Event-related desynchronization and Parkinson disease. Importance in the analysis of the phase of preparation for movement]

This study was aimed at determining the spatiotemporal distribution of event-related desynchronization (ERD) during self-paced voluntary movement in order to establish the interest of this method for the analysis of movement programming in Parkinson's disease. Desynchronization of mu rhythm was recorded 2 s before to 0.5 s after right then left self-paced voluntary wrist flexions from 11 leads covering the primary sensorimotor cortex (central), supplementary motor area (frontocentral) and parietal cortex (parietocentral). Recordings were obtained from ten control subjects, ten patients treated for Parkinson's disease (bilateral symptoms) and 20 patients presenting with right or left hemiparkinsonism before and after chronic administration of L-dopa. In the control group, ERD started over the contralateral primary sensorimotor cortex 1,750 ms before movement and was bilateral just before performance of the movement. In both treated and de novo Parkinson's disease groups, decrease in ERD latency (1,000 to 1,250 ms before movement) was only observed when movements were performed with the akinetic hand and corresponded to a decrease in motor cortical activity. This confirmed that programming of movement is affected in Parkinson's disease. Earlier ERD with central ipsilateral distribution were also observed, suggesting that other cortical areas might be activated to compensate for dysfunction of movement programming and to increase the level of cortical activity required for performance of the movement. The administration of L-dopa to de novo hemiparkinsonians patients resulted in increased ERD latency over contralateral and ipsilateral central areas. As in the treated Parkinson's disease group, frontocentral ERD could also be recorded. L-dopa would thus partially restore the affected motor programmation and modulate cortical activation in both supplementary motor area and primary motor cortex, the later receiving more afferences from basal ganglia.     

Movement related desynchronisation pattern preceding voluntary movement in untreated Parkinson''s disease.

OBJECTIVE--To study planning of movement in Parkinson's disease. METHODS--The spatiotemporal pattern of movement related desynchronisation (MRD) preceding a self paced voluntary wrist flexion was compared between two groups of 10 untreated right and left hemiparkinsonian patients receiving no treatment and 10 control subjects. The MRD was computed in the 9 to 11 Hz frequency band from 11 source derivations covering the frontocentral, central, and parietocentral areas, during two successive left and right experimental conditions. RESULTS--In the two patient groups the desynchronisation appeared over the primary sensorimotor area contralateral to the affected side with a shorter latency (750 ms before movement onset for the right hemiparkinsonian group and 875 ms for the left hemiparkinsonian group) than in the control group (1750 ms), only when the movements were performed with the akinetic hand. For the non-affected hand, the same latency as in the control group was noted (1750 ms). CONCLUSION--The delay of appearance of MRD in Parkinson's disease confirmed that the programming of movement is affected, thus partially explaining akinesia.     

Event-related desynchronization and synchronization. Reactivity of electrocortical rhythms in relation to the planning and execution of voluntary movement]

Cortical electroencephalographic rhythms reactivity may be quantified using event-related desynchronization (ERD) and synchronization (ERS) methods. We therefore studied cortical activation occurring during programming and performance of voluntary movement in healthy subjects. EEG power evolution within the reactive frequency bands (mu and beta central rhythms) was averaged before, during and after a minimum of 50 self-paced flexions of the thumb. Recordings in 18 normal adults showed that ERD (decrease in power) of mu rhythm started 2,000 ms before movement onset, while ERD of beta rhythm started 1,500 ms before movement onset. Early ERD of mu and beta rhythms were located over the contralateral central region covering primary motor cortex. They were followed by bilateral ERD occurring over ipsilateral and contralateral central regions during performance of the movement. At the end of the movement, an ERS (increase in power) of beta rhythm occurred. These results suggest that programming of voluntary movement induces early activation in contralateral sensorimotor areas, while performance of the movement induces bilateral activation in sensorimotor areas. ERS of beta rhythm occurring at the end of the movement could correspond to inactivation of motor areas activated by movement. Based on EEG activity, ERD and ERS prove to be useful methods to analyze cortical activation during programming and performance of voluntary movements with good spatial and temporal resolution.     

