Motor complications in Parkinson's disease: ten year follow-up study.

Parkinson's disease (PD) can be symptomatically controlled with standard treatments; however, after a few years, this response typically declines and most patients develop motor complications. We carried out a prospective practice-based study to evaluate the evolution appearance and evolution of motor complications in 64 de novo PD patients over 5 years and in 38 PD patients over 10 years. We studied untreated patients from initial assessment at basal conditions and evaluated every 6 months thereafter with treatment (levodopa versus other drugs). The follow-up assessments were performed with the Unified Parkinson's Disease Rating Scale (UPDRS). At each assessment, patients were monitored regarding the development of dyskinesias, motor fluctuations, freezing, loss of postural reflexes, and cognitive impairment. We observed a significant improvement in UPDRS scores during the first year, then a progressive decline, more evident after the third year. Motor complications increased after the third year, and at the end of the survey (tenth year); drug-induced dyskinesias and motor fluctuations were experienced (71.1 and 94.7%, respectively). After the first decade, many complications arose from the non-levodopa-responsive features of the disease (cognitive impairment was present in 52.6% and gait freezing in 71.1%). Initial medication may influence medium-term complications but not long-term problems. Most long-term disabling problems of PD were related to non-levodopa-responsive features.

Capit timed tests quantify age-related motor decline in normal subjects.

Slowing of motor performance in human aging is a well demonstrated clinical observation. Age-related motor decline has been also confirmed in animal models including rodents and non human primates. We studied the motor performance of 60 normal subjects (age: 20-87). Motor study included the four timed tests (TT) recommended in CAPIT protocol: pronation-supination (PS), finger dexterity (FD), movement between two points (MTP) or tapping, and walking test (WT). Finally we compared normal controls with a group of 30 patients with Parkinson's disease (PD) of similar age. Age inversely correlated with TT performance in normal subjects (for PS, r:0.33, p<0.01; FD, r:0.44, p<0.0005; MTP, r:0.51, p<0.0001; WT, r:0.59, p<0.0001, Pearson). Our results confirm that motor performance (measured with CAPIT TT) deteriorates linearly with age. Simple tasks, such as CAPIT TT can help to study and quantify age-related motor decline.