RESUMO
Huntington disease (HD) is characterized by several hyperkinesias though motor slowness is also another cardinal in this disease. In addition, self-paced timing movements are also disturbed in HD, which may also affect several rhythmic voluntary movements such as gait. Motor slowness can be measured with clinical scales such as the Unified Huntington's Disease Rating Scale (UHDRS) and timed tests, but also with the reaction time (RT) paradigm. We evaluated RT as a measure of motor slowness in 30 patients with genetically confirmed Huntington's disease and 24 control subjects. We also evaluated self-paced timing precision (SPTP) by applying a simple software program devised by our group. Clinical assessment was performed according to the UHDRS, including motor section, total functional capacity (TFC) and cognitive section (verbal fluency test, symbol digit, and Stroop test) The mean values obtained for RT and SPTP were statistically different in HD as compared with those from controls (p<0.0005). We observed a statistically significant correlation between RT and TFC scores (rs=-0.57, p<0.005 Spearman's correlation) and also between SPTP values and TFC scores (rs=-0.40, p<0.05 Spearman's correlation). In addition, RT and SPTP significantly correlated with cognitive scores (including digit symbol, verbal fluency and Stroop tests). Simple tests such as RT and SPTP provide an objective evaluation of motor impairment in HD yielding measures that correlate with clinical assessment and functional disability.
Assuntos
Doença de Huntington/fisiopatologia , Periodicidade , Tempo de Reação/fisiologia , Percepção do Tempo/fisiologia , Adulto , Feminino , Humanos , Doença de Huntington/genética , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa , Estatística como Assunto , Repetições de Trinucleotídeos/genéticaRESUMO
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Assuntos
Humanos , Masculino , Idoso , Paresia/diagnóstico , Doenças do Nervo Oculomotor/diagnóstico , Tronco Encefálico/lesões , Anestesia Local/efeitos adversos , Extração de CatarataAssuntos
Anestesia Local/efeitos adversos , Tronco Encefálico/efeitos dos fármacos , Tronco Encefálico/fisiopatologia , Doenças dos Nervos Cranianos/induzido quimicamente , Doenças dos Nervos Cranianos/fisiopatologia , Nervo Oculomotor/efeitos dos fármacos , Nervo Oculomotor/fisiopatologia , Idoso , Anestesia Local/métodos , Extração de Catarata/efeitos adversos , Humanos , Complicações Pós-OperatóriasRESUMO
INTRODUCTION AND DEVELOPMENT: The non-motor symptoms of Parkinson's disease have a great impact in terms of quality of life. They are frequently underdiagnosed and clinical experience suggests that not only is dopamine therapy ineffective but that in many cases it is also responsible for the appearance of some of these symptoms. Different studies have drawn attention to the involvement of the dopaminergic pathways in the pathogenesis of some non-motor symptoms. It has been observed that they can undergo fluctuations in relation to dopaminergic stimulation, generally in wearing off states, while displaying a significant correlation with motor fluctuations and a clinical response with continuous dopaminergic therapy. CONCLUSIONS: Although recent reviews offer insufficient evidence for treatment of non-motor symptoms with dopaminergic therapy, involvement of the dopaminergic pathways in the aetiopathogenesis of some of these disorders and the clinical observation that such symptoms undergo fluctuations in relation to pulsatile dopaminergic stimulation may lead us to reconsider the possible role of dopaminergic therapy in the treatment of these symptoms.
