Paula,

This is a find! I have been wondering about this phenomenon which is part of that weird thing going on referred to as paradoxical movement. A PD person who is normally bradykinetic or akinetic, will, upon an emergency, move like there's no tomorrow. I think it's just as fascinating that those PWP who do have REM Sleep Disorder, move with ease, and most importantly they are completely fluid - the movements in REM do not look Parkinsonian!

What gives? If we have too much poorly modulated (dopamine is the modulator) acetylcholine, in our normal day, we then end up dystonic. Why then don't we end up a ball of spasm if the acetylcholine is not at all being held in check? This leaves me with the big question that perhaps dopamine is playing a bigger part here and if we could harness why, all of a sudden, things flow for us, could we possibly have new treatments?

One other thing...can we also start looking at having too much acetylcholine as a basis for having PD subtypes? In other words, does the akinetic-rigid type have more of an acetylcholine imbalance than tremor dominant?

Thanks for sharing

Laura