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—Direnfeld and colleagues1 suggested a relationship of laterality of motor signs to neuropsychological and neurochemical abnormalities in Parkinson's disease (PD). By comparing nine patients with PD who had asymmetric motor findings, the authors concluded that patients more affected on the left side (PDL, N=5) had more neuropsychological impairment than those predominantly affected on the right side (PDR, N=4). Unfortunately, the population sample was small, the selection criteria were not defined, and the degree of asymmetry was not stated. The laterality of the clinical manifestations was established by asking the patients which side they believed was more affected and by rating (on a scale of 0 to 4) tremor, rigidity, and bradykinesia. Of these motor signs, bradykinesia was given the most weight, although the weighing criteria were not specified.In most clinical studies the bradykinesia score represents an overall assessment of slowness and poverty of
Zetusky WJ, Jankovic J. Laterality and Symptom Association in Parkinson's Disease. Arch Neurol. 1985;42(12):1132. doi:10.1001/archneur.1985.04060110010001
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