SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Motivational modulation of bradykinesia in Parkinson's disease off and on dopaminergic medication.

Kojovic, M; Mir, P; Trender-Gerhard, I; Schneider, SA; Pareés, I; Edwards, MJ; Bhatia, KP; Jahanshahi, M (2014) Motivational modulation of bradykinesia in Parkinson's disease off and on dopaminergic medication. J Neurol, 261 (6). pp. 1080-1089. ISSN 1432-1459 https://doi.org/10.1007/s00415-014-7315-x
SGUL Authors: Edwards, Mark John James

[img]
Preview
PDF Published Version
Available under License Creative Commons Attribution.

Download (479kB) | Preview

Abstract

Motivational influence on bradykinesia in Parkinson's disease may be observed in situations of emotional and physical stress, a phenomenon known as paradoxical kinesis. However, little is known about motivational modulation of movement speed beyond these extreme circumstances. In particular, it is not known if motivational factors affect movement speed by improving movement preparation/initiation or execution (or both) and how this effect relates to the patients' medication state. In the present study, we tested if provision of motivational incentive through monetary reward would speed-up movement initiation and/or execution in Parkinson's disease patients and if this effect depended on dopaminergic medication. We studied the effect of monetary incentive on simple reaction time in 11 Parkinson's disease patients both "off" and "on" dopaminergic medication and in 11 healthy participants. The simple reaction time task was performed across unrewarded and rewarded blocks. The initiation time and movement time were quantified separately. Anticipation errors and long responses were also recorded. The prospect of reward improved initiation times in Parkinson's disease patients both "off" and "on" dopaminergic medication, to a similar extent as in healthy participants. However, for "off" medication, this improvement was associated with increased frequency of anticipation errors, which were eliminated by dopamine replacement. Dopamine replacement had an additional, albeit small effect, on reward-related improvement of movement execution. Motivational strategies are helpful in overcoming bradykinesia in Parkinson's disease. Motivational factors may have a greater effect on bradykinesia when patients are "on" medication, as dopamine appears to be required for overcoming speed-accuracy trade-off and for improvement of movement execution. Thus, medication status should be an important consideration in movement rehabilitation programmes for patients with Parkinson's disease.

Item Type: Article
Additional Information: © The Author(s) 2014 Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
Keywords: Aged, Case-Control Studies, Dopamine Agents, Female, Humans, Hypokinesia, Male, Middle Aged, Motivation, Parkinson Disease, Reaction Time, Time Factors, Humans, Parkinson Disease, Hypokinesia, Dopamine Agents, Case-Control Studies, Motivation, Reaction Time, Time Factors, Aged, Middle Aged, Female, Male, Parkinson's disease, Bradykinesia, Motivation, Reward, Reaction time, Neurology & Neurosurgery, 1103 Clinical Sciences, 1109 Neurosciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Neuroscience (INCCNS)
Journal or Publication Title: J Neurol
ISSN: 1432-1459
Language: eng
Dates:
DateEvent
June 2014Published
1 April 2014Published Online
12 March 2014Accepted
Publisher License: Creative Commons: Attribution 4.0
PubMed ID: 24687892
Web of Science ID: WOS:000337750700004
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109513
Publisher's version: https://doi.org/10.1007/s00415-014-7315-x

Actions (login required)

Edit Item Edit Item