Objective: To evaluate if the presence of glabellar and palmomental reflexes in patients with parkinsonism is significantly more common in neurodegenerative etiology compared with non-neurodegenerative etiologies.

Background: The clinical distinction between neurodegenerative and non-neurodegenerative parkinsonism can be difficult. Misdiagnosis of PD or other neurodegenerative parkinsonian conditions is not uncommon. Diagnostic tests have been developed to increase the accuracy in the diagnosis of parkinsonism. The dopamine transporter scan (DATscan) has become a useful tool in the evaluation of  dopaminergic neurodegeneration. Unfortunately, due to limited availability and substantial cost, its use in daily clinical practice is restricted. Other tools have been evaluated to make the distinction between neurodegenerative and non-neurodegenerative parkinsonism.

Primitive reflexes are a group of motor-behavioral evoked responses, physiologically present in childhood and suppressed during normal development. The reappearance of these reflexes in adulthood may occur in different neurological conditions including neurodegenerative disorders. To the best of our knowledge, glabellar and palmomental reflexes have not been studied as clinical tools to make the distinction between degenerative and non- neurodegenerative parkinsonism.

Methods: This is a case control prospective study. Patients with neurodegenerative parkinsonism with at least grade 2 loss on a DATscan and patients with non-neurodegenerative parkinsonism confirmed by a normal DATscan were recruited. Patients with significant cognitive impairment were excluded. In each subject, glabellar and palmomental reflexes were elicited and recorded. 

Results: Recruitment was completed as of 1/6/2017.  Total of 100 patients were recruited,  54 with neurodegenerative parkinsonism, 46 patients with non-neurodegenerative parkinsonism.   Two blinded raters will be asked to indicate absence or presence of the reflexes based on the video clip.   Presence or absence of the glabellar and palmomental reflexes will be analyzed as categorical variables. Statistical tests will be applied. 

Conclusions: Available upon data analysis and completion of study.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/can-glabellar-and-palmomental-reflexes-differentiate-neurodegenerative-from-non-neurodegenerative-parkinsonism/