides. Impaired finger dexterity in PD is related to elementary parkinsonian motor deficits and nigrostriatal dopamine loss. Impaired dominant hand dexterity associated with nigrostriatal dopamine loss seems to be compensated to some extent by the dominant cerebral cortex specialized for controlling precise finger movements.
帕金森病（PD）患者存在手指灵活性受损，被认为与原发性感觉皮质功能障碍有关的肢体运动性失用症。为了研究黑质纹状体多巴胺丧失和原发性帕金森运动缺陷在 PD 患者手指灵活性受损中的作用。纳入 32 名右利手未经治疗的 PD 患者和 30 名右利手健康对照者。所有患者均接受[F] FP-CIT 正电子发射断层扫描研究。我们检查了单侧硬币旋转（CR）评分、统一帕金森病评定量表（UPDRS）运动迟缓与僵硬亚评分与相应手臂对侧纹状体多巴胺转运体（DAT）摄取之间的关系。我们还测量了口服左旋多巴剂量对 CR 评分和 UPDRS 亚评分的影响。PD 患者在 CR 任务中的表现逊于对照组。单侧手臂 UPDRS 运动迟缓评分与对侧壳核 DAT 摄取相关。左 CR 评分与左手臂运动迟缓和僵硬评分以及右侧壳核后部 DAT 摄取相关，而右侧 CR 评分则无相关性。利手对壳核 DAT 摄取与 CR 评分的相关性有显著影响，但对 UPDRS 亚评分无影响。口服左旋多巴可改善双侧 CR 评分和 UPDRS 亚评分。PD 患者手指灵活性受损与原发性帕金森运动缺陷和黑质纹状体多巴胺丧失有关。与黑质纹状体多巴胺丧失相关的优势手灵活性受损似乎在一定程度上被优势大脑皮层控制精细手指运动的功能所代偿。
