Movement-related potentials in Parkinson's disease. Motor imagery and movement preparation

Movement-related potentials (MRPs) associated with voluntary movements reflect cortical activity associated with processes of movement preparation and movement execution. Early-stage pre-movement activity is reduced in amplitude in Parkinson's disease. However, it is unclear whether this neurophysiological deficit relates to preparatory or execution-related activity, since previous studies have not been able to separate different functional components of MRPs. Motor imagery is thought to involve mainly processes of movement preparation, with reduced involvement of end-stage movement execution-related processes. Therefore, MRP components relating to movement preparation and execution may be examined separately by comparing MRPs associated with imagined and actual movements. In this study, MRPs were recorded from 14 subjects with Parkinson's disease and 10 age-matched control subjects while they performed a sequential button-pressing task, and while they imagined performance of the same task. Early-stage pre-movement activity was present in both Parkinson's disease patients and control subjects when they imagined movement, but was reduced in amplitude compared with that for actual movement. Movement execution-related components, arising predominantly from the primary motor cortex, were relatively unaffected in Parkinson's disease subjects. However, motor preparatory processes, probably involving the supplementary motor area, were reduced in amplitude overall and abnormally prolonged, indicating impaired termination following the motor response. Further, this impaired termination of preparatory-phase activity was observed only in patients with more severe parkinsonian symptoms, and not in early-stage Parkinson's disease.