Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/37250
Title: Novel insights into the effects of levodopa on the up- and downstrokes of writing sequences
Authors: Broeder, Sanne
Boccuni, Leonardo
Vandendoorent, Britt
Verheyden, Geert
MEESEN, Raf 
Nieuwboer, Alice
Issue Date: 2022
Publisher: SPRINGER WIEN
Source: JOURNAL OF NEURAL TRANSMISSION, 129 (4) , p. 379 -386
Abstract: Motor control of automatized and overlearned sequences, such as writing, is affected in Parkinson's disease (PD), impacting patients' daily life. Medication effects on motor performance are not only task-specific, but also variable within tasks. The nature of this variance is still unclear. This study aimed to investigate whether medication affects writing sequences differently when producing up- or downstrokes. Writing was assessed in healthy controls (HC) (N=31) and PD (N=32), when ON and OFF medication in a randomized order (interspersed by two months). Subjects wrote a sequential pattern with an increasing size on a digital tablet. Writing outcomes were movement vigor (amplitude and velocity), error and end-point variability, and sequence continuation, calculated separately for up- and downstrokes. Results showed that PD patients OFF-medication reduced movement vigor (amplitude) for up- and downstrokes compared to HC. Clear deficits were found for up- but not for downstroke error in PD patients in OFF, suggesting a directional bias. Dopaminergic medication improved motor vigor by increasing writing amplitude and upstroke continuation, but this occurred at the cost of the downstroke trajectory. Other writing outcomes did not improve with medication intake. In conclusion, we interpret these findings as that the impact of dopamine is complex, highly task-specific, supporting the most highly energy demanding components of a writing sequence. As medication did not regulate downstroke writing, we recommend supplementary training to address task demands that were less modulated by dopamine (registration: https://osfloigk5q8/, 17 July 2018).
Notes: Broeder, S (corresponding author), Katholieke Univ Leuven, Dept Rehabil Sci, Neurorehabil Res Grp eNRGy, Tervuursevest 101,Bus 1501, B-3001 Leuven, Belgium.
sanne.broeder@kuleuven.be
Keywords: Parkinson's disease; Dysgraphia; Handwriting; Motor control;;Dopaminergic medication
Document URI: http://hdl.handle.net/1942/37250
ISSN: 0300-9564
e-ISSN: 1435-1463
DOI: 10.1007/s00702-022-02493-6
ISI #: WOS:000777226200002
Rights: © The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2022
Category: A1
Type: Journal Contribution
Validations: ecoom 2023
Appears in Collections:Research publications

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