Modulation of corticomotor excitability after maximal or sustainable-rate repetitive finger movement is impaired in Parkinson’s disease and is reversed by levodopa

•The normal reduction in corticomotor excitability that occurs after performing non-fatiguing finger movement tasks is absent in PD patients when off medication.•Dopamine deficiency is associated with impaired modulation of corticomotor excitability after repetitive finger movements.•Administration of levodopa improves movement kinematics and restores normal post-exercise modulation of corticomotor excitability.

ObjectivesIn healthy subjects, fatiguing exercises induce a period of post-exercise corticomotor depression (PECD) that is absent in Parkinson’s disease (PD). Our objective is to determine the time-course of corticomotor excitability changes following a 10-s repetitive index finger flexion–extension task performed at maximal voluntary rate (MVR) and a slower sustainable rate (MSR) in PD patients OFF and ON levodopa.MethodsIn 11 PD patients and 10 healthy age-matched controls, motor evoked potentials (MEPs) were recorded from the extensor indicis proprius (EIP) and first dorsal interosseous (FDI) muscles of the dominant arm immediately after the two tasks and at 2-min intervals for 10 min.ResultsIn the OFF condition the PECD was absent in the two test muscles after both the MVR and MSR tasks. In the ON condition finger movement kinematics improved and a period of PECD comparable to that in controls was present after both tasks.ConclusionThe absence of PECD in PD subjects off medication indicates a persisting increase in corticomotor excitability after non-fatiguing repetitive finger movement that is reversed by levodopa.SignificanceDopamine depletion is associated with impaired modulation of corticomotor excitability after non-fatiguing repetitive finger movement.