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Title Nature and Laterality of Motor Symptoms in Parkinson's Disease and Relationships to Cognitive Profile
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University/Publisher University of Washington
Abstract Previous research suggested that the nature (bradykinesia, rigidity, or tremor) and laterality (left or right-sided) of motor symptoms in Parkinson's disease (PD) are related to cognitive-linguistic profile later in the progression of the disease. Approximately 600 individuals with PD recruited through the Pacific Northwest Udall Center (PANUC) PD Registry were considered for participation. Individuals completed a neuropsychological test battery that assessed language, memory, visuospatial function, and executive function. Three logistic regression models using the same set of input variables were run: a binomial model comparing left versus right side of onset, a binomial model comparing the type of onset symptom, and a multinomial model comparing the right onset group with tremor as the predominant symptom against the three other subgroups defined by laterality and symptom type. In all three regression models, the selected cognitive variables were regressed on subgroups determined by laterality and nature of initial motor symptoms. These subgroups were left bradykinesia/rigidity onset (L-B/RO), left tremor onset (L-TO), right bradykinesia/rigidity onset (R-B/RO), and right tremor onset (R-TO). Chi squared tests revealed that the four subgroups were equivalent with respect to sex, years of education, disease duration and disease severity. Groups were significantly different with respect to age at initial neuropsychological testing, age at disease onset, and Geriatric Depression Scale total score, and these variables were entered as covariates in the regression. Overall, the regression models did not significantly differentiate the left-onset group from the right-onset group or the tremor group from the bradykinesia/rigidity group. However, the regression model with subgroups based on the combination of laterality and symptom type was found to significantly differentiate the L-TO, L-B/RO and R-B/RO subgroups from the R-TO subgroup. This finding suggests that the interaction of laterality at disease onset and nature of motor symptoms is significantly associated with the cognitive-linguistic profile of individuals with PD.
Subjects/Keywords bradykinesia; cognitive; laterality; motor symptoms; Parkinson's disease; tremor; Speech therapy; Speech
Contributors Spencer, Kristie (advisor)
Language en
Rights Copyright is held by the individual authors.
Country of Publication us
Record ID handle:1773/21837
Repository washington
Date Retrieved
Date Indexed 2020-01-07
Issued Date 2013-02-25 00:00:00
Note [] Thesis (Master's) – University of Washington, 2012;

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…the issue of symptom laterality and its relationship to cognition will be reviewed, followed by the interaction of symptom nature and laterality. Finally, an overview of the cognitive-linguistic deficits associated with PD will be provided. Nature…

…tremor in the head and neck area may cause a tremulous vocal quality in speech tasks such as vowel prolongation (Duffy, 2005). A second hallmark motor symptom of PD is bradykinesia, or slowness of movement. Berardelli and colleagues (2001…

…insufficiency (e.g., monopitch, monoloudness, reduced stress) in the speech of some individuals with PD (Duffy, 2005). 3 The third primary motor symptom of PD is rigidity. Clinically, this stiffness results in resistance when an…

…to common patient reports of drooling, dysphagia, and speech difficulties, such as inappropriate silences (Duffy, 2005). The final cardinal motor symptom, postural instability, commonly occurs following the onset of other motor symptoms and…

…of motor 6 symptom onset, this association becomes clouded when laterality of symptom presentation is considered. Laterality of motor symptoms and cognition in individuals with Parkinson’s disease Individuals with PD often do not experience motor…

…performance on a neuropsychological test battery designed to measure executive function, memory, working memory, attention, and visuospatial processing. 8 Numerous studies have investigated the relationship between laterality of symptoms and specific…

…evidence exists concerning differences in executive function impairment based on laterality of motor symptoms. 9 With respect to attention, 11/14 studies reviewed in the Verreyt et al. (2011) review found no difference between L-PD and R-PD…

…differences based on motor symptom laterality exist mainly in the spatial domain. Research has found that the basal ganglia- thalamo-frontal pathways have a large effect on memory function (Middleton & Strick, 2000). Dopamine depletion in the basal…

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