The effect of viewing graspable objects and actions in Parkinson's disease

Investigating Object Affordance in People with Complex Regional Pain Syndrome: No Alterations in the Automatic Activation of Motor Plans

Complex Regional Pain Syndrome (CRPS) is a condition of chronic pain, predominantly affecting one limb. CRPS is characterised by motor changes including slowed or uncoordinated movements. Cognitive processes that drive movement planning and/or execution might contribute to these changes. We aimed to investigate the potential alterations to such cognitive mechanisms using an 'object affordance' paradigm. Object affordance refers to the observation that viewing an object modulates associated motor responses, presumably due to the automatic activation of a motor plan. We hypothesised that people with CRPS would show reduced object affordance effects for their affected compared to unaffected hand, and compared to pain-free controls. First, we validated an online object affordance task involving button press responses to everyday objects with handles, in pain-free participants (n = 63; Experiment 1). Object affordance was reflected by faster and more accurate responses when the object handle was aligned to the responding hand ("aligned") compared to when the handle was aligned to the other hand ("non-aligned"). These results were similar for the online task as when administered in person. Second, in a case-control study, we administered the online object affordance task to people with CRPS predominantly affecting the upper limb (n = 25), and age-matched pain-free controls (n = 68; Experiment 2). People with CRPS responded faster and more accurately in the aligned versus non-aligned condition (ie, an object affordance effect), both for the affected and unaffected hands. There were no differences to pain-free participants. Therefore, object affordance effects were seen in people with CRPS, providing no evidence for altered motor planning. PERSPECTIVE: This article presents research investigating cognitive processes related to motor planning in Complex Regional Pain Syndrome (CRPS). Using an online object affordance paradigm, validated in pain-free controls, the authors found that people with CRPS showed intact object affordance effects in the affected and unaffected hand, suggesting unaltered motor planning. DATA AVAILABILITY: The experiment materials, data, pre-processing scripts, and analysis scripts can be found via Open Science Framework (https://osf.io/nc825/files/osfstorage).

What matters is the underlying experience: Similar motor responses during processing observed hand actions and hand-related verbs

It is well-accepted that processing observed actions involves at some extent the same neural mechanisms responsible for action execution. More recently, it has been forwarded that also the processing of verbs expressing a specific motor content is subserved by the neural mechanisms allowing individuals to perform the content expressed by that linguistic material. This view is also known as embodiment and contrasts with a more classical approach to language processing that considers it as amodal. In the present study, we used a go/no-go paradigm, in which participants were requested to respond to real words and pictures and refrain from responding when presented stimuli were pseudowords and scrambled images. Real stimuli included pictures depicting hand- and foot-related actions and verbs expressing hand- and foot-related actions. We, therefore, directly compared the modulation of hand motor responses during the observation of actions and the presentation of verbs, expressing actions in the same category. The results have shown that participants gave slower hand motor responses during the observation of hand actions and the processing of hand-related verbs as than observed foot actions and related verbs. These findings support embodiment showing that whatever the modality of presentation (observed action or verb), the modulation of hand motor responses was similar, thus suggesting that processing seen actions and related verbs shares common mechanisms most likely involving the motor system and the underlying motor experience.

Object affordances from the perspective of an avatar

Humans often interact with avatars in video gaming, workplace, or health applications, for instance. The present research studied object affordances from an avatar's perspective. In two experiments, participants responded to objects with a left/right keypress, indicating whether the objects were upright or inverted. Task-irrelevant objects' handles were aligned with either the left or right hand of the actor and/or avatar. We hypothesized that actors respond faster when the handles are aligned, as compared to non-aligned, with the respective avatar hand (spatial alignment effect or object-based Simon effect). In Experiment 1, the spatial alignment effect was increased through the presentation of avatar hands as compared to when no hands were presented. In Experiment 2, the avatar perspective was rotated by 90° to the right and left of the actor's view. Here, the spatial alignment effect was guided by the avatar, suggesting that the actors took its perspective when perceiving objects' affordances.

