Effects of Parkinson's disease on visuomotor adaptation.

Visuomotor adaptation to a kinematic distortion was investigated in Parkinson's disease (PD) patients and age-matched controls. Participants performed pointing movements in which the visual feedback of hand movement, displayed as a screen cursor, was normal (pre-exposure condition) or rotated by 90 degrees counterclockwise (exposure condition). Aftereffects were assessed in a post-exposure condition in which the visual feedback of hand movement was set back to normal. In pre- and early-exposure trials, both groups showed similar initial directional error (IDE) and movement straightness (RMSE, root mean square error), but the PD group showed reduced movement smoothness (normalized jerk, NJ) and primary submovement to total movement distance ratios (PTR). During late-exposure the PD subjects, compared with controls, showed larger IDE, RMSE, NJ, and smaller PTR scores. Moreover, PD patients showed smaller aftereffects than the controls during the post-exposure condition. Overall, the PD group showed both slower and reduced adaptation compared with the control group. These results are discussed in terms of reduced signal-to-noise ratio in feedback signals related to increased movement variability and/or disordered kinesthesia, deficits in movement initiation, impaired selection of initial movement direction, and deficits in internal model formation in PD patients. We conclude that Parkinson's disease impairs visuomotor adaptation.