Axial versus distal motor impairment in Parkinson's disease

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Abstract
We measured axial (head rotation) and distal (wrist flexion and extension) movements in parkinsonian patients with varying stages of disability, before and after administration of L-dopa. Velocities for both movements were proportionately reduced in all stages of disease. L-Dopa administration provided a small but consistent increase in distal movement velocity for most patients, whereas in patients with advanced disease (stages III to V), axial movement velocity actually declined after administration of L-dopa. This decline may be partially responsible for the failure of L-dopa administration to reverse the loss of "righting reflexes" in these patients. Measurement of axial motor control may be a useful tool in evaluating therapeutics for Parkinson's disease patients.