Abnormal Cortical Activation During Planning of Voluntary Movement in Patients with Epilepsy with Focal Motor Seizures: Event-Related Desynchronization Study of Electroencephalographic mu Rhythm

Summary: Purpose: The spatiotemporal distribution of EEG mu rhythm desynchronization was analyzed in patients with partial epilepsy to determine whether frequent focal motor seizures could induce a change of cortical activation during the planning of a voluntary movement.
Methods: The event-related desynchronization (ERD) of the mu rhythm was quantified during a self-paced voluntary movement of the thumb. The results were compared betyeen two groups of patients with epilepsy: in one group (n = 12), the patients had frontal lobe epilepsy with frequent focal motor seizures (FMS); in the second group (n = 12), they had temporal lobe epilepsy (TLE) with complex partial seizures but no ictal movement disorder. The results were also compared with those of control subjects of same age (n = 10).
Results: In the control group, desynchronization of murhythm began over the contralateral central region 2,000 ms before the movement onset. In the FMS group, the desynchronization of mu rhythm was delayed, appearing only 500 ms before the movement onset, and the amplitude of ERD was increased over the frontocentral region. In the TLE group, the spatiotemporal pattern of ERD was the same as in normal subjects, but the amplitude of ERD was increased.
Conclusions: These results indicate that there is a change of reactivity of mu rhythm in patients with partial epilepsy. The change in spatiotemporal pattern of ERD in patients with frequent focal motor seizures suggests that there is an abnormal cortical activation during the planning of a voluntary movement.     

Movement preparation is affected by tissue damage in multiple sclerosis: evidence from EEG event-related desynchronization.

OBJECTIVE: To investigate the impact of brain tissue damage in Multiple Sclerosis (MS) on the efficiency of programming of voluntary movement, assessed using event-related desynchronization of the EEG. METHODS: The onset latency of mu ERD (percent desyncronization of the mu rhythm preceding movement onset) to hand movement was studied in 34 MS patients. ERD onset was compared with normative data and correlated with T1 and T2 total lesion volume (TLV) at magnetic resonance imaging (MRI). RESULTS: ERD onset latency was significantly correlated with T1-TLV (r = 0.53, P = 0.001) and T2 lesion load (r = 0.5, P = 0.003), even after correcting for disability. Patients with higher T1-TLV had significantly delayed ERD onset compared with normal subjects and with patients with lower T1-TLV; patients with higher T2-TLV had significantly delayed ERD compared with normal subjects only. ERD onset latency was not correlated to clinical disability. CONCLUSIONS: Our finding of delayed ERD onset in patients with more severe measures of brain damage, independently from clinical disability, suggests that functional cortico-cortical and cortico-subcortical connections underlying the expression of ERD during programming of voluntary movement are disrupted by the MS related pathological process. Further, studies are needed to evaluate the role of specific anatomical cortico-subcortical circuits in determining this abnormality. SIGNIFICANCE: The extent of brain lesion load in multiple sclerosis affects cortical changes related to motor preparation, detected by analysis of onset latency of event-related desynchronization (ERD) of the mu rhythm to self-paced movement.     

Oscillatory cortical activity related to voluntary muscle relaxation: influence of normal aging.

OBJECTIVE: In this study we aimed to investigate if there are age-related differences in cortical oscillatory activity induced by self-paced muscular pure relaxation in comparison with muscle contraction as reference movement. METHODS: Event-related (de)synchronization (ERD/ERS) have been recorded related to voluntary muscle contraction and relaxation in 10 young and 10 elderly right-handed healthy subjects. The muscle relaxation task consisted in a voluntary relaxation of maintained wrist extension without any overt, associated muscle contraction. The muscle contraction task corresponded to a self-initiated brief wrist extension. RESULTS: In elderly subjects compared to young ones, mu and beta ERD preceding muscular relaxation was more widespread, beginning significantly earlier over contralateral frontocentral and parietocentral regions (p<0.05) as well as over ipsilateral regions (p<0.05). The beta synchronization was significantly attenuated (p<0.05). CONCLUSIONS: These results suggest an alteration of inhibitory motor systems and an altered post-movement somesthetic inputs processing with normal aging. These alterations were accompanied by compensatory mechanisms. SIGNIFICANCE: These age-related alterations during different phases of muscle relaxation could participate to explain global sensorimotor slowing observed with normal aging.     

