Objective: Objective: We aimed to correlate hand deformities in patients with Parkinson´s disease (PD) with demographics, motor status and other parkinsonian postural abnormalities in order to gain insights into contributing causes of such deformities and address whether these hand deformities are predictors of advanced PD, dyskinesia, worse motor and cognitive status.

Background: Background: Hand deformities have been recognized since the XIX century as part of the postural abnormalities observed in Parkinson´s disease (PD).

Method: Methods: We evaluated 104 hands of 52 consecutive patients with PD by high resolution photographs taken from the radial aspect of each hand; the degree of flexion of the 2nd metacarpophalangeal (MCP) joint was measured by software. The presence of classical striatal hand deformity (CSHD) was also evaluated, defined as MCP flexion, proximal interphalangeal joint extension and distal interphalangeal joint flexion.

Results: Results: Patients with PD had a mean age of 63.3 ± 12.7 years and 29 (56%) were males. The degree of MCP joint flexion (figure A-D) in both hands showed moderate correlation with the MDS-UPDRS-III motor score (r=0.518, P<0.001); mainly related to ipsilateral rigidity and ipsilateral bradykinesia scores; and fair correlation with the Hoehn-Yahr stage. A CSHD (figure E and F) only correlated with a younger age at onset of PD (P=0.049). These hand deformities were not markers of dyskinesia, levodopa-dose or cognitive dysfunction.

Conclusion: Conclusions: Hand abnormalities are common in patients with PD and consist mainly in mild to moderate degree of MCP joint flexion that correlates with the severity of ipsilateral rigidity and bradykinesia. CSHD is much less common, the fact that presents in individuals having an earlier onset of PD, and lacks correlation with other motor symptoms suggesting that these abnormalities are not necessarily a continuum and may represent two different phenomena.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-associations-of-hand-deformities-in-parkinsons-disease/