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Nervenheilkunde 2016; 35(04): 190-196
DOI: 10.1055/s-0037-1616376
Parkinson
Schattauer GmbH

Schreibstörungen bei Morbus Parkinson

Erscheinungsbild und TherapieImpairment of writing skills in Parkinson’s diseaseAppearance and therapy
W. Renzi
1   Abteilung Neurologie und klinische Neurophysiologie, Zentrum für Parkinson-Syndrome und Bewegungsstörungen, Schön Klinik München Schwabing
› Institutsangaben
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Publikationsverlauf

eingegangen am: 04. Januar 2016

angenommen am: 15. Januar 2016

Publikationsdatum:
10. Januar 2018 (online)

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Zusammenfassung

Die Beeinträchtigung der Handschrift stellt ein häufig auftretendes Symptom im Krankheitsverlauf von Parkinson-Syndromen dar. Aufgrund der Basalgangliendegeneration sind automatische Schreibbewegungen erschwert, oftmals sind Mikrografie, Veränderungen der Schreibgeschwindigkeit und -beschleunigung sowie der Schreibflüssigkeit erkennbar. Zu den Einflussfaktoren auf schreibmotorische Leistungen zählen das Alter, gleichzeitige Dual-Task-Aufgaben sowie feinmotorische Leistungen. Einen alltagsrelevanten Effekt auf die Fähigkeit zu schreiben zeigen dopaminerge Medikamente sowie neurostimulative Verfahren wie die tiefe Hirnstimulation und repetitive transkranielle Magnetstimulation. Speziell auf eine Verbesserung schreibmotorischer Leistungen im klinischen Alltag zielt ergotherapeutisches Schreibtraining anhand Erprobung individueller Strategien. Computergestützte Bewegungsanalysen wie mit der Software CSWin ermöglichen dabei eine detaillierte Analyse von Schreibstörungen und deren gezielte Therapie. Ein positiver Effekt auf schreibmotorische Leistungen von Parkinson-Patienten konnte durch den Einsatz visueller Hinweisreize (Cues) sowie externen Feedbacks aufgezeigt werden.

Summary

Impairment of handwriting skills are a common symptom in patients with idiopathic Parkinson´s disease. The execution and acquisition of automatic writing movements are impaired due to degeneration of the basal ganglia. Micrographia, variations velocity, acceleration and the degree of automation in writing are often observable. Influential factors on handwriting skills are age, dual-tasking and fine motor skills. Beneficial effects of dopaminergic medication and neurostimulation techniques such as deep brain stimulation or repetitive transcranial magnetic stimulation have been reported. Improvement of handwriting skills with trials of individual strategies is the aim of writing training in occupational therapy. Computer-assisted analyses of movements with e.g. the software CSWin can be used for the detailed kinematic analysis of writing impairments as a baseline to assess the effects of therapy. Several studies reported positive effects of visual cueing and external feedback on handwriting skills in patients with Parkinson´s disease.

Schlüsselwörter

Parkinson-Syndrom - Handschrift - Mikrografie - Schreibtraining - grafisches Tablett - visuelles Cueing - Feedback

Keywords

Parkinson´s disease - writing - micrographia - writing training - graphic tablet - visual cueing - feedback
 

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