title: Effects of a startling acoustic stimulus on reaction time in different parkinsonian syndromes.
abstract: BACKGROUND
  The functional assessment of the startle circuit is usually done by analyzing the acoustic startle response (ASR). However, a startling acoustic stimulus (SAS) also induces changes in the excitability of neural structures that can be demonstrated by studying the SAS-induced change in the behavior of certain neurophysiologic responses.
  
  
  OBJECTIVE
  To examine the effects induced by an SAS on voluntary reaction time in patients with parkinsonian syndromes (StartReact effect) and to compare the results with those obtained in a group of age-matched healthy volunteers.
  
  
  METHODS
  Twelve patients with idiopathic PD (IPD), seven patients with progressive supranuclear palsy (PSP), seven patients with multisystem atrophy (MSA), and seven healthy age-matched control volunteers performed a simple visual reaction time task and received SAS together with the "go" signal in random trials.
  
  
  RESULTS
  Baseline reaction time was significantly slower in PSP patients than in control subjects and MSA patients. The SAS induced a significant shortening of the reaction time in control subjects and in patients with IPD and MSA, but not in patients with PSP. The percentage of reaction time shortening with regard to the baseline values also differed significantly between PSP patients and the other groups of subjects. The StartReact effect was consistent throughout the experiment and showed reduced habituation with repeated testing.
  
  
  CONCLUSIONS
  The results are consistent with an abnormal function of the startle circuit in patients with PSP and agree with previous studies using the ASR. The reduced habituation of the StartReact effect favors its clinical applicability in the assessment of differences between patients with parkinsonian syndromes.
authors.affiliation: Neurology Department, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Valldeoriola
authors.forename: J
authors.initials: J
authors.lastname: Valls-Solé
authors.forename: E
authors.initials: E
authors.lastname: Tolosa
authors.forename: P J
authors.initials: PJ
authors.lastname: Ventura
authors.forename: F A
authors.initials: FA
authors.lastname: Nobbe
authors.forename: M J
authors.initials: MJ
authors.lastname: Martí
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001284:Atrophy; D004576:Electromyography; D005260:Female; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009068:Movement; D010300:Parkinson Disease / Q000503:physiopathology*; D010302:Parkinson Disease, Secondary / Q000503:physiopathology*; D011597:Psychomotor Performance / Q000502:physiology*; D011930:Reaction Time / Q000502:physiology*; D012016:Reference Values; D013216:Reflex, Startle / Q000502:physiology*; D013494:Supranuclear Palsy, Progressive / Q000503:physiopathology