Levodopa-induced modulation of subthalamic beta oscillations during self-paced movements in patients with Parkinson's disease

Excessive synchronization of neural activity in the beta frequency band ( approximately 20 Hz) within basal ganglia circuits might contribute to the paucity and slowness of movement in Parkinson's disease (PD). Treatment with dopaminergic drugs reduces the background level of beta frequency band synchronization in the subthalamic nucleus (STN), but has not been shown to increase the proportion of beta activity that is suppressed before voluntary movement in PD. We assessed changes in the event-related desynchronization (ERD) in the beta frequency band of local field potential signals from the region of the STN in 14 patients with PD as they performed self-paced movements of a joystick before and after levodopa administration. The dopamine precursor, levodopa, increased the duration and magnitude of the premovement beta ERD, but did not alter postmovement synchronization in the beta band. Both the latency and magnitude of the beta ERD inversely correlated with the degree of motor impairment. These findings suggest that the beta ERD recorded in the STN area reflects motor-preparative processes that are at least partly dependent on dopaminergic activity within the basal ganglia.     

Patterns of cortical activation during planning of voluntary movement

The influence of planning of self-paced voluntary finger movements on alpha band components was studied in 6 volunteers. Brain potentials from 29 electrodes, referred to the right ear, were recorded 4 sec before and 2 sec after movement onset. These data were transformed to obtain the laplacian operator, which was done by computing the local average reference. The event-related desynchronization (ERD) of upper alpha components was then calculated in each record at intervals of 250 msec and topographically displayed in the form of serial ERD maps. A first significant ERD (P less than 0.01, sign test) was found 1.75 sec +/- 0.61 before the movement, most prominent over the contralateral sensorimotor area and over midfrontal areas (the latter can probably be interpreted as an activation of the supplementary motor area). From these data we can conclude that the side of movement is predetermined more than 1 sec before movement onset.     

Acute effects of L-dopa on event-related desynchronization in Parkinson's disease

We tested whether dispersible L-dopa has acute effects on event-related desynchronization (ERD) of the mu rhythm in patients with idiopathic Parkinson's disease (IPD). ERD to voluntary movement is delayed in akinetic IPD patients and improves after chronic L-dopa treatment. We evaluated ERD to self-paced finger movement in 14 IPD patients (before and 30–40 min after oral administration of dispersible L-dopa) and in 10 normal subjects. Sensorimotor ERD onset contralateral to movement was significantly delayed in IPD patients compared to normal subjects. This abnormality was no longer significant after L-dopa treatment. We conclude that a single dose of dispersible L-dopa can improve not only motor performance in IPD patients but also the timing of cortical activation of sensorimotor areas during motor programming. Received: 22 November 2001 / Accepted in revised form: 11 June 2002 Correspondence to G. Magnani     

Properties of visual cue responses in primate precentral cortex

Monkeys were trained to perform a visuomotor task involving the alignment of a cursor over a vertical target line on a videomonitor by flexion or extension movements of the wrist. The forelimb area of the contralateral precentral cortex was thoroughly explored during the task. Intracortical microstimulation was employed to classify the forelimb region into wrist flexion--extension and non-wrist flexion--extension populations. Unit recording revealed an initial response to the cue for movement, viz. the appearance of the cursor and target line on the videomonitor, while visual signals not related to the task failed to evoke any response. The mean latency of these visual cue responses was approximately 150 ms. A great majority of the responses (96%) were bidirectional in character, in that they did not correlate with the directional information embedded in the visual cue, nor were they good predictors for the direction or timing of the subsequent movement. They were uniformly distributed in both the wrist and non-wrist regions of the forelimb area; the non-forelimb areas were devoid of the cue response. Further, when the variability of response to the visual cue for the wrist and non-wrist populations was compared, no significant difference was observed. These observations are consistent with an interpretation that the visually triggered cue responses provide a generalized activation over the task-related area of precentral cortex, paving the way for later and more specific activations leading to the execution of the task.     

