Dissociation between contingent negative variation (CNV) and Bereitschaftspotential (BP) in patients with parkinsonism.

In order to clarify the generator mechanism of the late component of contingent negative variation (CNV), we compared the late CNV with Bereitschaftspotential (BP) in patients with parkinsonism (Parkinson's disease and progressive supranuclear palsy). In patients with mild symptoms (Hoehn Yahr grade I and II) both the late CNV and BP were clearly seen. In patients with severe symptoms (Hoehn Yahr grade III, IV and V) the BP was normally seen, but the late CNV was significantly smaller or absent (P < 0.001 at Cz) and it was also significantly smaller than that obtained from age-matched normals. In one patient (H-Y grade II) who had normal BP, the late CNV was diminished selectively at the midline area. Since it was reported that the late CNV arises from at least the supplementary motor area (SMA), selective diminution of the late CNV at the midline could be explained by the decreased activity of the SMA in parkinsonism. It was also previously reported that the BP was absent but the late CNV was normally present in a patient with cerebellar efferent lesion (Ikeda et al., 1994). Taken together with the experimental results indicating that movement-related neurons in the putamen behave contingent on external stimuli, it is suggested that subcortical generating mechanism is different for the late CNV and BP although both commonly share at least some cortical generators, and that the basal ganglia are most likely responsible for the generation of the late CNV and the cerebellar efferent system for the generation of the BP.