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. 2020 Dec;27(12):2422-2429.
doi: 10.1111/ene.14452. Epub 2020 Aug 20.

Hypomimia in Parkinson's disease: an axial sign responsive to levodopa

L Ricciardi  1   2 , A De Angelis  1 , L Marsili  3 , I Faiman  4 , P Pradhan  4 , E A Pereira  1 , M J Edwards  1 , F Morgante  1   5 , M Bologna  6   7
Affiliations

Hypomimia in Parkinson's disease: an axial sign responsive to levodopa

L Ricciardi et al. Eur J Neurol. 2020 Dec.

Abstract

Background and purpose: Hypomimia is a prominent clinical feature in people with Parkinson's disease (PD), but it remains under-investigated. We aimed to examine the clinical correlates of hypomimia in PD and to determine whether this is a levodopa-responsive sign.

Methods: We included 89 people with PD. Hypomimia was assessed from digital video recordings by movement disorder specialists. Clinical evaluation included use of the Unified Parkinson's Disease Rating Scale part III (UPDRS-III), and assessment of motor and non-motor symptoms using standardized clinical scales. The relationships between hypomimia and other clinical data were analysed using Mann-Whitney U-tests and regression analysis.

Results: Hypomimia occurred in up to 70% of patients with PD. Patients with hypomimia had worse UPDRS-III 'off-medication' scores, mainly driven by bradykinesia and rigidity subscores. Patients with hypomimia also had worse apathy than patients without hypomimia. Finally, we found that hypomimia was levodopa-responsive and its improvement mirrored the change by levodopa in axial motor symptoms.

Conclusion: Our study provides novel information regarding the clinical correlates of hypomimia in people with PD. A better understanding of hypomimia may be relevant for improving treatment and quality of life in PD.

Keywords: Parkinson’s disease; face; facial bradykinesia; hypomimia; non-motor symptoms.

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References

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