The effect of directional social cues on saccadic eye movements in Parkinson's disease

There is growing interest in how social processes and behaviour might be affected in Parkinson’s disease. A task which has been widely used to assess how people orient attention in response to social cues is the spatial cueing task. Socially relevant directional cues, such as a picture of someone gazing or pointing to the left or the right have been shown to cause orienting of visual attention in the cued direction. The basal ganglia may play a role in responding to such directional cues, but no studies to date have examined whether similar social cueing effects are seen in people with Parkinson’s disease. In this study, patients and healthy controls completed a prosaccade (Experiment 1) and an antisaccade task (Experiment 2) in which the target was preceded by arrow, eye gaze or pointing finger cues. Patients showed increased errors and response times for antisaccades but not prosaccades. Healthy participants made most anticipatory errors on pointing finger cue trials, but Parkinson's patients were equally affected by arrow, eye gaze and pointing cues. It is concluded that Parkinson's patients have a reduced ability to suppress responding to directional cues, but this effect is not specific to social cues.

Action observation produces motor resonance in Parkinson's disease

Observation of movement activates the observer's own motor system, influencing the performance of actions and facilitating social interaction. This motor resonance is demonstrated behaviourally through visuomotor priming, whereby response latencies are influenced by the compatibility between an intended action and an observed (task-irrelevant) action. The impact of movement disorders such as Parkinson's disease (PD) on motor resonance is unclear, as previous studies of visuomotor priming have not separated imitative compatibility (specific to human movement) from general stimulus-response compatibility effects. We examined visuomotor priming in 23 participants with mild-to-moderate PD and 24 healthy older adults, using a task that pitted imitative compatibility against general stimulus-response compatibility. Participants made a key press after observing a task-irrelevant moving human finger or rectangle that was either compatible or incompatible with their response. Imitative compatibility effects, rather than general stimulus-response compatibility effects, were found specifically for the human finger. Moreover, imitative compatibility effects did not differ between groups, indicating intact motor resonance in the PD group. These findings constitute the first unambiguous demonstration of imitative priming in both PD and healthy ageing, and have implications for therapeutic techniques to facilitate action, as well as the understanding of social cognition in PD.

Postural Stabilization Strategies to Motor Contagion Induced by Action Observation Are Impaired in Parkinson's Disease

Postural reactions can be influenced by concomitant tasks or different contexts and are modulated by a higher order motor control. Recent studies investigated postural changes determined by motor contagion induced by action observation (chameleon effect) showing that observing a model in postural disequilibrium induces an increase in healthy subjects’ body sway. Parkinson’s disease (PD) is associated with postural instability and impairments in cognitively controlled balance tasks. However, no studies investigated if viewing postural imbalance might influence postural stability in PD and if patients are able to inhibit a visual postural perturbation. In this study, an action observation paradigm for assessing postural reaction to motor contagion in PD subjects and healthy older adults was used. Postural stability changes were measured during the observation of a static stimulus (control condition) and during a point-light display of a gymnast balancing on a rope (biological stimulus). Our results showed that, during the observation of the biological stimulus, sway area and antero-posterior and medio-lateral displacements of center of pressure significantly increased only in PD participants, whereas correct stabilization reactions were present in elderly subjects. These results demonstrate that PD leads to a decreased capacity to control automatic imitative tendencies induced by motor contagion. This behavior could be the consequence either of an inability to inhibit automatic imitative tendencies or of the cognitive load requested by the task. Whatever the case, the issue about the ability to inhibit automatic imitative tendencies could be crucial for PD patients since it might increase falls risk and injuries.

Sensory and semantic activations evoked by action attributes of manipulable objects: Evidence from ERPs

"Two route" theories of object-related action processing posit different temporal activation profiles of grasp-to-move actions (rapidly evoked based on object structure) versus skilled use actions (more slowly activated based on semantic knowledge). We capitalized on the exquisite temporal resolution and multidimensionality of Event-Related Potentials (ERPs) to directly test this hypothesis. Participants viewed manipulable objects (e.g., calculator) preceded by objects sharing either "grasp", "use", or no action attributes (e.g., bar of soap, keyboard, earring, respectively), as well as by action-unrelated but taxonomically-related objects (e.g., abacus); participants judged whether the two objects were related. The results showed more positive responses to "grasp-to-move" primed objects than "skilled use" primed objects or unprimed objects starting in the P1 (0-150 ms) time window and continuing onto the subsequent N1 and P2 components (150-300 ms), suggesting that only "grasp-to-move", but not "skilled use", actions may facilitate visual attention to object attributes. Furthermore, reliably reduced N400s (300-500 ms), an index of semantic processing, were observed to taxonomically primed and "skilled use" primed objects relative to unprimed objects, suggesting that "skilled use" action attributes are a component of distributed, multimodal semantic representations of objects. Together, our findings provide evidence supporting two-route theories by demonstrating that "grasp-to-move" and "skilled use" actions impact different aspects of object processing and highlight the relationship of "skilled use" information to other aspects of semantic memory.