Evaluation of event-related desynchronization (ERD) preceding and following voluntary self-paced movement.

A method of accurate storage and on-line preprocessing of an EEG signal, preceding and following a trigger signal, elicited by button pressing, is described. The method was used to study the changes occurring in the power of the rhythmic activity within the alpha band in central areas, during voluntary, self-paced movement in 10 normal humans. A short-lasting decrease or phasic event-related desynchronization (ERD) of alpha power, representing mu activity, was observed in all 10 subjects. During the 2 sec period preceding movement the phasic ERD was mostly bilateral, but larger prior to right than to left thumb movement. At onset and during the first second of execution of movement, the phasic ERD was mostly bilateral but predominant in ipsilateral areas. Preceding or during movement, maximum ERD was observed in most cases in central-vertex regions.     

Predictors of falls and fractures in bradykinetic rigid syndromes: a retrospective study

BACKGROUND: Falls and fractures contribute to morbidity and mortality in bradykinetic rigid syndromes. METHODS: The authors performed a retrospective case notes review at the Queen Square Brain Bank for Neurological Disorders and systematically explored the relation between clinical features and falls and fractures in 782 pathologically diagnosed cases (474 with Parkinson's disease (PD); 127 progressive supranuclear palsy (PSP); 91 multiple system atrophy (MSA); 46 dementia with Lewy bodies (DLB); 27 vascular parkinsonism; nine Alzheimer's disease; eight corticobasal degeneration). RESULTS: Falls were recorded in 606 (77.5%) and fractures in 134 (17.1%). In PD, female gender, symmetrical onset, postural instability, and autonomic instability all independently predicted time to first fall. In PD, PSP, and MSA latency to first fall was shortest in those with older age of onset of disease. Median latency from disease onset to first fall was shortest in Richardson's syndrome (12 months), MSA (42), and PSP-parkinsonism (47), and longest in PD (108). In all patients fractures of the hip were more than twice as common as wrist and forearm fractures. Fractures of the skull, ribs, and vertebrae occurred more frequently in PSP than in other diseases. CONCLUSION: Measures to prevent the morbidity associated with falls and fractures in bradykinetic rigid syndromes may be best directed at patients with the risk factors identified in this study.     

Changes in oscillatory cortical activity related to a visuomotor task in young and elderly healthy subjects.

OBJECTIVE: In order to better understand the spatio-temporal interaction of the activated cortical areas when the movement is visuo-guided and to assess the age effect on the spatio-temporal pattern of cortical activity, we have compared a proximo-distal movement with visual-motor control and hand-eye coordination (targeting movement) with a distal and a proximal movement. METHODS: Brain's electrical activity was studied using the analysis of event-related (de)synchronizations (ERD/S) of cortical mu and beta rhythms in 17 subjects, 8 young and 9 elderly subjects. RESULTS: In both populations, we found an earlier and broader mu and beta ERD during the preparation of the targeting movement compared to distal and proximal movements, principally involving the contralateral parietal region. During the execution, a spreading over the parietocentral region during proximal movement and over the parietal region during targeting movement was observed. After the execution of proximal and targeting movements, a wider and higher beta ERS was observed only in the young subjects. In the elderly subjects, our results showed a significant decrease of beta ERS during the targeting task. CONCLUSIONS: These results suggest there was a larger recruitment of cortical areas, involving notably the parietal cortex when the movement is visuo-guided. Moreover, cerebral aging-related changes in the spatio-temporal beta ERS pattern suggests an impaired sensory integration.     

