Impairment of motor planning in patients with Parkinson's disease: evidence from ideomotor apraxia testing (original) (raw)
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Motor planning in Parkinson patients
Neuropsychologia, 1983
This study was designed to determine if Parkinsonian patients exhibited a deficit in motor planning. Thirty adult males, 15 wiih Parkinson's disease and 15 normal controls, were given a gestural test which had twocomponents. The first component required the symbolic representationof implement usage' on verbal command and on imitation (repfesentational items) and the second component required the imitation of non-symbolic hand positions (non-representational items). The r e s u l~ indicateh that Parkinsonian patients performed ai a significantly lower gestural level on the representational tasks and made sjgn~ficantly more spatial errors on non-representational tasks than the normal controls. MOTOR PLANNING IN PARKINSON PATIENTS 46 1 University Medical Center. Margaret Lannon, R.N., MS., for her organization of Parkinsonian patients, and the persons at the Veterans Administration. Outpatient C!inic,
Journal of Neurology, Neurosurgery & Psychiatry, 1983
We studied the ability of Parkinsonian patients and controls to generate voluntary movements on a tracing task. Subjects were videotaped while tracing designs of increasing complexity, presented on a vertical, transparent screen. Some designs were presented in a degraded form and subjects filled in their missing sections. Subjects also received a constructional task and a test of general intellectual ability. The quality of errors on the tracing task differed in the Parkinsonian and control groups. Parkinsonian patients made two distinct types of errors. One probably related to the motor disorders of the disease, but another seemed to be related to a higher level of control over sequential and predictive movements. The latter correlated with performance on the constructional and general intellectual tasks. These results suggest that Parkinson's disease may affect basal ganglia structures that are necessary for voluntary movements which require sequencing or planning. Clinically this may be observed in perceptual motor tasks since they require both voluntary movement and sequential organisation of behaviour.
Visuo-motor coordination deficits and motor impairments in Parkinson's disease
PloS one, 2008
Visuo-motor coordination (VMC) requires normal cognitive executive functionality, an ability to transform visual inputs into movement plans and motor-execution skills, all of which are known to be impaired in Parkinson's disease (PD). Not surprisingly, a VMC deficit in PD is well documented. Still, it is not known how this deficit relates to motor symptoms that are assessed routinely in the neurological clinic. Such relationship should reveal how particular motor dysfunctions combine with cognitive and sensory-motor impairments to produce a complex behavioral disability. Thirty nine early/moderate PD patients were routinely evaluated, including motor Unified Parkinson's Disease Rating Scale (UPDRS) based assessment, A VMC testing battery in which the subjects had to track a target moving on screen along 3 different paths, and to freely trace these paths followed. Detailed kinematic analysis of tracking/tracing performance was done. Statistical analysis of the correlations be...
Movement Disorders, 2011
A B S T R AC T : Recent studies have reported cognitive decline to be common in the early phase of Parkinson's disease. Imaging data connect working memory and executive functioning to the dopamine system. It has also been suggested that bradykinesia is the clinical manifestation most closely related to the nigrostriatal lesion. Exploring the relationship between motor dysfunction and cognition can help us find shared or overlapping systems serving different functions. This relationship has been sparsely investigated in population-based studies of untreated Parkinson's disease. The aim of the present study was to investigate the association between motor signs and cognitive performance in the early stages of Parkinson's disease before the intake of dopaminergic medication. Patients were identified in a population-based study of incident cases with idiopathic parkinsonism. Patients with the postural instability and gait disturbances phenotype were compared with patients with the tremor-dominant phenotype on demo-graphics and cognitive measures. Associations between cognitive and motor scores were investigated, with age, education, and sex controlled for. Bradykinesia was associated with working memory and mental flexibility, whereas axial signs were associated with episodic memory and visuospatial functioning. No significant differences in the neuropsychological variables were found between the postural instability and gait disturbances phenotype and the tremor phenotype. Our results indicate a shared system for slow movement and inflexible thinking that may be controlled by a dopaminergic network different from dopaminergic networks involved in tremor and/or rigidity. The association between axial signs and memory and visuospatial function may point to overlapping systems or pathologies related to these abilities. V C 2011 Movement Disorder Society
Movement precues in planning and execution of aiming movements in Parkinson's disease
Experimental Neurology, 2005
Two experiments tested how changing a planned movement affects movement initiation and execution in idiopathic Parkinson's disease (PD) patients. In Experiment 1, PD patients, elderly controls, and young adults performed discrete aiming movements to one of two targets on a digitizer. A precue (80% valid cue and 20% invalid cue of all trials) reflecting the subsequent movement direction was presented prior to the imperative stimulus. All groups produced slower reaction times (RTs) to the invalid precue condition. Only the subgroup of patients with slowest movement time showed a significant prolongation of movement for the invalid condition. This suggests that, in the most impaired patients, modifying a planned action also affects movement execution.
