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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1993 Dec;56(12):1323–1326. doi: 10.1136/jnnp.56.12.1323

Primitive reflexes in Parkinson's disease.

F W Vreeling 1, F R Verhey 1, P J Houx 1, J Jolles 1
PMCID: PMC1015384  PMID: 8270937

Abstract

A standardised protocol for the examination of 15 primitive reflexes in which the amplitude and the persistence were scored separately, was applied to 25 patients with Parkinson's disease and an equal number of healthy matched control subjects. Most reflexes were found considerably more often in the patients than in the control subjects, especially the snout, the glabellar tap, and its variant, the nasopalpebral reflex. Only the mouth open finger spread reflex was present more often in the control subjects. For all reflexes except this last, the scores for amplitude and persistence of the reflexes for the control group never exceeded the scores for the patient group. Reflexes persisted more often in the patients than in the control subjects. Parkinsonism alone can explain a large number of primitive reflexes, irrespective of the severity or duration of the disease. In contrast, the number of reflexes was related more closely to cognitive scales. It is concluded that such reflexes may be helpful in diagnosing Parkinson's disease. In addition, a standardised protocol for eliciting and scoring is essential for the study of these reflexes in parkinsonism and other neuropsychiatric conditions.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bakchine S., Lacomblez L., Palisson E., Laurent M., Derouesne C. Relationship between primitive reflexes, extra-pyramidal signs, reflective apraxia and severity of cognitive impairment in dementia of the Alzheimer type. Acta Neurol Scand. 1989 Jan;79(1):38–46. doi: 10.1111/j.1600-0404.1989.tb03707.x. [DOI] [PubMed] [Google Scholar]
  2. Botez M. I., Bogen J. E. The grasp reflex of the foot and related phenomena in the absence of other reflex abnormalities following cerebral commissurotomy. Acta Neurol Scand. 1976 Nov;54(5):453–463. doi: 10.1111/j.1600-0404.1976.tb04377.x. [DOI] [PubMed] [Google Scholar]
  3. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  4. Franssen E. H., Reisberg B., Kluger A., Sinaiko E., Boja C. Cognition-independent neurologic symptoms in normal aging and probable Alzheimer's disease. Arch Neurol. 1991 Feb;48(2):148–154. doi: 10.1001/archneur.1991.00530140040015. [DOI] [PubMed] [Google Scholar]
  5. Giménez-Roldán S., Esteban A., Abad J. M. Reflejo palmomentoniano en enfermedad de Parkinson. Arch Neurobiol (Madr) 1976 Jul-Aug;39(4):233–248. [PubMed] [Google Scholar]
  6. Girling D. M., Berrios G. E. Extrapyramidal signs, primitive reflexes and frontal lobe function in senile dementia of the Alzheimer type. Br J Psychiatry. 1990 Dec;157:888–893. doi: 10.1192/bjp.157.6.888. [DOI] [PubMed] [Google Scholar]
  7. Gossman M. D., Jacobs L. Three primitive reflexes in parkinsonism patients. Neurology. 1980 Feb;30(2):189–192. doi: 10.1212/wnl.30.2.189. [DOI] [PubMed] [Google Scholar]
  8. Hoehn M. M., Yahr M. D. Parkinsonism: onset, progression and mortality. Neurology. 1967 May;17(5):427–442. doi: 10.1212/wnl.17.5.427. [DOI] [PubMed] [Google Scholar]
  9. Huber S. J., Paulson G. W. Influence of dopamine and disease severity on primitive reflexes in Parkinson's disease. Eur Neurol. 1989;29(3):141–144. doi: 10.1159/000116397. [DOI] [PubMed] [Google Scholar]
  10. Huber S. J., Paulson G. W. Relationship between primitive reflexes and severity in Parkinson's disease. J Neurol Neurosurg Psychiatry. 1986 Nov;49(11):1298–1300. doi: 10.1136/jnnp.49.11.1298. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Iriarte L. M., Chacon J., Madrazo J., Chaparro P., Vadillo J. Blink reflex in dyskinetic and nondyskinetic patients with Parkinson's disease. Eur Neurol. 1989;29(2):67–70. doi: 10.1159/000116380. [DOI] [PubMed] [Google Scholar]
  12. Jacobs L., Gossman M. D. Three primitive reflexes in normal adults. Neurology. 1980 Feb;30(2):184–188. doi: 10.1212/wnl.30.2.184. [DOI] [PubMed] [Google Scholar]
  13. Jenkyn L. R., Reeves A. G. Signs of cortical disinhibition in neuropsychiatric disorders. Psychiatr Med. 1983 Dec;1(4):389–405. [PubMed] [Google Scholar]
  14. Jenkyn L. R., Reeves A. G., Warren T., Whiting R. K., Clayton R. J., Moore W. W., Rizzo A., Tuzun I. M., Bonnett J. C., Culpepper B. W. Neurologic signs in senescence. Arch Neurol. 1985 Dec;42(12):1154–1157. doi: 10.1001/archneur.1985.04060110036012. [DOI] [PubMed] [Google Scholar]
  15. Klawans H. L., Jr, Goodwin J. A. Reversal of the glabellar reflex in Parkinsonism by L-dopa. J Neurol Neurosurg Psychiatry. 1969 Oct;32(5):423–427. doi: 10.1136/jnnp.32.5.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Maertens de Noordhout A., Delwaide P. J. The palmomental reflex in Parkinson's disease. Comparisons with normal subjects and clinical relevance. Arch Neurol. 1988 Apr;45(4):425–427. doi: 10.1001/archneur.1988.00520280075018. [DOI] [PubMed] [Google Scholar]
  17. Messina C., Di Rosa A. E., Tomasello F. Habituation of blink reflexes in parkinsonian patients under levodopa and amantadine treatment. J Neurol Sci. 1972 Oct;17(2):141–148. doi: 10.1016/0022-510x(72)90136-0. [DOI] [PubMed] [Google Scholar]
  18. Pearce J., Aziz H., Gallagher J. C. Primitive reflex activity in primary and symptomatic Parkinsonism. J Neurol Neurosurg Psychiatry. 1968 Oct;31(5):501–508. doi: 10.1136/jnnp.31.5.501. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Reisberg B., Ferris S. H., de Leon M. J., Crook T. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry. 1982 Sep;139(9):1136–1139. doi: 10.1176/ajp.139.9.1136. [DOI] [PubMed] [Google Scholar]
  20. Sandrini G., Alfonsi E., Martignoni E., Horowski R., Nappi G. Effects of lisuride on blink reflex habituation in Parkinson disease. Eur Neurol. 1985;24(6):374–379. doi: 10.1159/000115829. [DOI] [PubMed] [Google Scholar]
  21. ZUNG W. W. A SELF-RATING DEPRESSION SCALE. Arch Gen Psychiatry. 1965 Jan;12:63–70. doi: 10.1001/archpsyc.1965.01720310065008. [DOI] [PubMed] [Google Scholar]
  22. van Tiggelen C. J. The Bracha reflexes. Neurological indicators of localisation of brain damage. Implications for diagnosis and therapy of organic mental disorders. Aktuelle Gerontol. 1983 Sep;13(5):195–200. [PubMed] [Google Scholar]

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