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The frequency and diagnostic accuracy of hand deformities in Parkinson’s disease

  • José Fidel Baizabal-Carvallo
  • Marlene Alonso-Juarez
  • Robert Fekete
Neurology and Preclinical Neurological Studies - Original Article
  • 27 Downloads

Abstract

Hand deformities are well-known abnormalities observed in patients with Parkinson’s disease (PD). We determined the frequency and diagnostic accuracy of hand deformities in PD. We studied 44 consecutive patients with PD, 44 age- and gender-matched normal controls and 22 patients with essential tremor (ET). By means of photographs taken in both hands of all participants, the degree of metacarpophalangeal (MCP) joint flexion was quantified by software and by blinded evaluations using a semiquantitative scale from the radial aspect, we grouped hands into four grades. The presence of classical striatal hand deformity (CSHD), defined as MCP joint flexion, proximal interphalangeal joint extension and distal interphalangeal joint flexion was also evaluated. Patients with PD had a higher frequency of MCP joint flexion and CSHD compared to normal controls and patients with ET. Mean MCP joint flexion was higher in both hands in patients with PD: 20.8° vs. normal controls (3.3°–3.9°) and patients with ET (2.8°–6.3°), P = 0.001. Concordance between evaluators for MCP joint flexion was fair: κ = 0.34 (P < 0.001), but poor for CSHD: κ = 0.142–0.235 (P < 0.05). A right hand MCP joint flexion of 12.5° and left hand of 10.5°, showed similar sensitivity (0.70) and specificity (between 0.75 and 0.80) than any degree of MCP joint flexion for the diagnosis of PD. CSHD had a sensitivity (0.60–0.80) and specificity (0.78–0.98) for the diagnosis of PD. Hand deformities are commonly observed in patients with PD, they may aid in the diagnosis of PD when compared to normal controls and patients with ET.

Keywords

Parkinson´s disease Essential tremor Striatal hand Hand deformities Postural abnormalities 

Notes

Author contributions

JFB-C gathered the data, made the statistical analysis, conceptualized and wrote the first draft of the manuscript. MA-J made the clinical evaluations, conceptualized and reviewed the manuscript. RF made the clinical evaluations and reviewed the manuscript.

Funding

None.

Compliance with ethical standards

Conflict of interest

None for all authors.

Supplementary material

702_2018_1937_MOESM1_ESM.tif (501 kb)
Supplementary figure: Lines passing through the 2nd metacarpal bone and the second finger with intersection at the head of the 2nd metacarpal bone; in this case an angle of 31° was obtained (TIF 500 KB)

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurology, Parkinson’s Disease Center and Movement Disorders ClinicBaylor College of MedicineHoustonUSA
  2. 2.Department of Internal MedicineUniversity of GuanajuatoLeónMexico
  3. 3.National Polytechnic InstituteMexico CityMexico
  4. 4.New York Medical CollegeValhallaUSA

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