Side onset influences motor impairments in Parkinson disease

Stewart, Kim C.; Fernández, Hubert H.; Okun, Michael S.; Rodríguez, Ramón; Jacobson, Charles E.; Hass, Chris J.

doi:10.1016/j.parkreldis.2009.02.001

Cited by 23 publications

(16 citation statements)

References 11 publications

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“…In that retrospective, cross-sectional study, we found that patients with right-side symptom onset (RSO) possessed greater ‘symmetry’ of motor impairments than patients with left-side symptom onset (LSO). In other words, PD patients with RSO (i.e., presumably with greater dominant left-hemisphere damage) had greater detriments in their ipsilateral left hand than the group of PD patients with LSO (greater non-dominant right hemisphere involvement) [18]. More recently, we have also prospectively confirmed that the side of symptom onset affected upper-extremity motor functioning.…”

Section: Introductionsupporting

confidence: 55%

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Unilateral deep brain stimulation surgery in Parkinson’s disease improves ipsilateral symptoms regardless of laterality

Shemisa¹,

Hass²,

Foote³

et al. 2011

Parkinsonism & Related Disorders

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Purpose Researchers have consistently observed in right-handed individuals across normal and disease states that the ‘dominant’ left hemisphere has greater ipsilateral control of the left side than the right hemisphere has over the right. We sought to determine whether this ipsilateral influence of the dominant hemisphere reported in Parkinson’s disease extends to treatments such as deep brain stimulation (DBS) and whether it affects outcome. We hypothesised that among Parkinson right-handers, unilateral left DBS would provide greater ipsilateral motor improvement compared with the ipsilateral motor improvement experienced on the right side. Scope A total of 73 Parkinson patients who underwent unilateral DBS of the subthalamic nucleus (STN) or globus palidus internus (GPi) participated. Left and right ‘composite scores’, were computed by separately adding all items on the left and right side from the motor section of the Unified Parkinson Disease Rating Scale. The change in the pre- and 4-month post-implantation score was the primary outcome measure. The mean motor scores improved by 4.96 ± 11.79 points (p < 0.001) post-surgery on the ipsilateral side of the DBS implantation. Regression analyses revealed that the side (left vs. right) and target (STN vs. GPi) did not significantly contribute in the effect of ipsilateral motor improvement (p = 0.3557). Conclusion While DBS on the ‘dominant’ left side failed to exert a greater ipsilateral influence compared with DBS on the non-dominant right side, significant ipsilateral motor improvements were observed after unilateral stimulation regardless of site of implantation and laterality.

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Section: Introductionsupporting

confidence: 55%

“…We previously reported that PD patients who were more dominant hemisphere affected had greater ipsilateral motor deficits when compared with PD patients whose symptoms started on their non-dominant side [18]. This is the first study examining the ipsilateral motor effects on both side and surgical target within a PD DBS cohort.…”

Section: Discussionmentioning

confidence: 99%

Unilateral deep brain stimulation surgery in Parkinson’s disease improves ipsilateral symptoms regardless of laterality

Shemisa¹,

Hass²,

Foote³

et al. 2011

Parkinsonism & Related Disorders

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“…Empirical findings principally involve cognition: the side of motor onset does not influence cognition in newly diagnosed untreated patients (Erro et al, 2013; Poletti et al, 2013); in patients “on” dopaminergic therapy a right-side motor symptom predominance is typically associated with difficulties in tasks of language and verbal memory, whereas a left-side motor symptom predominance is typically associated with difficulties in visuospatial tasks (Verreyt et al, 2011). More heterogeneous and controversial are findings on the role of the side of motor onset on motor subtypes (e.g., Stewart et al, 2009; Baumann et al, 2013) and especially on psychopathological subtypes (e.g., Foster et al, 2011; Dewey et al, 2012), therefore more empirical studies are needed on this issue.…”

Section: Discussion: Relationships Among Pd Subtypesmentioning

confidence: 99%

Neural and behavioral substrates of subtypes of Parkinson’s disease

Moustafa

Poletti

2013

Front. Syst. Neurosci.

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Parkinson’s disease (PD) is a neurological disorder, associated with rigidity, bradykinesia, and resting tremor, among other motor symptoms. In addition, patients with PD also show cognitive and psychiatric dysfunction, including dementia, mild cognitive impairment (MCI), depression, hallucinations, among others. Interestingly, the occurrence of these symptoms—motor, cognitive, and psychiatric—vary among individuals, such that a subgroup of PD patients might show some of the symptoms, but another subgroup does not. This has prompted neurologists and scientists to subtype PD patients depending on the severity of symptoms they show. Neural studies have also mapped different motor, cognitive, and psychiatric symptoms in PD to different brain networks. In this review, we discuss the neural and behavioral substrates of most common subtypes of PD patients, that are related to the occurrence of: (a) resting tremor (vs. nontremor-dominant); (b) MCI; (c) dementia; (d) impulse control disorders (ICD); (e) depression; and/or (f) hallucinations. We end by discussing the relationship among subtypes of PD subgroups, and the relationship among motor, cognitive, psychiatric factors in PD.

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“…Onset of motor symptoms in Parkinson's Disease (PD) is usually an unilateral phenomena and typically emerges on the right side of the body (Stochl et al 2008;Stewart et al 2009). Pre-morbid hand preference seems to be associated with the side of onset of PD signs (van der Hoorn et al 2011;Barrett et al 2011;Uitti et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Changes of hand preference in Parkinson’s disease

et al. 2012

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This study focused on the difference between pre-morbid and current hand preference of patients with Parkinson's disease (PD). A survey instrument comprised items measuring pre-morbid and current hand preference and question related to the side of occurrence of initial symptoms. These questions were administered to 471 PD patients. The results show a significant change of pre-morbid right hand preference toward using the left when the side of PD onset was on the right hand and vice versa. Disease duration does not predict the amount of hand preference shift.

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Side onset influences motor impairments in Parkinson disease

Cited by 23 publications

References 11 publications

Unilateral deep brain stimulation surgery in Parkinson’s disease improves ipsilateral symptoms regardless of laterality

Unilateral deep brain stimulation surgery in Parkinson’s disease improves ipsilateral symptoms regardless of laterality

Neural and behavioral substrates of subtypes of Parkinson’s disease

Changes of hand preference in Parkinson’s disease

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