The aim of the present experimental series was to investigate the role of the medial frontal region including the supplementary motor area in the coordination between posture and movement in a bimanual load lifting task. The seated subject was instructed to maintain in a horizontal position one forearm (postural arm) which was loaded with a 1 kg weight. The unloading was performed either by the experimenter (imposed unloading) or by a voluntary movement of the other arm (voluntary unloading). In normal individuals, with the voluntary unloading, the movement control was accompanied by an anticipatory adjustment of the postural forearm flexor activity, which resulted in the maintenance of the forearm position despite the unloading. The anticipatory postural adjustments were impaired in 4 out of 5 patients with unilateral lesion of the SMA region; the defect was observed mainly when the postural forearm was contralateral to the lesion. No change in the anticipatory postural adjustment was observed in one patient with complete callosal section. This finding indicates that the coordination between the posture and movement in this task is not organized through callosal fibers linking the cortices on both sides but rather at a subcortical level. The anticipatory postural adjustments were abolished in two patients with spastic hemiparesis when the postural forearm was the spastic arm. It is suggested that the SMA region contralateral to the postural forearm, together with other premotor or motor areas, may select the circuits responsible for the phasic postural adjustments which are necessary to ensure postural maintenance, whereas the motor cortex contralateral to the voluntary movement controls both the movement and, via collaterals, the preselected circuits responsible for the associated postural adjustments.

SUMMARY Normal subjects and Parkinsonian patients performed a bimanual load lifting task. In this task, one "postural" forearm, held in a horizontal position while supporting a 1 kg weight, was unloaded either by the experimenter's hand (imposed unloading) or by the subject's other hand in response to a tone burst (voluntary unloading). The variables recorded were reaction time (RT: time interval between the tone and beginning of unloading) and movement time (MT: duration of the change in force measured by a force platform on the "postural" forearm). Elbow angle changes were also measured with a potentiometer. The EMG activity from brachioradialis of the "postural" arm and that from the biceps of the "active" arm were recorded. The Parkinsonian patients showed an increase in both RT and MT and an impairment of the co-ordination between movement and posture which was reflected in an increase in amplitude of the elbow rotation after voluntary unloading. Moreover, the decrease in EMG activity in the brachioradialis of the postural arm during unloading was less in Parkinsonian patients than in the normal group. This disorder of postural command was often accompanied by a lack of anticipatory EMG changes. Comparison between treated and non-treated patients showed that dopamine agonists brought about recovery of both RT and MT but did not improve postural co-ordination. The co-ordination was less impaired when the voluntary unloading was performed by the preferred hand. Several hypotheses are discussed concerning the mechanism underlying this impaired co-ordination.Performance of a voluntary movement by one body segment is usually accompanied by an adjustment of posture aimed at preventing the imbalance which would otherwise occur.1 Posture and movement have been shown to be co-ordinated in several situations. Under near-static conditions, for instance, Babinski2 observed that backward bending of the body is accompanied by flexion of the knees, restricting displacement of the vertical projection of the centre of gravity to within the area delimited by the feet on the ground. Similarly, raising of the arms forwards leads to a compensatory backward displacement of the trunk.3 Under dynamic conditions, when the voluntary movement is a fast one, the postural adjustment command usually precedes the actual movement. An

No abstract

No abstract