Dopaminergic deficiency in Parkinson’s disease (PD) has been associated with underactivation of the supplementary motor area and a reduction of voluntary actions. In these patients, awareness of intention to act has been shown to be delayed. However, delayed awareness of intention to act has also been shown in patients with hyperdopaminergic states and an excess of unwilled movements, as in Tourette’s, and in patients with functional movement disorders. Hence, the role of dopamine in the awareness of intention and action remains unclear. 36 PD patients were tested ON and OFF dopaminergic medication and compared with 35 healthy age-matched controls. In addition, 17 PD patients with subthalamic deep brain stimulation (DBS) were tested ON medication and ON and OFF stimulation. Participants judged either the moment a self-generated action was performed, or the moment the urge to perform the action was felt, using the “Libet method”. Temporal judgments of intention and action awareness were comparable between unmedicated PD patients and controls. Dopaminergic medication boosted anticipatory awareness of both intentions and actions in PD patients, relative to an unmedicated condition. The difference between ON/OFF DBS was not statistically reliable. Functional improvement of motor ability in PD through dopaminergic supplementation leads to earlier awareness of both intention, and of voluntary action.

帕金森氏病（PD）中的多巴胺能缺乏与辅助运动区的激活不足和自愿行为的减少有关。在这些患者中，行动意愿的觉察已被延迟。但是，在高多巴胺能状态和不想要的运动过多的患者中，例如在图雷特氏症患者和功能性运动障碍患者中，也表现出对行动意图的延迟意识。因此，不清楚多巴胺在意识意图和行动中的作用。对36名PD患者进行了多巴胺能药物的ON和OFF测试，并与35名年龄匹配的健康对照者进行了比较。此外，对17名具有丘脑深部脑刺激（PDS）的PD患者进行了药物，ON和OFF刺激测试。参与者使用“ Libet方法”判断执行自发动作的时间或感受到执行该动作的冲动的时间。意向和行动意识的时间判断在未药物治疗的PD患者和对照组之间具有可比性。相对于未用药情况，多巴胺能药物增强了PD患者对意向和行为的预期意识。ON / OFF DBS之间的差异在统计上并不可靠。通过补充多巴胺能可以改善PD运动能力，从而可以更早地意识到意图和自愿行为。相对于未用药情况，多巴胺能药物增强了PD患者对意向和行为的预期意识。ON / OFF DBS之间的差异在统计上并不可靠。通过补充多巴胺能可以改善PD运动能力，从而可以更早地意识到意图和自愿行为。相对于未用药情况，多巴胺能药物增强了PD患者对意向和行为的预期意识。ON / OFF DBS之间的差异在统计上并不可靠。通过补充多巴胺能可以改善PD运动能力，从而可以更早地意识到意图和自愿行为。