IMPAIRED UPPER-LIMB COORDINATION IN ALCOHOLIC CEREBELLAR DEGENERATION

Background: Alcoholic cerebellar degeneration (ACD) is a disorder resu lting from severe chronic alcoholism and malnutrition and is character ized by cognitive disturbances, ataxia of gait, and truncal instabilit y, with generally preserved coordination of the upper extremities. Obj ectives: 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 al cohol intake. Neuropsychological and motor function was measured using an expanded Halstead-Reitan Neuropsychological Test Battery, includin g the Tactual Performance Test and Grooved Pegboard Test. Results: Nei ther group had impaired coordination of upper limb function on clinica l neurological examination. Both groups had impaired performance on ne uropsychological tests involving executive function, but the patients with ACD had greater impairment of upper limb coordination than the pa tients without ACD as measured by the Tactual Performance Test and Gro oved Pegboard Test. Conclusions: The findings suggest that these 2 gro ups have similar cognitive deficits but that upper extremity motor fun ctions are more significantly impaired in the ACD group and that quant itative tasks of motor function reveal these impairments.