Disturbances of motor preparation in basal ganglia and cerebellar disorders

Movements of the arms (execution) in standing human subjects are preceded (preparation), accompanied, and followed (compensation) by muscular activity in postural trunk and leg muscles. Postural muscular activity compensates inertial forces acting on the body at the beginning and during arm movements and keeps the centre of gravity within the limits of stable upright standing. Standing normal subjects and patients performed bilateral arm elevations in response to an acoustic trigger. The beginning of EMG activity in the anterior deltoid muscle reflects the reaction time. Postural activity prior to the arm movement was observed in anterior tibialis, paraspinalis, and hamstring muscles. Compensatory muscular action occurred in the triceps surae. Motor preparation and compensation thus are an integral part of a motor programme. Muscles involved, latencies, and amount of EMG activity change with variations in the motor task (e.g. range of arm movement, changes in inertia of the arm, changes in initial body position). Reaction times and the pattern of preparatory and compensatory postural EMG activity were normal in most of the patients with Parkinson's disease. Reaction times were significantly increased in patients with cerebellar atrophy. The most prominent pathological feature in cerebellar patients was the inadequate temporal sequence of motor preparation and execution. Our results indicate that the basal ganglia play a minor role in motor preparation, whereas the cerebellum seems to coordinate the relative timing between motor preparation and execution.