Studies involving brain-lesioned subjects have used the paced finger
tapping (PFT) task to investigate the neural systems that govern motor
timing. Patients with Parkinson's disease (PD), for example,
demonstrate abnormal performance on the PFT, characterized by decreased
accuracy and variability changes, suggesting that the basal ganglia may
play a critical role in motor timing. Consistent with this hypothesis,
an fMRI study of healthy participants demonstrated that the medial
frontostriatal circuit (dorsal putamen, ventrolateral thalamus, SMA)
correlated with explicit time-dependent components of the PFT task. In
the current fMRI study, PD patients and healthy age-matched controls
were imaged while performing the PFT. PD patients underwent 2 imaging
sessions, 1 on and the other off dopamine supplementation. Relative to
controls, PD patients were less accurate and showed greater variability
on the PFT task relative to controls. No PFT performance differences
were observed between the on and off medication states despite
significantly greater motor symptoms on the Unified Parkinson's
Disease Rating Scale (UPDRS) in the off medication state. Functional
imaging results demonstrated decreased activation within the
sensorimotor cortex (SMC), cerebellum, and medial premotor system in
the PD patients compared to controls. With dopamine replacement, an
increase in the spatial extent of activation was observed within the
SMC, SMA, and putamen in the PD patients. These results indicate that
impaired timing reproduction in PD patients is associated with reduced
brain activation within motor and medial premotor circuits. Despite a
lack of improvement in PFT performance, PD patient's brain
activation patterns were partially “normalized” with
dopamine supplementation. These findings could not be attributed to
greater head movement artifacts or basal ganglia atrophy within the PD
group. (JINS, 2003, 9, 1088–1098.)