Sensory timing cues improve akinesia of grasping movements in Parkinson's disease: A comparison to the effects of subthalamic nucleus stimulation

Authors

  • Dennis A. Nowak MD,

    Corresponding author
    1. Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, United Kingdom
    2. Department of Neurology and Clinical Neurophysiology, Academic Hospital Bogenhausen, Technical University of Munich, Munich, Germany
    • Department of Psychiatry III, University of Ulm, Klinikbereich Safranberg, Leimgrubenweg 12, D-89075 Ulm, Germany
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  • Stephen Tisch MD,

    1. Functional Neurosurgery Unit, Institute of Neurology, University College London, London, United Kingdom
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  • Marwan Hariz MD, PhD,

    1. Functional Neurosurgery Unit, Institute of Neurology, University College London, London, United Kingdom
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  • Patricia Limousin MD,

    1. Functional Neurosurgery Unit, Institute of Neurology, University College London, London, United Kingdom
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  • Helge Topka MD,

    1. Department of Neurology and Clinical Neurophysiology, Academic Hospital Bogenhausen, Technical University of Munich, Munich, Germany
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  • John C. Rothwell PhD

    1. Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, United Kingdom
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Abstract

Five parkinsonian subjects with chronic bilateral stimulation of the subthalamic nucleus and five sex- and age-matched healthy controls grasped, lifted, and held an instrumented object. The grip–lift task was either performed at self-determined speed or in response to an auditory cuing signal. Parkinsonian subjects performed the task with subthalamic nucleus stimulation switched ON and OFF. In Parkinson's disease, stimulation of the subthalamic nucleus and the presentation of auditory timing cues improved akinesia of both the grasp and lift components of the task. The finding that auditory timing cues improve akinesia in the absence of subthalamic nucleus stimulation suggests that the basal ganglia are less involved in the control of movements made in response to environmental cues. However, subthalamic nucleus stimulation caused parkinsonian subjects to apply excessive grip forces, regardless of whether the movement was made under self-determined or externally guided speed conditions. This implies that subthalamic nucleus stimulation produces a generalized upregulation in the gain of all components of a movement without the subtlety of focused control that is required to normalize performance. © 2005 Movement Disorder Society

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