Studio funzionale RM delle aree motorie corticali nel morbo di Parkinson

Abstract

Impaired motor programming and performance in Parkinson's Disease (PD) is related to a functional deafferentation from the basal ganglia to the cortical motor areas, which can be partially reversed by dopaminergic drugs. The aim of this functional MRI study was to compare the activation pattern of motor areas in early PD patients on therapy versus age-matched controls and to show how the dopaminergic drug apomorphine modifies this activation pattern. The self-paced motor task was a complex fixed sequence of finger movements in opposition to the thumb. Comparison between whole activation of cortical motor areas in patients and controls revealed no significant differences. In patients a significant reduction of the activation was found in the primary motor cortex contralateral to the more affected hand; on the contrary a major increase in activation in the same motor area was observed after apomorphine. This could be evidence of the reversal of the partial deafferentation due to the direct dopaminergic action of apomorphine which is complementary to levodopa.