The medial frontal-prefrontal network for altered awareness and control of action in corticobasal syndrome

Wolpe, Noham; Moore, James W.; Rae, Charlotte L.; Rittman, Timothy; Altena, Ellemarije; Haggard, Patrick and Rowe, James B.. 2014. The medial frontal-prefrontal network for altered awareness and control of action in corticobasal syndrome. Brain, 137(1), pp. 208-220. ISSN 1460-2156 [Article]

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Abstract or Description

The volitional impairments of alien limb and apraxia are a defining feature of the corticobasal syndrome, but a limited under- standing of their neurocognitive aetiology has hampered progress towards effective treatments. Here we combined several key methods to investigate the mechanism of impairments in voluntary action in corticobasal syndrome. We used a quantitative measure of awareness of action that is based on well-defined processes of motor control; structural and functional anatomical information; and evaluation against the clinical volitional disorders of corticobasal syndrome. In patients and healthy adults we measured ‘intentional binding’, the perceived temporal attraction between voluntary actions and their sensory effects. Patients showed increased binding of the perceived time of actions towards their effects. This increase correlated with the severity of alien limb and apraxia, which we suggest share a core deficit in motor control processes, through reduced precision in voluntary action signals. Structural neuroimaging analyses showed the behavioural variability in patients was related to changes in grey matter volume in pre-supplementary motor area, and changes in its underlying white matter tracts to prefrontal cortex. Moreover, changes in functional connectivity at rest between the pre-supplementary motor area and prefrontal cortex were proportional to changes in binding. These behavioural, structural and functional results converge to reveal the frontal network for altered awareness and control of voluntary action in corticobasal syndrome, and provide candidate markers to evaluate new therapies.

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This work was supported by the James S McDonnell Foundation (‘Progress in Understanding Voluntary Action’); the Wellcome Trust [088324]; the National Institute for Health Research, Cambridge Biomedical Research Centre; and the Medical Research Council [MC_US_A060_0016]. N.W. was funded by a Gates Cambridge scholarship and the Raymond and Beverley Sackler foundation. P.H. was supported by an ESRC Professorial Fellowship, and by ERC Advanced Grant HUMVOL.


corticobasal syndrome, alien limb, apraxia, voluntary action, volition, pre-supplementary motor area

Departments, Centres and Research Units:

Psychology > Cognitive Neuroscience Unit


1 January 2014Published
29 November 2013Published Online
8 September 2013Accepted

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Date Deposited:

19 Feb 2014 16:18

Last Modified:

07 Apr 2020 10:57

Peer Reviewed:

Yes, this version has been peer-reviewed.


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