Experimental Brain Research

, Volume 227, Issue 3, pp 323–331 | Cite as

Comparing kinematic changes between a finger-tapping task and unconstrained finger flexion–extension task in patients with Parkinson’s disease

  • W. P. Teo
  • J. P. Rodrigues
  • F. L. Mastaglia
  • G. W. Thickbroom
Research Article


Repetitive finger tapping is a well-established clinical test for the evaluation of parkinsonian bradykinesia, but few studies have investigated other finger movement modalities. We compared the kinematic changes (movement rate and amplitude) and response to levodopa during a conventional index finger–thumb-tapping task and an unconstrained index finger flexion–extension task performed at maximal voluntary rate (MVR) for 20 s in 11 individuals with levodopa-responsive Parkinson’s disease (OFF and ON) and 10 healthy age-matched controls. Between-task comparisons showed that for all conditions, the initial movement rate was greater for the unconstrained flexion–extension task than the tapping task. Movement rate in the OFF state was slower than in controls for both tasks and normalized in the ON state. The movement amplitude was also reduced for both tasks in OFF and increased in the ON state but did not reach control levels. The rate and amplitude of movement declined significantly for both tasks under all conditions (OFF/ON and controls). The time course of rate decline was comparable for both tasks and was similar in OFF/ON and controls, whereas the tapping task was associated with a greater decline in MA, both in controls and ON, but not OFF. The findings indicate that both finger movement tasks show similar kinematic changes during a 20-s sustained MVR, but that movement amplitude is less well sustained during the tapping task than the unconstrained finger movement task. Both movement rate and amplitude improved with levodopa; however, movement rate was more levodopa responsive than amplitude.


Parkinson’s disease Bradykinesia Finger tapping Unrestrained finger flexion–extension task Movement rate Movement amplitude 


