SYMPTOMS

What is Bradykinesia?

Bradykinesia refers to reduced voluntary movement, characterized by slowness and clumsiness.

Early-stage bradykinesia manifests as slowed fine motor skills like buttoning clothes or tying shoelaces, gradually progressing to overall reduced voluntary movement and sluggishness. In advanced stages, combined with increased muscle rigidity, it may lead to difficulty getting out of bed or turning over.

Bradykinesia can result from various conditions, including stroke or brain tumors, but it is most commonly associated with Parkinson's disease. It is one of the primary symptoms doctors use to diagnose Parkinson's.

What are the specific manifestations of bradykinesia?

• Masked face: Expressionless appearance, fixed gaze, reduced blinking, resembling wearing a "mask"
• Slowed speech: Affected muscles in the mouth, throat, and palate lead to slower speech and lower pitch
• Difficulty with fine motor tasks: Slow movements in activities like buttoning or tying shoelaces
• Reduced repetitive movements: Slowed speed and decreased amplitude in rapid repetitive actions, such as finger tapping
• Micrographia: Handwriting becomes progressively smaller and more cramped
• Shuffling gait while walking, with reduced arm swing

What accompanying symptoms might occur with bradykinesia?

Bradykinesia may be accompanied by the following symptoms:

• Resting tremor: Tremors occur when the patient is at rest, diminish or stop during voluntary movement, worsen with stress or excitement, and typically disappear during sleep. A classic sign is the "pill-rolling" motion of the thumb and forefinger.
• Muscle rigidity: Increased resistance when passively moving joints, resembling bending a "lead pipe" ("lead-pipe rigidity") or intermittent pauses like a cogwheel ("cogwheel rigidity").
• Freezing episodes during walking, where the body suddenly becomes immobile, or taking extremely small steps with a "propulsion" tendency.
• Sensory impairments: Such as reduced sense of smell.
• Sleep disorders: Including REM sleep behavior disorder (RBD).
• Constipation, excessive sweating, drooling, etc.
• Depression, anxiety, etc.

TREATMENT

Can bradykinesia be treated with medication?

Yes, medication is currently the primary treatment for bradykinesia.

The most helpful medications for bradykinesia are those that enhance dopamine function. Common options include:

• Carbidopa-Levodopa
• Dopamine agonists
• MAO-B inhibitors
• ...

Patients need a doctor's guidance to find the most suitable medication. This process may not be straightforward, as these drugs often become less effective over time. Doctors will monitor the patient's response and adjust dosages or switch medications as needed.

Does bradykinesia require surgery?

Surgery may be considered in severe cases where medication fails to control symptoms.

A procedure called Deep Brain Stimulation (DBS) can alleviate bradykinesia by surgically implanting electrodes in specific brain areas to deliver electrical pulses. This treatment is typically reserved for advanced Parkinson's patients who respond poorly to conventional drugs.

What should patients with bradykinesia pay attention to in daily life?

Whether taking medication or not, patients can adopt lifestyle adjustments or "home remedies" as part of their treatment plan, but should consult their doctor first. Common approaches include:

• Eating a nutritious, high-fiber diet
• Exercising to improve strength, balance, and flexibility
• Engaging in activities like walking or swimming
• Taking precautions to prevent falls
• Maintaining a positive mindset

Can bradykinesia be reversed?

Proper medication and lifestyle interventions can significantly relieve symptoms, but recovery varies depending on the underlying cause.

DIAGNOSIS

Which department should I visit for bradykinesia?

It is recommended to first visit the neurology department.

What tests are needed for bradykinesia?

• Blood, saliva, cerebrospinal fluid: A small number of patients may show DNA gene mutations in blood or changes in α-synuclein and DJ-1 protein levels in cerebrospinal fluid and saliva tests.
• Olfactory stick and transcranial ultrasound: These can detect early-stage patients' reduced sense of smell or abnormal hyperechogenicity in the substantia nigra.
• Imaging: Molecular imaging such as PET or SPECT scans may reveal abnormalities in the early or subclinical stages of the disease, providing high diagnostic value.

POTENTIAL DISEASES

What diseases can cause bradykinesia?

Bradykinesia may occur with various forms of Parkinson's disease, but its presence does not necessarily indicate Parkinson's. Other possible causes include:

• Exposure to toxins
• Hypothyroidism
• Use of psychiatric medications
• Multiple system atrophy
• Hydrocephalus
• Brain tumors
• Stroke

Patients need to obtain an accurate diagnosis with a doctor's assistance as early as possible.