Bradykinesia and movement precision in Huntington's disease

To determine whether bradykinesia in patients with Huntington's disease (HD) reflects impaired force production or an increased requirement for terminal visual guidance, 11 HD patients and matched controls performed drawing movements with varying precision requirements. Participants used an electronic pen upon a WACOM SD420 graphics tablet to join targets of either 10 or 20 mm diameter which were separated by a distance of 62.5 or 125 mm. While HD patients had slower movements, exhibiting more cycles of acceleration and deceleration, patients were not disproportionately affected by variations in target size or separation. Bradykinesia did not seem to be a product of impaired force production or increased reliance upon terminal visual guidance, since neither accelerative or decelerative phases were specifically affected by HD. However, movements of HD patients were of less consistent duration, implying variability associated with internal cues regulating movement.