Grant: Operating Grant

THE PROBLEM. Side effects such as involuntary movements called drug-induced dyskinesia (DID) in Parkinson's disease still represent a huge obstacle for maintaining social interaction, independence and quality of life. No studies has tried to determine when DID becomes problematic for patients, and how reduction of DID through drug regimen modification will affect the daily activities of patients. HYPOTHESES. We believe that for patients with DID, (a) success of a particular task is dependent on the amplitude of the intended voluntary movement (signal), the amplitude of DID and the magnitude of other underlying symptoms (noise); and (b) improvement in how many daily activities one can perform is dependent on how drug regimen modification aiming to reduce DID will alter the signal-to-noise ratio. AIMS. (1) determine the which activities available to patients having DID; (2) assess the impact of a change of medication aiming at reducing DID on the activities of patients; (3) survey clinicians about their original goal when changing drug regimen, and verify whether the goals were reached; (4) test the ability of patients to evaluate the impact of DID on daily life activities. THE METHOD. Whole-body DID of patients will be recorded with a 15-sensor magnetic tracker system as they perform daily life motor tasks. Amplitude of DID will be measured in every limb at rest and during voluntary movement, and will be correlated with motor performance to determine the detrimental signal-to-noise ratio for each task. CLINICAL OUTCOME OF THIS RESEARCH. The proposed research will help us build a model of interaction between motor symptomatology and activities available to patients having DID. It will help determine how drug regimen modification to avoid DID affects activities of patients. The end goal is to develop better methods of evaluating treatment efficacy that focus on optimizing participation during daily life activities.