Hypomimia in Parkinson's disease: an axial sign responsive to levodopa

L Ricciardi; A De Angelis; L Marsili; I Faiman; P Pradhan; E A Pereira; M J Edwards; F Morgante; M Bologna

doi:10.1111/ene.14452

Hypomimia in Parkinson's disease: an axial sign responsive to levodopa

L Ricciardi, A De Angelis, L Marsili, I Faiman, P Pradhan, E A Pereira, M J Edwards, F Morgante, M Bologna

Psychological Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND AND PURPOSE: Hypomimia is a prominent clinical feature in people with Parkinson's disease (PD), but it remains under-investigated. We aimed to examine the clinical correlates of hypomimia in PD and to determine whether this is a levodopa-responsive sign.

METHODS: We included 89 people with PD. Hypomimia was assessed from digital video recordings by movement disorder specialists. Clinical evaluation included use of the Unified Parkinson's Disease Rating Scale part III (UPDRS-III), and assessment of motor and non-motor symptoms using standardized clinical scales. The relationships between hypomimia and other clinical data were analysed using Mann-Whitney U-tests and regression analysis.

RESULTS: Hypomimia occurred in up to 70% of patients with PD. Patients with hypomimia had worse UPDRS-III 'off-medication' scores, mainly driven by bradykinesia and rigidity subscores. Patients with hypomimia also had worse apathy than patients without hypomimia. Finally, we found that hypomimia was levodopa-responsive and its improvement mirrored the change by levodopa in axial motor symptoms.

CONCLUSION: Our study provides novel information regarding the clinical correlates of hypomimia in people with PD. A better understanding of hypomimia may be relevant for improving treatment and quality of life in PD.

Original language	English
Pages (from-to)	2422-2429
Number of pages	8
Journal	European Journal of Neurology
Volume	27
Issue number	12
DOIs	https://doi.org/10.1111/ene.14452
Publication status	Published - Dec 2020

Keywords

Antiparkinson Agents/therapeutic use
Facial Expression
Humans
Hypokinesia
Levodopa/therapeutic use
Mental Status and Dementia Tests
Parkinson Disease/complications
Quality of Life

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title = "Hypomimia in Parkinson's disease: an axial sign responsive to levodopa",

abstract = "BACKGROUND AND PURPOSE: Hypomimia is a prominent clinical feature in people with Parkinson's disease (PD), but it remains under-investigated. We aimed to examine the clinical correlates of hypomimia in PD and to determine whether this is a levodopa-responsive sign.METHODS: We included 89 people with PD. Hypomimia was assessed from digital video recordings by movement disorder specialists. Clinical evaluation included use of the Unified Parkinson's Disease Rating Scale part III (UPDRS-III), and assessment of motor and non-motor symptoms using standardized clinical scales. The relationships between hypomimia and other clinical data were analysed using Mann-Whitney U-tests and regression analysis.RESULTS: Hypomimia occurred in up to 70% of patients with PD. Patients with hypomimia had worse UPDRS-III 'off-medication' scores, mainly driven by bradykinesia and rigidity subscores. Patients with hypomimia also had worse apathy than patients without hypomimia. Finally, we found that hypomimia was levodopa-responsive and its improvement mirrored the change by levodopa in axial motor symptoms.CONCLUSION: Our study provides novel information regarding the clinical correlates of hypomimia in people with PD. A better understanding of hypomimia may be relevant for improving treatment and quality of life in PD.",

keywords = "Antiparkinson Agents/therapeutic use, Facial Expression, Humans, Hypokinesia, Levodopa/therapeutic use, Mental Status and Dementia Tests, Parkinson Disease/complications, Quality of Life",

author = "L Ricciardi and {De Angelis}, A and L Marsili and I Faiman and P Pradhan and Pereira, {E A} and Edwards, {M J} and F Morgante and M Bologna",

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year = "2020",

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doi = "10.1111/ene.14452",

language = "English",

volume = "27",

pages = "2422--2429",

journal = "European Journal of Neurology",

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TY - JOUR

T1 - Hypomimia in Parkinson's disease

T2 - an axial sign responsive to levodopa

AU - Ricciardi, L

AU - De Angelis, A

AU - Marsili, L

AU - Faiman, I

AU - Pradhan, P

AU - Pereira, E A

AU - Edwards, M J

AU - Morgante, F

AU - Bologna, M

PY - 2020/12

Y1 - 2020/12

N2 - BACKGROUND AND PURPOSE: Hypomimia is a prominent clinical feature in people with Parkinson's disease (PD), but it remains under-investigated. We aimed to examine the clinical correlates of hypomimia in PD and to determine whether this is a levodopa-responsive sign.METHODS: We included 89 people with PD. Hypomimia was assessed from digital video recordings by movement disorder specialists. Clinical evaluation included use of the Unified Parkinson's Disease Rating Scale part III (UPDRS-III), and assessment of motor and non-motor symptoms using standardized clinical scales. The relationships between hypomimia and other clinical data were analysed using Mann-Whitney U-tests and regression analysis.RESULTS: Hypomimia occurred in up to 70% of patients with PD. Patients with hypomimia had worse UPDRS-III 'off-medication' scores, mainly driven by bradykinesia and rigidity subscores. Patients with hypomimia also had worse apathy than patients without hypomimia. Finally, we found that hypomimia was levodopa-responsive and its improvement mirrored the change by levodopa in axial motor symptoms.CONCLUSION: Our study provides novel information regarding the clinical correlates of hypomimia in people with PD. A better understanding of hypomimia may be relevant for improving treatment and quality of life in PD.

AB - BACKGROUND AND PURPOSE: Hypomimia is a prominent clinical feature in people with Parkinson's disease (PD), but it remains under-investigated. We aimed to examine the clinical correlates of hypomimia in PD and to determine whether this is a levodopa-responsive sign.METHODS: We included 89 people with PD. Hypomimia was assessed from digital video recordings by movement disorder specialists. Clinical evaluation included use of the Unified Parkinson's Disease Rating Scale part III (UPDRS-III), and assessment of motor and non-motor symptoms using standardized clinical scales. The relationships between hypomimia and other clinical data were analysed using Mann-Whitney U-tests and regression analysis.RESULTS: Hypomimia occurred in up to 70% of patients with PD. Patients with hypomimia had worse UPDRS-III 'off-medication' scores, mainly driven by bradykinesia and rigidity subscores. Patients with hypomimia also had worse apathy than patients without hypomimia. Finally, we found that hypomimia was levodopa-responsive and its improvement mirrored the change by levodopa in axial motor symptoms.CONCLUSION: Our study provides novel information regarding the clinical correlates of hypomimia in people with PD. A better understanding of hypomimia may be relevant for improving treatment and quality of life in PD.

KW - Antiparkinson Agents/therapeutic use

KW - Facial Expression

KW - Humans

KW - Hypokinesia

KW - Levodopa/therapeutic use

KW - Mental Status and Dementia Tests

KW - Parkinson Disease/complications

KW - Quality of Life

U2 - 10.1111/ene.14452

DO - 10.1111/ene.14452

M3 - Article

C2 - 32702196

SN - 1351-5101

VL - 27

SP - 2422

EP - 2429

JO - European Journal of Neurology

JF - European Journal of Neurology

IS - 12

ER -

Hypomimia in Parkinson's disease: an axial sign responsive to levodopa

Abstract

Keywords

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