Progress and Prospects in Parkinson's Research/Symptoms/Motor

Motor symptoms of Parkinson's disease

The symptoms that usually lead a clinician to suspect Parkinson's are the ones that affect movement.

Bradykinesia

( To subpage for editing >> ) Bradykinesia Slowness of movement. The following references are relevant:- Morris et al (2010) Striding Out With Parkinson Disease: Evidence-Based Physical Therapy for Gait Disorders Schenkman et al (2011) Profile of Functional Limitations and Task Performance Among People With Early- and Middle-Stage Parkinson Disease Heldman et al (2011) The Modified Bradykinesia Rating Scale for Parkinson’s Disease: Reliability and Comparison with Kinematic Measures Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Bradykinesia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar See Also:- Introduction to Parkinson's Science/Q Page 2 Symptomatic Relief for PD/Bradykinesia References

Rigidity

( To subpage for editing >> ) Hypokinesia Reduced force, impetus or speed of movement The following refences are relevant:- Ackermann et al (1989) Palilalia as a symptom of levodopa induced hyperkinesia in Parkinson's disease. Heldman et al (2011) The Modified Bradykinesia Rating Scale for Parkinson’s Disease: Reliability and Comparison with Kinematic Measures # Espay et al (2011) Differential Response of Speed, Amplitude, and Rhythm to Dopaminergic Medications in Parkinson’s Disease Further Research Search the scientific literature for Hypokinesia Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Hypokinesia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar Search the scientific literature for Rigidity Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Rigidity. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References Reference

Tremor

( To subpage for editing >> ) Tremor Involuntary shaking, trembling or quivering movements of the muscles The following references are relevant:- Sanchez-Ramos et al (2011) Quantitative Analysis of Tremors in Welders Mure et al (2011) Parkinson’s Disease Tremor-Related Metabolic Network: Characterization, Progression, and Treatment Effects Helmich et al (2012) Cerebral causes and consequences of parkinsonian resting tremor: a tale of two circuits? Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Tremor. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Here is a list of other motor symptoms of Parkinson's. Some are less prominent than those above, at least initially and some may occur only rarely. Many are not unique to Parkinson's:

Akathesia

Redirected to Restless Legs Syndrome: ( To subpage for editing >> ) Restless Legs Syndrome Uncontrollable, involuntary movement of the legs and feet The following references are relevant:- Gao et al (2010) Restless Legs Syndrome and Erectile Dysfunction Gao et al (2010) Restless legs syndrome and Parkinson’s disease in men Pourcher et al (2010) Compulsive habits in restless legs syndrome patients under dopaminergic treatment Peeraully and Tan (2012) Linking restless legs syndrome with Parkinson's disease: clinical, imaging and genetic evidence http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802250/ Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Restless_Legs_Syndrome. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Akinesia

( To subpage for editing >> ) Akinesia Also see Freezing Put further text about the symptom here Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Akinesia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Amimia

( To subpage for editing >> ) Amimia Fixed and vacant expression (masking) Very little research has been carried out on this common PD symptom but the following are relevant :- Allen (1931) The Dissociation of voluntary and emotional movements of the face with special reference to emotional paresis as a physical sign Hemmesch et al (2009)The Influence of Facial Masking and Sex on Older Adults’ Impressions of Individuals with Parkinson’s Disease. Clark et al (2011) Visual Exploration of Emotional Facial Expressions in Parkinson's Disease Tickle-Degnen et al (2011) Culture, Gender and Health Care Stigma: Practitioners’ Response to Facial Masking Experienced by People with Parkinson’s Disease < Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Amimia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Aphagia

( To subpage for editing >> ) Aphagia Inability to swallow Swallowing problems are frequently reported by PD patients but the symptom awaits detailed scientific research. The following references are relevant:- eHealthMe (1977)Could Parkinson's disease cause Aphagia? A study of 26 patients eHealthMe (1977) Could Azilect cause Aphagia? Russell et al (2010) Targeted exercise therapy for voice and swallow in persons with Parkinson’s disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Aphagia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Aphonia

Aphonia: Inability to make sounds. ( To subpage for editing >> ) Aphonia Inability to make sounds The following references are relevant:- Critchley (1981) Speech disorders of Parkinsonism: a review Russell et al (2010) Targeted exercise therapy for voice and swallow in persons with Parkinson’s disease Hallett (2011) Psychogenic Parkinsonism Search the scientific literature (Aphonia) Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Aphonia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Athetosis

( To subpage for editing >> ) Athetosis Involuntary movements of the face, tongue and extremities. A number of projects have concentrated on this symptom:- Neilson (1974) Measurement of involuntary arm movement in athetotic patients Hallett and Alvarez (1983) Attempted rapid elbow movements in patients with athetosis Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Athetosis. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Automatism

( To subpage for editing >> ) Automatism Forced obedience to external stimuli or commands. Some potentially relevant references are:- Allain et al (1995) Explicit and procedural memory in Parkinson's disease. Allain et al (1995) Procedural memory and Parkinson's disease. Perez-Velazquez (2012) The biophysical bases of will-less behaviours Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Automatism. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Balance

( To subpage for editing >> ) Balance Susceptibility to falls Alternative terms Postural instability---Falls The following references are relevant:- King et al (2012) Do clinical scales of balance reflect turning abnormalities in people with Parkinson's disease? Duncan and Earhart (2012) Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease? Boonsinsukh et al (2012) A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Balance. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Blepharospasm

( To subpage for editing >> ) Blepharospasm Spasm of the eyelid The following references are relevant:- Elston (1992) A new variant of blepharospasm Hallett et al (2008) ..Update on blepharospasm: Report from the BEBRF International Workshop Armstrong (2011) Visual symptoms in Parkinson's Disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Blepharospasm. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Bruxism

