Document Detail


Differential susceptibility to motor impulsivity among functional subtypes of Parkinson's disease.
MedLine Citation:
PMID:  22917670     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Parkinson's disease patients with predominant postural instability and gait difficulties (PIGD) may experience unique cognitive difficulties compared to patients with tremor predominant (TD) symptoms. PIGD patients are also at high risk for falling, and some of the worst fallers seem to react impulsively to their environment. We tested the hypothesis that PIGD patients show poorer control over motor impulses compared to TD patients.
METHODS: 34 PD participants were divided into predominant PIGD (n=17) or TD (n=17) functional subtypes based on their presenting symptoms in their optimally treated motor state. All participants performed a speeded reaction task that quantified motor impulsivity and the proficiency of inhibiting prepotent motor impulses.
RESULTS: The groups showed similar reaction times, but compared to TD patients, PIGD patients made significantly more impulsive motor errors. Notably, when the initial impulsive erroneous response was avoided, PIGD and TD groups were similar in their ability to suppress the incorrect motor impulse from further interfering with the selection of a correct action.
CONCLUSIONS: PD patients with PIGD predominant symptoms show greater susceptibility to acting on prepotent motor impulses compared to TD patients. This finding may have direct implications for fall risk and also points to dissociable neurocognitive pathologies in TD and PIGD subtypes. Clinically, the use of specific cognitive instruments to assess the expression and inhibition of motor impulses may help identify PD patients who have difficulty 'thinking before they leap' and are at high risk of falling.
Authors:
Scott A Wylie; Wery van den Wildenberg; K Richard Ridderinkhof; Daniel O Claassen; George F Wooten; Carol A Manning
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-08-23
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  83     ISSN:  1468-330X     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-15     Completed Date:  2013-01-16     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  1149-54     Citation Subset:  IM    
Affiliation:
Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA. scott.a.wylie@vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Gait Disorders, Neurologic / etiology,  physiopathology
Humans
Male
Middle Aged
Motor Activity*
Movement Disorders / etiology*
Neurologic Examination
Neuropsychological Tests
Parkinson Disease / classification,  complications*,  physiopathology*
Postural Balance
Psychomotor Performance
Reaction Time
Tremor / etiology,  physiopathology
Verbal Learning
Grant Support
ID/Acronym/Agency:
K23 AG028750/AG/NIA NIH HHS; K23AG028750/AG/NIA NIH HHS
Comments/Corrections

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