Effects of Mood, Motivation, Stress and Alertness on the Performance in Parkinson's Disease

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Abstract
The description of Parkinson''s disease emphasizes rigidity, tremor, loss of facial expression, and associated movements. The most devastating symptom, however, is that of akinesia. It is essentially impairment in initiating voluntary movements, continuing them, and altering them. In purely unilateral cases there is little, if any, akinesia. As soon as the case becomes bilateral it begins to appear. The amount of rigidity and tremor is in no way connected with the amount of akinesia. Examples are shown of akinesia being made much worse by minor emotional stresses and unexpected sensory stimuli. It becomes considerably reduced under the stimulation of increased motivation and incentive. Akinesia paradoxica is defined as a complete loss of akinesia and disability of Parkinson''s disease under emergency, extraordinary stimulation such as a house afire, but it lasts only a minute or two, and the patient is then back to his previous degree of disability.

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