( To subpage for editing >> ) Bruxism Grinding of teeth These references are relevant:- Magee (1970) Bruxisma related to levadopa therapy Durham et al (1993) Management of orofacial manifestations of Parkinson's disease with splint therapy: a case report. Stivastaya et al (2002) Bruxism as presenting feature of Parkinson's disease. Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Bruxism. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Catalepsy

( To subpage for editing >> ) Catalepsy Tireless, timeless , effortless maintenance of postures. The following references are relevant:- Azam et al (2010) Design, synthesis and anti-Parkinsonian evaluation of 3-alkyl/aryl-8-(furan-2-yl)thiazolo[5,4-e][1,2,4]triazolo[1,5-c]pyrimidine-2(3H)-thiones against neuroleptic-induced catalepsy and oxidative stress in mice. Nayebi et al (2010) Buspirone improves 6-hydroxydopamine-induced catalepsy through stimulation of nigral 5-HT(1A) receptors in rats. Mahmoudi et al (2011) Buspirone improves the anti-cataleptic effect of levodopa in 6-hydroxydopamine-lesioned rats. Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Catalepsy. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Catatonia

( To subpage for editing >> ) Catatonia Holding of statuesque postures The following references are relevant:- Northoff et al (1997) Glutamatergic dysfunction in catatonia? Successful treatment of three acute akinetic catatonic patients with the NMDA antagonist amantadine. Bhati et al(2007) Clinical Manifestations, Diagnosis, and Empirical Treatments for Catatonia Carroll et al(2007) Katatonia - A New Conceptual Understanding of Catatonia and a New Rating Scale Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Catatonia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Chorea

( To subpage for editing >> ) Chorea Involuntary, desultory flickering movement. The following references are relevant:- Barbeau et al (1965) Fingerprint Patterns in Huntington's Chorea and Parkinson's Disease Reuter et al (2000) Late onset levodopa responsive Huntington's disease with minimal chorea masquerading as Parkinson plus syndrome Ciammola et al (2011) Atypical Parkinsonism Revealing a Late Onset, Rigid and Akinetic Form of Huntington's Disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Chorea. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Choreoathetosis

( To subpage for editing >> ) Choreoathetosis Involuntary jerky snake-like movements usually of the arms. The following references are relevant:- Teräväinen and Calne (1980) Action tremor in Parkinson’s disease Bhidayasiri and Truong,(2004) Chorea and related disorders Perkovic et al (2010) Sildenafil induced choreoathetosis in men with Parkinson's disease. Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Choreoathetosis. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Clonus

( To subpage for editing >> ) Clonus Vibrato-like reaction to forced muscle stretching. The following references are relevant:- Hofmann (1962) Observations on peripheral servo mechanisms in Parkinsonian rigidity Burke et al (1972) Tonic vibration reflex in spasticity, Parkinson's disease, and normal subjects Findley et al (1981) Tremor, the cogwheel phenomenon and clonus in Parkinson's disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Clonus. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Cogwheel rigidity

( To subpage for editing >> ) Cogwheel rigidity Stiffness in the muscles, with a jerky quality when arms and legs are repeatedly moved. The following references are relevant:- Lance et al(1963) Action tremor and the cogwheel phenomenon in Parkinson’s disease Findley et al (1981) Tremor, the cogwheel phenomenon and clonus in Parkinson’s disease Ghiglione et al(2005) Cogwheel Rigidity Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Cogwheel rigidity. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. rigidity Pubmed (abstracts) rigidity Pubmed_Central (Full_Text) rigidity Google_Scholar References

Contractures

( To subpage for editing >> ) Contractures Permanent contraction at joints. The following references are relevant:- Ebin (1951) Surgical Treatment of Parkinsonism: Indications and Results Kyriakides and Hewer (1988) Hand contractures in Parkinson's disease. Shah et al (2005) Flexion contracture after total knee arthroplasty in a patient with Parkinson's disease: successful treatment with botulinum toxin type A. Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Contractures. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Disequilibrium

Redirected to Balance. ( To subpage for editing >> ) Balance Susceptibility to falls Alternative terms Postural instability---Falls The following references are relevant:- King et al (2012) Do clinical scales of balance reflect turning abnormalities in people with Parkinson's disease? Duncan and Earhart (2012) Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease? Boonsinsukh et al (2012) A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Balance. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Drop Foot

Redirected to Foot_Drop ( To subpage for editing >> ) Foot Drop or (Drop Foot) Locomotion defect whereby the heel of a foot is raised from the ground while walking The following references are relevant:- Belfiore and Campanella (1994) A clinical sign of Parkinson's disease: the absence of lateral foot drop Rogers et al (2011) Perturbations of ground support alter posture and locomotion coupling during step initiation in Parkinson's disease The following references are relevant:- Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Foot_Drop. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Dyskinesia

( To subpage for editing >> ) Dyskinesia Abnormality of muscle tone or movement. The following references are relevant:- Chung et al(2010) Objective Measurement of Dyskinesia in Parkinson Disease using a Force Plate Timbasco et al (2012) Clinical Aspects and Management of Levodopa-Induced Dyskinesia Espay et al (2012) “On” state freezing of gait in Parkinson disease -A paradoxical levodopa-induced complication Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Dyskinesia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Dystonia

( To subpage for editing >> ) Dystonia Sustained muscle contractions causing twisting and repetitive movements or abnormal postures. Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Dystonia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Exotropia

Redirected to Strabismus (To subpage for editing >> ) Strabismus Divergent squint of the eyes (See also Exotropia = Outward divergence and Esotropia = Inward Divergence. Also Tic) The following references are relevant:- Rascol et al (1991) Square wave jerks in parkinsonian syndromes Scoditti, et al (1993) Peroneal muscular atrophy with parkinsonism, ptosis, and congenital strabismus. Almer et al (2011) Ocular Motor and Sensory Function in Parkinson Disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Strabismus. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Facial Masking

