Effects of levodopa on upper limb mobility and gait in Parkinson’s disease

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 74; no. 9; pp. 1304 - 1307
• Main Authors: Vokaer, M, Azar, N Abou, de Beyl, D Zegers
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.09.2003; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Aged; Anticonvulsants. Antiepileptics. Antiparkinson agents; Antiparkinson Agents - administration & dosage; Antiparkinson Agents - pharmacology; Biological and medical sciences; Female; Fingers - physiology; Gait; Gait - drug effects; Hands; Humans; levodopa; Levodopa - administration & dosage; Levodopa - pharmacology; Male; Medical sciences; Middle Aged; motor function; Motor Skills - drug effects; Neuropharmacology; Parkinson Disease - complications; Parkinson Disease - drug therapy; Parkinson's disease; Patients; Pharmacology. Drug treatments; Short Report; Treatment Outcome; upper limb; Velocity; Walking; Human; Nervous system diseases; Evaluation scale; Mobility; Parkinson disease; Psychometrics; Antiparkinson agent; Cerebral disorder; Walking; Chemotherapy; Treatment; Central nervous system disease; Adult; Evolution; Degenerative disease; Upper limb; Levodopa; Measurement method; Extrapyramidal syndrome
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.74.9.1304

Background: Most clinicians rely on clinical scales such as the unified Parkinson’s disease rating scale (UDPRS) for evaluating parkinsonian patients and assessing their response to levodopa. Gait analysis is not commonly used, probably because of the equipment required and the time needed. Few data have been published on the relations between gait variables and measures of arm and hand mobility. Objectives: To evaluate the correlation between dopa induced gait improvement and upper limb motor improvement using a rapid and simple method; and to evaluate the correlation between gait improvement and UPDRS III improvement. Methods: A finger tapping test and a simple walking test were used to measure the OFF-ON variations of upper limb motor function and gait in 23 patients with Parkinson’s disease. The UPDRS motor score and the Hoehn and Yahr stage were measured in the OFF and the ON state. Results: There was no correlation between OFF-ON variation of the number of hits with the finger tapping test and OFF-ON variation in the gait variables. OFF-ON variation in the UPDRS motor score was not correlated with OFF-ON variation in the gait variables. Conclusions: There was a dissociation between the effect of levodopa on upper limb and gait. The findings suggest that simple measures like the finger tapping test and a walking test should be included in the usual evaluation of patients with Parkinson’s disease.