Learning and consolidation of visuo-motor adaptation in Parkinson's disease

Department of Physiology & Pharmacology, CUNY Medical School, New York, NY 100031, USA.
Parkinsonism & Related Disorders (Impact Factor: 3.97). 05/2008; 15(1):6-11. DOI: 10.1016/j.parkreldis.2008.02.012
Source: PubMed


We have previously shown in normal subjects that motor adaptation to imposed visual rotation is significantly enhanced when tested few days later. This occurs through a process of sleep-dependent memory consolidation. Here we ascertained whether patients with Parkinson's disease (PD) learn, improve, and retain new motor skills in the same way as normal subjects. We tested 16 patients in early stages of PD and 21 control subjects over two days. All subjects performed reaching movements on a digitizing tablet. Vision of the limb was precluded with an opaque screen; hand paths were shown on the screen with the targets' position. Unbeknownst to the subjects, the hand path on the screen was rotated by 30 degrees . In experiment 1, patients taking dopaminergic treatment and controls adapted to rotation with targets appearing in an unpredictable order. In experiment 2, drug-naïve patients and controls adapted to rotation in a less challenging task where target's appearance was predictable. Patients and controls made similar movements and adapted to rotation in the same way. However, when tested again over the following days, controls' performance significantly improved compared to training, while patients' performance did not. This lack of consolidation, which is present in the early stages of the disease and is independent from therapy, may be due to abnormal homeostatic processes that occur during sleep.

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    • "It is also evident that learning ability in PD is positively influenced by the use of " augmented feedback " which, however, implies potential deterioration of performance when the augmented cues are removed or the environmental conditions are changed. On the other hand, consolidation and retention are significantly impaired in PD subjects [15]. The RESCUE trial [16] documented a limited retention and transfer ability of learning. "
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    • "With regards to the pattern of within and between session performance, it appears that different processes may be underlying these different stages of motor skill learning. A similar pattern of intact learning within sessions, but impaired retention between-sessions, has been reported previously in individuals with PD (Bédard and Sanes, 2011; Leow et al., 2012; Marinelli et al., 2009; Mochizuki-Kawai et al., 2004). In terms of processes, it has been argued that the cortico-cerebellar circuit along with the hippocampus and frontal regions are primarily involved in early stages of learning and therefore, may support initial skill learning, but that the striatal system is particularly critical for long-term retention of motor skills after initial training (Albouy et al., 2013; Doyon et al., 2009; Mochizuki-Kawai et al., 2004). "
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    • "The idea of instance-reliant learning can account for the phenomenon of savings by suggesting that the instances obtained during the initial learning period are available to facilitate relearning, even after the algorithm developed during initial training may no longer be available due to unlearning or forgetting. The basal ganglia may also be involved in instance–reliant learning, because studies have reported that despite their intact ability to adapt to novel visuomotor conditions, parkinsonian patients show lack of savings (Marinelli et al., 2009; Bédard & Sanes, 2011; Leow, Loftus, & Hammond, 2012). It is plausible that parkinsonian patients can adapt to the novel condition as well as controls by employing algorithmic learning, whereas their savings is absent because instance–reliant learning is impaired in these patients. "
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