Objective: To investigate the presence of a strategy in dyskinesia amplitude re-distribution enabling patients to perform motor tasks.

Background: In Parkinson’s disease (PD), occurrence of dyskinesia is considered one major side effect of long-term use of antiparkinsonian drugs. As a result, clinicians tend to delay its use in the treatment of PD, despite its proven higher efficacy to counteract disabling PD symptoms. Nevertheless, it seems that many patients facing dyskinesia are still able to function adequately, leading to hypothesize that these patients have strategies to alleviate the impact of dyskinesia on their ability to function.

Methods: 45 patients living with PD (mean age = 65.4 ± years old) and experiencing choreic-type, peak-dose dyskinesia were asked to perform a geostationary task where they were required to stabilize a glass of water at eye level for 15 seconds. Whole-body kinematics data were acquired with inertial measurement units (IMUs) while doing so. Energy deployed by each body segment during the task was extracted from accelerometric data, and its distribution among the body segments with time, analyzed.

Results: At initial glass stabilisation, most of the energy was allocated to segments other than the one specifically involved in the movement (i.e. the hand). Although steady for the first few seconds of the stabilisation phase, data revealed that there was a progressive transfer of energy distribution with the hand taking most of the energy, hence generating displacement of the glass of water. Subset analysis using the energy level at rest to divide the group into quartiles have shown that patients with lower levels of dyskinesia at rest behaved differently from the rest of the group; most of the energy remained at hand level throughout the stabilisation phase, although the importance of the hand also increased after a certain stabilisation period.

Conclusions: Analysis of energy distribution suggest that patients experiencing dyskinesia have developed strategies to enable them to perform the required tasks, but that this strategy can only be maintained for a certain period before “re-emerging” dyskinesia occurs.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/patients-experiencing-peak-dose-dyskinesia-use-re-distribution-of-involuntary-movement-amplitude-throughout-their-body-to-minimize-the-functional-impact-of-dyskinesia/