Redirected to Amimia ( To subpage for editing >> ) Amimia Fixed and vacant expression (masking) Very little research has been carried out on this common PD symptom but the following are relevant :- Allen (1931) The Dissociation of voluntary and emotional movements of the face with special reference to emotional paresis as a physical sign Hemmesch et al (2009)The Influence of Facial Masking and Sex on Older Adults’ Impressions of Individuals with Parkinson’s Disease. Clark et al (2011) Visual Exploration of Emotional Facial Expressions in Parkinson's Disease Tickle-Degnen et al (2011) Culture, Gender and Health Care Stigma: Practitioners’ Response to Facial Masking Experienced by People with Parkinson’s Disease < Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Amimia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Falls

Redirected to Balance ( To subpage for editing >> ) Balance Susceptibility to falls Alternative terms Postural instability---Falls The following references are relevant:- King et al (2012) Do clinical scales of balance reflect turning abnormalities in people with Parkinson's disease? Duncan and Earhart (2012) Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease? Boonsinsukh et al (2012) A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Balance. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Festination

( To subpage for editing >> ) Festination Forced hurrying of walking, talking or thought. The following references are relevant:- Devos et al (2007) Improvement of gait by chronic, high doses of methylphenidate in patients with advanced Parkinson's disease Hausdorff (2009) Gait dynamics in Parkinson’s disease: Common and distinct behavior among stride length, gait variability, and fractal-like scaling Hove et al (2012) Interactive Rhythmic Auditory Stimulation Reinstates Natural 1/f Timing in Gait of Parkinson's Patients Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Festination. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Flexion

( To subpage for editing >> ) Flexion Bent or curved posture The following references are relevant:- Hong and Earhart (2010) Effects of Medication on Turning Deficits in Individuals with Parkinson's Disease Mak et al (2011) Limb Collapse, Rather Than Instability, Causes Failure in Sit-to-Stand Performance Among Patients With Parkinson Disease Xia et al (2011) Differentiation between the contributions of shortening reaction and stretch-induced inhibition to rigidity in Parkinson’s disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Flexion. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Foot Drop

( To subpage for editing >> ) Foot Drop or (Drop Foot) Locomotion defect whereby the heel of a foot is raised from the ground while walking The following references are relevant:- Belfiore and Campanella (1994) A clinical sign of Parkinson's disease: the absence of lateral foot drop Rogers et al (2011) Perturbations of ground support alter posture and locomotion coupling during step initiation in Parkinson's disease The following references are relevant:- Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Foot_Drop. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Freezing of Gait

( To subpage for editing >> ) Freezing of gait Inability to initiate locomotion The following references are relevant:- Morris et al (2010) Striding Out With Parkinson Disease: Evidence-Based Physical Therapy for Gait Disorders Maidan et al (2010) Heart rate changes during freezing of gait in patients with Parkinson's disease Espay et al(2012) “On” state freezing of gait in Parkinson disease - A paradoxical levodopa-induced complication Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Freezing_of_gait. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Hyperkinesia

( To subpage for editing >> ) Hyperkinesia Increased force, speed, violence, speed of movement. The following references are relevant:- Ackermann et al (1989) Palilalia as a symptom of levodopa induced hyperkinesia in Parkinson's disease. Inzelberg et al (1995) Kinematic properties of upper limb trajectories in idiopathic torsion dystonia Thomsen et al (2011) Psychomotor stimulation by dopamine D1-like but not D2-like agonists in most mouse strains Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Hyperkinesia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Hypertonia

( To subpage for editing >> ) Hypertonia Excessive muscle tone The followng references are relevant:- Wright et al (2007) Axial hypertonicity in Parkinson’s disease: Direct measurements of trunk and hip torque Goldenberg(2008) Medical Management of Parkinson’s Disease Xia et al (2011) Differentiation between the contributions of shortening reaction and stretch-induced inhibition to rigidity in Parkinson’s disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Hypertonia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Hypokinesia

( To subpage for editing >> ) Hypokinesia Reduced force, impetus or speed of movement The following refences are relevant:- Ackermann et al (1989) Palilalia as a symptom of levodopa induced hyperkinesia in Parkinson's disease. Heldman et al (2011) The Modified Bradykinesia Rating Scale for Parkinson’s Disease: Reliability and Comparison with Kinematic Measures # Espay et al (2011) Differential Response of Speed, Amplitude, and Rhythm to Dopaminergic Medications in Parkinson’s Disease Further Research Search the scientific literature for Hypokinesia Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Hypokinesia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar Search the scientific literature for Rigidity Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Rigidity. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References Reference