Subthalamic stimulation influences postmovement cortical somatosensory processing in Parkinson's disease

In Parkinson's disease, poor motor performance (resulting primarily from abnormal cortical activation during movement preparation and execution) may also be due to impaired sensorimotor integration and defective cortical activity termination of the ongoing movement, thus delaying preparation of the following one. Reduced movement-related synchronization of the beta rhythm in Parkinson's disease compared to controls has been put forward as evidence for impaired postmovement cortical deactivation. We assessed the effects of subthalamic deep brain stimulation and l-dopa on beta rhythm synchronization over the premotor and primary sensorimotor cortex. Ten advanced patients performed self-paced wrist flexion in four conditions according to the presence or not of stimulation and l-dopa. Compared to without treatment, the motor score improved by approximately 60%; the beta synchronization was present over the contralateral frontocentral region and increased significantly over the contralateral central region under stimulation and under l-dopa, with a maximal effect when both treatments were associated. Our advanced patients displayed very focused and attenuated beta rhythm synchronization which, under stimulation, increased over the contralateral premotor and primary sensorimotor cortex. Stimulation and l-dopa both partly restored postmovement cortical deactivation in advanced Parkinson's disease, although the respective mechanisms probably differ. They may improve bradykinesia and cortical deactivation by reestablishing movement-related somatosensory processing at the end of the movement through the basal ganglia into the cortex.     

Brief and sustained movements: differences in event-related (de)synchronization (ERD/ERS) patterns.

OBJECTIVE: (1) To determine if there are changes in event-related desynchronization/event-related synchronization (ERD/ERS) patterns when the movement is sustained? (2) To determine, from a technical point of view for ERD calculation, if it is possible to take the reference period during muscular activation? METHODS: Eight healthy subjects performed two series of brief and sustained self-paced extensions with their dominant wrist. The end of the sustained movement was externally triggered by the examinator. ERD/ERS was calculated in mu and beta bands from 13 source derivations covering motor areas, computed from 29 scalp electrodes. Movement onset and offset were determined by electromyographic activity (EMG) of wrist extensors. RESULTS: When the movement was sustained, power in the mu and beta bands returned to baseline values within 4-5 s. Movement duration had little effect, if at all, on both pre and post-movement periods. Compared to brief movement, after the onset of the prolonged movement, mu ERD just returned to baseline, without synchronization. In contrast, beta ERS was still present though earlier and much lower. CONCLUSIONS: The reference period for ERD calculation may be taken during muscular activation if its duration is long enough. Beta synchronization may occur despite a non-deactivated motor cortex, suggesting a contribution from afferent somesthetic inputs.     

Basic mechanisms of central rhythms reactivity to preparation and execution of a voluntary movement: a stereoelectroencephalographic study.

OBJECTIVE: To localize the sources of mu, beta and gamma rhythms and to explore the functional significance of their reactivity. METHODS: We used the method of quantification of event-related desynchronization (ERD) and synchronization (ERS) to analyze the reactivity of intracerebral rhythms recorded in stereoelectroencephalography within the sensorimotor areas during the preparation and the execution of a simple self-paced hand movement. We recorded 3 epileptic subjects who were explored before a surgical treatment. RESULTS: An ERD of mu and beta rhythms has been recorded before the movement onset in the precentral gyrus, spreading then to the postcentral gyrus and to the frontal medial cortex. The frontal lateral cortex was inconstantly involved during the movement. The movement offset was followed by an important and focused beta ERS which was found within the pre- and post-central gyrus and the frontal medial cortex. Within the beta band, we observed several narrower bands with different reactivities and locations. Focused gamma reactivity was also found in the precentral and postcentral gyri. CONCLUSIONS: The reactivities of mu and beta rhythms are different but their locations overlap. Mu ERD is a diffuse phenomenon that reflects the activation of all the sensorimotor areas during a simple movement. Beta band is likely to be composed of different rhythms with different functional significance. The primary motor area seems to contain two distinct areas with different reactivity to the movement preparation and execution.     

Motor preparation is more impaired in Parkinson's disease when sensorimotor integration is involved

