Parkinson's disease: reorganization of the reach to grasp movement in response to perturbation of the distal motor patterning.

This study assessed the kinematic changes to the reach to grasp movement in response to a perturbation of object size in 15 Parkinson's disease (PD) and 15 control subjects. For non-perturbed trials subjects reached 35 cm to grasp and lift either an illuminated small (0.7 cm) or large (8 cm) diameter cylinder. For perturbed trials (20%), illumination shifted unexpectedly from the small to the large or from the large to the small cylinder at the onset of the reach. For Condition One trials subjects were given no instructions as to which grasp to use. With perturbation, they thus naturally changed grasp from precision grip to whole hand prehension or vice versa. The results for the PD subjects indicated a slowness at the transition from one to another grasp. This contrasted to the smooth transitions when perturbation required only a change of grasp aperture (precision grip--Condition Two; whole hand prehension--Condition Three). PD subjects thus showed dysfunction in the suppression/activation of different grasp programs rather than deficits in the on-line modification of an operating program.