People with Parkinson’s disease (PD) may experience two seemingly contradictory movement problems. One, bradykinesia, is slowness of movement and is a cardinal symptom of the disease. For a diagnosis of PD, one must have bradykinesia plus either tremor or rigidity. Bradykinesia may appear as a reduction in automatic movements such as blinking or swinging of arms while walking, or it may manifest as trouble initiating intentional movements or just slowness of actions. The second movement problem is dyskinesia, in which people have involuntary, erratic, writhing movements. They can be slow and fluid or rapid and jerking. They are a complication of some Parkinson’s medications and not a symptom of the disease itself. Sometimes people have to decide on their medication dosage and timing whether they would rather be “on” with some dyskinesia or “off” and unable to move well.
In this podcast episode, neurologist Dr. Benjamin Walter delves into bradykinesia and dyskinesia. He is the head of the Section of Movement Disorders and medical director for deep brain stimulation at Cleveland Clinic in Ohio, a Parkinson’s Foundation Center of Excellence. He describes how bradykinesia and dyskinesia can affect people’s lives, what people can do for themselves to alleviate the discomfort, how they can work with their neurologist to minimize the disorders, and what is in development to help.
- Expert Briefing: Motor Symptoms Co-Management: Occupational Therapy and Neurology (webinar)
- Expert Briefings: Medication Side Effects (webinar)
- Medications: A Treatment Guide to Parkinson’s Disease (book)
- Episode 96: PD Medications and Side Effects (podcast)
About This Episode
Released: January 26, 2021
Benjamin Walter, MD
Dr. Benjamin Walter is the head of the Section of Movement Disorders and medical director for deep brain stimulation at Cleveland Clinic in Ohio, a Parkinson’s Foundation Center of Excellence. Prior to this role, he held the Penni and Stephen Weinberg Chair in Brain Health at University Hospitals and was an associate professor of neurology and biomedical engineering at Case Western Reserve University School of Medicine.
He is board-certified in neurology. Special interests include DBS, dystonia, functional magnetic resonance imaging (MRI), intrathecal baclofen, the mechanism of effect of DBS, movement disorders, Parkinson’s disease and tremors.
He earned his medical degree from MCP-Hahnemann School of Medicine in Philadelphia. He completed his internship in internal medicine and residency in neurology at Emory University Hospital, as well as fellowship training in movement disorders with an emphasis on intraoperative mapping and deep brain stimulation.
In his research laboratory, Dr. Walter uses functional MRI to study mechanisms underlying changes in Parkinson’s disease and dystonia, participating in several projects funded by the National Institutes of Health (NIH). He is currently an investigator on an NIH-funded project exploring intracortical control of arm and hand function restored by functional electrical stimulation in people with spinal cord injury (Brain Gate). He has also served as an investigator on the Enhanced Exercise Study for Patients with Parkinson’s Disease (EXCEED) study of how exercise and education affects people with Parkinson’s disease and depression, as well as on an NIH-funded project to develop an “intelligent” bicycle for rehabilitation in Parkinson’s patients.
Dr. Walter is the author of more than 20 articles in peer-reviewed medical journals, as well as five book chapters. He has presented posters and abstracts at more than 20 international and national peer-reviewed medical conferences.
In addition, Dr. Walter has served as an invited lecturer/instructor at national and international medical education conferences and colloquia. He is grant reviewer for the NIH and the American Association for the Advancement of Science and also reviews manuscripts for several prominent medical journals. He is a member of the Organization for Human Brain Mapping, Society for Neuroscience, American Academy of Neurology and the Movement Disorder Society.
For all of our Substantial Matters podcast episodes, visit parkinson.org/podcast.