Sensory perception in Parkinson disease.

OBJECTIVE To determine whether there is a complex sensory disturbance that may be contributing to the motor deficit in patients with Parkinson disease. DESIGN Comparison of performance by patients and healthy, age- and sex-matched subjects in tests of various sensory functions. SETTING The Center for Human Performance and Testing at a university hospital and research center. PARTICIPANTS Ten subjects with Parkinson disease and 10 control subjects matched for age and sex. MAIN OUTCOME MEASURE Performance on 4 subjects of the Sensory Integration and Praxis Test: finger identification, graphesthesia, localization of tactile stimuli, and kinesthesia. RESULTS Data were analyzed using paired t tests for ratio data and the paired Wilcoxon test for ordinal data. Patients with Parkinson disease performed significantly worse (P = .001) than the control patients on the test of kinesthesia. There were no significant differences between the 2 groups on the other subtests. CONCLUSIONS Without visual guidance, patients with Parkinson disease had more difficulty in perceiving the extent of a movement made to a target away from the body, a task requiring reliance on proprioceptive feedback. Parkinsonian patients had no more difficulty than controls in making movements to a target on the surface of the body when they could use tactile sensations. Movement difficulties in patients with Parkinson disease may relate in part to a decrease in proprioception. Activities that enhance kinesthetic awareness may be an important adjunct to the treatment of these patients.

[1]  K. Flowers.  Visual "closed-loop" and "open-loop" characteristics of voluntary movement in patients with Parkinsonism and intention tremor. , 1976, Brain : a journal of neurology.

[2]  L. Tremblay,et al.  Abnormal influences of passive limb movement on the activity of globus pallidus neurons in parkinsonian monkeys , 1988, Brain Research.

[3]  M. Borutta,et al.  A defect of kinesthesia in Parkinson's disease , 1995, Movement disorders : official journal of the Movement Disorder Society.

[4]  V B Brooks,et al.  Basal ganglia cooling disables learned arm movements of monkeys in the absence of visual guidance. , 1977, Science.

[5]  C. Markham,et al.  Deficits in orofacial sensorimotor function in Parkinson's disease , 1986, Annals of neurology.

[6]  M. Delong,et al.  Primate models of movement disorders of basal ganglia origin , 1990, Trends in Neurosciences.

[7]  J. Schneider,et al.  Basal ganglia: Motor influences mediated by sensory interactions , 1982, Experimental Neurology.

[8]  M. Hoehn,et al.  Parkinsonism , 1967, Neurology.

[9]  Z. Mailloux.  An overview of Sensory Integration and Praxis Tests. , 1990, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[10]  D. Roeltgen,et al.  Motor and nonmotor behavioral deficits in monkeys made hemiparkinsonian by intracarotid MPTP infusion , 1992, Neurology.

[11]  T. Flash,et al.  Kinematic analysis of upper limb trajectories in Parkinson's disease , 1992, Experimental Neurology.

[12]  Schneider Js.  Basal ganglia role in behavior: importance of sensory gating and its relevance to psychiatry. , 1984 .

[13]  J. Parkinson.  An Essay on the Shaking Palsy , 2002 .

[14]  C. Markham,et al.  Parkinson's disease , 1987, Neurology.

[15]  M. Merzenich,et al.  Sensory dysfunction associated with repetitive strain injuries of tendinitis and focal hand dystonia: a comparative study. , 1996, The Journal of orthopaedic and sports physical therapy.