Impaired anticipatory control of force sharing patterns during whole-hand grasping in Parkinson's disease.

We examined the coordination of multi-digit grasping forces as they developed during object grasping and lifting. Ten subjects with Parkinson's disease (PD; OFF and ON medication) and ten healthy age-matched control subjects lifted a manipulandum that measured normal forces at each digit and the manipulandum's position. The center of mass (CM) was changed from trial to trial in either a predictable (blocked) or unpredictable (random) order. All subjects modulated individual fingertip forces to counterbalance forces exerted by the thumb and minimize object tilt after lift-off. However, subjects with PD OFF exhibited an impaired ability to use anticipatory mechanisms resulting in less differentiated scaling of individual finger forces to the object CM location. Remarkably, these between-group differences in force modulation dissipated as subjects reached peak grip forces during object lift, although these occurred significantly later in subjects with PD OFF than controls and PD ON. Analysis of the tilt of the object during lift revealed all subjects had similar deviations of the object from the vertical, the direction of which depended on CM location. Thus these findings in subjects with PD indicate that: (a) PD-induced impairments in anticipatory force mechanisms appear to be greatly increased in multi-digit grasping as opposed to previous reports from two-digit grasping; (b) inaccurate scaling of fingertip force amplitude and sharing patterns before object lift is recovered during object lift; (c) the implementation of appropriate force amplitude and sharing among the digits during the lift occurs significantly later than for controls; (d) medication improves the temporal recovery of multi-digit force coordination. These results are discussed within the framework of PD-related deficits in sensorimotor integration and control of multi-degrees of freedom movement.