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The effects of auditory startle and nonstartle stimuli on step initiation in Parkinson's disease§

Authors

  • Miguel Fernández-Del-Olmo PhD,

    Corresponding author
    1. Learning and Human Movement Control Group, INEF Galicia, University of A Coruña, A Coruña, Spain
    • Departamento de Educación Física e Deportiva, Facultade de Ciencias do Deporte e a Educación Física, Universidade da Coruña, Avenida Ernesto Che Guevara 121, Pazos-Liáns, 15179 Oleiros, A Coruña, Spain
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  • Olalla Bello PhD,

    1. Learning and Human Movement Control Group, INEF Galicia, University of A Coruña, A Coruña, Spain
    2. Physical Therapy Department, University School of Physical Therapy, University of A Coruña, A Coruña, Spain
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  • Virginia Lopez-Alonso BA,

    1. Learning and Human Movement Control Group, INEF Galicia, University of A Coruña, A Coruña, Spain
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  • Jose Andrés Sanchez PhD,

    1. Learning and Human Movement Control Group, INEF Galicia, University of A Coruña, A Coruña, Spain
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  • Diego Santos-García MD,

    1. Department of Neurology, Hospital A. Marcide, Ferrol, Spain
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  • Josep Valls-Solé MD

    1. EMG Unit, Neuroloogy Department, Hospital Clinic, University of Barcelona, IDIBAPS (Institut d'Investigació August Pi i Sunyer), Barcelona, Spain
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  • Funding agencies: This work was supported by Ministerio de Ciencia e Innovación, Spain (PSI2008-03175).

  • Relevant conflicts of interest/financial

    disclosures: Nothing to report.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Background:

Auditory external cues enhance step initiation in Parkinson's disease (PD) patients. We wanted to explore whether a startle reaction has a comparable effect on step initiation in PD.

Methods:

Thirteen PD patients and 13 aged-matched controls participated in this study. Electromyography pattern and onset toe-off time during a step initiation task were recorded in response to three different stimuli: a visual imperative stimulus; visual stimulus simultaneous with a nonstartle auditory stimulus and with a startle auditory stimulus.

Results:

In all subjects, onset of tibialis anterior was faster in the startle auditory condition, compared with the nonstartle auditory condition. However, in the patient group, there was no difference in onset of soleus and toe-off between the startle and nonstartle conditions.

Conclusions:

Startle reaction in PD patients demonstrates a disordered coupling between the anticipatory postural adjustments that initiate the weight shift and the movement to initiate toe-off during step initiation. © 2012 Movement Disorder Society

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