Date: Sunday, October 7, 2018
Session Title: Phenomenology and Clinical Assessment Of Movement Disorders
Session Time: 1:45pm-3:15pm
Location: Hall 3FG
Objective: We intent to explore the tapping profile in PD patients in “ON state” compared to controls in repetitive trials to clarify if motor control of self-cued movement is normalized by dopaminergic treatment.
Background: Motor features of parkinsonism, defined as bradykinesia plus rest tremor or rigidity are the main characteristics used for its diagnosis. Bradykinesia is defined as the progressive reduction in speed, amplitude, or both of repetitive actions. One of the tasks for its evaluation is the finger tapping task of the UPDRS-III. The finger tapping test focuses on the evaluation of decrement in rate, amplitude, or both with repetitive action. As part of the clinical picture of PD, there have been described motor blocks that can be evidenced in gait but also in handwriting, speech and tapping. Another clinical feature that is usually described linked to motor blocks is festination, defined as a tendency to speed up when performing repetitive movements.
Methods: 22 PD subjects (15 male; 21 right handed; age 64±9) in HY stage III or less with no clinical evident fluctuations or gait freezing were included, (mean disease duration 7± 4,11 years UPDRS III score 14,72 ±6,56, left side worst). Cases were matched with 24 healthy controls (19 male, 24 right handed, age 69±9,5). Participants were asked to perform taps on the space bar of the computer as fast as they could during 5 consecutive trials of 10 seconds with each hand. Times elapsed between consecutive taps were recorded on the computer. (PD patients were in ON state)
Results: Festination nor blocks presented significant differences amongst groups but isolated faster taps (IFT) were identified in significant higher number with the right hand in PD. Inter-hand difference of IFT percentage 1.62 (2.11) vs 3.47 (3.06) t(45)=-2.375,p= 0.023 and mean time 572.01(677.54)vs1078.95 (809.18)t(45)=-2.337, p=0.024, were higher for the patient group. Tap cadence was less uniform in higher UPDRS subjects. This was more evident in non-dominant, and more affected hand and latter trials.
Conclusions: Despite dopaminergic treatment, there is not only a clear persistence of asymmetry and fatigability that correlate with UPDRS severity but found the occurrence of frequent faster taps that could be a motor residue of self-cued movement dysregulation and maybe an equivalent to festination in OFF patients. Motor blocks and freezing seem to be very rare in treated PD patients.
References: Barut, Ç., Kızıltan, E., Gelir, E., & Köktürk, F. (2013). Advanced Analysis of Finger-Tapping Performance: A Preliminary Study. Balkan Medical Journal, 30(2), 167-171. Delval, A., Rambour, M., Tard, C., Dujardin, K., Devos, D., Bleuse, S., … Moreau, C. (2016). Freezing/festination during motor tasks in early-stage Parkinson’s disease: A prospective study. Movement Disorders: Official Journal of the Movement Disorder Society, 31(12), 1837-1845.
To cite this abstract in AMA style:JP. Romero, I. Serrano, D. Del Castillo, A. Arroyo, V. Cortés, J. Andreo, J. Periañez, M. Rios. Finger Tapping Profile in “On State” PD Patients [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/finger-tapping-profile-in-on-state-pd-patients/. Accessed December 2, 2023.
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