Motor symptoms in Parkinson's disease: A unified framework

Ahmed A Moustafa; Srinivasa Chakravarthy; Joseph R Phillips; Ankur Gupta; Szabolcs Keri; Bertalan Polner; Michael J Frank; Marjan Jahanshahi

doi:10.1016/j.neubiorev.2016.07.010

Motor symptoms in Parkinson's disease: A unified framework

Neurosci Biobehav Rev. 2016 Sep:68:727-740. doi: 10.1016/j.neubiorev.2016.07.010. Epub 2016 Jul 12.

Authors

Ahmed A Moustafa¹, Srinivasa Chakravarthy², Joseph R Phillips³, Ankur Gupta², Szabolcs Keri⁴, Bertalan Polner⁵, Michael J Frank⁶, Marjan Jahanshahi⁷

Affiliations

¹ Department of Veterans Affairs, New Jersey Health Care System, East Orange, NJ, United States; School of Social Sciences and Psychology & Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, New South Wales, Australia; Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, New South Wales, Australia. Electronic address: a.moustafa@westernsydney.edu.au.
² Department of Biotechnology, Indian Institute of Technology, Madras, Chennai, India.
³ School of Social Sciences and Psychology & Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, New South Wales, Australia.
⁴ Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary; Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary; Department of Physiology, Faculty of Medicine, University of Szeged, Hungary.
⁵ Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary; Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary.
⁶ Department of Cognitive, Linguistic Sciences and Psychological Sciences, Brown Institute for Brain Science, Brown University, Providence RI 02912, USA.
⁷ Cognitive Motor Neuroscience Group and Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, The National Hospital for Neurology and Neurosurgery London, UK.

PMID: 27422450
DOI: 10.1016/j.neubiorev.2016.07.010

Abstract

Parkinson's disease (PD) is characterized by a range of motor symptoms. Besides the cardinal symptoms (akinesia and bradykinesia, tremor and rigidity), PD patients show additional motor deficits, including: gait disturbance, impaired handwriting, grip force and speech deficits, among others. Some of these motor symptoms (e.g., deficits of gait, speech, and handwriting) have similar clinical profiles, neural substrates, and respond similarly to dopaminergic medication and deep brain stimulation (DBS). Here, we provide an extensive review of the clinical characteristics and neural substrates of each of these motor symptoms, to highlight precisely how PD and its medical and surgical treatments impact motor symptoms. In conclusion, we offer a unified framework for understanding the range of motor symptoms in PD. We argue that various motor symptoms in PD reflect dysfunction of neural structures responsible for action selection, motor sequencing, and coordination and execution of movement.

Keywords: Akinesia; Bradykinesia; Freezing of gait; Grip force; Handwriting; Parkinson’s disease; Rigidly; Speech; Tremor.

Publication types

Review

MeSH terms

Deep Brain Stimulation
Dopamine Agents
Gait
Humans
Motor Activity*
Parkinson Disease*
Speech

Substances

Dopamine Agents