Clinical Neurology and Neurosurgery 110 (2008) 160–167
Short-term variability in amplitude and motor topography of
whole-body involuntary movements in Parkinson’s disease
dyskinesias and in Huntington’s chorea
, Mandar S. Jog
, Christian Duval
D´epartement de Kinanthropologie, Universit´eduQu´ebec `a Montr´eal, C.P. 8888,
Succursale Centre-Ville, Montr´eal, Qu´ebec, Canada H3C 3P8
Department of Clinical Neurological Sciences, Movement Disorders Program,
University of Western Ontario, London, Ont., Canada
Received 27 April 2007; received in revised form 15 October 2007; accepted 16 October 2007
Objectives: Clinical observations have noted variability in amplitude of levodopa-induced dyskinesias (LID) in Parkinson’s disease (PD)
and chorea in Huntington’s disease (HD) during the day. However, no studies have examined whether both the amplitude and body location
(motor topography) of whole-body involuntary movement (WBIM) varied over short periods of time (seconds or minutes), which may have
a distinct and signiﬁcant effect on how disruptive these WBIM may be. The present study quantiﬁed the variability of WBIM amplitude and
motor topography in patients with PD having LID and in patients with HD having chorea.
Patients and methods: WBIM was quantiﬁed using the MotionMonitor
magnetic motion tracker system. Five patients in each group were
tested in two conditions: sitting and standing.
Results: WBIM increased from sitting to standing, more so in choreic patients. WBIM varied from 17% to 102% of total WBIM amplitude.
Chorea tended to present with greater variability than LID in absolute terms in the standing condition, but not when the mean WBIM amplitude
was taken into consideration. Motor topography of WBIM also varied more in the HD group, but mostly in the seated condition where more
limbs were free to move. Neither group expressed any laterality of involuntary movement, with amplitude being equally distributed on both
sides of the body.
Conclusion: Results show signiﬁcant short-term variability in amplitude of chorea and LID, as well as, variability in location of these
involuntary movements, illustrating the complexity of the adaptations required to live and be active with involuntary movements such as HD
chorea or PD dyskinesias.
© 2007 Elsevier B.V. All rights reserved.
Keywords: Parkinson; Huntington; Chorea; Dyskinesia; Motor topography; Involuntary movements
Peak-dose dyskinesias (choreic type) in Parkinson’s
disease (PD) and chorea in Huntington’s disease (HD)
are dynamic whole-body involuntary movements (WBIM),
which involve displacement of limbs with signiﬁcant ampli-
tude in both rest and active states. These conditions also
involve disordered voluntary motor behaviours. In patients
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E-mail address: email@example.com (C. Duval).
with PD, long-term levodopa therapy can result in motor ﬂuc-
tuations such as levodopa-induced dyskinesias (LID) [1–3],
occurring in approximately 50–80% of patients with PD
receiving levodopa for more than 5–10 years [4,5,18,19].
Choreic LID, the most common of the several observed types
[2,6–8], are considered to be purposeless, non-rhythmic,
abrupt, rapid, irregular, and un-sustained movements of one
or several body parts  that occur when plasma level con-
centration of levodopa reaches peak-dose. In adult-onset HD
with chorea, motor abnormalities are thought to progress
from hyperkinetic in the early stages, to hypokinetic in the
later stages . Chorea in HD is also described as irregular,
0303-8467/$ – see front matter © 2007 Elsevier B.V. All rights reserved.