Quantitative assessment of daytime motor activity provides a responsive measure of functional decline in patients with Huntington's disease

✍ Scribed by J.P.P. van Vugt; S. Siesling; K.K.E. Piet; A.H. Zwinderman; H.A.M. Middelkoop; J.J. van Hilten; R.A.C. Roos

• Publisher: John Wiley and Sons
• Year: 2001
• Tongue: English
• Weight: 188 KB
• Volume: 16
• Category: Article
• ISSN: 0885-3185
• DOI: 10.1002/mds.1097

✦ Synopsis

Abstract

Voluntary motor impairment is a functionally important aspect of Huntington's disease (HD). Therefore, quantitative assessment of disturbed voluntary movement might be important in follow‐up. We investigated the relation between quantitatively assessed daytime motor activity and symptom severity in HD and evaluated whether assessment of daytime motor activity is a responsive measure in the follow‐up of patients.

Sixty‐four consecutive HD patients and 67 age‐ and sex‐matched healthy controls were studied. Daytime motor activity was recorded using a wrist‐worn activity monitor that counts all movements during a period of five consecutive days. Patients were rated clinically for voluntary motor impairment, dyskinesias, posture & gait, depression, cognitive impairment and functional capacity. Follow‐up was available from 40 patients (mean follow‐up 2.0 years) and 29 controls (mean follow‐up 5.9 years).

Despite chorea, patients had less daytime motor activity than controls (P < 0.005). This hypokinesia correlated with impaired voluntary movements (r = 0.37; P < 0.01), disturbed posture & gait (r = 0.38; P < 0.005) and especially with reduced functional capacity (r = 0.51; P < 0.0005). During follow‐up, hypokinesia remained unchanged in clinically stable patients, but became worse in those whose functional disability progressed (P < 0.005).

Hypokinesia seems a core symptom of HD which is related to functional capacity. Actimetric assessment of hypokinesia is responsive to disease progression and can be used as an objective tool for follow‐up. © 2001 Movement Disorder Society.