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Evolving concepts on bradykinesia.

Abstract
Bradykinesia is one of the cardinal motor symptoms of Parkinson's disease and other parkinsonisms. The various clinical aspects related to bradykinesia and the pathophysiological mechanisms underlying bradykinesia are, however, still unclear. In this article, we review clinical and experimental studies on bradykinesia performed in patients with Parkinson's disease and atypical parkinsonism. We also review studies on animal experiments dealing with pathophysiological aspects of the parkinsonian state. In Parkinson's disease, bradykinesia is characterized by slowness, the reduced amplitude of movement, and sequence effect. These features are also present in atypical parkinsonisms, but the sequence effect is not common. Levodopa therapy improves bradykinesia, but treatment variably affects the bradykinesia features and does not significantly modify the sequence effect. Findings from animal and patients demonstrate the role of the basal ganglia and other interconnected structures, such as the primary motor cortex and cerebellum, as well as the contribution of abnormal sensorimotor processing. Bradykinesia should be interpreted as arising from network dysfunction. A better understanding of bradykinesia pathophysiology will serve as the new starting point for clinical and experimental purposes.
AuthorsMatteo Bologna, Giulia Paparella, Alfonso Fasano, Mark Hallett, Alfredo Berardelli
JournalBrain : a journal of neurology (Brain) Vol. 143 Issue 3 Pg. 727-750 (03 01 2020) ISSN: 1460-2156 [Electronic] England
PMID31834375 (Publication Type: Journal Article, Research Support, N.I.H., Intramural, Review)
Copyright© The Author(s) (2019). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For permissions, please email: [email protected].
Chemical References
  • Levodopa
Topics
  • Animals
  • Humans
  • Hypokinesia (complications, drug therapy, physiopathology)
  • Levodopa (therapeutic use)
  • Neural Pathways (physiopathology)
  • Parkinsonian Disorders (complications, drug therapy, physiopathology)

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