Affiliations: [a] Department of Neurology, Hospital Eugenio Espejo, Quito, Ecuador
| [b] Faculty of Medicine, Central University of Ecuador, Quito, Ecuador
| [c] Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| [d] Department of Clinical and Movement Neurosciences & Reta Lila Weston, Institute of Neurology, London, UK
Correspondence:
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Correspondence to: Fernando Alarcón, MD, Chief of Movement Disorders and Neurodegenerative Unit, Professor of Neurology, Department of Neurology, Hospital Eugenio Espejo, Quito, Ecuador. Tel.: + 593 2 222 1202; + 593 2 250 3296; E-mail: falarcn2000@hotmail.com.
Abstract: Background:Recognition of motor signs in the prodromal stage could help identify those at risk of developing Parkinson’s disease (PD). Objective:This study identified motor symptoms and signs in individuals suspected of having PD but who did not have a progressive reduction in the speed and amplitude of finger tapping or other physical signs indicative of bradykinesia. Methods:146 patients, who had symptoms or signs suggestive of PD, were serially evaluated by a movement disorder specialist, using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III and video recordings. If the patients ‘converted’ to PD during follow-up, they were categorized as cases and compared with those who did not meet PD criteria during follow-up (non-cases). Results:The 82 cases were more likely to have action dystonia or postural/action/rest tremor of a limb (OR 2.8; 95% CI 1.1–7.1; p = 0.02), a reduced blink rate at rest (OR 2.3; 95% CI 1.2–4.6; p = 0.01), anxiety (OR 8.9; 95% CI 2.6–31.1; p < 0.001), depression (OR 7.0; 95% CI 2.9–17.2; p < 0.001), or a frozen shoulder (OR 3.1; 95% CI 1.6–6.2) than the 64 ‘non-cases’.A reduction of the fast blink rate was common in patients who met the criteria for PD (p < 0.001). Conclusions:This study emphasizes that motor dysfunction is a component of the clinical prodrome seen in some patients with PD.
Keywords: Parkinson’s disease, prodrome, motor dysfunction