  1. Agostino R, Berardelli A, Curra A, Accornero N, Manfredi M (1998) Clinical impairment of sequential finger movements in Parkinson’s disease. Mov Disord 13(3):418–421PubMedCrossRefGoogle Scholar
  2. Agostino R, Curra A, Giovannelli M, Modugno N, Manfredi M, Berardelli A (2003) Impairment of individual finger movements in Parkinson’s disease. Mov Disord 18(5):560–565PubMedCrossRefGoogle Scholar
  3. Benecke R, Rothwell JC, Dick JP, Day BL, Marsden CD (1986) Performance of simultaneous movements in patients with Parkinson’s disease. Brain 109(Pt 4):739–757PubMedCrossRefGoogle Scholar
  4. Berardelli A, Rothwell JC, Thompson PD, Hallett M (2001) Pathophysiology of bradykinesia in parkinson’s disease. Brain 124(11):2131–2146PubMedCrossRefGoogle Scholar
  5. Bronte-Stewart HM, Ding L, Alexander C, Zhou Y, Moore GP (2000) Quantitative digitography (qdg): a sensitive measure of digital motor control in idiopathic parkinson’s disease. Mov Disord 15(1):36–47PubMedCrossRefGoogle Scholar
  6. Brown VJ, Schwarz U, Bowman EM, Fuhr P, Robinson DL, Hallett M (1993) Dopamine dependent reaction time deficits in patients with parkinson’s disease are task specific. Neuropsychologia 31(5):459–469PubMedCrossRefGoogle Scholar
  7. Espay AJ, Beaton DE, Morgante F, Gunraj CA, Lang AE, Chen R (2009) Impairments of speed and amplitude of movement in Parkinson’s disease: a pilot study. Mov Disord 24(7):1001–1008PubMedCrossRefGoogle Scholar
  8. Espay AJ, Lang AE, Chen R (2010) Effect of movement frequency on repetitive finger movements in patients with parkinson’s disease. Mov Disord 25(2):252–258PubMedCrossRefGoogle Scholar
  9. Espay AJ, Giuffrida JP, Chen R, Payne M, Mazzella F, Dunn E, Vaughan JE, Duker AP, Sahay A, Kim SJ, Revilla FJ, Heldman DA (2011) Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson’s disease. Mov Disord 26(14):2504–2508PubMedCrossRefGoogle Scholar
  10. Gandevia SC (2001) Spinal and supraspinal factors in human muscle fatigue. Physiol Rev 81(4):1725–1789PubMedGoogle Scholar
  11. Gandevia SC, Allen GM, Butler JE, Taylor JL (1996) Supraspinal factors in human muscle fatigue: evidence for suboptimal output from the motor cortex. J Physiol 490(Pt 2):529–536PubMedGoogle Scholar
  12. Gerloff C, Richard J, Hadley J, Schulman AE, Honda M, Hallett M (1998) Functional coupling and regional activation of human cortical motor areas during simple, internally paced and externally paced finger movements. Brain 121(Pt 8):1513–1531PubMedCrossRefGoogle Scholar
  13. Goetz CG, Fahn S, Martinez-Martin P, Poewe W, Sampaio C, Stebbins GT, Stern MB, Tilley BC, Dodel R, Dubois B, Holloway R, Jankovic J, Kulisevsky J, Lang AE, Lees A, Leurgans S, LeWitt PA, Nyenhuis D, Olanow CW, Rascol O, Schrag A, Teresi JA, Van Hilten JJ, LaPelle N (2007) Movement disorder society-sponsored revision of the unified Parkinson’s disease rating scale (mds-updrs): process, format, and clinimetric testing plan. Mov Disord 22(1):41–47PubMedCrossRefGoogle Scholar
  14. Hazeltine E, Helmuth LL, Ivry RB (1997) Neural mechanisms of timing. Trends Cogn Sci 1(5):163–169PubMedCrossRefGoogle Scholar
  15. Jahanshahi M, Brown RG, Marsden CD (1992) Simple and choice reaction time and the use of advance information for motor preparation in Parkinson’s disease. Brain 115(Pt 2):539–564PubMedCrossRefGoogle Scholar
  16. Jenkins IH, Jahanshahi M, Jueptner M, Passingham RE, Brooks DJ (2000) Self-initiated versus externally triggered movements ii. The effect of movement predictability on regional cerebral blood flow. Brain 123:1216–1228PubMedCrossRefGoogle Scholar
  17. Koop MM, Andrzejewski A, Hill BC, Heit G, Bronte-Stewart HM (2006) Improvement in a quantitative measure of bradykinesia after microelectrode recording in patients with Parkinson’s disease during deep brain stimulation surgery. Mov Disord 21(5):673–678PubMedCrossRefGoogle Scholar
  18. Mizelle JC, Forrester L, Hallett M, Wheaton LA (2010) Theta frequency band activity and attentional mechanisms in visual and proprioceptive demand. Exp Brain Res 204(2):189–197PubMedCrossRefGoogle Scholar
  19. Nakamura R, Nagasaki H, Narabayashi H (1978) Disturbances of rhythm formation in patients with Parkinson’s disease: part i. characteristics of tapping response to the periodic signals. Percept Mot Skills 46(1):63–75PubMedCrossRefGoogle Scholar
  20. Pascual-Leone A, Valls-Sole J, Brasil-Neto JP, Cohen LG, Hallett M (1994) Akinesia in Parkinson’s disease. i. shortening of simple reaction time with focal, single-pulse transcranial magnetic stimulation. Neurology 44(5):884–891PubMedCrossRefGoogle Scholar
  21. Rao SM, Harrington DL, Haaland KY, Bobholz JA, Cox RW, Binder JR (1997) Distributed neural systems underlying the timing of movements. J Neurosci 17(14):5528–5535PubMedGoogle Scholar
  22. Rodrigues JP, Walters SE, Stell R, Mastaglia FL, Thickbroom GW (2008) Spike-timing-related plasticity is preserved in Parkinson’s disease and is enhanced by dopamine: evidence from transcranial magnetic stimulation. Neurosci Lett 448:29–32PubMedCrossRefGoogle Scholar
  23. Rodrigues JP, Mastaglia FL, Thickbroom GW (2009) Rapid slowing of maximal finger movement rate: fatigue of central motor control? Exp Brain Res 196:557–563PubMedCrossRefGoogle Scholar
  24. Stegemoller EL, Simuni T, MacKinnon C (2009) Effect of movement frequency on repetitive finger movements in patients with Parkinson’s disease. Mov Disord 24(8):1162–1169PubMedCrossRefGoogle Scholar
  25. Taylor JL, Allen GM, Butler JE, Gandevia SC (2000) Supraspinal fatigue during intermittent maximal voluntary contractions of the human elbow flexors. J Appl Physiol 89(1):305–313PubMedGoogle Scholar
  26. Teo WP, Rodrigues JP, Mastaglia FL, Thickbroom GW (2012a) Changes in corticomotor excitability and inhibition after exercise are influenced by hand dominance and motor demand. Neuroscience 210:110–117PubMedCrossRefGoogle Scholar
  27. Teo WP, Rodrigues JP, Mastaglia FL, Thickbroom GW (2012b) Post-exercise depression in corticomotor excitability after dynamic movement: a general property of fatiguing and non-fatiguing exercise. Exp Brain Res 216(1):41–49PubMedCrossRefGoogle Scholar
  28. Yahalom G, Simon ES, Thorne R, Peretz C, Giladi N (2004) Hand rhythmic tapping and timing in Parkinson’s disease. Parkinsonism Relat Disord 10(3):143–148PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • W. P. Teo
    • 1
  • J. P. Rodrigues
    • 1
  • F. L. Mastaglia
    • 1
  • G. W. Thickbroom
    • 1
  1. 1.Australian Neuromuscular Research Institute, Centre for Neuromuscular and Neurological DisordersUniversity of Western AustraliaNedlandsAustralia

Personalised recommendations