Experimental Brain Research

, Volume 238, Issue 1, pp 229–245 | Cite as

Synergic control of action in levodopa-naïve Parkinson’s disease patients: I. Multi-finger interaction and coordination

  • Paulo B. de Freitas
  • Sandra M. S. F. Freitas
  • Sasha Reschechtko
  • Tyler Corson
  • Mechelle M. Lewis
  • Xuemei Huang
  • Mark L. LatashEmail author
Research Article


We explored the origin of the impaired control of action stability in Parkinson’s disease (PD) by testing levodopa-naïve PD patients to disambiguate effects of PD from possible effects of long-term exposure to levodopa. Thirteen levodopa-naïve PD patients and 13 controls performed single- and multi-finger force production tasks, including producing a self-paced quick force pulse into a target. A subgroup of patients (n = 10) was re-tested about 1 h after the first dose of levodopa. Compared to controls, PD patients showed lower maximal forces and synergy indices stabilizing total force (reflecting the higher inter-trial variance component affecting total force). In addition, PD patients showed a trend toward shorter anticipatory synergy adjustments (a drop in the synergy index in preparation to a quick action) and larger non-motor equivalent finger force deviations. Lower maximal force, higher unintentional force production (enslaving) and higher inter-trial variance indices occurred in PD patients after one dosage of levodopa. We conclude that impairment in synergies is present in levodopa-naïve patients, mainly in indices reflecting stability (synergy index), but not agility (anticipatory synergy adjustments). A single dose of levodopa, however, did not improve synergy indices, as it did in PD patients on chronic anti-PD medication, suggesting a different mechanism of action. The results suggest that indices of force-stabilizing synergies may be used as an early behavioral sign of PD, although it may not be sensitive to acute drug effects in drug-naïve patients.


Parkinson’s disease Synergy Fingers Hand Enslaving Uncontrolled manifold 



Anticipatory synergy adjustment


Total force


Hoehn and Yahr


Maximal voluntary contraction


Parkinson’s disease


Uncontrolled manifold


Motor equivalent


Non-motor equivalent



We would like to thank all the participants in the study. XH and MML were supported by NIH Grants NS060722, ES019672, and NS082151. MLL, XH, and MML were supported by NIH Grant NS095873.

Compliance with ethical standards

Conflict of interest

No conflicts of interest are claimed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Paulo B. de Freitas
    • 1
    • 2
    • 3
  • Sandra M. S. F. Freitas
    • 2
    • 3
    • 4
  • Sasha Reschechtko
    • 2
    • 8
  • Tyler Corson
    • 3
  • Mechelle M. Lewis
    • 3
    • 5
  • Xuemei Huang
    • 3
    • 5
    • 6
    • 7
  • Mark L. Latash
    • 2
    Email author
  1. 1.Interdisciplinary Graduate Program in Healthy SciencesCruzeiro do Sul UniversitySão PauloBrazil
  2. 2.Department of KinesiologyThe Pennsylvania State UniversityUniversity ParkUSA
  3. 3.Department of Neurology, Milton S. Hershey Medical CenterThe Pennsylvania State UniversityHersheyUSA
  4. 4.Master and Doctoral Program in Physical TherapyCity University of São PauloSão PauloBrazil
  5. 5.Department of Pharmacology, Milton S. Hershey Medical CenterThe Pennsylvania State UniversityHersheyUSA
  6. 6.Department of Radiology, Milton S. Hershey Medical CenterThe Pennsylvania State UniversityHersheyUSA
  7. 7.Department of Neurosurgery, Milton S. Hershey Medical CenterThe Pennsylvania State UniversityHersheyUSA
  8. 8.Department of Physiology and PharmacologyUniversity of Western OntarioLondonCanada

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