Autistic traits affect interpersonal motor coordination by modulating strategic use of role-based behavior

Background

Despite the fact that deficits in social communication and interaction are at the core of Autism Spectrum Conditions (ASC), no study has yet tested individuals on a continuum from neurotypical development to autism in an on-line, cooperative, joint action task. In our study, we aimed to assess whether the degree of autistic traits affects participants' ability to modulate their motor behavior while interacting in a Joint Grasping task and according to their given role.

Methods

Sixteen pairs of adult participants played a cooperative social interactive game in which they had to synchronize their reach-to-grasp movements. Pairs were comprised of one ASC and one neurotypical with no cognitive disability. In alternate experimental blocks, one participant knew what action to perform (instructed role) while the other had to infer it from his/her partner’s action (adaptive role). When in the adaptive condition, participants were told to respond with an action that was either opposite or similar to their partner. Participants also played a non-social control game in which they had to synchronize with a non-biological stimulus.

Results

In the social interactive task, higher degree of autistic traits predicted less ability to modulate joint action according to one’s interactive role. In the non-social task, autistic traits did not predict differences in movement preparation and planning, thus ruling out the possibility that social interactive task results were due to basic motor or executive function difficulties. Furthermore, when participants played the non-social game, the higher their autistic traits, the more they were interfered by the non-biological stimulus.

Conclusions

Our study shows for the first time that high autistic traits predict a stereotypical interaction style when individuals are required to modulate their movements in order to coordinate with their partner according to their role in a joint action task. Specifically, the infrequent emergence of role-based motor behavior modulation during on-line motor cooperation in participants with high autistic traits sheds light on the numerous difficulties ASC have in nonverbal social interactions.

Electronic supplementary material

The online version of this article (doi:10.1186/s13229-017-0141-0) contains supplementary material, which is available to authorized users.

Processing graspable object images and their nouns is impaired in Parkinson's disease patients

According to embodiment, the recruitment of the motor system is necessary to process language material expressing a motor content. Coherently, an impairment of the motor system should affect the capacity to process language items with a motor content. The aim of the present study was to assess the capacity to process graspable objects and their nouns in Parkinson's disease (PD) patients and healthy controls. Participants saw photos and nouns depicting graspable and non-graspable objects. Scrambled images and pseudo-words served as control stimuli. At 150 msec after stimulus presentation, they had to respond when the stimulus referred to a real object, and refrain from responding when it was meaningless (go-no go paradigm). In the control group, participants gave slower motor responses for stimuli (both photos and nouns) related to graspable objects as compared to non-graspable ones. This in keeping with data obtained in a previous study with young healthy participants. In the PD group, motor responses were similar for both graspable and non-graspable items. Moreover, error number was significantly greater than in controls. These findings support the notion that when the motor circuits are lesioned, like in PD, patients do not show the typical modulation of motor responses and have troubles in processing graspable objects and their nouns.

Impaired perception of biological motion in Parkinson's disease

OBJECTIVE

We examined biological motion perception in Parkinson's disease (PD). Biological motion perception is related to one's own motor function and depends on the integrity of brain areas affected in PD, including posterior superior temporal sulcus. If deficits in biological motion perception exist, they may be specific to perceiving natural/fast walking patterns that individuals with PD can no longer perform, and may correlate with disease-related motor dysfunction.

METHOD

Twenty-six nondemented individuals with PD and 24 control participants viewed videos of point-light walkers and scrambled versions that served as foils, and indicated whether each video depicted a human walking. Point-light walkers varied by gait type (natural, parkinsonian) and speed (0.5, 1.0, 1.5 m/s). Participants also completed control tasks (object motion, coherent motion perception), a contrast sensitivity assessment, and a walking assessment.

RESULTS

The PD group demonstrated significantly less sensitivity to biological motion than the control group (p < .001, Cohen's d = 1.22), regardless of stimulus gait type or speed, with a less substantial deficit in object motion perception (p = .02, Cohen's d = .68). There was no group difference in coherent motion perception. Although individuals with PD had slower walking speed and shorter stride length than control participants, gait parameters did not correlate with biological motion perception. Contrast sensitivity and coherent motion perception also did not correlate with biological motion perception.

