Hand preshaping in Parkinson’s disease: effects of visual feedback and medication state

The Cortical Control of Visually Guided Grasping

People have always been fascinated by the exquisite precision and flexibility of the human hand. When hand meets object, we confront the overlapping worlds of sensorimotor and cognitive functions. The complex apparatus of the human hand is used to reach for objects, grasp and lift them, manipulate them, and use them to act on other objects. This review examines what is known about the control of the hand by the cerebral cortex. It compares and summarizes results from behavioral neuroscience, electrophysiology, and neuroimaging to provide a detailed description of the neural circuits that facilitate the formation of grip patterns in human and nonhuman primates. NEUROSCIENTIST 14(2):157—170, 2008. DOI: 10.1177/1073858407312080

Impaired anticipatory control of force sharing patterns during whole-hand grasping in Parkinson's disease

We examined the coordination of multi-digit grasping forces as they developed during object grasping and lifting. Ten subjects with Parkinson's disease (PD; OFF and ON medication) and ten healthy age-matched control subjects lifted a manipulandum that measured normal forces at each digit and the manipulandum's position. The center of mass (CM) was changed from trial to trial in either a predictable (blocked) or unpredictable (random) order. All subjects modulated individual fingertip forces to counterbalance forces exerted by the thumb and minimize object tilt after lift-off. However, subjects with PD OFF exhibited an impaired ability to use anticipatory mechanisms resulting in less differentiated scaling of individual finger forces to the object CM location. Remarkably, these between-group differences in force modulation dissipated as subjects reached peak grip forces during object lift, although these occurred significantly later in subjects with PD OFF than controls and PD ON. Analysis of the tilt of the object during lift revealed all subjects had similar deviations of the object from the vertical, the direction of which depended on CM location. Thus these findings in subjects with PD indicate that: (a) PD-induced impairments in anticipatory force mechanisms appear to be greatly increased in multi-digit grasping as opposed to previous reports from two-digit grasping; (b) inaccurate scaling of fingertip force amplitude and sharing patterns before object lift is recovered during object lift; (c) the implementation of appropriate force amplitude and sharing among the digits during the lift occurs significantly later than for controls; (d) medication improves the temporal recovery of multi-digit force coordination. These results are discussed within the framework of PD-related deficits in sensorimotor integration and control of multi-degrees of freedom movement.

Role of vision in aperture closure control during reach-to-grasp movements

We have previously shown that the distance from the hand to the target at which finger closure is initiated during the reach (aperture closure distance) depends on the amplitude of peak aperture, as well as hand velocity and acceleration. This dependence suggests the existence of a control law according to which a decision to initiate finger closure during the reach is made when the hand distance to target crosses a threshold that is a function of the above movement-related parameters. The present study examined whether the control law is affected by manipulating the visibility of the hand and the target. Young adults made reach-to-grasp movements to a dowel under conditions in which the target or the hand or both were either visible or not visible. Reaching for and grasping a target when the hand and/or target were not visible significantly increased transport time and widened peak aperture. Aperture closure distance was significantly lengthened and wrist peak velocity was decreased only when the target was not visible. Further analysis showed that the control law was significantly different between the visibility-related conditions. When either the hand or target was not visible, the aperture closure distance systematically increased compared to its value for the same amplitude of peak aperture, hand velocity, and acceleration under full visibility. This implies an increase in the distance-related safety margin for grasping when the hand or target is not visible. It has been also found that the same control law can be applied to all conditions, if variables describing hand and target visibility were included in the control law model, as the parameters of the task-related environmental context, in addition to the above movement-related parameters. This suggests that that the CNS utilizes those variables for controlling grasp initiation based on a general control law.

Dopamine replacement therapy does not restore the ability of Parkinsonian patients to make rapid adjustments in motor strategies according to changing sensorimotor contexts

The ability of dopamine replacement to restore rapid motor adjustments in Parkinson's disease (PD) was investigated. Medicated and non-medicated patients performed finger-to-nose movements while simultaneously bending the trunk forward, without vision. Trunk motion was blocked unexpectedly, necessitating rapid adjustments in arm trajectories. Patients exhibited irregular hand paths, plateaus in hand velocity, and prolonged movement times, which were significantly greater in perturbed trials. Medication improved kinematics but perturbation-induced disturbances persisted and did not approximate the levels of non-perturbed trials nor those of controls. Dopaminergic replenishment in PD may therefore have limited restorative benefits for rapid context-specific motor control.

Perception of active and passive turning in Parkinson disease

BACKGROUND

Many individuals with Parkinson disease (PD) experience difficulty with turning, yet little is known about the reasons for this difficulty.

