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Gait in SWEDDs patients: Comparison with Parkinson's disease patients and healthy controls§

Authors

  • Omar S. Mian PhD,

    Corresponding author
    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
    • Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, 33 Queen Square, London, WC1N 3BG, UK

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  • Susanne A. Schneider MD, PhD,

    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
    2. Schilling Section of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Lübeck, Lübeck, Germany
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  • Petra Schwingenschuh MD,

    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
    2. Department of Neurology, Division of Special Neurology, Medical University Graz, Graz, Austria
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  • Kailash P. Bhatia MD,

    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
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  • Brian L. Day DPhil

    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
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  • Relevant conflicts of interest/financial disclosures: During the study, Omar S. Mian was funded by a UK Medical Research Council grant awarded to Brian L. Day. Susanne A. Schneider received support from the Brain Research Trust, UK (JJ Astor Studentship), Novartis Foundation for Therapeutic Medicine, Empiris Foundation, Switzerland, and the University of Lübeck, Germany (employment). Petra Schwingenschuh received funding from a research grant from the Austrian Science Fund (FWF; Erwin Schrödinger Grant J 2764) and funding to attend conferences from UCB, GlaxoSmithKline, Boehringer Ingelheim, Novartis, and Ipsen pharmaceutical companies. Kailash P. Bhatia received advisor/honoraria/financial support to speak/attend meetings from GSK, Boehringer-Ingelheim, Ipsen, Merz, and Orion pharmaceutical companies and UCB companies and grants from the Dystonia Society UK, the Halley Stewart Trust, the Wellcome Trust, and the Parkinson's Disease Society UK. Brian L. Day received research/equipment funds from the UK Medical Research Council, the Wellcome Trust, and Ataxia UK.

  • The study was supported by a UK Medical Research Council project grant (G0502136) and a Wellcome Trust equipment grant. This work was undertaken at UCLH/UCL, which received a portion of its funding from the Department of Health's NIHR Biomedical Research Centres funding scheme.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Patients diagnosed with Parkinson's disease on clinical grounds who subsequently turn out to have normal dopamine transporter imaging have been referred to as SWEDDs (scans without evidence of dopaminergic deficits). Despite having clinical features similar to those of Parkinson's disease, these patients seem to have different pathophysiology, prognosis, and treatment requirements. In this study we determined the similarities and differences in the gaits of SWEDDs and Parkinson's disease patients to investigate whether walking patterns can distinguish these entities. We used 3-D motion capture to analyze the gaits of 11 SWEDDs patients (who had unilateral or asymmetric upper limb tremor with a rest component), 12 tremor-dominant Parkinson's disease patients, and 13 healthy control participants. In common with Parkinson's disease patients, SWEDDs patients had a slow gait mainly because of a small stride length, as well as a reduced arm swing. However, several abnormal features of posture and gait in Parkinson's disease were normal in SWEDDs. Thus, SWEDDs patients had normal trunk and elbow posture, normal stride length variability, and normal bilateral step-phase coordination, all of which were abnormal in Parkinson's disease patients. We also searched for signs of ataxic movements during normal and tandem walking, but found no evidence that ataxic gait was a general feature in SWEDDs. These findings could aid the clinician in identification of potential tremulous SWEDDs cases. © 2011 Movement Disorder Society

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