Attention and reach-to-grasp movements in Parkinson's disease.

The role of attention in grasping movements directed at common objects has not been examined in Parkinson's disease (PD), though these movements are critical to activities of daily living. Our primary objective was to determine whether patients with PD demonstrate automaticity in grasping movements directed toward common objects. Automaticity is assumed when tasks can be performed with little or no interference from concurrent tasks. Grasping performance in three patient groups (newly diagnosed, moderate, and advanced/surgically treated PD) on and off of their medication or deep brain stimulation was compared to performance in an age-matched control group. Automaticity was demonstrated by the absence of a decrement in grasping performance when attention was consumed by a concurrent spatial-visualization task. Only the control group and newly diagnosed PD group demonstrated automaticity in their grasping movements. The moderate and advanced PD groups did not demonstrate automaticity. Furthermore, the well-known effects of pharmacotherapy and surgical intervention on movement speed and muscle activation patterns did not appear to reduce the impact of attention-demanding tasks on grasping movements in those with moderate to advanced PD. By the moderate stage of PD, grasping is an attention-demanding process; this change is not ameliorated by dopaminergic or surgical treatments. These findings have important implications for activities of daily living, as devoting attention to the simplest of daily tasks would interfere with complex activities and potentially exacerbate fatigue.

Degradation of stored movement representations in the Parkinsonian brain and the impact of levodopa.

Parkinson's disease (PD) results from the depletion of dopamine and other neurotransmitters within the basal ganglia, and is typically characterized by motor impairment (e.g., bradykinesia) and difficulty initiating voluntary movements. Difficulty initiating a movement may result from a deficit in accessing or executing a stored representation of the movement, or having to create a new representation each time a movement is required. To date, it is unclear which may be responsible for movement initiation impairments observed in PD. In this study, we used functional magnetic resonance imaging and a task in which participants passively viewed familiar and unfamiliar graspable objects, with no confounding motor task component. Our results show that the brains of PD patients implicitly analyze familiar graspable objects as if the brain has little or no motor experience with the objects. This was observed as a lack of differential activity within brain regions associated with stored movement representations for familiar objects relative to unfamiliar objects, as well as significantly greater activity for familiar objects when off levodopa relative to on medication. Symptom severity modulated this activity difference within the basal ganglia. Levodopa appears to normalize brain activity, but its effect may be one of attenuation of brain hyperactivity within the basal ganglia network, which is responsible for controlling motor behavior and the integration of visuomotor information. Overall, this study demonstrates that difficulty initiating voluntary movements experienced by PD patients may be the result of degradation in stored representations responsible for the movement.

Learned perceptual associations influence visuomotor programming under limited conditions: cues as surface patterns.

The present set of three experiments was designed to extend the findings that visuomotor programming can make use of learned size information under some, but not all, conditions. An association was established between the size of square wooden blocks and a perceptual cue in all experiments. In Experiment 1 the perceptual cue to size was a small two-dimensional drawing of a shape affixed to the top of the blocks (e.g. triangle = large; circle = small, or vice versa). In Experiment 2 size and shape were again associated but this time a pattern of two-dimensional shapes covered the visible surface of the blocks. In Experiment 3 block size was associated with the colour of a small circle affixed to the top of the blocks (e.g. red = large; yellow = small, or vice versa). All of the subjects grasped the blocks, and on other trials estimated the size of the blocks by opening their thumb and finger a matching amount. Consistent with previous reports, in all experiments, the learned associations changed the perceived size of two test blocks halfway in size between the large and small blocks: estimations of the test block matched by shape or colour to the group of large objects were smaller than estimations of the test block matched to the group of small objects. The effect appears to result from relative-size comparisons being made between the medium-sized test blocks and the size category (large or small) associated with the matching shape or colour cue. Despite the significant effect of the learned perceptual associations on manual estimations, no effect on grip scaling was seen when the cues associated with size were single small elements centred on the top of the block (Experiment 1 and Experiment 3). Changes in grip scaling corresponded to the change in perceived size only when the cue to size covered the entire block (Experiment 2), forming a surface pattern. These findings suggest that visuomotor programming is more likely to use learned size information when the cue providing the size association covers the visible surface of the target objects, perhaps by acting as a texture that provides reliable information about the target's material and identity.

Learned perceptual associations influence visuomotor programming under limited conditions: kinematic consistency.

Previous findings have suggested that visuomotor programming can make use of learned size information in experimental paradigms where movement kinematics are quite consistent from trial to trial. The present experiment was designed to test whether or not this conclusion could be generalized to a different manipulation of kinematic variability. As in previous work, an association was established between the size and colour of square blocks (e.g. red = large; yellow = small, or vice versa). Associating size and colour in this fashion has been shown to reliably alter the perceived size of two test blocks halfway in size between the large and small blocks: estimations of the test block matched in colour to the group of large blocks are smaller than estimations of the test block matched to the group of small blocks. Subjects grasped the blocks, and on other trials estimated the size of the blocks. These changes in perceived block size were incorporated into grip scaling only when movement kinematics were highly consistent from trial to trial; that is, when the blocks were presented in the same location on each trial. When the blocks were presented in different locations grip scaling remained true to the metrics of the test blocks despite the changes in perceptual estimates of block size. These results support previous findings suggesting that kinematic consistency facilitates the incorporation of learned perceptual information into grip scaling.

A temporal analysis of grasping in the Ebbinghaus illusion: planning versus online control.

Recent work has shown that pictorial illusions have a greater effect on perceptual judgements than they do on the visual control of actions, such as object-directed grasping. This dissociation between vision for perception and vision for action is thought to reflect the operation of two separate streams of visual processing in the brain. Glover and Dixon claim, however, that perceptual illusions can influence the control of grasping but that these effects are evident only at early stages of the movement. By the time the action nears its completion any effect of illusions disappears. Glover and Dixon suggest that these results are consistent with what they call a 'planning and control' model of action, in which actions are planned using a context-dependent visual representation but are monitored and corrected online using a context-independent representation. We reanalysed data from an earlier experiment on grasping in the Ebbinghaus illusion in which we showed that maximum grip aperture was unaffected by this size-contrast illusion. When we looked at these data more closely, we found no evidence for an effect of the illusion even at the earliest stages of the movement. These findings support the suggestion that the initial planning of a simple object-directed grasping movement in this illusory context is indeed refractory to the effects of the illusion. This is not to suggest that more deliberate and/or complex movements could not be influenced by contextual information.