VA Northern California Health Care System, Martinez, CA, USA.
J Parkinsons Dis. 2013;3(2):181-92. doi: 10.3233/JPD-130181.
Parkinson's disease (PD), traditionally considered a movement disorder, has been shown to affect executive function such as the ability to adapt behavior in response to new environmental situations.
to identify the impact of PD on neural substrates subserving two specific components of normal movement which we refer to as activation (initiating an un-cued response) and inhibition (suppressing a cued response).
We used fMRI to measure pre-movement processes associated with activating an un-cued response and inhibiting a cued response plan in 13 PD (ON anti-parkinsonian medications) and 13 control subjects. Subjects were shown a visual arrow cue followed by a matched or mismatched response target that instructed them to respond with a right, left, or bilateral button press. In mismatched trials, an un-cued (new) response was initiated, or the previously cued response was suppressed.
We were able to isolate pre-movement responses in dorsolateral prefrontal cortex, specifically in the right hemisphere. During the activation of an un-cued movement, PD subjects showed decreased activity in the putamen and increased cortical activity in bilateral DLPFC, SMA, subcentral gyrus and inferior frontal operculum. During inhibition of a previously cued movement, the PD group showed increased activation in SMA, S1/M1, premotor and superior parietal areas.
Right DLPFC plays a role in pre-movement processes, and DLPFC activity is abnormal in PD. Decreased specificity of responses was observed in multiple ROI's. The basal ganglia are involved in circuits that coordinate activation and inhibition involved in action selection as well as execution.
帕金森病（PD），传统上被认为是一种运动障碍，已经被证明会影响执行功能，例如根据新的环境情况调整行为的能力。
确定 PD 对正常运动两个特定成分的神经基础的影响，我们称之为激活（发起无提示反应）和抑制（抑制提示反应计划）。
我们使用 fMRI 来测量与激活无提示反应和抑制提示反应计划相关的运动前过程，这些过程涉及 13 名 PD（ON 抗帕金森病药物）和 13 名对照受试者。受试者会看到一个视觉箭头提示，然后是一个匹配或不匹配的反应目标，指示他们用右手、左手或双手按钮做出反应。在不匹配的试验中，会发起无提示（新的）反应，或抑制先前提示的反应。
我们能够在背外侧前额叶皮层（DLPFC）中分离出运动前反应，特别是在右半球。在激活无提示运动时，PD 受试者的壳核活动减少，双侧 DLPFC、SMA、中央下回和额下回运动前区的皮质活动增加。在抑制先前提示的运动时，PD 组的 SMA、S1/M1、运动前区和上顶叶区的激活增加。
右 DLPFC 在运动前过程中起作用，PD 中的 DLPFC 活动异常。在多个 ROI 中观察到反应的特异性降低。基底神经节参与协调激活和抑制的回路，这些回路涉及动作选择和执行。
