Parkinson's Disease affects the contextual control, but not the expression, of a rapid visuomotor response that initiates visually-guided reaching: Evidence for multiple, interacting motor pathways and implications for motor symptoms in Parkinson's Disease

Abstract

Despite significant deficits in voluntary motor control, patients with Parkinsons disease (PD) can generate reflexive or stimulus-driven movements. How are such spared capabilities realized? Here, we recorded upper limb muscle activity in patients with PD and age-matched healthy controls (HCs) as they reached either toward or away from a visual stimulus. The task promoted express visuomotor responses (EVRs), which are brief bursts of muscle recruitment time-locked (<100 ms) to stimulus presentation that are thought to originate from the midbrain superior colliculus. Across two experiments, we observed a remarkable sparing of the latency and magnitude of EVRs in patients with PD, but a decreased ability for patients with PD to contextually modulate the EVR depending on trial instruction. EVR Magnitudes were strikingly strongly correlated with PD Reaction times and Error rates, despite compromised levels of electromyographic (EMG) recruitment in subsequent phases of muscle activity, which predicted lower Peak velocities. Our results are consistent with a differential influence of PD on parallel-but-interacting subcortical and cortical pathways that converge onto brainstem and spinal circuits during reaching. This differential influence is discriminable even within a single trial in the selective sparing of stimulus-aligned but not movement-aligned muscle recruitment, and has implications for our understanding of the motor and cognitive deficits seen in PD.