Preparation for voluntary movement in healthy and clinical populations: evidence from startle.

In this review we provide a summary of the observations made regarding advance preparation of the motor system when presenting a startling acoustic stimulus (SAS) during various movement tasks. The predominant finding from these studies is that if the participant is prepared to make a particular movement a SAS can act to directly and quickly trigger the prepared action. A similar effect has recently been shown in patients with Parkinson's disease. This "StartReact" effect has been shown to be a robust indicator of advance motor programming as it can involuntarily release whatever movement has been prepared. We review the historical origins of the StartReact effect and the experimental results detailing circumstances where advance preparation occurs, when it occurs, and how these processes change with practice for both healthy and clinical populations. Data from some of these startle experiments has called into question some of the previously held hypotheses and assumptions with respect to the nature of response preparation and initiation, and how the SAS results in early response expression. As such, a secondary focus is to review previous hypotheses and introduce an updated model of how the SAS may interact with response preparation and initiation channels from a neurophysiological perspective.