Objective: To check whether there is a correlation between measures of hand dexterity and standard motor scores in Parkinson’s diseases (PD). Even more importantly, whether treatment induced improvement in motor scores is reflected in improvements in hand dexterity.

Background: Clinical motor scales, such as Unified Parkinson’s Disease Rating Scale (UPDRS), typically do not assess fine motor skills, hand dexterity in particular. Hand dexterity is important feature of many everyday tasks. Impairment of hand dexterity can significantly affect patients’ quality of life, but may be neglected by standard clinical motor scales. Moreover, the assessment of the medication effects may be incomplete without hand dexterity assessment.

Methods: Motor part of the standard UPDRS clinical scale was used for assessment of the PD motor state. Purdue Pegboard Task (PPT) was used for hand dexterity assessment. Each hand was assessed separately with PPT. Thirty PD patients were assessed off medication, e.g. morning after an overnight withdrawal of medication; twenty-four of them were assessed once more on medication, on another morning after taking their usual morning medication.

Results: There was significant correlation between UPDRS and PPT scores for both worst affected and less affected hand, and in both conditions, off and on treatment. However, although UPDRS on score was significantly better that UPDRS off score (p<0.00001), the PPT scores in on and off conditions for the worst affected hand did not differ (p=0.11) while for the less affected hand the difference was only of modest significance (p=0.011). Moreover, there was no correlation between the treatment induced UPDRS and PPT score changes (i.e. off score ­– on score) for either of the hands (p=0.10, and p=0.34, respectively). Similar results were obtained when lateralised UPDRS and lateralised bradykinesia sub-scores were analysed.

Conclusions: Although antiparkinsonian treatment induces significant improvement in PD patients’ overall motor functions, this seems not to be paralleled in improvement in hand dexterity. This discrepancy may be reflected in patient’s perception of the (lack of) effectiveness of medication treatment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/treatment-associated-improvement-in-motor-scores-is-not-reflected-in-improvement-in-hand-dexterity-in-parkinsons-disease-patients/