Aims: The objective of this study was to investigate the relation between impaired fine motor skills in Parkinson disease (PD) patients and their cognitive status, and to determine whether fine motor skills are more impaired in PD patients with mild cognitive impairment (MCI) than in non-MCI patients. Methods: Twenty PD MCI and 31 PD non-MCI patients (mean age 66.7 years, range 50-84, 36 males/15 females), all right-handed, took part in a motor performance test battery. Steadiness, precision, dexterity, velocity of arm-hand movements, and velocity of wrist-finger movements were measured and compared across groups and analyzed for confounders (age, sex, education, severity of motor symptoms, and disease duration). Statistical analysis included t tests corrected for multiple testing, and a linear regression with stepwise elimination procedure was used to select significant predictors for fine motor function. Results: PD MCI patients performed significantly worse in precision (p < 0.05), dexterity (p < 0.05), and velocity (arm-hand movements; p < 0.05) compared to PD non-MCI patients. The fine motor function skills were confounded by age. Conclusions: Fine motor skills in PD MCI patients are impaired compared to PD non-MCI patients. Investigating the relation between the fine motor performance and MCI in PD might be a relevant subject for future research.

Keywords:
Parkinson disease, Motor impairment, Mild cognitive impairment
1.
Caviness JN, Hentz JG, Evidente VG, Driver-Dunckley E, Samanta J, Mahant P, et al: Both early and late cognitive dysfunction affects the electroencephalogram in Parkinson's disease. Parkinsonism Relat Disord 2007;13:348-354.
2.
Aarsland D, Bronnick K, Williams-Gray C, Weintraub D, Marder K, Kulisevsky J, et al: Mild cognitive impairment in Parkinson disease: a multicenter pooled analysis. Neurology 2010;75:1062-1069.
3.
Janvin C, Aarsland D, Larsen JP, Hugdahl K: Neuropsychological profile of patients with Parkinson's disease without dementia. Dement Geriatr Cogn Disord 2003;15:126-131.
4.
Pedersen K, Larsen J, Tysnes O, Alves G: Prognosis of mild cognitive impairment in early Parkinson disease: the Norwegian ParkWest Study. JAMA Neurol 2013;70:580-586.
5.
Stefanova E, Žiropadja L, Stojković T, Stanković I, Tomić A, Ječmenica-Lukić M, et al: Mild cognitive impairment in early Parkinson's disease using the Movement Disorder Society Task Force criteria: cross-sectional study in Hoehn and Yahr stage 1. Dement Geriatr Cogn Disord 2015;40:199-209.
6.
Litvan I, Goldman JG, Tröster AI, Schmand BA, Weintraub D, Petersen RC, et al: Diagnostic criteria for mild cognitive impairment in Parkinson's disease: Movement Disorder Society Task Force guidelines. Mov Disord 2012;27:349-356.
7.
Brown P, Marsden CD: Bradykinesia and impairment of EEG desynchronization in Parkinson's disease. Mov Disord 1999;14:423-429.
8.
Benecke R, Rothwell JC, Dick JPR, Day BL, Marsden CD: Disturbance of sequential movements in patients with Parkinson's disease. Brain 1987;110:361-379.
9.
Poizner H, Feldman AG, Levin MF, Berkinblit MB, Hening WA, Patel A, et al: The timing of arm-trunk coordination is deficient and vision-dependent in Parkinson's patients during reaching movements. Exp Brain Res 2000;133:279-292.
10.
Lukos JR, Poizner H, Sage JI: Hand function in Parkinson's disease; in Duruöz MT (ed): Hand Function. New York, Springer, 2014, pp 133-149.
11.
Stelmach GE, Worringham CJ, Strand EA: Movement preparation in Parkinson's disease. Brain 1986;109:1179-1194.
12.
Schettino LF, Rajaraman V, Jack D, Adamovich SV, Sage J, Poizner H: Deficits in the evolution of hand preshaping in Parkinson's disease. Neuropsychologia 2004;42:82-94.
13.
Adamovich SV, Berkinblit MB, Hening W, Sage J, Poizner H: The interaction of visual and proprioceptive inputs in pointing to actual and remembered targets in Parkinson's disease. Neuroscience 2001;104:1027-1041.
14.
Abbruzzese G, Berardelli A: Sensorimotor integration in movement disorders. Mov Disord 2003;18:231-240.