Kinesia paradoxa

Redirected to ( To subpage for editing >> ) Paradoxical kinesia Sometimes referred to as 'Kinesia paradoxa' Unexpected reversal of motor symptoms Many PD patients find that the daily onset of movement disorders is inconsistent and unpredictable and varies according to the type of activity they undertake, their emotional state and social circumstances. For example it may seem easier to walk across uneven ground rather than on a flat, hard surface, or it may seem easier to climb stairs or a slope than progress on the level. This gives a pointer to alternative neural pathways which could be exploited to ameliorate PD symptoms. Faith 'Cures' The earliest reference to this phenomenon is to be found in Chapter 2 of the Gospel of St. Mark, where Jesus is at Capernaum and is faced with a bedridden man who is "sick of the palsy". 10 But ye may know that the Son of man hath power on earth to forgive sins,(he saith to the sick of the palsy.) 11. I say unto thee, Arise, and take up thy bed, and go thy way t12. And immediately he arose, took up the bed, and went forth before them all; insomuch that they were all amazed, and glorified God, saying, We never saw it on this fashion. This account begs the questions as to whether the palsy as described equates with PD and whether the observable benefits were permanent or temporary. In modern times the most documented "miracle" cure is that of Sister Marie Simon-Pierre, who attested that she had been cured of Parkinson's Disease after praying to the late Pope John Paul II.[who himself manifested advanced symptoms of PD] ROME, APRIL 30, 2011 .- Here is a [part of]translation of the testimony of Sister Marie Simon-Pierre of the Congregation of the Little Sisters of Catholic Motherhood, regarding her miraculous cure from Parkinson's that she attributes to the intercession of Pope John Paul II. The testimony, written in 2006, formed part of John Paul II's case for beatification. Reports of medical and legal experts on the French nun's healing were submitted to the dicastery for scientific examination last October. The phenomenon was recognized by the Vatican as a miracle attributed to the intercession of John Paul II In June 2001, I was diagnosed with Parkinson's disease. The disease had affected the whole left side of my body, creating great difficulties for me as I am left-handed. After three years, the initial phase of the disease, slow but progressive, was followed by an aggravation of the symptoms: accentuation of the trembling, rigidity, pain, insomnia. From April 2, 2005, I began to worsen week by week, I grew worse day by day, I was unable to write (I repeat that I am left-handed), and if I attempted it, what I wrote was unintelligible. I could drive only for short trips because my left leg would stiffen sometimes, and my rigidity would have impeded my driving. Moreover, to do my work in a hospital, it took more time than usual. I was exhausted....... ......On May 13 [2005}, feast of Our Lady of Fatima, Benedict XVI announced the special dispensation to initiate the cause of beatification of John Paul II. Beginning the following day, the sisters of all the French and African communities began to pray for my cure through the intercession of John Paul II. They prayed incessantly until the news arrived of my cure. At that time I was on vacation. On May 26, my time of rest being at an end, I re-turned totally exhausted by the disease. "If you believe, you will see the glory of God": this phrase of St. John's Gospel accompanied me from May 14 onward. On June 1, I was finished; I struggled to stand and to walk. On June 2 in the afternoon. With effort, I wrote: "John Paul II." We remained in silence before the il-legible letters, then the day continued as usual. At the end of the evening prayer, at 9 o'clock at night, I went to my office before going to my room. I felt the need to pick up the pen and to write, just as if someone within me was saying: "Pick up the pen and write." It was between 9:30 and 9:40 at night. To my great surprise I saw that the writing was clearly legible. Not understanding anything, I went to bed. Two months exactly had gone by since John Paul II's departure to the House of the Father. I woke up at 4:30 a.m., surprised that I was able to sleep and I leapt out of bed: my body was no longer insensitive, rigid, and interiorly I was not the same....... ......Ten months have passed now since I interrupted all types of treatment. I am working normally again, I have no difficulty in writing and I also drive long distances. It feels as if I have been reborn: a new life, because nothing is as it was before..... It is not possible to evaluate these events without a sight of the report of the panel of medical experts set up by the Vatican to evaluate claims of cures. More Observations (1921) Souques observed the phenomenon and coined the term 'Paradoxical kinesia' to describe it. (1976) Marshall et al Activation-induced restoration of sensorimotor functions in rats with dopamine-depleting brain lesions succeeded in reproducing Kinesia Paradoxica by exposing Parkinsonian rats to potentially life-threatening situations. They began to move and respond appropriately to environmental stimuli when placed in a sink of water, in a shallow ice bath, or among a colony of cats or rats. A reversal of the sensorimotor dysfunctions was still apparent shortly after the animals were removed from each activating situation. However, the therapeutic effects dissipated rapidly, and by 4 hr after an exposure the rats responded as poorly as they had prior to activation. (1989) Keefe et al Dopamine ReleaseStudies in an Animal Model found that by inducing PK they could switch Parkinson symptoms on and off in rats. Rats were given brain lesions to inhibit their dopamine production capacity by 98% and they became Parkinsonian. They were placed in deep water and managed to swim effectively. They also escaped from shallow ice baths. These behaviors were not abolished by pretreating the animals with the dopamine antagonists haloperidol and SCH-23390. In contrast, haloperidol completely blocked the brain-damaged animals' behavioral responses to amphetamine. These results suggest that the paradoxical kinesia of dopamine-depleted rats is not a consequence of dopamine release from residual dopaminergic fibers. (2007) Schlesinger et al interviewed 50 PD patients, who had been exposed to life-threatening situations in war. Two had experiened PK. (2009) Robottom et al < noted that symptoms varied when PD patients were placed under emotional or physical stress. The Abruzzi earthquake (2009) At 03.32 Central European Summer Time on the night of 6th April 2009 the city of L'Aquila, which is the capital of the Abruzzo region in Italy, was devastated by a sudden earthquake with a strength of 5.8 on the Richter Scale. There was considerable damage to property, 308 people lost their lives and some 1,500 were injured.However there is a long history of earth tremors in the region and the majority of citizens evacuated their properties forthwith and survived. It so happened that 70km. away was a Movement Disorder clinic, operated by the University G.D. Annunzio