One of the predominant symptoms of early stages of hepatic encephalopathy (HE) is bradykinesia.
In this study a research team further analyzed the pathophysiology of bradykinesia in HE.
The researchers, from Germany, performed a 3-dimensional computer-assisted movement analysis was performed in 36 cirrhotics with grade 0-I HE. They compared the results with those from 18 matched controls, and 16 patients with Parkinson's disease (PD).
The team studied 4 types of movement: finger tapping, hand tapping, pronation/supination of the forearm, and flexion/extension in the hip joint.
|Patients with hepatic encephalopathy had no change in maximal movement velocity.|
|Journal of Hepatology|
Patients with PD presented with a decrease of the maximal movement velocity (VMAX), and a prolongation of the time needed to reach VMAX (VTIME).
The researchers found that in patients with minimal or grade I HE, the VMAX of all movements was unchanged, compared to controls, while the VTIME was significantly prolonged.
This was caused by a delay before the beginning of each new part of the diadochokinetic movement cycle.
Dr Michael Joebges’s team concluded, “The data suggest an impairment of movement initiation as main cause of bradykinesia in early HE”.