OBJECTIVE

The authors sought to determine whether individuals with PD can use visual, vestibular, and proprioceptive cues to estimate how far they have turned.

METHODS

Fifteen PD subjects and 11 controls performed active and passive turns to the left and right, with and without vision, with amplitudes of 90, 180, 270, and 360 degrees. For active conditions, subjects were told the direction and amplitude of the desired turn and then attempted to turn in place the specified amount via actively stepping. For passive conditions, subjects were told that the disc they stood on would turn and they were to press a button when they had traveled the specified amplitude.

RESULTS

There were no differences between PD and control groups in any of the conditions, suggesting that those with PD effectively used sensory cues available in the different conditions to accurately judge distance turned. The authors found no apparent deficits in the visual, vestibular, or proprioceptive systems or in integration of these senses for performance of the turning task tested.

CONCLUSIONS

Turning difficulties associated with PD may more likely relate to motor or sensorimotor integration deficits than to pure sensory or sensory integration deficits. Generalizability of the study may be limited by the fact that subjects were tested at a single velocity for passive rotations, were on medication, and had relatively mild PD (primarily H&Y 2).

Parkinsonian deficits in sensory integration for postural control: Temporal response to changes in visual input

This study investigated the effect of Parkinson's disease (PD) on the time course for postural control following the removal and reinsertion of visual information. Twelve medicated PD patients (PD) and 12 age matched control (CTRL) subjects performed two 45-s quiet standing trials, during which visual feedback was available (0-15s), deprived (15-30s), and then restored (30-45s). The 45s test trial was divided into 5s time bins to compare the time-based effect of sensory reorganization during deprivation and reintegration. Results revealed an increase in Elliptical Sway Area (ESA) following visual deprivation for both groups; this increased ESA remained significantly higher than the baseline level for the duration of the deprivation period among PD patients and returned to baseline the level among CTRL. Despite elevated ESA at the end of visual deprivation among PD patients, neither group showed a change in ESA after visual information was restored. These results indicate a PD-associated deficit with the reorganization of sensory priorities for postural control, and may implicate the basal ganglia as being critical for integration of sensory information for postural control.

Snakes as agents of evolutionary change in primate brains

Current hypotheses that use visually guided reaching and grasping to explain orbital convergence, visual specialization, and brain expansion in primates are open to question now that neurological evidence reveals no correlation between orbital convergence and the visual pathway in the brain that is associated with reaching and grasping. An alternative hypothesis proposed here posits that snakes were ultimately responsible for these defining primate characteristics. Snakes have a long, shared evolutionary existence with crown-group placental mammals and were likely to have been their first predators. Mammals are conservative in the structures of the brain that are involved in vigilance, fear, and learning and memory associated with fearful stimuli, e.g., predators. Some of these areas have expanded in primates and are more strongly connected to visual systems. However, primates vary in the extent of brain expansion. This variation is coincident with variation in evolutionary co-existence with the more recently evolved venomous snakes. Malagasy prosimians have never co-existed with venomous snakes, New World monkeys (platyrrhines) have had interrupted co-existence with venomous snakes, and Old World monkeys and apes (catarrhines) have had continuous co-existence with venomous snakes. The koniocellular visual pathway, arising from the retina and connecting to the lateral geniculate nucleus, the superior colliculus, and the pulvinar, has expanded along with the parvocellular pathway, a visual pathway that is involved with color and object recognition. I suggest that expansion of these pathways co-occurred, with the koniocellular pathway being crucially involved (among other tasks) in pre-attentional visual detection of fearful stimuli, including snakes, and the parvocellular pathway being involved (among other tasks) in protecting the brain from increasingly greater metabolic demands to evolve the neural capacity to detect such stimuli quickly. A diet that included fruits or nectar (though not to the exclusion of arthropods), which provided sugars as a neuroprotectant, may have been a required preadaptation for the expansion of such metabolically active brains. Taxonomic differences in evolutionary exposure to venomous snakes are associated with similar taxonomic differences in rates of evolution in cytochrome oxidase genes and in the metabolic activity of cytochrome oxidase proteins in at least some visual areas in the brains of primates. Raptors that specialize in eating snakes have larger eyes and greater binocularity than more generalized raptors, and provide non-mammalian models for snakes as a selective pressure on primate visual systems. These models, along with evidence from paleobiogeography, neuroscience, ecology, behavior, and immunology, suggest that the evolutionary arms race begun by constrictors early in mammalian evolution continued with venomous snakes. Whereas other mammals responded by evolving physiological resistance to snake venoms, anthropoids responded by enhancing their ability to detect snakes visually before the strike.