Parkinson's disease patients experiencing peak-dose dyskinesia redistribute involuntary movements throughout their body to improve motor control

Abstract

Introduction: In Parkinson's disease (PD), dyskinesia is considered a major side effect of dopamine replacement therapy. Nevertheless, many patients with dyskinesia function adequately.

Objective: To study objectively dyskinesia phenomenology in order to understand why or how patients with dyskinesia are still able to perform motor tasks.

Methods: Patients with and without dyskinesia, as well as healthy older adults, performed a geostationary task during which they attempted to stabilize a glass of water at eye level. Dyskinesia amplitude displayed by each body segment was extracted from accelerometers, and its distribution among the segments, analyzed.

Results: Patients experiencing dyskinesia initially distributed most of their dyskinesia away from the segments directly involved in the task. With time, this distribution shifts back towards the hand.

Conclusion: Our results suggest that patients developed a strategy of involuntary movement's redistribution to attenuate their functional impact on voluntary movements. However, this strategy can only be maintained for a certain period before "re-emerging" dyskinesia occurs.

Keywords: Dyskinesia; Energy; Parkinson; Strategy.