Bereitschaftspotential and movement-related potentials: origin, significance, and application in disorders of human movement.

The existence of a slow negative wave, the Bereitschaftspotential ("BP"), preceding voluntary movement by 1 second or more was first reported more than 40 years ago. There appears to be considerable interindividual differences, but there is general agreement that the initial negativity actually consists of two distinct phases. Uncertainty remains about many other properties and features of the response, including nomenclature, which makes the existing literature difficult to synthesize. The duration of the premovement negativity raises questions about how and when voluntary movement is initiated. Premovement negativities can also be seen before (predictably) externally paced movement, and these have similarities to the BP. Although lateralized generators exist, it is likely that the majority of the early component of the BP (BP1 or early BP), arises from the anterior supplementary motor area (SMA) and more rostral pre-SMA. The late phase of the BP (BP2 or late BP) is probably generated by activity in both the SMA proper and the contralateral motor cortex. Changes in the BP occur in several movement disorders, notably Parkinson's disease, in which the pattern is consistent with a failure of pre-SMA activation. The presence (or absence) of a clear preceding negativity can also have diagnostic importance for certain movement disorders.