SLOWNESS OF MOVEMENT IN PARKINSONS-DISEASE
SLOWNESS OF MOVEMENT IN PARKINSONS-DISEASE
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DOI：
10.1002/mds.870040505
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发表时间：
1989-01-01
影响因子：
8.6
通讯作者：
MARSDEN, CD
中科院分区：
文献类型：
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作者：
MARSDEN, CD
运动能力的丧失是帕金森病最典型和最基本的运动缺陷。帕金森病患者表现出运动不能（不能启动运动）、运动减退（运动减少）和运动迟缓（运动本身缓慢）。(All这些现象将被归入运动不能的标题下。僵硬的肌肉可能会导致运动不能，但它们不是原因。这从立体定向手术和左旋多巴治疗的效果中显而易见。立体定向丘脑切开术是消除对侧强直（和震颤）的有效手段，但不能缓解运动不能，其进展导致残疾增加。另一方面，左旋多巴治疗可以显著缓解运动不能，即使是那些以前接受过立体定向手术的患者。帕金森氏病的运动不能是一种主要的阴性症状，因此，可能是最好的线索，说明在这种情况下基底神经节功能出了什么问题（1，2）。然而，运动不能的病理生理学分析已被证明是困难的。一个是处理复杂的高阶运动功能。
Loss of the ability to move is the most characteristic and fundamental motor deficit in Parkinson’s disease. Parkinsonian patients exhibit akinesia (inability to initiate movement), hypokinesia (reduced movement), and bradykinesia (slowness of the movement itself).(All these phenomena will be subsumed under the title akinesia.)Rigid muscles may contribute to akinesia, but they are not the cause. This is evident from the effects of both stereotactic surgery and treatment with levodopa. Stereotactic thalamotomy is an effective means of abolishing contralateral rigidity (and tremor), but does not relieve akinesia, which progresses to cause increasing disability. Levodopa therapy, on the other hand, dramatically relieves akinesia, even in those who have undergone previous stereotactic surgery. The akinesia of Parkinson’s disease represents a major negative symptom and, as such, probably gives the best clue as to what goes wrong with basal ganglia function in that condition (1, 2). However, analysis of the pathophysiology of akinesia has proved difficult. One is dealing with higher-order motor function in all its complexity.