INVESTIGADORES
PEREZ LLORET Santiago
artículos
Título:
Actigraphic evaluation of motor fluctuations in patients with Parkinson's disease.
Autor/es:
SANTIAGO PEREZ-LLORET; MALCO ROSSI; DANIEL P. CARDINALI; MARCELO MERELLO
Revista:
THE INTERNATIONAL JOURNAL OF NEUROSCIENCE.
Editorial:
TAYLOR & FRANCIS LTD
Referencias:
Año: 2010 vol. 120 p. 137 - 143
ISSN:
0020-7454
Resumen:
BACKGROUND: There is
growing interest in developing inexpensive and objective motor
fluctuation evaluation methods for Parkinson's disease (PD).
OBJECTIVES: We
aim to compare activity level in the off state, on state, and
dyskinetic periods as evaluated either by a physician during a levodopa
challenge or by a 72-hr on-off diary self-evaluation in the ambulatory
setting. Finally, the effect of daily activities on motor activity in PD
and healthy controls was further explored.
METHODS: The
study was conducted in three consecutive phases. For phase I, in which
the on state, off state, and dyskinesia were evaluated using actigraphy,
recordings were made during standard acute levodopa challenge in nine
dyskinetic PD patients. For phase II, a different set of 16 dyskinetic
PD patients was monitored in the ambulatory setting for 72 consecutive
hours by actigraphy and a standardized on-off diary. For phase III, 62
PD patients and 14 age- and sex-matched healthy controls wore an
actigraph and completed a daily activities diary for 7 days.
RESULTS: No
differences in activity level between on state and off state during the
acute levodopa challenge (phase I) or the 72-hr ambulatory period
(phase II) were found. Activity during dyskinesia periods was
significantly higher than during on state periods without dyskinesia (p
< .01). During the third phase, dyskinetic PD patients and healthy
controls showed higher actigraphy-measured activity as compared to de
novo, stable, or fluctuating PD (p < .0001), which remained unaltered
by daily activities performed during the study period. Tremor UPDRS
scores did not correlate with activity level.
CONCLUSIONS: These
results confirm the lack of specificity of simple wrist-worn actigraphy
and further suggest it may be suitable for dyskinesia assessment but
not for on state and off state evaluation.