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Hand Function pp 163-179 | Cite as

Hand Function in Parkinson’s Disease

  • Jamie R. Lukos
  • Howard PoiznerEmail author
  • Jacob Sage
Chapter

Abstract

Parkinson’s disease (PD) patients have a number of functional hand impairments. The latency and rate of isometric force generation is impaired in PD. Motor dysfunction is also related to impaired integration of sensory feedback and motor output. Moreover, PD patients exhibit sensory deficits such as decreased spatial and temporal tactile discrimination thresholds of the fingertips. Impairments of reaching and grasping are seen as patients tend to exhibit difficulty in movement initiation to a target. There are deficits in hand preshaping to object geometry. There is a lack of coordination between the timing of the reach and grasp components. Patients have an overall dependence on visual cues to control movement. They exhibit impairments in the planning of where to place their digits, resulting in suboptimal performance of object manipulation. It is hypothesized that predictive force control deficits are a result of central impairments associated with the generation and/or retrieval of sensorimotor memories for movement planning.

Clinical aspects of hand function include resting, postural or internal tremor, bradykinesia, and rigidity. Elements of the unified Parkinson’s disease rating scale (UPDRS) are the best way to measure deficits in hand function. Choreiform dyskinesias and dystonia may interfere with hand function.

Keywords

Basal ganglion Deep brain stimulation Visual feedback Grip force Hand function 

Notes

Acknowledgment

Supported in part by NIH grant #2 R01 NS036449 (HP)

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Institute for Neural ComputationUniversity of California, San DiegoLa JollaUSA
  2. 2.Department of NeurologyRobert Wood Johnson Medical SchoolNew BrunswickUSA

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