bradykinesi

Bradykinesi, also known as bradykinesia, is a disorder characterized by slowness of movement, including reduced speed and amplitude of voluntary actions and difficulty initiating movements. It is a core motor feature of parkinsonism and can appear in other neurological conditions. The slowness may be gradual and progressive and affect both simple and complex movements.

Clinically, bradykinesi presents with a diminished ability to start moving and to perform rapid, repetitive tasks. Patients often have a masked facial expression (hypomimia), reduced arm swing, and a tendency to take small, shuffling steps with festination when walking. Writing or other fine motor tasks may become micrographia or exhibit decreased speed and precision. Symptoms may be asymmetric in early stages and can contribute to gait disturbance, fatigue, and reduced spontaneous movement.

Causes include primary Parkinson’s disease and other parkinsonian syndromes such as multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration. Bradykinesi can also result from secondary factors, including drug-induced parkinsonism from dopamine antagonists, metabolic disorders, toxins, or vascular disease. The condition is often evaluated in the context of a broader syndrome, with accompanying signs such as tremor, rigidity, and postural instability.

Pathophysiology involves loss or dysfunction of dopaminergic neurons in the substantia nigra pars compacta, leading to impaired dopamine signaling in the basal ganglia. This disrupts the balance of the direct and indirect pathways that regulate movement, resulting in slowed initiation and execution of movements.

Diagnosis is clinical and supported by response to dopaminergic therapy. Management focuses on symptom control through medications such as levodopa, dopaminergic agonists, and MAO-B inhibitors, supplemented by physical therapy, occupational therapy, gait training, and regular exercise. In select cases, deep brain stimulation may be considered.