Chieti-Pescari, which had neen monitoring the symptoms of 14 patients in the city with parkinsonism and dementia. The movemnt disorders of all of them were at Hoehn and Yahr stages 3 to 5. Measurements taken 3 months after the earthquake showed an unaccountable significant improvement in their UPDRS motor rating. There was also considerable anecdotal evidence of their performmance at the moment when the earthquake struck:- "He ran like hell out of the two storey building pushing his two children (17 and 15 years old) and his wife" relates to a 59 year old retired chemical engineer in his tenth year since being diagnosed with PD. "During the earthquake hit he ran from his house." describes a 58 year old retired truck driver five years after PD diagnosis. "During the night time earthquake, she rose from her bed and hurried out of her apartment at the third floor. When she was examined, 15 days after the earthquake, she walked to the office assisted by her daughter (in the previous visit she had been carried on a wheelchair)." Describes a 90 year old woman with both PD and dementia. "During the night time earthquake hit he ran away from his second floor apartment." relates to a 77 year od retired public employee. "During the earthquake, he jumped out of bed and ran through three flights of stairs, carrying and pushing his 72 year old wife (she reported he practically lifted her up through the collapsing apartment and floors)." Part of an acount of a 77 year old retired engineer who had experienced PD symptoms for three year. After 5 months the patients had regressed to their pre-earthquake state. A full account was published by Bonanni et al(2010) Protracted benefit from paradoxical kinesia in typical and atypical parkinsonisms Oliver Sacks PK can occur without the need for divine intervention or geological catastrophes. “Awakenings”, by Oliver Sacks, is one of the most lucid and closely observed accounts of PD symptoms. It is based on the case notes of a series of encounters that he had with patients as a result of the PD pandemic called Encephalitis Lethargica. In the 1920’s. This form of the disease is characterised by its rapid onset and progression and its pronounced symptoms. For example bradykinesia progresses to the point where the patient becomes catatonic. Sacks noted a number of occurrences of Pardoxical kinesia:- Thus one may see such patients rigid, motionless, seemingly lifeless as statues, abruptly called into normal life and action by some sudden exigency which catches their attention (in one famous case, a drowning man was saved by a Parkinsonian patient who leapt from his wheelchair into the breakers.) In the 1950s there was a PD patient at the Highlands Hospital, London, who:- would often sit frozen and motionless unless he were thrown a ball. This would instantly call him to life and he would leap to his feet, swerving, running, dribbling he ball……If thrown a match box he would catch it on the tip of one foot, kick it up, catch it, kick it up again, and in this fashion, juggling the matchbox on one foot, hop the entire length of the ward. At the same hospital were two PD patients who shared a room for 20 years. Both were motionless and mute, but one evening:- Dr. Stern heard a terrific noise coming from this room of perpetual silence. Rushing to it with a couple of nurses, he found its inmates in the midst if a violent fight, throwing each other around and houting obscenities. The moment they were separated they became motionless and mute again and have remained so ever since. Another patient at Mount Carmel Hospital would sit completely motionless unless she was suddenly thrown three (or more) oranges. Instantly she starts juggling them – she can juggle up to seven, in a manner incredible to see – and can continue doing so for half an hour on end, But if she drops one, or is interrupted for a moment, she suddenly becomes motionless again. Another Mount Carmel patient seemed totally incapable of movement until one day when:- he suddenly took up my ophthalmoscope, a most intricate one, unscrewed it, put it together again, and gave a stunning imitation of me examining an eye. The entire performance, which was flawless and brilliant, occupied no more than a few seconds. Hypotheses for PK (1989) Morris et al evaluated the factors influencing gait in PD patients. Through bypassing the defective basal ganglia and instead using the frontal cortex to regulate movement size or timing by consciously thinking about the desired movement, people with PD arguably compensate for the neurotransmitter imbalance in the basal ganglia. Other strategies include visualizing walking with long steps, mentally rehearsing the desired movement pattern before the action is performed, breaking down long or complex motor sequences into parts and focusing on the performance of each individual segment (segmentation), avoiding dual task performance, reading instructions on a cue card, and verbally reciting phrases such as “think big” or “long steps.”This model is based on the theory that the ability to move normally is not lost in PD. Instead, there is an activation problem that can be overcome through targeted physical therapy together with optimal pharmacotherapy. (1991) Glickstein and Stein The stimuli that often elicit paradoxical movements are similar to those that relay visual information to the cerebellum. We suggest that many instances of paradoxical movement may be explained by the fact that the pathways relaying those visual stimuli can bypass the damaged basal ganglia and allow an intact cerebellar circuit to be used for visuomotor control. (2009) Schlesimger et al (Ibid) advanced three possible hypotheses to explain PK. Basal Ganglia Reserves This assumes that reserves of dopamine are held in the basal ganglia and are released in emergencies. Compensatory cerebellar circuitry This assumes that dormant alternative cerebellar circuitry can be activated by reward-seeking behaviour. Noradrenic augmentation This assumes that a primitive, latent system of movement can be stimulated into use by the secretion of the neurotransmitter noradrenaline acting upon the sympathetic nervous system. This is also known as the "fight-or-flight response" Visual Cueing Visual cueing is a form of PK which can be activated, and controlled by an indvidual as an alternative form of locomotion. Morris et al evaluated cadence control for slow to medium walking speeds in PD patients and showed that an increase in step frequency was a compensation for reduced stride length. They concluded:- The findings indicated that cadence control remains unaffected throughout its entire range in Parkinson's disease and that gait hypokinesia is directly attributable to an inability to internally generate sufficiently large steps. Further Reading Search the scientific literature (Paradoxical_kinesia) Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Paradoxical_kinesia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar Search the scientific literature (kinesia paradoxa) Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease kinesia_paradoxa. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar Related Pages References

