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Force and time control in the production of rhythmic movement sequences in Parkinson's disease

This study investigated force and time control in rhythm production in Parkinson's disease. Patients and age‐matched controls reproduced rhythms consisting of equal (600 ms) or alternating (400 and 800 ms) intervals, produced with equal (12 N) or alternating (8 and 16 N) forces, under paced (synchronization) and unpaced (continuation) conditions. Performance was assessed in terms of accuracy and variability. Reproduction of force amplitudes was less accurate in patients than in controls when either time or force alternated but did not deteriorate further when force and time alternated. In contrast, interval timing was least accurate in patients compared with controls when rhythm alternated on both dimensions. The ratio between alternating force levels was better maintained by controls than by patients, without influence of timing requirements in either group. In contrast, the ratio between alternating intervals was relatively preserved in patients when force remained constant but was severely compromised when force alternated. Timing variability was greater in the patient group, especially in the more affected side, but there was no difference in timing variability between groups as a function of rhythm, and there were no differences between groups in variability of force. The results show that force and time control in patients are affected in different ways. We interpret the preserved timing of rhythms with alternation on one dimension as evidence of intact ability to organize movements in a sequence. The data are compatible with a basal ganglia role in the coregulation of time and force, but do not support a general timing function of the basal ganglia.