Objective: We aimed to verify the discriminative properties of facial-, upper- and lower-limb bradykinesia in patients with PD, as assessed by motion capture analysis.

Background: Kinematic analysis allows objective evaluation of bradykinesia, one of the cardinal motor symptoms in patients with Parkinson’s disease (PD). While upper-limb bradykinesia in PD has been characterized in a relatively high number of studies using kinematic techniques, little is known on facial- and lower-limb bradykinesia.

Method: We included 15 patients with PD patients (10M, 5F), mean age ± 1 S.D.= 65.8±6.59 (range 45-76) years and 10 (4 M, 6 F) healthy controls, mean age ± 1 S.D.= 64.3±6.23 (range 55-72) years. The clinical assessment of patients included the motor section (part III) of the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Repetitive voluntary blinking as well as the finger- and toe-tapping subtest of the MDS-UPDRS (part 3), were recorded using an optoelectronic 3D motion capture system. Number of movements, movement rhythm, amplitude (hypokinesia) and velocity (bradykinesia) and progressive amplitude and velocity reduction during movement repetition (sequence effect) were analysed. Receiver operating characteristic (ROC), its area under curve (AUC) and Hanley-McNeil’s 95% AUC confidence intervals were computed.

Results: During voluntary blinking, velocity (bradykinesia) measures only differentiated between PD patients and controls (AUC = 0.80; P<0.01). During finger tapping, amplitude (hypokinesia) and velocity (bradykinesia) measures differentiated between PD patients and controls (both AUC = 0.78; both Ps<0.01). For the lower limb measurements similar values were observed for both amplitude (AUC = 0.73; P<0.05) and velocity (AUC = 0.78; P<0.01). In addition, among the toe tapping measurements the movement rhythm also differentiated PD patients and controls (AUC = 0.70; P<0.05)

Conclusion: Kinematic analysis of finger and toe tapping allowed an objective analysis of facial, upper and lower limb bradykinesia. The results provide evidence of a rostrocaudal motor impairment in PD, possibly reflecting distinct pathophysiological mechanisms in the various body segments. The data emphasize the importance of the lower limb assessment in differentiating between PD patients and controls.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/kinematic-analysis-of-facial-upper-and-lower-limb-bradkinesia-in-parkinsons-disease/