Masking

Redirected to ( To subpage for editing >> ) Amimia Fixed and vacant expression (masking) Very little research has been carried out on this common PD symptom but the following are relevant :- Allen (1931) The Dissociation of voluntary and emotional movements of the face with special reference to emotional paresis as a physical sign Hemmesch et al (2009)The Influence of Facial Masking and Sex on Older Adults’ Impressions of Individuals with Parkinson’s Disease. Clark et al (2011) Visual Exploration of Emotional Facial Expressions in Parkinson's Disease Tickle-Degnen et al (2011) Culture, Gender and Health Care Stigma: Practitioners’ Response to Facial Masking Experienced by People with Parkinson’s Disease < Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Amimia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Micrographia

( To subpage for editing >> ) Micrographia Microscopic handwriting The following references are relevant:- Oliveira et al (1997) Micrographia in Parkinson's disease: the effect of providing external cues Dounskaia et al (2009) Biased Wrist and Finger Coordination in Parkinsonian Patients during Performance of Graphical Tasks Shukla et al (2012) Micrographia and related deficits in Parkinson's disease: a cross-sectional study Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Micrographia . This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Micrographia Pubmed (abstracts) Micrographia Pubmed_Central (Full_Text) Micrographia Google_Scholar References

Motor fluctuations

( To subpage for editing >> ) Motor fluctuations 'On-off' periods, wearing off, dose failures, and freezing associated with long-term levodopa use The following references are relevant:- Bordelon et al (2011) Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease / Bohnen et al (2011) Leucoaraiosis, nigrostriatal denervation and motor symptoms in Parkinson’s disease Mera et al (2012) Feasibility of home-based automated Parkinson’s disease motor assessment Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Motor_fluctuations. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Myoclonus

( To subpage for editing >> ) Myoclonus Sudden violent jerks. The following references are relevant:- Mera et al (2011) Feasibility of home-based automated Parkinson’s disease motor assessment Lanska (2010) Chapter 33: the history of movement disorders Kojovic et al (2011) Myoclonic disorders: a practical approach for diagnosis and treatment Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Myoclonus. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Oculogyric crises

( To subpage for editing >> ) Oculogyric crises Attacks of forced deviation of gaze; The following references are relevant:- Clough et al (1983) Oculogyric crises and parkinsonism. A case of recent onset Furumoto et al (1989) Oculogyric crisis as an initial symptom of juvenile parkinsonism-like disease Wilkaniec et al (2013) Toxicity of extracellular secreted alpha-synuclein: Its role in nitrosative stress and neurodegeneration. Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Oculogyric. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

'On-off'

Redirected to ( To subpage for editing >> ) Motor fluctuations 'On-off' periods, wearing off, dose failures, and freezing associated with long-term levodopa use The following references are relevant:- Bordelon et al (2011) Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease / Bohnen et al (2011) Leucoaraiosis, nigrostriatal denervation and motor symptoms in Parkinson’s disease Mera et al (2012) Feasibility of home-based automated Parkinson’s disease motor assessment Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Motor_fluctuations. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Palipraxia

( To subpage for editing >> ) Palipraxia Forced repetitive movement. The following references are relevant:- Ghika (----) Mood and behaviour in disorders of the basal ganglia. Critchley (1970) Aphasioloy and other aspects of language Naremore (1981) Language science : recent advances Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Palipraxia . This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Paradoxical kinesia

