Baylor College of Medicine, Houston, Texas.
University of Guanajuato, Leon, México.
Acta Neurol Scand. 2019 Aug;140(2):162-166. doi: 10.1111/ane.13117. Epub 2019 May 28.
Hand deformities have been recognized since the 19th century as part of the postural abnormalities observed in Parkinson's disease (PD). However, their pathogenesis and clinical correlations are poorly understood.
We evaluated 104 hands of 52 consecutive patients with PD by high-resolution photographs taken from the radial aspect of each hand; the degree of flexion of the 2nd metacarpophalangeal (MCP) joint was measured by software. The presence of classical striatal hand deformity (CSHD) was also evaluated, defined as MCP flexion, proximal interphalangeal joint extension, and distal interphalangeal joint flexion.
Patients with PD had a mean age of 63.3 ± 12.7 years, and 29 (56%) were male. The degree of MCP joint flexion in both hands showed moderate correlation with the MDS-UPDRS-III motor score (r = 0.518, P < 0.001), mainly related to ipsilateral rigidity and ipsilateral bradykinesia scores, and fair correlation with the Hoehn-Yahr stage. A CSHD only correlated with a younger age at onset of PD (P = 0.049). These hand deformities were not markers of dyskinesia, levodopa equivalent dose, or cognitive dysfunction.
Metacarpophalangeal joint flexion is the most common hand deformity in PD and correlates with rigidity and bradykinesia. A CSHD was only related to a younger age at onset.
手部畸形自 19 世纪以来一直被认为是帕金森病（PD）所观察到的姿势异常的一部分。然而，其发病机制和临床相关性仍不清楚。
我们通过从每个手部的桡侧拍摄高分辨率照片来评估 52 例连续 PD 患者的 104 只手；通过软件测量第 2 掌指关节（MCP）的弯曲程度。还评估了经典纹状体手畸形（CSHD）的存在，定义为 MCP 弯曲、近端指间关节伸展和远端指间关节弯曲。
PD 患者的平均年龄为 63.3±12.7 岁，29 名（56%）为男性。双手 MCP 关节弯曲程度与 MDS-UPDRS-III 运动评分呈中度相关（r=0.518，P<0.001），主要与同侧僵硬和同侧运动迟缓评分相关，与 Hoehn-Yahr 分期呈中度相关。CSHD 仅与 PD 的发病年龄较早相关（P=0.049）。这些手部畸形不是运动障碍、左旋多巴等效剂量或认知功能障碍的标志物。
MCP 关节弯曲是 PD 中最常见的手部畸形，与僵硬和运动迟缓相关。CSHD 仅与发病年龄较早有关。
