Parkinson's - is time on your side? : temporal enhancement of motor performance using sensory guides

The basal ganglia system is directly involved in functions of habitual motor control, organisation and initiation of movement (Redgrave et al., 2010). As decreased dopamine levels debilitate normal motor function, people with Parkinson's disease tend to move 30-40% slower than healthy adults, with a movement range that is often compromised (Stelmach, Teasdale, Philips, & Worringham, 1989). There is lack of consistent evidence as to how well Parkinson's Disease patients are able to temporally control their movements. This thesis reports on work exploring the underpinnings of temporal control of movement in healthy brains and Parkinson's disease patients. Initial investigations suggest that basal ganglia play an important role in sensorimotor synchronisation through error correction and temporal anticipation processes. We demonstrate that progression of the disease has a debilitating impact on the ability to time the movement with regards to an external temporal framework in intercepting beat task and is independent from underscaling of the movement. We further explore ways of enhancement of temporal control in Parkinson's disease by providing an extrinsic kinematic template for the movement. We present novel evidence that enhancement of motor performance in Parkinson's disease (paradoxical kinesia) is triggered by the dynamic temporal information in the environment (moving object, visual and auditory arrays of information). We demonstrate that both healthy controls and patients can exploit the characteristics of specially engineered sensory guides (visual and acoustic) to improve the timing of their movement (finger tracking and ball catching). The findings from this report have both theoretical and practical implications. We propose that ability for sensorimotor synchronisation could be a behavioural marker of Parkinson's disease progression. Finally, we point towards the use of dynamic guides based on biological motion to aid motor planning in daily activities and facilitate exercise in Parkinson's disease.EThOS - Electronic Theses Online ServiceGBUnited Kingdo