15.
Lee MS, Lyoo CH, Lee MJ, Sim J, Cho H, Choi YH: Impaired finger dexterity in patients with Parkinson's disease correlates with discriminative cutaneous sensory dysfunction. Mov Disord 2010;25:2531-2535.
16.
Frischer M: Voluntary vs autonomous control of repetitive finger tapping in a patient with Parkinson's disease. Neuropsychologia 1989;27:1261-1266.
17.
Norman KE, Héroux ME: Measures of fine motor skills in people with tremor disorders: appraisal and interpretation. Front Neurol 2013;4:50.
18.
Katzen HL, Levin BE, Weiner W: Side and type of motor symptom influence cognition in Parkinson's disease. Mov Disord Off J Mov Disord Soc 2006;21:1947-1953.
19.
Mortimer JA, Pirozzolo FJ, Hansch EC, Webster DD: Relationship of motor symptoms to intellectual deficits in Parkinson disease. Neurology 1982;32:133-133.
20.
Schoppe KJ: Das MLS-Gerät: ein neuer Testapparat zur Messung fein-motorischer Leistungen. Diagnostica 1974;20:43-47.
21.
Gibb WR, Lees AJ: The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease. J Neurol Neurosurg Psychiatry 1988;51:745-752.
22.
Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state': a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.
23.
Fahn S, Marsden CD, Calne DB, Goldstein M: Unified Parkinson's disease scale - UPDRS; in Fahn S, Marsden CD, Calne DB, Goldstein M: Recent Developments in Parkinson's Disease, ed 2. Florham Park, Macmillan Health Care Information, 1987, pp 153-163, 293-304.
25.
Janz M: Feinmotoriktestung bei Morbus Parkinson; thesis, Ruhr-Universität, Bochum, 2003.
26.
Schäfer S: Evaluierung apparativer Verfahren zur Quantifizierung der motorischen Leistungseinschränkungen bei unbehandelten Parkinson Patienten im Vergleich zu gesunden Kontrollen; thesis, Ruhr-Universität, Bochum, 2001.
27.
Benjamini Y, Hochberg Y: Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Ser B Methodol 1995;57:289-300.
28.
Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE: Systematic review of levodopa dose equivalency reporting in Parkinson's disease. Mov Disord 2010;25:2649-2653.
29.
Venables WN, Ripley BD: Modern Applied Statistics with S, ed 4. New York, Springer, 2002.. http://www.springer.com/statistics/computational+statistics/book/978-0-387-95457-8 (accessed October 15, 2013).
30.
Ekman U, Eriksson J, Forsgren L, Mo SJ, Riklund K, Nyberg L: Functional brain activity and presynaptic dopamine uptake in patients with Parkinson's disease and mild cognitive impairment: a cross-sectional study. Lancet Neurol 2012;11:679-687.
31.
Rand MK, Smiley-Oyen AL, Shimansky YP, Bloedel JR, Stelmach GE: Control of aperture closure during reach-to-grasp movements in Parkinson's disease. Exp Brain Res 2006;168:131-142.
32.
Jackson GM, Jackson SR, Hindle JV: The control of bimanual reach-to-grasp movements in hemiparkinsonian patients. Exp Brain Res 2000;132:390-398.
33.
Plotnik M, Flash T, Inzelberg R, Schechtman E, Korczyn AD: Motor switching abilities in Parkinson's disease and old age: temporal aspects. J Neurol Neurosurg Psychiatry 1998;65:328-337.
34.
Quencer K, Okun MS, Crucian G, Fernandez HH, Skidmore F, Heilman KM: Limb-kinetic apraxia in Parkinson disease. Neurology 2007;68:150-151.
35.
Mendoza JE, Apostolos GT, Humphreys JD, Hanna-Pladdy B, O'Bryant SE: Coin rotation task (CRT): a new test of motor dexterity. Arch Clin Neuropsychol Off J Natl Acad Neuropsychol 2009;24:287-292.
36.
Morris RG, Downes JJ, Sahakian BJ, Evenden JL, Heald A, Robbins TW: Planning and spatial working memory in Parkinson's disease. J Neurol Neurosurg Psychiatry 1988;51:757-766.
37.
Berg D: Marker for a preclinical diagnosis of Parkinson's disease as a basis for neuroprotection. J Neural Transm Suppl 2006;123-132.
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2016
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