Movement cueing and motor execution in patients with dystonia: A kinematic study

Antonio Currá, Alfredo Berardelli, Rocco Agostino, Morena Giovannelli, Giacomo Koch, Mario Manfredi

Research output: Contribution to journalArticle

Abstract

To investigate whether the type of movement cueing influences motor performance in patients with dystonia, we studied externally triggered (ET) and self-initiated (SI) sequential rapid arm movements in patients with generalized or focal dystonia and healthy control subjects. The ET task required subjects to initiate movements in response to consecutive visual cues; the SI task allowed them to start at will. To determine whether patients found sequential motor tasks more difficult than single tasks, we also analyzed single ET movements. Control subjects performed the SI task significantly faster than the ET task. Their single ET movements and first ET sequential submovements had similar speeds. Patients with generalized dystonia were slow in performing the single movement, the ET and the SI sequential tasks, and they executed the SI sequence more slowly than the ET. They made long pauses between SI sequential submovements, had longer reaction times during the ET sequences, and performed the first ET submovement more slowly than the single ET movement. Patients with focal dystonia had normal reaction times but they performed single and sequential tasks slowly, made long pauses during SI tasks, and also executed the first ET submovement more slowly than the single ET movement. Our findings indicate that patients with dystonia have a general impairment of sequential movements. The more marked slowness in executing SI than ET movements observed in patients with generalized dystonia shows that dystonia impairs internal cueing more than external cueing mechanisms. Overall, these findings imply abnormal activation of primary and nonprimary motor areas during movement in dystonia. The greater impairment of SI tasks as well as the delayed motor responses during ET task suggest predominant underactivity of the supplementary motor area.

Original languageEnglish
Pages (from-to)103-112
Number of pages10
JournalMovement Disorders
Volume15
Issue number1
DOIs
Publication statusPublished - 2000

Keywords

  • Dystonia
  • External cueing
  • Internal cueing
  • Motor sequences

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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