Impaired self-awareness of motor deficits in Parkinson's disease: association with motor asymmetry and motor phenotypes.
BACKGROUND
This study investigated impaired self-awareness of motor deficits in nondemented, nondepressed Parkinson's disease (PD) patients during a defined clinical on state.


METHODS
Twenty-eight PD patients were examined. Patients' self-ratings and experts' ratings of patients' motor performance were compared. Patient-examiner discrepancies and level of impairment determined severity of impaired self-awareness. Motor exam assessed overall motor functioning, hemibody impairment, and 4 motor phenotypes. Neuropsychological tests were also conducted.


RESULTS
Signs of impaired self-awareness were present in 17 patients (60.7%). Higher severity of impaired self-awareness correlated significantly with higher postural-instability and gait-difficulty off scores (r = .575; P = .001), overall motor off scores (r = .569; P = .002), and higher left hemibody off scores (r = .490; P = .008). In multiple linear regression analyses, higher postural-instability and gait-difficulty off scores remained as the only significant predictor of impaired self-awareness severity.


CONCLUSIONS
Postural instability and gait difficulties, disease severity, and right hemisphere dysfunction seem to contribute to impaired self-awareness.
Department of Neurology, University Hospital Cologne, Cologne, Germany.
Franziska
F
Maier
George P
GP
Prigatano
Elke
E
Kalbe
Michael T
MT
Barbe
Carsten
C
Eggers
Catharine J
CJ
Lewis
Richard S
RS
Burns
Jeannine
J
Morrone-Strupinsky
Guillermo
G
Moguel-Cobos
Gereon R
GR
Fink
Lars
L
Timmermann
D000368:Aged; D001364:Awareness / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications* / Q000523:psychology*; D010641:Phenotype; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology; D012044:Regression Analysis; D012720:Severity of Illness Index