van Hilten J J, van Eerd A A, Wagemans E A, Middelkoop H A, Roos R A
Department of Neurology, Leiden University Medical Center, The Netherlands.
J Neural Transm (Vienna). 1998;105(2-3):229-37. doi: 10.1007/s007020050051.
Because in the literature bradykinesia and hypokinesia are frequently confounded, we assessed the relation between these two fundamental aspects of altered movement and the influence of disease severity on these measures in 41 patients with Parkinson's disease (PD) and 24 age-matched healthy controls. Bradykinesia was measured with a test microcomputer interfaced with a response-board. Hypokinesia was assessed by activity monitoring at home over a period of 5 successive days. For each subject the choice reaction time and measures reflecting bradykinesia (tap rate, movement time) and hypokinesia (movement index, duration of immobility periods) were calculated. Patients with PD had a normal choice reaction time and a significantly impaired execution of voluntary movement and reduced amount of movement over time. Bradykinesia was clearly present in the less affected patients with PD, and worsened as the disease severity increased. Hypokinesia, however, emerged prominently only in the more affected patients. There was a striking lack of relation between the measures that reflect bradykinesia and hypokinesia. The use of levodopa or dopamine agonists did not confound these findings. Our findings show the very different character and course of two tiers of altered movement in patients with PD and question the causative mechanisms of both motor features in PD. A more precise use of the terms brady- and hypokinesia is a prerequisite for future studies that attempt to provide insight in the causative mechanisms of both motor features.
由于在文献中运动迟缓与运动减少常被混淆，我们评估了这两个运动改变的基本方面之间的关系，以及疾病严重程度对41例帕金森病（PD）患者和24例年龄匹配的健康对照者这些指标的影响。运动迟缓通过与反应板相连的测试微型计算机进行测量。运动减少通过连续5天在家进行活动监测来评估。为每个受试者计算选择反应时间以及反映运动迟缓（敲击速率、运动时间）和运动减少（运动指数、静止期持续时间）的指标。PD患者的选择反应时间正常，但随意运动的执行明显受损，且随着时间推移运动总量减少。运动迟缓在病情较轻的PD患者中明显存在，并随着疾病严重程度的增加而恶化。然而，运动减少仅在病情较重的患者中显著出现。反映运动迟缓与运动减少的指标之间明显缺乏关联。左旋多巴或多巴胺激动剂的使用并未混淆这些发现。我们的研究结果显示了PD患者运动改变的两个层面具有非常不同的特征和病程，并对PD这两种运动特征的致病机制提出了质疑。更精确地使用运动迟缓和运动减少这两个术语是未来研究试图深入了解这两种运动特征致病机制的前提条件。
