Consideration of mechanisms of muscular rigidity in Parkinson's disease

WCN 2013 No: 1869 Topic: 2 — Movement Disorders Parkinson disease's epidemiology in Goias and Brazil H.H.S.Matozinho, N.S. Dias, M.O.F. Iwamoto, T.A.G.J. Ribeiro, F.O. Gomes. Faculdade de Medicina, Universidade Federal de Goias, Goiânia, Brazil Background: Parkinson Disease (PD) is a result of complex interection between genetic and environmental factors. It is characterized by 4 clinical signs: resting tremor, rigidity, bradykinesia, instability, gait and postural difficulty. Objectives: This study aims to check the prevalence of PD in Goias, comparing it with Brazil and data in literature. Methods: Analysis of the numbers of PD hospitalizations through the Unified Health System (UHS), focusing on aspects as: gender, age, race, year of internalization (2000–2011), in Goias and Brazil. The Hospital Information System (HIS) — Unified Health System Informatics Department (UHSID) provided data. Results: The gender number of hospitalizations in Goias was: 57% ‘male’ and 42% ‘female’; Brazil: 51% ‘male’ and 48% ‘female’. The most common ages affected with PD in Goias were: 30% ‘70–79 years old’, 26.5% ‘60–69 years old’, 23.5% ‘above 80 years old’; Brazil: 32% ‘70– 79 years old’, 24.4% ‘60–69 years old’, 19.4% ‘above 80 years old’. The race prevalence for PD in Goias was: 44% white and 15% grayishbrown; Brazil: 50% white and 12.5% grayish-brown. Conclusion: Although some articles say that PD is more prevalent among men, this study found no prevalence difference between genders in Goias, neither in Brazil. The most common affected ages and races by PD in literature are the same found in this study. doi:10.1016/j.jns.2013.07.590 Abstract — WCN 2013 No: 2111 Topic: 2 — Movement Disorders Consideration of mechanisms of muscular rigidity in Parkinson's disease WCN 2013 No: 2111 Topic: 2 — Movement Disorders Consideration of mechanisms of muscular rigidity in Parkinson's disease M. Nagaoka, N. Kakuda, Y. Hayashi, G. Futatsubashi, T. Fukushima, K. Watanabe. Rehabilitation Medicine, Juntendo University, Tokyo, Japan; Neurology, Higashiyamato Hospital, Tokyo, Japan; Comprehensive Educational Science, Tokyo Gakugei University, Tokyo, Japan Background: Rigidity is one of the cardinal symptoms in Parkinson's disease. Based on the findings of microneurography, Burke D et al. (1977) suggested that, in Parkinson patients, the spindle afferent responses look like those of normal subjects who are not fully relaxed and in whom there is a co-activation of the skeletomotor and fusimotor activity. In previous paper (J Physiol, 1998), we showed the existence of dynamic and static fusimotor actions on the human muscle spindle during voluntary contraction. Objective: In this experiment, we tested whether increased spindle activities during weak isometric contraction of forearm muscles may enhance the stretch reflex as seen in Parkinson's disease. Subjects and methods: Thirteen healthy subjects (8 males and 5 females, age between 26 and 50 years old) were recruited. The details of methods were the same as appeared in previous paper. A tungsten micro-electrode was inserted into the left radial nerve and spindle activities were recorded from extensor carpi radialis brevis (ECRB). The wrist joint was moved 25° with 5–40°/s by DC-Torque motor. Spindle activities and EMG were recorded and analyzed by SC/ZOOM system (Umea University). Results: Total number of 43 spindles was recorded from ECRB. All spindles increased the firing rate by lengthening of ECRB. There was no stretch reflex in ECRB at rest and during isometric contraction except one subject. Conclusion: These findings suggest that increased stretch reflex was exceptional in normal subjects even with α-γ co-activation. There might be substantially increased excitability in α motoneurons in Parkinson's disease. doi:10.1016/j.jns.2013.07.591 Abstract — WCN 2013 No: 323 Topic: 2 — Movement Disorders Pathophysiological analysis of dropped head syndrome caused by various diagnoses — Based on surface EMG findings and responses to physiotherapy WCN 2013 No: 323 Topic: 2 — Movement Disorders Pathophysiological analysis of dropped head syndrome caused by various diagnoses — Based on surface EMG findings and responses to physiotherapy M. Nagaoka, H.-N. Lin, Y. Hayashi, I. Yonezawa. Rehabilitation Medicine, Juntendo University, Tokyo, Japan; Orthopedic Surgery, Juntendo University, Tokyo, Japan Background: Dropped head syndrome is seen in various diseases. Its pathophysiological mechanisms are unknown. Patients and methods: We investigated its pathophysiological mechanisms with physical and radiological examinations including MRI, surface EMG and responses to physiotherapy. Subjects had dropped head as a complaint, but their primary diagnoses were various. We investigated 16 cases: 10 cases of Parkinson disease and related disorders, 3 cases of cervical spondylosis and 3 cases with other diagnoses. Results: We found that patients had common findings such as bulging of cervical muscles, and tonic EMG activities mainly in the extensors in the sitting and standing position, but in the flexors of the neck only in the supine position. Of the 16 cases, 14 were treated with physiotherapy to improve the alignment of the pelvis and whole vertebral column; 6 of the 14 cases (42%) showed remarkable improvement. Conclusion: We conclude that the primary reason of dropped head syndrome is unknown in Parkinson disease and cervical spondylosis, but also that many of the patients have secondary changes in alignment of the skeletomuscular system which could be treated with physiotherapy. For 8 cases with no improvement by physiotherapy, plausible factors relating to prognosis will be discussed. doi:10.1016/j.jns.2013.07.592 Abstract — WCN 2013 No: 2122 Topic: 2 — Movement Disorders “Restless bladder” and the boundaries of the restless legs syndrome WCN 2013 No: 2122 Topic: 2 — Movement Disorders “Restless bladder” and the boundaries of the restless legs syndrome E. Antelmi, G. Coccagna, L. Ferini-Strambi, S. Marelli, F. Provini. IRCCS Institute of Neurological Sciences and Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy; University of Alabama at Birmingham Bologna, Bologna, Italy; Department of Neurosciences, Sleep Disorders Center, Universita Vita-Salute San Raffaele, Milan, Italy Background: Recently different reports on atypical localization of Restless Legs Syndrome (RLS) symptoms (namely one arm, tongue, thorax, and abdomen) beg the question of the boundaries of RLS. Objective: This study aims to present two patients with a new atypical localization of restlessness sensation. Patients and methods: A 43-year-old woman and a 47 years old man, with a positive family history for RLS, came to our attention Abstracts / Journal of the Neurological Sciences 333 (2013) e65–e108 e92