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R Cunnington

Publications and source records attributed to R Cunnington.

25 records · Page 2Linked to original sources

Impairments of movement kinematics in patients with Huntington's disease: a comparison with and without a concurrent task.

This study aimed to quantify the efficiency and smoothness of voluntary movement in Huntington's disease (HD) by the use of a graphics tablet that permits analysis of movements profiles. In particular, we aimed to ascertain whether a concurrent task (digit span) would affect the kinematics of goal-directed movements. Twelve patients with HD and their matched controls performed 12 vertical zig-zag movements, with both left and right hands (with and without the concurrent task), to large or small circular targets over long or short extents. The concurrent task was associated with shorter movement times and reduced right-hand superiority. Patients with HD were overall slower, especially, with long strokes, and had similar peak velocities for both small and large targets, so that controls could better accommodate differences in target size. Patients with HD spent more time decelerating, especially with small targets, whereas controls allocated more nearly equal proportions of time to the acceleration and deceleration phases of movement, especially with large targets. Short strokes were generally less force inefficient than were long strokes, especially so for either hand in either group in the absence of the concurrent task, and for the right hand is its presence. With the concurrent task, however, the left hand's behavior changed differentially for the two groups; for patients with HD, it became more force efficient with short strokes and even less efficient with long strokes, whereas for controls, it became more efficient with long strokes. Controls may be able to divert attention away from the inferior left hand, increasing its automaticity, whereas patients with HD, because of disease, may be forced to engage even further online visual control under the demands of a concurrent task. Patients with HD may perhaps become increasingly reliant on terminal visual guidance, which indicates an impairment in constructing and refining an internal representation of the movement necessary for its effective execution. Basal ganglia dysfunction may impair the ability to use internally generated cues to guide movement.

Adrenergic Uptake Inhibitors↗

Movement-related potentials in Parkinson's disease. Motor imagery and movement preparation.

Movement-related potentials (MRPs) associated with voluntary movements reflect cortical activity associated with processes of movement preparation and movement execution. Early-stage pre-movement activity is reduced in amplitude in Parkinson's disease. However, it is unclear whether this neurophysiological deficit relates to preparatory or execution-related activity, since previous studies have not been able to separate different functional components of MRPs. Motor imagery is thought to involve mainly processes of movement preparation, with reduced involvement of end-stage movement execution-related processes. Therefore, MRP components relating to movement preparation and execution may be examined separately by comparing MRPs associated with imagined and actual movements. In this study, MRPs were recorded from 14 subjects with Parkinson's disease and 10 age-matched control subjects while they performed a sequential button-pressing task, and while they imagined performance of the same task. Early-stage pre-movement activity was present in both Parkinson's disease patients and control subjects when they imagined movement, but was reduced in amplitude compared with that for actual movement. Movement execution-related components, arising predominantly from the primary motor cortex, were relatively unaffected in Parkinson's disease subjects. However, motor preparatory processes, probably involving the supplementary motor area, were reduced in amplitude overall and abnormally prolonged, indicating impaired termination following the motor response. Further, this impaired termination of preparatory-phase activity was observed only in patients with more severe parkinsonian symptoms, and not in early-stage Parkinson's disease.

Aged↗

Functional asymmetries in the movement kinematics of patients with Tourette's syndrome.

OBJECTIVES: This study adopted a concurrent task design and aimed to quantify the efficiency and smoothness of voluntary movement in Tourette's syndrome via the use of a graphics tablet which permits analysis of movement profiles. In particular, the aim was to ascertain whether a concurrent task (digit span) would affect the kinematics of goal directed movements, and whether patients with Tourette's syndrome would exhibit abnormal functional asymmetries compared with their matched controls. METHODS: Twelve patients with Tourette's syndrome and their matched controls performed 12 vertical zig zag movements, with both left and right hands (with and without the concurrent task), to large or small targets over long or short extents. RESULTS: With short strokes, controls showed the predicted right hand superiority in movement time more strongly than patients with Tourette's syndrome, who instead showed greater hand symmetry with short strokes. The right hand of controls was less force efficient with long strokes and more force efficient with short strokes, whereas either hand of patients with Tourette's syndrome was equally force efficient, irrespective of stroke length, with an overall performance profile similar to but better than that of the controls' left hand. The concurrent task, however, increased the force efficiency of the right hand in patients with Tourette's syndrome and the left hand in controls. CONCLUSIONS: Patients with Tourette's syndrome, compared with controls, were not impaired in the performance of fast, goal directed movements such as aiming at targets; they performed in certain respects better than controls. The findings clearly add to the growing literature on anomalous lateralisation in Tourette's syndrome, which may be explained by the recently reported loss of normal basal ganglia asymmetries in that disorder.

