Journal of Neurology

, 254:1366 | Cite as

Diagnostic accuracy of the clapping test in Parkinsonian disorders

  • W. F. Abdo
  • A. G. W. van Norden
  • K. F. de Laat
  • F-E. de Leeuw
  • G. F. Borm
  • M. M. Verbeek
  • P. H. P. Kremer
  • B. R. Bloem
ORIGINAL COMMUNICATION

Abstract

Background

To determine the diagnostic value of the clapping test, which has been proposed as a reliable measure to differentiate between progressive supranuclear palsy (where performance is impaired) and Parkinson’s disease (where performance should be normal).

Methods

Our study group included a large cohort of consecutive outpatients including 44 patients with Parkinson's disease, 48 patients with various forms of atypical parkinsonism and 149 control subjects. All subjects performed the clapping test according to a standardized protocol.

Results

Clapping test performance was normal in all control subjects, and impaired in 63% of the patients with atypical parkinsonism. Unexpectedly, we also found an impaired clapping test in 29% of the patients with Parkinson's disease.

Conclusion

Although the proportion with an abnormal clapping test was significantly higher in atypical parkinsonism, the clapping test did not discriminate well between Parkinson's disease and atypical parkinsonism.

Key words

movement disorders clapping test applause sign 

References

  1. 1.
    Brass M, Derrfuss J, Forstmann B, von Cramon DY (2005) The role of the inferior frontal junction area in cognitive control. Trends Cogn Sci 9:314-16CrossRefPubMedGoogle Scholar
  2. 2.
    Buccino G,Vogt S, Ritzl A, Fink GR, Zilles K, Freund HJ, Rizzolatti G (2004) Neural circuits underlying imitation learning of hand actions: an eventrelated fMRI study. Neuron 42:323-34CrossRefPubMedGoogle Scholar
  3. 3.
    Dubois B, Slachevsky A, Pillon B, Beato R, Villalponda JM, Litvan I (2005) "Applause sign" helps to discriminate PSP from FTD and PD. Neurology 64:2132-133CrossRefPubMedGoogle Scholar
  4. 4.
    Foltynie T, Brayne CE, Robbins TW, Barker RA (2004) The cognitive ability of an incident cohort of Parkinson's patients in the UK. The CamPaIGN study. Brain 127:550-60CrossRefPubMedGoogle Scholar
  5. 5.
    Gelb DJ,Oliver E, Gilman S (1999) Diagnostic criteria for Parkinson disease. Arch Neurol 56:33-9CrossRefPubMedGoogle Scholar
  6. 6.
    Iacoboni M, Woods RP, Brass M, Bekkering H,Mazziotta JC, Rizzolatti G (1999) Cortical mechanisms of human imitation. Science 286:2526-528CrossRefPubMedGoogle Scholar
  7. 7.
    Kuniyoshi S, Riley DE, Zee DS, Reich SG,Whitney C, Leigh RJ (2002) Distinguishing progressive supranuclear palsy from other forms of Parkinson’s disease Evaluation of new signs. Neurobiology of Eye Movements: from Molecules to Behavior 956:484-86Google Scholar
  8. 8.
    Litvan I, Bhatia KP, Burn DJ, Goetz CG, Lang AE, McKeith I, Quinn N, Sethi KD, Shults C, Wenning GK (2003) Movement Disorders Society Scientific Issues Committee report: SIC Task Force appraisal of clinical diagnostic criteria for Parkinsonian disorders. Mov Disord 18:467-86CrossRefPubMedGoogle Scholar
  9. 9.
    McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM (1984) Clinical diagnosis of Alzheimer's disease: report of the NINCDSADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 34:939-44PubMedGoogle Scholar
  10. 10.
    Monza D, Soliveri P, Radice D, Fetoni V, Testa D, Caffarra P, Caraceni T, Girotti F (1998) Cognitive dysfunction and impaired organization of complex motility in degenerative parkinsonian syndromes. Arch Neurol 55:372-78CrossRefPubMedGoogle Scholar
  11. 11.
    Muslimovic D, Post B, Speelman JD, Schmand B (2005) Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology 65:1239-245CrossRefPubMedGoogle Scholar
  12. 12.
    Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, Amaducci L, Orgogozo JM, Brun A, Hofman A (1993) Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 43:250-60PubMedGoogle Scholar
  13. 13.
    Schott JM, Rossor MN (2003) The grasp and other primitive reflexes. J Neurol Neurosurg Psychiatry 74:558-60CrossRefPubMedGoogle Scholar
  14. 14.
    Zijlmans JC, Daniel SE, Hughes AJ, Revesz T, Lees AJ (2004) Clinicopathological investigation of vascular parkinsonism, including clinical criteria for diagnosis. Mov Disord 19:630-40CrossRefPubMedGoogle Scholar

Copyright information

© Steinkopff-Verlag 2007

Authors and Affiliations

  • W. F. Abdo
    • 1
    • 2
  • A. G. W. van Norden
    • 2
  • K. F. de Laat
    • 2
  • F-E. de Leeuw
    • 2
  • G. F. Borm
    • 3
  • M. M. Verbeek
    • 2
    • 4
  • P. H. P. Kremer
    • 2
  • B. R. Bloem
    • 1
    • 2
  1. 1.Parkinson Centre Nijmegen (ParC), Institute of Neurology (935)Radboud University Nijmegen Medical CentreHB NijmegenThe Netherlands
  2. 2.Institute of NeurologyRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
  3. 3.Dept. of Epidemiology and BiostatisticsRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
  4. 4.Laboratory of Paediatrics and NeurologyRadboud University Nijmegen Medical CentreNijmegenThe Netherlands

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