Motor Onset Topography and Progression in Parkinson's Disease: the Upper Limb Is First.
Mariana H G MonjeAlvaro Sánchez-FerroJose Angel Pineda-PardoLydia Vela-DesojoFernando Alonso-FrechJosé A ObesoPublished in: Movement disorders : official journal of the Movement Disorder Society (2021)
Motor manifestations in PD start distally in one upper limb. The complexity of the motor repertoire and, consequently, the presumed larger dopaminergic striatal demand for maintaining skillful motor function in the upper limb, may contribute to greater vulnerability of dopaminergic striatal terminals. Recognition of this motor pattern could be used to monitor the evolution of nigrostriatal degeneration and the putative impact of therapies. © 2021 International Parkinson and Movement Disorder Society.