Subcortical lesions have been simultaneously implicated in both real and simulated movement deficits. However, the analysis of the simulated opposition axis in precision grasping reveals that, in individuals with idiopathic bilateral Parkinson' disease motor imagery is impaired and that execution of overt movements is spared. This constitutes the first lesion observation congruent with the anatomical and functional dichotomy between real and simulated movements seen in experimental studies. These results underline the modality-specific nature of motor imagery and show that subcortical damage differentially impacts on motor activity.