CONCLUSION

PD leads to a deficit in perceiving biological motion, which is independent of gait dysfunction and low-level vision changes, and may therefore arise from difficulty perceptually integrating form and motion cues in posterior superior temporal sulcus. (PsycINFO Database Record

Action Observation and Motor Imagery: Innovative Cognitive Tools in the Rehabilitation of Parkinson's Disease

Parkinson's disease (PD) is characterized by a progressive impairment of motor skills with deterioration of autonomy in daily living activities. Physiotherapy is regarded as an adjuvant to pharmacological and neurosurgical treatment and may provide small and short-lasting clinical benefits in PD patients. However, the development of innovative rehabilitation approaches with greater long-term efficacy is a major unmet need. Motor imagery (MI) and action observation (AO) have been recently proposed as a promising rehabilitation tool. MI is the ability to imagine a movement without actual performance (or muscle activation). The same cortical-subcortical network active during motor execution is engaged in MI. The physiological basis of AO is represented by the activation of the "mirror neuron system." Both MI and AO are involved in motor learning and can induce improvements of motor performance, possibly mediated by the development of plastic changes in the motor cortex. The review of available evidences indicated that MI ability and AO feasibility are substantially preserved in PD subjects. A few preliminary studies suggested the possibility of using MI and AO as parts of rehabilitation protocols for PD patients.

Dissociating between object affordances and spatial compatibility effects using early response components

Perception and action are tightly linked: objects may be perceived not only in terms of visual features, but also in terms of possibilities for action. Previous studies showed that when a centrally located object has a salient graspable feature (e.g., a handle), it facilitates motor responses corresponding with the feature's position. However, such so-called affordance effects have been criticized as resulting from spatial compatibility effects, due to the visual asymmetry created by the graspable feature, irrespective of any affordances. In order to dissociate between affordance and spatial compatibility effects, we asked participants to perform a simple reaction-time task to typically graspable and non-graspable objects with similar visual features (e.g., lollipop and stop sign). Responses were measured using either electromyography (EMG) on proximal arm muscles during reaching-like movements, or with finger key-presses. In both EMG and button press measurements, participants responded faster when the object was either presented in the same location as the responding hand, or was affordable, resulting in significant and independent spatial compatibility and affordance effects, but no interaction. Furthermore, while the spatial compatibility effect was present from the earliest stages of movement preparation and throughout the different stages of movement execution, the affordance effect was restricted to the early stages of movement execution. Finally, we tested a small group of unilateral arm amputees using EMG, and found residual spatial compatibility but no affordance, suggesting that spatial compatibility effects do not necessarily rely on individuals' available affordances. Our results show dissociation between affordance and spatial compatibility effects, and suggest that rather than evoking the specific motor action most suitable for interaction with the viewed object, graspable objects prompt the motor system in a general, body-part independent fashion.

The contribution of brain sub-cortical loops in the expression and acquisition of action understanding abilities

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Focusing on cortical areas is too restrictive to explain action understanding ability.

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We propose that sub-cortical areas support action understanding ability.

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Cortical and sub-cortical processes allow acquisition of action understanding ability.

Research on action understanding in cognitive neuroscience has led to the identification of a wide “action understanding network” mainly encompassing parietal and premotor cortical areas. Within this cortical network mirror neurons are critically involved implementing a neural mechanism according to which, during action understanding, observed actions are reflected in the motor patterns for the same actions of the observer. We suggest that focusing only on cortical areas and processes could be too restrictive to explain important facets of action understanding regarding, for example, the influence of the observer's motor experience, the multiple levels at which an observed action can be understood, and the acquisition of action understanding ability. In this respect, we propose that aside from the cortical action understanding network, sub-cortical processes pivoting on cerebellar and basal ganglia cortical loops could crucially support both the expression and the acquisition of action understanding abilities. Within the paper we will discuss how this extended view can overcome some limitations of the “pure” cortical perspective, supporting new theoretical predictions on the brain mechanisms underlying action understanding that could be tested by future empirical investigations.

