Movement activation and inhibition in Parkinson's disease: a functional imaging study.
BACKGROUND
Parkinson's disease (PD), traditionally considered a movement disorder, has been shown to affect executive function such as the ability to adapt behavior in response to new environmental situations.


OBJECTIVE
to identify the impact of PD on neural substrates subserving two specific components of normal movement which we refer to as activation (initiating an un-cued response) and inhibition (suppressing a cued response).


METHODS
We used fMRI to measure pre-movement processes associated with activating an un-cued response and inhibiting a cued response plan in 13 PD (ON anti-parkinsonian medications) and 13 control subjects. Subjects were shown a visual arrow cue followed by a matched or mismatched response target that instructed them to respond with a right, left, or bilateral button press. In mismatched trials, an un-cued (new) response was initiated, or the previously cued response was suppressed.


RESULTS
We were able to isolate pre-movement responses in dorsolateral prefrontal cortex, specifically in the right hemisphere. During the activation of an un-cued movement, PD subjects showed decreased activity in the putamen and increased cortical activity in bilateral DLPFC, SMA, subcentral gyrus and inferior frontal operculum. During inhibition of a previously cued movement, the PD group showed increased activation in SMA, S1/M1, premotor and superior parietal areas.


CONCLUSIONS
Right DLPFC plays a role in pre-movement processes, and DLPFC activity is abnormal in PD. Decreased specificity of responses was observed in multiple ROI's. The basal ganglia are involved in circuits that coordinate activation and inhibition involved in action selection as well as execution.
VA Northern California Health Care System, Martinez, CA, USA. eadisbrow@ucdavis.edu
Elizabeth A
EA
Disbrow
Karen A
KA
Sigvardt
Elizabeth A
EA
Franz
Robert S
RS
Turner
Kim A
KA
Russo
Leighton B
LB
Hinkley
Timothy J
TJ
Herron
Maria I
MI
Ventura
Lin
L
Zhang
Norika
N
Malhado-Chang
D000368:Aged; D001921:Brain / Q000098:blood supply*; D001931:Brain Mapping; D003463:Cues; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007266:Inhibition, Psychological; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D010100:Oxygen / Q000097:blood; D010300:Parkinson Disease / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D010775:Photic Stimulation; D011597:Psychomotor Performance / Q000502:physiology; D011930:Reaction Time / Q000502:physiology
D010100:Oxygen