Objective: To evaluate, through kinematic analysis, the major phenomenological features of bradykinesia, with a specific focus on their combination, in a relatively large sample of individuals with Parkinson’s disease (PD) and elderly healthy controls (HC).

Background: Bradykinesia is defined as movement slowness and a progressive decrease in amplitude and velocity during movement repetition (i.e., sequence effect) and it is the main diagnostic feature of PD [1-2]. Recently, we proposed redefining bradykinesia, based on a dual-axis approach, i.e., describing the major phenomenological features of bradykinesia in a given patient (Axis I), and elucidating the underlying etiology (Axis II) [3].

Method: We examined a sample of 172 PD patients (OFF medication) and 145 HC. Kinematic techniques were used for finger-tapping analysis [4]. Receiver Operating Characteristic (ROC) curve analysis was used to determine cut-off values for movement velocity, amplitude, rhythm, and sequence effect [4]. We then quantified the percentage of movement abnormalities in the two groups, whether occurring in isolation or variable combinations.

Results: Among PD patients, 171 (99.9%) exhibited at least one movement abnormality. Movement slowness or sequence effect, occurred in 77.2% and 80.9% of cases, respectively. Concerning current clinical criteria, the combination of movement slowness and sequence effect was observed in only 59.6% of cases. Movement abnormalities were also present in a significant proportion of HC; however, in these cases, they predominantly occurred as isolated abnormalities. The combination of 3-4 abnormalities was observed in 66.7% of PD patients and 15.9% of HC (p<0.05 by Χ² test).

Conclusion: The study objectively outlines the phenomenological features of bradykinesia in a large group of people with PD and healthy elderly individuals. Further information on bradykinesia features combination will be obtained from the analysis of their clinical correlates and the effects of pharmacological therapies.

References: 1. Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W, Obeso J, Marek K, Litvan I, Lang AE, Halliday G, Goetz CG, Gasser T, Dubois B, Chan P, Bloem BR, Adler CH, Deuschl G. MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord. 2015 Oct;30(12):1591-601. doi: 10.1002/mds.26424.

2. Bologna M, Paparella G, Fasano A, Hallett M, Berardelli A. Evolving concepts on bradykinesia. Brain. 2020 Mar 1;143(3):727-750. doi: 10.1093/brain/awz344. PMID: 31834375; PMCID: PMC8205506.

3. Bologna M, Espay AJ, Fasano A, Paparella G, Hallett M, Berardelli A. Redefining Bradykinesia. Mov Disord. 2023 Apr;38(4):551-557. doi: 10.1002/mds.29362.

4. Paparella G, Cannavacciuolo A, Angelini L, Costa D, Birreci D, Alunni Fegatelli D, Guerra A, Berardelli A, Bologna M. May Bradykinesia Features Aid in Distinguishing Parkinson’s Disease, Essential Tremor, And Healthy Elderly Individuals? J Parkinsons Dis. 2023;13(6):1047-1060. doi: 10.3233/JPD-230119.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/analysing-the-bradykinesia-features-combination-in-people-with-parkinsons-disease-and-elderly-healthy-individuals/