Spatial-orientation priming impedes rather than facilitates the spontaneous control of hand-retraction speeds in patients with Parkinson's disease

Background

Often in Parkinson’s disease (PD) motor-related problems overshadow latent non-motor deficits as it is difficult to dissociate one from the other with commonly used observational inventories. Here we ask if the variability patterns of hand speed and acceleration would be revealing of deficits in spatial-orientation related decisions as patients performed a familiar reach-to-grasp task. To this end we use spatial-orientation priming which normally facilitates motor-program selection and asked whether in PD spatial-orientation priming helps or hinders performance.

Methods

To dissociate spatial-orientation- and motor-related deficits participants performed two versions of the task. The biomechanical version (DEFAULT) required the same postural- and hand-paths as the orientation-priming version (primed-UP). Any differences in the patients here could not be due to motor issues as the tasks were biomechanically identical. The other priming version (primed-DOWN) however required additional spatial and postural processing. We assessed in all three cases both the forward segment deliberately aimed towards the spatial-target and the retracting segment, spontaneously bringing the hand to rest without an instructed goal.

Results and Conclusions

We found that forward and retracting segments belonged in two different statistical classes according to the fluctuations of speed and acceleration maxima. Further inspection revealed conservation of the forward (voluntary) control of speed but in PD a discontinuity of this control emerged during the uninstructed retractions which was absent in NC. Two PD groups self-emerged: one group in which priming always affected the retractions and the other in which only the more challenging primed-DOWN condition was affected. These PD-groups self-formed according to the speed variability patterns, which systematically changed along a gradient that depended on the priming, thus dissociating motor from spatial-orientation issues. Priming did not facilitate the motor task in PD but it did reveal a breakdown in the spatial-orientation decision that was independent of the motor-postural path.

Representation of action in Parkinson's disease: imagining, observing, and naming actions

People with Parkinson's disease (PD) exhibit slowed movements and difficulty in initiating movements. This review addresses the issue of whether or not cognitive representations of actions in PD are affected, alongside these motor problems. In healthy people, the motor system can be involved in tasks such as observing a graspable object or another person's action, or imagining and naming actions, in the absence of overt movement. As described in this review, the fact that the slowed real movements exhibited by PD patients are coupled with slower motor imagery and verb processing provides additional evidence for the involvement of the motor system in these processes. On the other hand, PD patients can still engage in motor imagery and action observation to some extent, which is encouraging for the use of these processes in rehabilitation. Findings across the different domains of action-representation reveal several important factors. First, the nature of action is critical: patients' performance in observation and naming tasks is influenced by whether or not the action is in their repertoire and by the extent of motion required to execute the action. Second, people with PD may use alternative or compensatory mechanisms to represent actions, such as relying more on a third-person perspective or a visual strategy. Third, people with PD show a lack of specificity, responding as strongly to stimuli related and unrelated to actions. Investigating action-representation in PD has implications for our understanding of both the symptoms of PD and the cognitive representation of actions in the healthy system.

Altered perceptual sensitivity to kinematic invariants in Parkinson's disease

Ample evidence exists for coupling between action and perception in neurologically healthy individuals, yet the precise nature of the internal representations shared between these domains remains unclear. One experimentally derived view is that the invariant properties and constraints characterizing movement generation are also manifested during motion perception. One prominent motor invariant is the "two-third power law," describing the strong relation between the kinematics of motion and the geometrical features of the path followed by the hand during planar drawing movements. The two-thirds power law not only characterizes various movement generation tasks but also seems to constrain visual perception of motion. The present study aimed to assess whether motor invariants, such as the two thirds power law also constrain motion perception in patients with Parkinson's disease (PD). Patients with PD and age-matched controls were asked to observe the movement of a light spot rotating on an elliptical path and to modify its velocity until it appeared to move most uniformly. As in previous reports controls tended to choose those movements close to obeying the two-thirds power law as most uniform. Patients with PD displayed a more variable behavior, choosing on average, movements closer but not equal to a constant velocity. Our results thus demonstrate impairments in how the two-thirds power law constrains motion perception in patients with PD, where this relationship between velocity and curvature appears to be preserved but scaled down. Recent hypotheses on the role of the basal ganglia in motor timing may explain these irregularities. Alternatively, these impairments in perception of movement may reflect similar deficits in motor production.

An investigation of co-speech gesture production during action description in Parkinson's disease

INTRODUCTION

Parkinson's disease (PD) can impact enormously on speech communication. One aspect of non-verbal behaviour closely tied to speech is co-speech gesture production. In healthy people, co-speech gestures can add significant meaning and emphasis to speech. There is, however, little research into how this important channel of communication is affected in PD.