( To subpage for editing >> ) Paradoxical kinesia Sometimes referred to as 'Kinesia paradoxa' Unexpected reversal of motor symptoms Many PD patients find that the daily onset of movement disorders is inconsistent and unpredictable and varies according to the type of activity they undertake, their emotional state and social circumstances. For example it may seem easier to walk across uneven ground rather than on a flat, hard surface, or it may seem easier to climb stairs or a slope than progress on the level. This gives a pointer to alternative neural pathways which could be exploited to ameliorate PD symptoms. Faith 'Cures' The earliest reference to this phenomenon is to be found in Chapter 2 of the Gospel of St. Mark, where Jesus is at Capernaum and is faced with a bedridden man who is "sick of the palsy". 10 But ye may know that the Son of man hath power on earth to forgive sins,(he saith to the sick of the palsy.) 11. I say unto thee, Arise, and take up thy bed, and go thy way t12. And immediately he arose, took up the bed, and went forth before them all; insomuch that they were all amazed, and glorified God, saying, We never saw it on this fashion. This account begs the questions as to whether the palsy as described equates with PD and whether the observable benefits were permanent or temporary. In modern times the most documented "miracle" cure is that of Sister Marie Simon-Pierre, who attested that she had been cured of Parkinson's Disease after praying to the late Pope John Paul II.[who himself manifested advanced symptoms of PD] ROME, APRIL 30, 2011 .- Here is a [part of]translation of the testimony of Sister Marie Simon-Pierre of the Congregation of the Little Sisters of Catholic Motherhood, regarding her miraculous cure from Parkinson's that she attributes to the intercession of Pope John Paul II. The testimony, written in 2006, formed part of John Paul II's case for beatification. Reports of medical and legal experts on the French nun's healing were submitted to the dicastery for scientific examination last October. The phenomenon was recognized by the Vatican as a miracle attributed to the intercession of John Paul II In June 2001, I was diagnosed with Parkinson's disease. The disease had affected the whole left side of my body, creating great difficulties for me as I am left-handed. After three years, the initial phase of the disease, slow but progressive, was followed by an aggravation of the symptoms: accentuation of the trembling, rigidity, pain, insomnia. From April 2, 2005, I began to worsen week by week, I grew worse day by day, I was unable to write (I repeat that I am left-handed), and if I attempted it, what I wrote was unintelligible. I could drive only for short trips because my left leg would stiffen sometimes, and my rigidity would have impeded my driving. Moreover, to do my work in a hospital, it took more time than usual. I was exhausted....... ......On May 13 [2005}, feast of Our Lady of Fatima, Benedict XVI announced the special dispensation to initiate the cause of beatification of John Paul II. Beginning the following day, the sisters of all the French and African communities began to pray for my cure through the intercession of John Paul II. They prayed incessantly until the news arrived of my cure. At that time I was on vacation. On May 26, my time of rest being at an end, I re-turned totally exhausted by the disease. "If you believe, you will see the glory of God": this phrase of St. John's Gospel accompanied me from May 14 onward. On June 1, I was finished; I struggled to stand and to walk. On June 2 in the afternoon. With effort, I wrote: "John Paul II." We remained in silence before the il-legible letters, then the day continued as usual. At the end of the evening prayer, at 9 o'clock at night, I went to my office before going to my room. I felt the need to pick up the pen and to write, just as if someone within me was saying: "Pick up the pen and write." It was between 9:30 and 9:40 at night. To my great surprise I saw that the writing was clearly legible. Not understanding anything, I went to bed. Two months exactly had gone by since John Paul II's departure to the House of the Father. I woke up at 4:30 a.m., surprised that I was able to sleep and I leapt out of bed: my body was no longer insensitive, rigid, and interiorly I was not the same....... ......Ten months have passed now since I interrupted all types of treatment. I am working normally again, I have no difficulty in writing and I also drive long distances. It feels as if I have been reborn: a new life, because nothing is as it was before..... It is not possible to evaluate these events without a sight of the report of the panel of medical experts set up by the Vatican to evaluate claims of cures. More Observations (1921) Souques observed the phenomenon and coined the term 'Paradoxical kinesia' to describe it. (1976) Marshall et al Activation-induced restoration of sensorimotor functions in rats with dopamine-depleting brain lesions succeeded in reproducing Kinesia Paradoxica by exposing Parkinsonian rats to potentially life-threatening situations. They began to move and respond appropriately to environmental stimuli when placed in a sink of water, in a shallow ice bath, or among a colony of cats or rats. A reversal of the sensorimotor dysfunctions was still apparent shortly after the animals were removed from each activating situation. However, the therapeutic effects dissipated rapidly, and by 4 hr after an exposure the rats responded as poorly as they had prior to activation. (1989) Keefe et al Dopamine ReleaseStudies in an Animal Model found that by inducing PK they could switch Parkinson symptoms on and off in rats. Rats were given brain lesions to inhibit their dopamine production capacity by 98% and they became Parkinsonian. They were placed in deep water and managed to swim effectively. They also escaped from shallow ice baths. These behaviors were not abolished by pretreating the animals with the dopamine antagonists haloperidol and SCH-23390. In contrast, haloperidol completely blocked the brain-damaged animals' behavioral responses to amphetamine. These results suggest that the paradoxical kinesia of dopamine-depleted rats is not a consequence of dopamine release from residual dopaminergic fibers. (2007) Schlesinger et al interviewed 50 PD patients, who had been exposed to life-threatening situations in war. Two had experiened PK. (2009) Robottom et al < noted that symptoms varied when PD patients were placed under emotional or physical stress. The Abruzzi earthquake (2009) At 03.32 Central European Summer Time on the night of 6th April 2009 the city of L'Aquila, which is the capital of the Abruzzo region in Italy, was devastated by a sudden earthquake with a strength of 5.8 on the Richter Scale. There was considerable damage to property, 308 people lost their lives and some 1,500 were injured.However there is a long history of earth tremors in the region and the majority of citizens evacuated their properties forthwith and survived. It so happened that 70km. away was a Movement Disorder clinic, operated by the University G.D. Annunzio Chieti-Pescari, which had neen monitoring the symptoms of 14 patients in the city with parkinsonism and dementia. The movemnt disorders of all of them were at Hoehn and Yahr stages 3 to 5. Measurements taken 3 months after the earthquake showed an unaccountable significant improvement in their UPDRS motor rating. There was also considerable anecdotal evidence of their performmance at the moment when the earthquake struck:- "He ran like hell out of the two storey building pushing his two children (17 and 15 years old) and his wife" relates to a 59 year old retired chemical engineer in his tenth year since being diagnosed with PD. "During the earthquake hit he ran from his house." describes a 58 year old retired truck driver five years after PD diagnosis. "During the night time earthquake, she rose from her bed and hurried out of her apartment at the third floor. When she was examined, 15 days after the earthquake, she walked to the office assisted by her daughter (in the previous visit she had been carried on a wheelchair)." Describes a 90 year old woman with both PD and dementia. "During the night time earthquake hit he ran away from his second floor apartment." relates to a 77 year od retired public employee. "During the earthquake, he jumped out of bed and ran through three flights of stairs, carrying and pushing his 72 year old wife (she reported he practically lifted her up through the collapsing apartment and floors)." Part of an acount of a 77 year old retired engineer who had experienced PD symptoms for three year. After 5 months the patients had regressed to their pre-earthquake state. A full account was published by Bonanni et al(2010) Protracted benefit from paradoxical kinesia in typical and atypical parkinsonisms Oliver Sacks PK can occur without the need for divine intervention or geological catastrophes. “Awakenings”, by Oliver Sacks, is one of the most lucid and closely observed accounts of PD symptoms. It is based on the case notes of a series of encounters that he had with patients as a result of the PD pandemic called Encephalitis Lethargica. In the 1920’s. This form of the disease is characterised by its rapid onset and progression and its pronounced symptoms. For example bradykinesia progresses to the point where the patient becomes catatonic. Sacks noted a number of occurrences of Pardoxical kinesia:- Thus one may see such patients rigid, motionless, seemingly lifeless as statues, abruptly called into normal life and action by some sudden exigency which catches their attention (in one famous case, a drowning man was saved by a Parkinsonian patient who leapt from his wheelchair into the breakers.) In the 1950s there was a PD patient at the Highlands Hospital, London, who:- would often sit frozen and motionless unless he were thrown a ball. This would instantly call him to life and he would leap to his feet, swerving, running, dribbling he ball……If thrown a match box he would catch it on the tip of one foot, kick it up, catch it, kick it up again, and in this fashion, juggling the matchbox on one foot, hop the entire length of the ward. At the same hospital were two PD patients who shared a room for 20 years. Both were motionless and mute, but one evening:- Dr. Stern heard a terrific noise coming from this room of perpetual silence. Rushing to it with a couple of nurses, he found its inmates in the midst if a violent fight, throwing each other around and houting obscenities. The moment they were separated they became motionless and mute again and have remained so ever since. Another patient at Mount Carmel Hospital would sit completely motionless unless she was suddenly thrown three (or more) oranges. Instantly she starts juggling them – she can juggle up to seven, in a manner incredible to see – and can continue doing so for half an hour on end, But if she drops one, or is interrupted for a moment, she suddenly becomes motionless again. Another Mount Carmel patient seemed totally incapable of movement until one day when:- he suddenly took up my ophthalmoscope, a most intricate one, unscrewed it, put it together again, and gave a stunning imitation of me examining an eye. The entire performance, which was flawless and brilliant, occupied no more than a few seconds. Hypotheses for PK (1989) Morris et al evaluated the factors influencing gait in PD patients. Through bypassing the defective basal ganglia and instead using the frontal cortex to regulate movement size or timing by consciously thinking about the desired movement, people with PD arguably compensate for the neurotransmitter imbalance in the basal ganglia. Other strategies include visualizing walking with long steps, mentally rehearsing the desired movement pattern before the action is performed, breaking down long or complex motor sequences into parts and focusing on the performance of each individual segment (segmentation), avoiding dual task performance, reading instructions on a cue card, and verbally reciting phrases such as “think big” or “long steps.”This model is based on the theory that the ability to move normally is not lost in PD. Instead, there is an activation problem that can be overcome through targeted physical therapy together with optimal pharmacotherapy. (1991) Glickstein and Stein The stimuli that often elicit paradoxical movements are similar to those that relay visual information to the cerebellum. We suggest that many instances of paradoxical movement may be explained by the fact that the pathways relaying those visual stimuli can bypass the damaged basal ganglia and allow an intact cerebellar circuit to be used for visuomotor control. (2009) Schlesimger et al (Ibid) advanced three possible hypotheses to explain PK. Basal Ganglia Reserves This assumes that reserves of dopamine are held in the basal ganglia and are released in emergencies. Compensatory cerebellar circuitry This assumes that dormant alternative cerebellar circuitry can be activated by reward-seeking behaviour. Noradrenic augmentation This assumes that a primitive, latent system of movement can be stimulated into use by the secretion of the neurotransmitter noradrenaline acting upon the sympathetic nervous system. This is also known as the "fight-or-flight response" Visual Cueing Visual cueing is a form of PK which can be activated, and controlled by an indvidual as an alternative form of locomotion. Morris et al evaluated cadence control for slow to medium walking speeds in PD patients and showed that an increase in step frequency was a compensation for reduced stride length. They concluded:- The findings indicated that cadence control remains unaffected throughout its entire range in Parkinson's disease and that gait hypokinesia is directly attributable to an inability to internally generate sufficiently large steps. Further Reading Search the scientific literature (Paradoxical_kinesia) Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Paradoxical_kinesia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar Search the scientific literature (kinesia paradoxa) Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease kinesia_paradoxa. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar Related Pages References

