Enhanced fatigue during motor performance in patients with Parkinson's disease
Enhanced fatigue during motor performance in patients with Parkinson's disease
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DOI：
10.1212/wnl.51.6.1583
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发表时间：
1998-12-01
期刊：
影响因子：
9.9
通讯作者：
Melamed, E
中科院分区：
文献类型：
--
作者：
Ziv, I;Avraham, M;Melamed, E
目的：定量测量 PD 患者连续运动表现期间的疲劳程度。背景：执行运动任务时的疲劳感增强是 PD 患者非常常见且致残的主诉，但对其特征和了解知之甚少。最近的证据表明线粒体功能障碍在帕金森病的发病机制中发挥作用。运动能力降低是全身性线粒体损伤的标志之一。方法：作者使用自动化系统测量 17 名 PD 患者和 10 名年龄匹配的对照受试者在连续（30 秒）最大等距前臂屈曲期间的肌肉疲劳情况。然后计算疲劳指数（FI）。测量峰值力（PF）作为检查的内部标准。在口服左旋多巴/卡比多巴（125 mg/12.5 mg）之前和之后 2 小时进行测量。结果：PD 患者的 Fl 增加了 50%。 Fl 的增加通常是不对称的，并且在受疾病影响更严重的一侧更为明显。 FI 对口服左旋多巴有显着反应并在口服后得到改善。左旋多巴引起的 F1 改善率与疾病严重程度相关，通过统一帕金森病评定量表进行测量。未观察到 PF 发生显着变化。结论：增强的肌肉疲劳应被视为 PD 运动障碍的一个组成部分。然而，我们的数据表明它与中枢多巴胺缺乏有关，而不是与肌肉线粒体异常有关。
Objective: To measure fatigue quantitatively during continuous motor performance in patients with PD. Background: Enhanced fatigue on performance of motor tasks is a very frequent and disabling complaint of PD patients, and is poorly characterized and understood. Recent evidence suggests a role for mitochondrial dysfunction in the pathogenesis of PD. Reduced exercise capacity is one of the hallmarks of systemic mitochondrial impairment. Methods: The authors used an automated system to measure muscle fatigue during a continuous (30-second), maximal, isometric forearm flexion in 17 PD patients and 10 age-matched control subjects. A fatigue index (FI) was then calculated. Peak force (PF) was measured as an internal standard of the examination. Measurements were performed before and 2 hours after an oral dose of levodopa/carbidopa (125 mg/12.5 mg). Results: In PD patients there was a 50% increase in Fl. The increased Fl was often asymmetric and more pronounced on the side more affected by the disease. FI was significantly responsive to, and improved after, an oral dose of levodopa. The rate of improvement in Fl induced by levodopa correlated with disease severity, as measured by the Unified Parkinson's Disease Rating Scale. No significant alterations in PF were observed. Conclusions: Enhanced muscle fatigue should be recognized as an integral part of the spectrum of motor impairment of PD. However, our data argue for its association with a central dopamine deficiency rather than with a muscle mitochondrial abnormality.