METHODS

The present study provides a systematic analysis of co-speech gestures which spontaneously accompany the description of actions in a group of PD patients (N = 23, Hoehn and Yahr Stage III or less) and age-matched healthy controls (N = 22). The analysis considers different co-speech gesture types, using established classification schemes from the field of gesture research. The analysis focuses on the rate of these gestures as well as on their qualitative nature. In doing so, the analysis attempts to overcome several methodological shortcomings of research in this area.

RESULTS

Contrary to expectation, gesture rate was not significantly affected in our patient group, with relatively mild PD. This indicates that co-speech gestures could compensate for speech problems. However, while gesture rate seems unaffected, the qualitative precision of gestures representing actions was significantly reduced.

CONCLUSIONS

This study demonstrates the feasibility of carrying out fine-grained, detailed analyses of gestures in PD and offers insights into an as yet neglected facet of communication in patients with PD. Based on the present findings, an important next step is the closer investigation of the qualitative changes in gesture (including different communicative situations) and an analysis of the heterogeneity in co-speech gesture production in PD.

Exploring visuomotor priming following biological and non-biological stimuli

Observation of human actions influences the observer's own motor system, termed visuomotor priming, and is believed to be caused by automatic activation of mirror neurons. Evidence suggests that priming effects are larger for biological (human) as opposed to non-biological (object) stimuli and enhanced when viewing stimuli in mirror compared to anatomical orientation. However, there is conflicting evidence concerning the extent of differences between biological and non-biological stimuli, which may be due to stimulus related confounds. Over three experiments, we compared how visuomotor priming for biological and non-biological stimuli was affected over views, over time and when attention to the moving stimulus was manipulated. The results indicated that the strength of priming for the two stimulus types was dependent on attentional location and load. This highlights that visuomotor priming is not an automatic process and provides a possible explanation for conflicting evidence regarding the differential effects of biological and non-biological stimuli.

Tracking the time course of action priming on object recognition: evidence for fast and slow influences of action on perception

Perception and action are classically thought to be supported by functionally and neuroanatomically distinct mechanisms. However, recent behavioral studies using an action priming paradigm challenged this view and showed that action representations can facilitate object recognition. This study determined whether action representations influence object recognition during early visual processing stages, that is, within the first 150 msec. To this end, the time course of brain activation underlying such action priming effects was examined by recording ERPs. Subjects were sequentially presented with two manipulable objects (e.g., tools), which had to be named. In the congruent condition, both objects afforded similar actions, whereas dissimilar actions were afforded in the incongruent condition. In order to test the influence of the prime modality on action priming, the first object (prime) was presented either as picture or as word. We found an ERP effect of action priming over the central scalp as early as 100 msec after target onset for pictorial, but not for verbal primes. A later action priming effect on the N400 ERP component known to index semantic integration processes was obtained for both picture and word primes. The early effect was generated in a fronto-parietal motor network, whereas the late effect reflected activity in anterior temporal areas. The present results indicate that action priming influences object recognition through both fast and slow pathways: Action priming affects rapid visuomotor processes only when elicited by pictorial prime stimuli. However, it also modulates comparably slow conceptual integration processes independent of the prime modality.

Insights into the neural control of locomotion from walking through doorways in Parkinson's disease

Recent evidence suggests that a network of brain areas may be involved in visually guided walking. Here we study patients with Parkinson's disease (PD) who experience 'freezing' behaviour to investigate the visual control of locomotion and the role of the basal ganglia in this system. We use a variable-width doorway to measure the scaling of motor output to visual input specifying door width. By measuring walking behaviour as participants passed through the doorway, we show that both PD and healthy control participants scaled their locomotor outputs to door width. Both groups reacted to narrower doors by walking more slowly with shorter strides. However, the changes were greater in the PD group, where walking speed dramatically decreased while approaching the doorway. Such a pattern could help explain why doorways cause freezing episodes in PD. Neither explicit perceptual judgements of door width, nor performance on motor tasks, predicted the door behaviour. On the basis of these findings, we propose that PD is associated with a visuomotor disturbance, such that responses to action-relevant visual information are exaggerated. In the PD group, dopaminergic medications improved many baseline gait variables but did not affect their sensitivity to door width, suggesting that this visuomotor effect is not mediated by the basal ganglia. This hypothesis provides a novel framework for interpreting a variety of results with PD patients.