Adult↗

Movement-related potentials associated with movement preparation and motor imagery.

Movement-related potentials (MRPs), reflecting cortical activity associated with voluntary movement, typically show a slowly increasing negative potential beginning between 1 and 2 s prior to movement, which most likely reflects motor preparatory processes. Studies of regional cerebral blood flow implicate the supplementary motor area in such preparatory processes; however, the contribution of the supplementary motor area to premovement activity observed in MRPs is debated. It is possible to examine MRPs relating to movement preparation alone, in the absence of movement execution, by recording MRPs associated with imagined movements. In this study, MRPs were recorded from 11 healthy control subjects while performing a sequential button-pressing task in response to external cues, and while imaging performance of the same task in response to the same cues. The early component of MRPs was found not to differ in amplitude, onset time, or topography when performing compared with imagining movement, indicating that both movement execution and motor imagery involve similar pre-movement preparatory processes generated in the same cortical area-most likely the supplementary motor area. It is therefore concluded that the early component of the MRP reflects activity arising pre-dominantly from the supplementary motor area and is associated with pre-movement motor preparatory processes which occur relatively independently of actual movement execution.

Adult↗

Effects of magnetic stimulation over supplementary motor area on movement in Parkinson's disease.

Movement execution can be delayed by transcranial magnetic stimulation delivered over primary motor cortical areas, resulting in transient inhibition of cortico-motor output. Inhibition or disruption of higher-order motor planning and preparatory processes, such as are thought to occur in the supplementary motor area (SMA), would allow an examination of processes at other stages of the motor control system. In this study, six subjects with Parkinson's disease and six healthy control subjects performed a non-cued sequential finger movement task. At various times relative to movement, high-intensity single-pulse magnetic stimulation was delivered over the region of the SMA, with minimal current spread to primary motor areas. When magnetic stimulation was given at early stages during the movement for parkinsonian subjects, movement times were significantly increased, indicating disrupted movements. Supplementary motor area stimulation had no effect when delivered during later stages of the movement or immediately prior to movement onset, and had no apparent effect on control subjects at any time. It is therefore suggested that the SMA is important in motor planning and preparatory processes, since SMA stimulation has no effect on movements in their later stages when planning may be complete, but may disrupt movements in their early stages, when preparation for later stages may still be in progress. Further, possible instability of motor planning/preparation processes in Parkinson's disease is suggested, since these processes appeared more susceptible to disruption by magnetic stimulation in parkinsonian subjects than controls.

Aged↗

Movement-related potentials in Parkinson's disease. Presence and predictability of temporal and spatial cues.

Activity of the supplementary motor area may be inferred from movement-related potentials (MRPs) which are associated with the preparation and execution of voluntary, or internally determined movements. Supplementary motor area activity may be abnormal in Parkinson's disease since its major input from the basal ganglia is disrupted. Investigation of the abnormalities in supplementary motor area activity associated with movement deficits in Parkinson's disease may therefore reveal functions of the basal ganglia and the supplementary motor area. Movement-related potentials associated with sequential movements were investigated under various cueing conditions in Parkinson's disease subjects and age-matched controls. In controls, MRPs revealed involvement of the supplementary motor area in movements which can be internally determined (non-cued and externally cued, predictable movements, but not unpredictable movements). In Parkinson's disease, however, the supplementary motor area was only involved in movements which must be internally determined (non-cued movements, but not externally cued movements); therefore impaired internal control mechanisms, operating via the supplementary motor area, are bypassed when external cues are given. As a result, Parkinson's disease patients are more reliant on external cues and are unable to use predictive models to internally guide movement. Supplementary motor area involvement also relied on the predictability (in controls) or presence (in Parkinson's disease) of timing cues and not spatial cues, indicating a role of the supplementary motor area and basal ganglia in the temporal organizations of sequential movement rather than the programming of specific movements. For non-cued movements, abnormalities in MRPs for Parkinson's disease subjects consisted of delayed MRP onset and peak times, and prolonged cortical activity following movement. These observations led to a proposed model of the interaction between the basal ganglia and the supplementary motor area, involving the temporal organization of voluntary and internally determined sequential movements.

Aged↗