Music and Metronomes Differentially Impact Motor Timing in People with and without Parkinson's Disease: Effects of Slow, Medium, and Fast Tempi on Entrainment and Synchronization Performances in Finger Tapping, Toe Tapping, and Stepping on the Spot Tasks

Introduction: Rhythmic Auditory Stimulation (RAS) has successfully helped regulate gait for people with Parkinson’s disease. However, the way in which different auditory cues and types of movements affect entrainment, synchronization and pacing stability has not been directly compared in different aged people with and without Parkinson's. Therefore, this study compared music and metronomes (cue types) in finger tapping, toe tapping and stepping on the spot tasks to explore the potential of RAS training for general use.Methods: Participants (aged 18-78 years) included people with Parkinson’s (n=30, Hoehn & Yahr Mean=1.78), Older (n=26), and Younger adult controls (n=36), as age may effect motor timing. Timed motor production was assessed using an extended synchronization-continuation task in cue type and movement conditions for slow, medium and fast tempi (81, 116 and 140 mean beats-per-minute respectively).Results: Analyses revealed main effects of cue and movement type but no between group interactions, suggesting no differences in motor timing between people with Parkinson's and controls. Music supported entrainment better than metronome in medium and fast tempi, and stepping on the spot enabled better entrainment and less asynchrony, as well as more stable pacing compared to tapping in medium and fast tempi. Age was not confirmed as a factor and no differences were observed in slow tempo.Conclusion: This is the first study to directly compare how different external auditory cues and movement types affect motor timing. The music and the stepping enabled participants to maintain entrainment once the external pacing cue ceased, suggesting endogenous mechanisms continued to regulate the movements. The superior performance of stepping on the spot suggests embodied entrainment can occur during continuous movement, and this may be related to emergent timing in tempi above 600 ms. These findings can be applied therapeutically to manage and improve adaptive behaviours for people with Parkinson’s.