Objective: This study aimed to investigate changes in spatio-temporal, event-related (de)synchronization (ERD/ERS) patterns recorded with respect to the more akinetic versus the less akinetic side during performance of a visuo-guided targeting movement when compared to an index finger extension.Methods: Twelve de novo parkinsonian patients were recorded. ERD/ERS in mu and beta frequency bands was computed from 21 source derivations.Results: When the index finger extension was performed with the less akinetic limb, mu ERD focused over contralateral central region appeared 2 s before movement. With the targeting movement, additional pre-movement mu ERD was observed over the parietal region, as well as earlier ipsilateral mu ERD. When the same movements were performed with the more akinetic limb, we observed delayed mu ERD over contralateral regions, earlier ipsilateral mu ERD and a lack of contralateral parietal mu ERD before the targeting movement. Following index finger extension for the less akinetic limb, a focused contralateral central beta ERS was recorded, increasing and spreading after the targeting movement. In contrast, for the more akinetic limb, beta ERS was dramatically attenuated and remained unchanged after the targeting movement.Conclusions: These results confirm the fact that motor programming is delayed, and provide some insight into what may well be impaired sensorimotor integration in Parkinson's disease.     

Asymmetric spatiotemporal patterns of event-related desynchronization preceding voluntary sequential finger movements: a high-resolution EEG study.

OBJECTIVE: To study spatiotemporal patterns of event-related desynchronization (ERD) preceding voluntary sequential finger movements performed with dominant right hand and nondominant left hand. METHODS: Nine subjects performed self-paced movements consisting of three key strokes with either hand. Subjects randomized the laterality and timing of movements. Electroencephalogram (EEG) was recorded from 122 channels. Reference-free EEG power measurements in the beta band were calculated off-line. RESULTS: During motor preparation (-2 to -0.5s with respect to movement onset), contralateral preponderance of event-related desynchronization (ERD) (lateralized power) was only observed during right hand finger movements, whereas ERD during left hand finger movements was bilateral. CONCLUSIONS: For right-handers, activation on the left hemisphere during left hand movements is greater than that on the right hemisphere during right hand movements. SIGNIFICANCE: We provide further evidence for motor dominance of the left hemisphere in early period of motor preparation for complex sequential finger movements.     

Pre-movement facilitation of motor-evoked potentials in man during transcranial stimulation of the central motor pathways

Motor evoked potentials (MEPs) following trans-cranial stimulation (TCS) through unifocal electric or magnetic impulses have been evaluated in the pre-movement period in 8 healthy volunteers. By utilizing a simple reaction time paradigm, progressive amplitude increments and latency decrements of MEPs have been demonstrated in the 100 ms preceding the onset of EMG activity in the muscle examined. By employing surface and depth recordings from various muscles of hand and forearm contralateral to the TCS, it was observed that in the 'early' period of pre-EMG facilitation (100-60 ms before EMG onset) TCS solely recruited the same low-threshold motor units which are fired first during self-paced contractions. In the 'middle and late' epochs of pre-EMG facilitation, TCS served when MEPs were recorded from a relaxed muscle, during TCS of progressively higher intensity. Multiple muscle recordings showed that pre-EMG facilitation was remarkably limited to the muscular group of the hand primarily involved in the intended movement.     

Event-related desynchronization and excitability of the ipsilateral motor cortex during simple self-paced finger movements.

OBJECTIVE: To study the time course of oscillatory EEG activity and corticospinal excitability of the ipsilateral primary motor cortex (iM1) during self-paced phasic extension movements of fingers II-V. METHODS: We designed an experiment in which cortical activation, measured by spectral-power analysis of 28-channel EEG, and cortical excitability, measured by transcranial magnetic stimulation (TMS), were assessed during phasic self-paced extensions of the right fingers II-V in 28 right-handed subjects. TMS was delivered to iM1 0-1500 ms after movement onset. RESULTS: Ipsilateral event-related desynchronization (ERD) during finger movement was paralleled by increased cortical excitability of iM1 from 0-200 ms after movement onset and by increased intracortical facilitation (ICF) without changes in intracortical inhibition (ICI) or peripheral measures (F waves). TMS during periods of post-movement event-related synchronization (ERS) revealed no significant changes in cortical excitability in iM1. CONCLUSIONS: Our findings indicate that motor cortical ERD ipsilateral to the movement is associated with increased corticospinal excitability, while ERS is coupled with its removal. These data are compatible with the concept that iM1 contributes actively to motor control. No evidence for inhibitory modulation of iM1 was detected in association with self-paced phasic finger movements. SIGNIFICANCE: Understanding the physiological role of iM1 in motor control.