Sensory attenuation is related to dopamine dose in Parkinson’s disease

Abnormal initiation and control of voluntary movements are among the principal manifestations of Parkinsons disease (PD). However, the processes underlying these abnormalities and their potential remediation by dopamine treatment remain poorly understood. Normally, movements depend on the integration of sensory information with the predicted consequences of action. This integration leads to a suppression in the intensity of predicted sensations, and increases the relative salience of unexpected stimuli to facilitate the control of movements. We examined this integration process and its relation to dopamine in PD, by measuring sensorimotor attenuation - the reduction in the perceived intensity of predicted sensations from self-generated versus external actions. Patients with idiopathic PD (n=18) and population-derived controls (n=175) matched a set of target forces applied to their left index finger by a torque motor. To match the force, participants either pressed with their right index finger ( Direct condition) or used a linear potentiometer that controlled a motor ( Slider condition). We found that despite changes in sensitivity to different forces, overall sensory attenuation did not differ between medicated PD patients and controls. Importantly, the degree of attenuation was negatively related to PD motor severity but positively related to individual patient dopamine dose, as measured by levodopa dose equivalency. The results suggest that dopamine could regulate the integration of sensorimotor prediction with sensory information to facilitate the control of voluntary movements.