Anat Mirelman1,2,3,4, Hagar Bernad-Elazari5,6, Avner Thaler7,8, Eytan Giladi-Yacobi7, Tanya Gurevich7,8, Mali Gana-Weisz9, Rachel Saunders-Pullman10,11, Deborah Raymond10,11, Nancy Doan10,11, Susan B Bressman10,11, Karen S Marder12,13, Roy N Alcalay12, Ashwini K Rao13,14, Daniela Berg15, Kathrin Brockmann15, Jan Aasly16, Bjørg Johanne Waro16, Eduardo Tolosa17, Dolores Vilas17, Claustre Pont-Sunyer17, Avi Orr-Urtreger7,9, Jeffrey M Hausdorff7,8,6,18,19, Nir Giladi7,8,19. 1. Laboratory for Early Markers of Neurodegeneration, Tel Aviv Medical Center, Tel Aviv, Israel. anatmi@tlvmc.gov.il. 2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. anatmi@tlvmc.gov.il. 3. Neurology Institute, Tel Aviv Medical Center, Tel Aviv, Israel. anatmi@tlvmc.gov.il. 4. Center for the Study of Movement, Cognition and Mobility, Tel Aviv Medical Center, Tel Aviv, Israel. anatmi@tlvmc.gov.il. 5. Laboratory for Early Markers of Neurodegeneration, Tel Aviv Medical Center, Tel Aviv, Israel. 6. Center for the Study of Movement, Cognition and Mobility, Tel Aviv Medical Center, Tel Aviv, Israel. 7. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 8. Neurology Institute, Tel Aviv Medical Center, Tel Aviv, Israel. 9. Genetic Institute, Tel Aviv Medical Center, Tel Aviv, Israel. 10. Departments of Neurology, Mount Sinai Beth Israel Medical Center, New York, New York, USA. 11. Icahn School of Medicine at Mount Sinai, New York, New York, USA. 12. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA. 13. G. H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA. 14. Department of Rehabilitation & Regenerative Medicine (Physical Therapy), New York, New York, USA. 15. Hertie-Institut für klinische Hirnforschung, Tubingen, Germany. 16. Norwegian University of Science and Technology, Trondheim, Norway. 17. Institut de Neurociències Hospital Clìnic, Barcelona, Spain. 18. Department of Physical Therapy, Tel Aviv University, Tel Aviv, Israel. 19. Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
Abstract
BACKGROUND: Reduced arm swing is a well-known clinical feature of Parkinson's disease (PD), often observed early in the course of the disease. We hypothesized that subtle changes in arm swing and axial rotation may also be detectable in the prodromal phase. OBJECTIVE: The purpose of this study was to evaluate the relationship between the LRRK2-G2019S mutation, arm swing, and axial rotation in healthy nonmanifesting carriers and noncarriers of the G2019S mutation and in patients with PD. METHODS: A total of 380 participants (186 healthy nonmanifesting controls and 194 PD patients) from 6 clinical sites underwent gait analysis while wearing synchronized 3-axis body-fixed sensors on the lower back and bilateral wrists. Participants walked for 1 minute under the following 2 conditions: (1) usual walking and (2) dual-task walking. Arm swing amplitudes, asymmetry, variability, and smoothness were calculated for both arms along with measures of axial rotation. RESULTS: A total of 122 nonmanifesting participants and 67 PD patients were carriers of the G2019S mutation. Nonmanifesting mutation carriers walked with greater arm swing asymmetry and variability and lower axial rotation smoothness under the dual task condition when compared with noncarriers (P < .04). In the nonmanifesting mutation carriers, arm swing asymmetry was associated with gait variability under dual task (P = .003). PD carriers showed greater asymmetry and variability of movement than PD noncarriers, even after controlling for disease severity (P < .009). CONCLUSIONS: The G2019S mutation is associated with increased asymmetry and variability among nonmanifesting participants and patients with PD. Prospective studies should determine if arm swing asymmetry and axial rotation smoothness may be used as motor markers of prodromal PD.
BACKGROUND: Reduced arm swing is a well-known clinical feature of Parkinson's disease (PD), often observed early in the course of the disease. We hypothesized that subtle changes in arm swing and axial rotation may also be detectable in the prodromal phase. OBJECTIVE: The purpose of this study was to evaluate the relationship between the LRRK2-G2019S mutation, arm swing, and axial rotation in healthy nonmanifesting carriers and noncarriers of the G2019S mutation and in patients with PD. METHODS: A total of 380 participants (186 healthy nonmanifesting controls and 194 PDpatients) from 6 clinical sites underwent gait analysis while wearing synchronized 3-axis body-fixed sensors on the lower back and bilateral wrists. Participants walked for 1 minute under the following 2 conditions: (1) usual walking and (2) dual-task walking. Arm swing amplitudes, asymmetry, variability, and smoothness were calculated for both arms along with measures of axial rotation. RESULTS: A total of 122 nonmanifesting participants and 67 PDpatients were carriers of the G2019S mutation. Nonmanifesting mutation carriers walked with greater arm swing asymmetry and variability and lower axial rotation smoothness under the dual task condition when compared with noncarriers (P < .04). In the nonmanifesting mutation carriers, arm swing asymmetry was associated with gait variability under dual task (P = .003). PD carriers showed greater asymmetry and variability of movement than PD noncarriers, even after controlling for disease severity (P < .009). CONCLUSIONS: The G2019S mutation is associated with increased asymmetry and variability among nonmanifesting participants and patients with PD. Prospective studies should determine if arm swing asymmetry and axial rotation smoothness may be used as motor markers of prodromal PD.
Authors: Xuemei Huang; Joseph M Mahoney; Mechelle M Lewis; Stephen J Piazza; Joseph P Cusumano Journal: Gait Posture Date: 2011-11-17 Impact factor: 2.840
Authors: Roy N Alcalay; Anat Mirelman; Rachel Saunders-Pullman; Ming-X Tang; Helen Mejia Santana; Deborah Raymond; Ernest Roos; Martha Orbe-Reilly; Tanya Gurevich; Anat Bar Shira; Mali Gana Weisz; Kira Yasinovsky; Maayan Zalis; Avner Thaler; Andres Deik; Matthew James Barrett; Jose Cabassa; Mark Groves; Ann L Hunt; Naomi Lubarr; Marta San Luciano; Joan Miravite; Christina Palmese; Rivka Sachdev; Harini Sarva; Lawrence Severt; Vicki Shanker; Matthew Carrington Swan; Jeannie Soto-Valencia; Brooke Johannes; Robert Ortega; Stanley Fahn; Lucien Cote; Cheryl Waters; Pietro Mazzoni; Blair Ford; Elan Louis; Oren Levy; Llency Rosado; Diana Ruiz; Tsvyatko Dorovski; Michael Pauciulo; William Nichols; Avi Orr-Urtreger; Laurie Ozelius; Lorraine Clark; Nir Giladi; Susan Bressman; Karen S Marder Journal: Mov Disord Date: 2013-10-15 Impact factor: 10.338