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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1996 Dec;61(6):645–648. doi: 10.1136/jnnp.61.6.645

Disordered axial movement in Parkinson's disease.

M J Steiger 1, P D Thompson 1, C D Marsden 1
PMCID: PMC486665  PMID: 8971118

Abstract

Axial motor impairments are a common cause of disability in patients with Parkinson's disease, become more prominent with longer disease duration, and have been said to be less responsive to levodopa replacement therapy. The ability to turn in bed while lying supine before and after dopaminergic stimulation was studied in a group of 36 patients with Parkinson's disease; 23 were in Hoehn and Yahr stages 3-5 when "off", and 13 were in stages 1-2. Turning was also compared with postural stability and gait before ("off") and after ("on") dopaminergic stimulation. Failure to turn in bed was noted in 19 of the 36 patients in the "off" state, with significant associations between disturbances of gait, postural stability, rising from a chair, whole body bradykinesia, and axial rigidity. Gait, postural stability, rising from a chair, whole body bradykinesia, and axial rigidity were significantly correlated in the "off" state. Disorder of axial movement, gait, and postural stability were not dependent on age at onset of Parkinson's disease, but did relate to duration of disease. After a levodopa challenge, turning in bed returned to normal in all but one patient, and gait, postural stability, rising from a chair, whole body bradykinesia, and axial rigidity also improved in nearly all. It is concluded that in the later stages of Parkinson's disease at least some aspects of axial motor control can remain dopamine responsive.

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Selected References

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

  1. Bonnet A. M., Loria Y., Saint-Hilaire M. H., Lhermitte F., Agid Y. Does long-term aggravation of Parkinson's disease result from nondopaminergic lesions? Neurology. 1987 Sep;37(9):1539–1542. doi: 10.1212/wnl.37.9.1539. [DOI] [PubMed] [Google Scholar]
  2. Klawans H. L. Individual manifestations of Parkinson's disease after ten or more years of levodopa. Mov Disord. 1986;1(3):187–192. doi: 10.1002/mds.870010304. [DOI] [PubMed] [Google Scholar]
  3. Koller W. C., Glatt S., Vetere-Overfield B., Hassanein R. Falls and Parkinson's disease. Clin Neuropharmacol. 1989 Apr;12(2):98–105. doi: 10.1097/00002826-198904000-00003. [DOI] [PubMed] [Google Scholar]
  4. Kuypers H. G., Brinkman J. Precentral projections to different parts of the spinal intermediate zone in therhesus monkey. Brain Res. 1970 Nov 11;24(1):29–48. doi: 10.1016/0006-8993(70)90272-6. [DOI] [PubMed] [Google Scholar]
  5. Lakke J. P. Axial apraxia in Parkinson's disease. J Neurol Sci. 1985 May-Jun;69(1-2):37–46. doi: 10.1016/0022-510x(85)90005-x. [DOI] [PubMed] [Google Scholar]
  6. Lakke J. P., van Weerden T. W., Staal-Schreinemachers A. Axial apraxia, a distinct phenomenon. Clin Neurol Neurosurg. 1984;86(4):291–294. doi: 10.1016/0303-8467(84)90291-9. [DOI] [PubMed] [Google Scholar]
  7. Lawrence D. G., Kuypers H. G. The functional organization of the motor system in the monkey. I. The effects of bilateral pyramidal lesions. Brain. 1968 Mar;91(1):1–14. doi: 10.1093/brain/91.1.1. [DOI] [PubMed] [Google Scholar]
  8. Lawrence D. G., Kuypers H. G. The functional organization of the motor system in the monkey. II. The effects of lesions of the descending brain-stem pathways. Brain. 1968 Mar;91(1):15–36. doi: 10.1093/brain/91.1.15. [DOI] [PubMed] [Google Scholar]
  9. Parkes J. D., Calver D. M., Zilkha K. J., Knill-Jones R. P. Controlled trial of amantadine hydrochloride in Parkinson's disease. Lancet. 1970 Feb 7;1(7641):259–262. doi: 10.1016/s0140-6736(70)90634-3. [DOI] [PubMed] [Google Scholar]
  10. Quinn N., Marsden C. D., Parkes J. D. Complicated response fluctuations in Parkinson's disease: response to intravenous infusion of levodopa. Lancet. 1982 Aug 21;2(8295):412–415. doi: 10.1016/s0140-6736(82)90442-1. [DOI] [PubMed] [Google Scholar]
  11. Steiger M. J., Berman P. Gait disturbances in the acute medically ill elderly. Postgrad Med J. 1993 Feb;69(808):141–146. doi: 10.1136/pgmj.69.808.141. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Zetusky W. J., Jankovic J., Pirozzolo F. J. The heterogeneity of Parkinson's disease: clinical and prognostic implications. Neurology. 1985 Apr;35(4):522–526. doi: 10.1212/wnl.35.4.522. [DOI] [PubMed] [Google Scholar]

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