Motor symptoms in Parkinson's disease: A unified framework

Ahmed A. Moustafa, Srinivasa Chakravarthy, Joseph R. Phillips, Ankur Gupta, Szabolcs Keri, Bertalan Polner, Michael J. Frank, Marjan Jahanshahi

Research output: Contribution to journalReview article

41 Citations (Scopus)


Parkinson's disease (PD) is characterized by a range of motor symptoms. Besides the cardinal symptoms (akinesia and bradykinesia, tremor and rigidity), PD patients show additional motor deficits, including: gait disturbance, impaired handwriting, grip force and speech deficits, among others. Some of these motor symptoms (e.g., deficits of gait, speech, and handwriting) have similar clinical profiles, neural substrates, and respond similarly to dopaminergic medication and deep brain stimulation (DBS). Here, we provide an extensive review of the clinical characteristics and neural substrates of each of these motor symptoms, to highlight precisely how PD and its medical and surgical treatments impact motor symptoms. In conclusion, we offer a unified framework for understanding the range of motor symptoms in PD. We argue that various motor symptoms in PD reflect dysfunction of neural structures responsible for action selection, motor sequencing, and coordination and execution of movement.

Original languageEnglish
Pages (from-to)727-740
Number of pages14
JournalNeuroscience and Biobehavioral Reviews
Publication statusPublished - Sep 1 2016



  • Akinesia
  • Bradykinesia
  • Freezing of gait
  • Grip force
  • Handwriting
  • Parkinson's disease
  • Rigidly
  • Speech
  • Tremor

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Cognitive Neuroscience
  • Behavioral Neuroscience

Cite this

Moustafa, A. A., Chakravarthy, S., Phillips, J. R., Gupta, A., Keri, S., Polner, B., Frank, M. J., & Jahanshahi, M. (2016). Motor symptoms in Parkinson's disease: A unified framework. Neuroscience and Biobehavioral Reviews, 68, 727-740.