Toward a functional analysis of the basal ganglia.

Parkinson patients were tested in two paradigms to test the hypothesis that the basal ganglia are involved in the shifting of attentional set. Set shifting means a respecification of the conditions that regulate responding, a process sometimes referred to as an executive process. In one paradigm, upon the appearance of each stimulus, subjects were instructed to respond either to its color or to its shape. In a second paradigm, subjects learned to produce short sequences of three keypresses in response to two arbitrary stimuli. Reaction times were compared for the cases where set either remained the same or changed for two successive stimuli. Parkinson patients were slow to change set compared to controls. Parkinson patients were also less able to filter the competing but irrelevant set than were control subjects. The switching deficit appears to be dopamine based; the magnitude of the shifting deficit was related to the degree to which 1-dopa-based medication ameliorated patients' motor symptoms. Moreover, temporary withholding of medication, a so-called off manipulation, increased the time to switch. Using the framework of equilibrium point theory of movement, we discuss how a set switching deficit may also underlie clinical motor disturbances seen in Parkinson's disease.