Effect of External Feedback on Bimanual Coordination Control in Patients with Parkinson’s Disease

Bimanual coordination control requires task-specific control of the spatial and temporal characteristics of the coupling of both upper limbs. The present study examined the effects of external feedback (i.e., auditory signal) on bimanual coordination movement during patients with Parkinson’s disease (PD). Twelve PD patients in advanced stages and 12 early stages of untreated PD patients, and 12 age-matched normal adults were instructed to perform bimanual coordination control using preference (1 Hz) and fast (1.75 Hz) speeds with metronome auditory cue. The results demonstrated that the advanced PD patients showed reduced synchronized bimanual coordination control during the anti-phase movement compared with other two groups. Moreover, the decreased movement accuracy was exhibited not only at the preference speed, but also more particularly at the fast speed with anti-phase rather than in-phase movement. This suggests that PD results in impairments in scaling the bimanual movement speed and amplitude of limb, and these deficits were more pronounced as a function of movement control speed. Overall, the current data provide evidence of the pathophysiology of the basal ganglia on the bimanual coordination movement.