Proprioception and Motor Control in Parkinson's Disease

ABSTRACT

Parkinson's disease (PD) is a neurodegenerative disorder that leads to a progressive decline in motor function. Growing evidence indicates that PD patients also experience an array of sensory problems that negatively impact motor function. This is especially true for proprioceptive deficits, which profoundly degrade motor performance. This review specifically address the relation between proprioception and motor impairments in PD. It is structured around 4 themes: (a) It examines whether the sensitivity of kinaesthetic perception, which is based on proprioceptive inputs, is actually altered in PD. (b) It discusses whether failed processes of proprioceptive-motor integration are central to the motor problems in PD. (c) It presents recent findings focusing on the link between the proprioception and the balance problems in PD. And (d) it discusses the current state of knowledge of how levodopa medication and deep brain stimulation affect proprioceptive and motor function in PD. The authors conclude that a failure to evaluate and to map proprioceptive information onto voluntary and reflexive motor commands is an integral part of the observed motor symptoms in PD.

Keywords:

• basal ganglia
• kinaesthesia
• movement disorder
• sensorimotor integration

ACKNOWLEDGMENTS

The idea for this review originated from an international workshop on Motor Control and Proprioception in Parkinson's Disease, which was held in Minneapolis on September 18–19, 2008. All authors attended this workshop that was supported in part by the Minnesota Medical Foundation, the University of Minnesota Center for Clinical Movement Science, the University of Minnesota Academic Health Center, and by the University of Minnesota School of Kinesiology. Aspects of the research were supported in part by NIH grants NS036449 (HP) and NS40902 (DMC).