title: Median and Ulnar Neuropathy Assessment in Parkinson's Disease regarding Symptom Severity and Asymmetry.
abstract: Background. While increasing evidence suggests comorbidity of peripheral neuropathy (PNP) and Parkinson's disease (PD), the pathogenesis of PNP in PD is still a debate. The aim of this article is to search the core PD symptoms such as rigidity and tremor as contributing factors to mononeuropathy development while emphasizing each individual patient's asymmetric symptom severity.Methods. We studied 62 wrists and 62 elbows of 31 patients (mean age 66.48 ± 10.67) and 64 wrists and 64 elbows of 32 age-gender matched healthy controls (mean age 62.03 ± 10.40,p= 0.145). The Hoehn and Yahr disability scale and Unified Parkinson's Disease Rated Scale were used to determine the severity of the disease.Results. According to electrodiagnostic criteria, we confirmed median neuropathy in 16.12% (bilateral in two-thirds of the patients) and ulnar neuropathy in 3.22% of the PD group. While mean age (p= 0.003), age at PD onset (p= 0.019), and H&Y scores (p= 0.016) were significant, tremor and rigidity scores were not. The comparison of the mean indices of electrophysiologic parameters indicated subclinical median and ulnar nerve demyelination both at the wrist and at the elbow in the patient groups where a longer disease duration and mild tremor and rigidity scores are prominent, remarkably.Conclusion. A disease related peripheral neurodegeneration beyond symptom severity occurs in PD.
authors.affiliation: Neurology Department, Minasera Aldan Hospital, Ahmet Taner Kislali Mah. 2741, Street No. 2 Cayyolu, Ankara, Turkey.
authors.forename: Nilgul
authors.identifier: 0000-0002-1602-1186
authors.initials: N
authors.lastname: Yardimci
authors.affiliation: Physical Medicine and Rehabilitation Department, Medical Park Ankara Hospital, Kentkoop Mah., Kentkoop Parkici Yolu, Yenimahalle, Ankara, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Cemeroglu
authors.affiliation: Biostatistics Department, Medicine Faculty, Hacettepe University, Hacettepe Mah., 06230 Ankara, Turkey.
authors.forename: Eda
authors.initials: E
authors.lastname: Ozturk
authors.affiliation: Physical Medicine and Rehabilitation Department, Medicine Faculty, Turgut Ozal University, Alparslan Turkes Cad. No. 57, Emek, 06510 Ankara, Turkey.
authors.forename: Gülsüm
authors.initials: G
authors.lastname: Gürlü
authors.affiliation: Physical Medicine and Rehabilitation Department, Medicine Faculty, Turgut Ozal University, Alparslan Turkes Cad. No. 57, Emek, 06510 Ankara, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Şahin
authors.affiliation: Physical Medicine and Rehabilitation Department, Medicine Faculty, Turgut Ozal University, Alparslan Turkes Cad. No. 57, Emek, 06510 Ankara, Turkey.
authors.forename: Saliha
authors.initials: S
authors.lastname: Bozkurt
authors.affiliation: Neurology Department, Medicine Faculty, Turgut Ozal University, Alparslan Turkes Cad. No. 57, Emek, 06510 Ankara, Turkey.
authors.forename: Tugba
authors.initials: T
authors.lastname: Cengiz
authors.affiliation: Neurology Department, Medicine Faculty, Turgut Ozal University, Alparslan Turkes Cad. No. 57, Emek, 06510 Ankara, Turkey.
authors.forename: Gulderen
authors.initials: G
authors.lastname: Karali
authors.affiliation: Physical Medicine and Rehabilitation Department, Medical Park Ankara Hospital, Kentkoop Mah., Kentkoop Parkici Yolu, Yenimahalle, Ankara, Turkey.
authors.forename: Hasim
authors.initials: H
authors.lastname: Cakirbay
authors.affiliation: Neurology Department, Medicine Faculty, Gazi University, Emniyet, Yenimahalle, 06560 Ankara, Turkey.
authors.forename: Atilla
authors.initials: A
authors.lastname: İlhan