Paratonia

Redirected to ( To subpage for editing >> ) Gegenhalten Involuntary variable resistance during passive movement The following references are relevant:- Bahram et al (2009) Exercise therapy, quality of life, and activities of daily living in patients with Parkinson disease: a small scale quasi-randomised trial Franzen et al (2009) Reduced Performance in Balance, Walking and Turning Tasks is Associated with Increased Neck Tone in Parkinson's Disease Xia et al (2011) Differentiation between the contributions of shortening reaction and stretch-induced inhibition to rigidity in Parkinson’s disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Gegenhalten. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Paresis

( To subpage for editing >> ) Paresis Partial paralysis. The following references are relevant:- Chao et al (2007) Surgical Management of Parkinson's Disease: Update and Review Halett(2011) Psychogenic Parkinsonism Armstrong et al(2011) Visual Symptoms in Parkinson's Disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Paresis. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Postural instability

Redirected to ( To subpage for editing >> ) Balance Susceptibility to falls Alternative terms Postural instability---Falls The following references are relevant:- King et al (2012) Do clinical scales of balance reflect turning abnormalities in people with Parkinson's disease? Duncan and Earhart (2012) Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease? Boonsinsukh et al (2012) A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Balance. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Propulsive gait

( To subpage for editing >> ) Propulsive gait When walking, steps become faster and faster with progressively shorter steps that passes from a walking to a running pace Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Propulsive gait. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. gait Pubmed (abstracts) gait Pubmed_Central (Full_Text) gait Google_Scholar References

Resting Tremor

Redirected to Tremor ( To subpage for editing >> ) Tremor Involuntary shaking, trembling or quivering movements of the muscles The following references are relevant:- Sanchez-Ramos et al (2011) Quantitative Analysis of Tremors in Welders Mure et al (2011) Parkinson’s Disease Tremor-Related Metabolic Network: Characterization, Progression, and Treatment Effects Helmich et al (2012) Cerebral causes and consequences of parkinsonian resting tremor: a tale of two circuits? Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Tremor. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Restless Legs Syndrome

( To subpage for editing >> ) Restless Legs Syndrome Uncontrollable, involuntary movement of the legs and feet The following references are relevant:- Gao et al (2010) Restless Legs Syndrome and Erectile Dysfunction Gao et al (2010) Restless legs syndrome and Parkinson’s disease in men Pourcher et al (2010) Compulsive habits in restless legs syndrome patients under dopaminergic treatment Peeraully and Tan (2012) Linking restless legs syndrome with Parkinson's disease: clinical, imaging and genetic evidence http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802250/ Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Restless_Legs_Syndrome. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Shaking Palsy
( To subpage for editing >> ) Shaking Palsy An early name for Parkinson's Disease.

Tachykinesia

( To subpage for editing >> ) Tachykinesia Rapid Movement The following references are relevant:- Ellis et al (2011) Which Measures of Physical Function and Motor Impairment Best Predict Quality of Life in Parkinson’s Disease? Ellis et al (2011) Factors Associated With Exercise Behavior in People With Parkinson Disease Espay et al(2012) “On” state freezing of gait in Parkinson disease - A paradoxical levodopa-induced complication Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Tachykinesia. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Tic

Redirected to Blepharospasm ( To subpage for editing >> ) Blepharospasm Spasm of the eyelid The following references are relevant:- Elston (1992) A new variant of blepharospasm Hallett et al (2008) ..Update on blepharospasm: Report from the BEBRF International Workshop Armstrong (2011) Visual symptoms in Parkinson's Disease Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Blepharospasm. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

Torticolls

( To subpage for editing >> ) Torticollis Asymmetric spasm of the neck muscles The following references are relevant:- Bronstein and Rudge (1986) Vestibular involvement in spasmodic torticollis Jahanshah (2000) Factors that ameliorate or aggravate spasmodic torticollis Thompson et al (2011) Convergent mechanisms in etiologically-diverse dystonias Further Research Search the scientific literature Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Torticollis. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References

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