Impaired upper limb coordination in alcoholic cerebellar degeneration
D. Johnson-Greene, K. M. Adams, S. Gilman, K. J. Kluin, L. Junck, S. Martorello and M. Heumann
Psychology Service, Ann Arbor Veterans Affairs Medical Center, USA. johnsong@welchlink.welch.jhu.edu
BACKGROUND: Alcoholic cerebellar degeneration (ACD) is a disorder resulting
from severe chronic alcoholism and malnutrition and is characterized by
cognitive disturbances, ataxia of gait, and truncal instability, with
generally preserved coordination of the upper extremities. OBJECTIVES: To
determine whether cognitive deficits in patients with ACD are the same as
those seen in patients with severe chronic alcoholism without ACD and to
determine whether upper limb motor coordination is different in the 2
groups. DESIGN: We examined cognitive function and upper limb coordination
in 56 patients with severe chronic alcoholism, 13 with ACD and 43 without
ACD, who had comparable levels of total alcohol intake. Neuropsychological
and motor function was measured using an expanded Halstead-Reitan
Neuropsychological Test Battery, including the Tactual Performance Test and
Grooved Pegboard Test. RESULTS: Neither group had impaired coordination of
upper limb function on clinical neurological examination. Both groups had
impaired performance on neuropsychological tests involving executive
function, but the patients with ACD had greater impairment of upper limb
coordination than the patients without ACD as measured by the Tactual
Performance Test and Grooved Pegboard Test. CONCLUSIONS: The findings
suggest that these 2 groups have similar cognitive deficits but that upper
extremity motor functions are more significantly impaired in the ACD group
and that quantitative tasks of motor function reveal these impairments.
