Performance of a bimanual load-lifting task by parkinsonian patients.

Normal subjects and Parkinsonian patients performed a bimanual load lifting task. In this task, one "postural" forearm, held in a horizontal position while supporting a 1 kg weight, was unloaded either by the experimenter's hand (imposed unloading) or by the subject's other hand in response to a tone burst (voluntary unloading). The variables recorded were reaction time (RT: time interval between the tone and beginning of unloading) and movement time (MT: duration of the change in force measured by a force platform on the "postural" forearm). Elbow angle changes were also measured with a potentiometer. The EMG activity from brachioradialis of the "postural" arm and that from the biceps of the "active" arm were recorded. The Parkinsonian patients showed an increase in both RT and MT and an impairment of the co-ordination between movement and posture which was reflected in an increase in amplitude of the elbow rotation after voluntary unloading. Moreover, the decrease in EMG activity in the brachioradialis of the postural arm during unloading was less in Parkinsonian patients than in the normal group. This disorder of postural command was often accompanied by a lack of anticipatory EMG changes. Comparison between treated and non-treated patients showed that dopamine agonists brought about recovery of both RT and MT but did not improve postural co-ordination. The co-ordination was less impaired when the voluntary unloading was performed by the preferred hand. Several hypotheses are discussed concerning the mechanism underlying this impaired co-ordination.