Planning and executing an action in Parkinson's disease
Movement Disorders, 1999
We evaluated the possible impairment in planning and executing an action in patients with Parkinson's disease (PD). The action considered in the present study was formed by two successive motor acts: reaching-grasping an object (first target) and placing it on a second target of the same shape and size. We examined the effects of extrinsic properties of the second target (that is, distance) on the various kinematic phases of reaching-grasping movements. Distance, position, and size of both stimuli were randomly varied across the experimental session. Movements were executed with and without visual control of both targets and arm. The performance of six patients with PD was compared with an age-matched control group. The kinematics of the initial phase of reaching was influenced by position and size of the first target and by distance of the second target in both patients and control subjects. In particular, peak acceleration was higher for farther position of the second target. However, in the subsequent phase patients, differently from control subjects, removed the effects of the sec-ond target distance by modifying their reaching kinematics. This was obtained by varying the duration of the acceleration phase. In summary, the patients reprogrammed the reaching component by taking into account only the properties of the first target. The decreasing influence of second-target distance on reaching kinematics of patients was more evident during movements executed under visual control. Moreover, their movements executed without visual control were slowed down from the beginning. The second target affected the grasping kinematics only of the control subjects. Globally, these results indicate that PD patients are able to compute the general program of an action that takes into account extrinsic properties of the final target. However, the finding that PD patients reprogrammed the movement during its execution suggests a decay of the program during its time course, that is, basal ganglia can be involved in storing the plan of an action and in controlling its correct execution.
Learning and retention of movement sequences in Parkinson's disease
Movement Disorders, 2006
The purpose of this study was to examine motor learning and retention given extensive practice in two fundamentally different movement sequences. One sequence was a memory-driven task (performing a series of whole body positions from memory) and the other a context-driven task (buttoning). Practice took place over 3 weeks, with performance measured weekly; retention was measured weekly for 3 weeks after practice. There were 7 people with Parkinson's disease (PD) and 7 age-matched neurologically healthy people who participated in this study. Both groups improved performance on both tasks with practice, with the majority of the change for the PD group occurring between 1 and 2 weeks of practice. Although those with PD did not necessarily perform as well as age-matched controls, they learned both sequences in a manner similar to age-matched controls, and exhibited retention across the 3-week retention interval. If people with PD are given sufficient practice they can learn and retain both memory-based and context-driven movement sequences as well as agematched controls. The results provide support for maintaining physical activity and for intervention through movement therapy.
Learning sequence movements in a homogenous sample of patients with Parkinson's disease
Neuropsychologia, 2006
We investigated the acquisition of sequence movements in Parkinson's disease (PD) by means of the serial reaction time (SRT) task. To this end, we used a sample of PD patients that fell within the same stage of the disease. Sixteen PD patients and 16 age-, sex-and education-matched control subjects performed the SRT task with a first-order conditional (FOC) sequence and with a second-order conditional (SOC) sequence. The results showed that the group of PD patients could be divided into two distinct subgroups: a fast PD patient subgroup (n = 11) and a slow PD patient subgroup (n = 5). FOC and SOC sequence learning in faster PD patients proved to be highly comparable to the group of controls. In contrast, learning of FOC and SOC sequences was severely impaired in slower PD patients. Since slow PD patients also scored lower on measures of cognitive functioning than faster PD patients, we assume that the deficits in SRT learning of the former reflect some more general cognitive impairment. This indicates that SRT performance can provide additional information about the cognitive abilities of PD patients, and accordingly may contribute to disease screening.
Critical dimensions affecting imitation performance of patients with ideomotor apraxia.
… Devoted to the Study of the …, 2001
Examines the roles of long-term memory, a motor programming component, and a working memory component, including short-term memory and supervisory attentional system, in imitation of symbolic and nonsymbolic gestures in 86 patients (aged 75+ yrs) with ideomotor apraxia following a left-hemisphere vascular lesion. Results show that the programming of gestures is impaired in these patients, suggesting damage in the motor programming and working memory systems for hand/arm gestures but not for fingers gestures. Results also indicate that, by generating syntactic representations of gestures, the supervisory attentional system might alleviate the short-term memory load, and thereby compensate for the short-term memory deficit. A similar explanation might hold for the paradoxical results obtained by patients on symbolic vs. nonsymbolic sequences. Ss performed better on symbolic hand/arm sequences, but showed the opposite effect on fingers sequences. These findings might reflect differences in the possibility to be "syntactically encoded' among the various subsets of sequences. Results did not provide evidence that the meaning of a gesture can compensate for either a working memory or motor programming deficit. (PsycINFO Database Record (c) 2010 APA, all rights reserved)