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Motor switching abilities in Parkinson’s disease and old age: temporal aspects

OBJECTIVES To investigate capabilities of arm trajectory modification in patients with Parkinson’s disease and elderly subjects using a double step target displacement paradigm. METHODS Nine patients with Parkinson’s disease and seven age matched control subjects were instructed to move a stylus towards visual targets presented on a digitising table. Within each session, in some trials the target location was changed before initiation of movement and the subjects were to modify their movements towards the new target (switching trials). In other trials the target location was not changed (control trials). This procedure was repeated for four different target configurations, using interstimulus time intervals of six different durations. The subjects’ hand trajectories were recorded and their kinematic characteristics were analysed. RESULTS In switching trials, about 40% of the movements were aimed directly toward the final target location in both groups. When the trajectories were initially directed toward the first target and then modified toward the second, the reaction time (RT) to the second stimulus (RT2) was longer than to the first stimulus (RT1). The RT2/RT1 ratio was significantly larger in patients with Parkinson’s disease than in healthy elderly subjects. CONCLUSIONS Patients with Parkinson’s disease and elderly subjects are substantially slower in responding to a required modification of their movement than in responding to the required movement initiation. Patients with Parkinson’s disease have impaired capabilities in processing simultaneously the motor responses to two visual stimuli presented in rapid succession.