Sensory perception in Parkinson disease

Objective: To determine whether there is a complex sensory disturbance that may be contributing to the motor deficit in patients with Parkinson disease. Design: Comparison of performance by patients and healthy, age- and sex-matched subjects in tests of various sensory functions. Setting: The Center for Human Performance and Testing at a university hospital and research center. Participants: Ten subjects with Parkinson disease and 10 control subjects matched for age and sex. Main Outcome Measure: Performance on 4 subtests of the Sensory Integration and Praxis Test: finger identification, graphesthesia, localization of tactile stimuli,and kinesthesia. Results: Data were analyzed using paired t tests for ratio data and the paired Wilcoxon test for ordinal data. Patients with Parkinson disease performed significantly worse (P=.001) than the control patients on the test of kinesthesia. There were no significant differences between the 2 groups on the ether subtests. Conclusions: Without visual guidance, patients with Parkinson disease had more difficulty in perceiving the extent of a movement made to a target away from the body, a task requiring reliance on proprioceptive feedback. Parkinsonian patients had no more difficulty than controls in making movements to a target on the surface of the body when they could use tactile sensations. Movement difficulties inpatients with Parkinson disease may relate in part to a decrease in proprioception. Activities that enhance kinesthetic awareness may be an important adjunct to the treatment of these patients.