Brain, Vol. 119, No. 2, 661-674, 1996
© 1996 Oxford University Press
review-article |
Single–joint rapid arm movements in normal subjects and in patients with motor disorders
1Department of Neurological Sciences, University ‘La Sapienza’ Rome, Italy 2National Institute of Health, Bethesda, USA 3Department of Neurology, the National Hospital for Neurology and Neurosurgery London, UK 4The University Department of Medicine Adelaide, Australia
Correspondence to:
Correspondence to: A. Berardelli, MD, Dipartimento Scienze Neurologiche, Wale Universitá30, Universitd ‘La Sapienza’, 00185 Roma, Italia
In normal subjects the execution of single rapid one-joint movements is characterized by an electromyo graphic (EMG) pattern composed of three discrete bursts of activity: two bursts (first and second agonist bursts, or AG1 and AG2) are present in the agonist muscle separated by an almost complete period of electrical silence. During this pause, another burst (antagonist burst, or ANT) occurs in the antagonist muscle. If a rapid movement is executed during tonic activation of the agonist muscle, tonic activity is inhibited just prior to AGI onset (agonist inhibition). Similarly, if the movement is performed during tonic activation of the antagonist muscle, such activity is also inhibited prior to AGI onset (antagonist inhibition). Antagonist inhibition also starts prior to AGI onset and lasts until ANT onset. A general descriptor of the kinematic features related to the EMG pattern described above is a symmetrical and unimodal velocity profile that is bell-shaped and shows an acceleration time roughly equal to the deceleration time. This holds true for movements performed under low accuracy constraints; as accuracy demands become stricter and stricter, the peak velocity decreases but, as long as the movement is made with one continuous trajectory, the velocity profile remains roughly symmetrical. In general terms, the function of AGI is to provide the impulsive force to start the movement; the function of ANT is to halt the movement at the desired end-point; and the function of AG2 is to dampen out the oscillations which might occur at the end of the movement. The timing and size of the bursts vary according to the speed and amplitude of the movement. The origin of the EMG pattern is a central programme, but afferent inputs can modulate the voluntary activity. In this paper, we also review the EMG and kinematic abnormalities that are present during the execution of single-joint, rapid arm movements in patients with Parkinson’s disease, Huntington’s disease, Sydenham’s chorea, dystonia, athetosis, cerebellar deficits, upper motor neuron syndrome, essential tremor and large-fibre sensory neuropathy. The data from these studies lead us to the following conclusions: (i) the basal ganglia have a role in scaling the size of AG1, reinforcing the voluntary command and inhibiting inappropriate EMG activity; (ii) the cerebellum has a role in timing the voluntary bursts and probably in implementing muscle force phasically; (iii) the corticospinal tract has a role in determining spatial and temporal recruitment of motor units; (iv) proprioceptive feedback is not necessary to produce the triphasic pattern but it contributes to the accuracy of both the trajectory and the end-point of rapid movements.
rapid movements; arm; normal subjects; motor disorders
Received July 5, 1995. Revised October 25, 1995. Accepted November 15, 1995.
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