Sensorimotor adaptation in Parkinson's disease: evidence for a dopamine dependent remapping disturbance

Novelty exposure induces stronger sensorimotor representations during a manual adaptation task

Active exploration of novel spatial environments enhances memory for subsequently presented explicit, declarative information in humans. These effects have been attributed to novelty promoting dopamine release via mesolimbic dopaminergic pathways in the brain. As procedural motor learning has been linked to dopamine as well, we predict that novelty effects extend to this domain. To test this hypothesis, the present study examined whether spatial novelty exploration benefits subsequent sensorimotor adaptation. Participants explored either two different virtual environments (i.e., novelty condition; n = 210) or two identical environments (i.e., familiar condition; n = 253). They then performed a manual adaptation task in which they had to adapt joystick movements to a visual perturbation. We assessed the rate of adaptation following the introduction of this perturbation, and the rate of deadaptation following its removal. While results showed reliable adaptation patterns and similar adaptation rates across both conditions, individuals in the novelty condition showed slower deadaptation. This suggests that exposure to spatial novelty induced stronger sensorimotor representations during adaptation, potentially through novelty-induced dopaminergic effects in mesocortical and/or nigrostriatal pathways. Novelty exposure may be employed to promote motor learning on tasks that require precision movements in altered sensory contexts, for example, in astronauts moving in microgravity or patients with impaired motor processing.

Brain Activity and Functional Connectivity Patterns Associated With Fast and Slow Motor Sequence Learning in Late Middle Adulthood

The human brain undergoes structural and functional changes across the lifespan. The study of motor sequence learning in elderly subjects is of particularly interest since previous findings in young adults might not replicate during later stages of adulthood. The present functional magnetic resonance imaging (fMRI) study assessed the performance, brain activity and functional connectivity patterns associated with motor sequence learning in late middle adulthood. For this purpose, a total of 25 subjects were evaluated during early stages of learning [i.e., fast learning (FL)]. A subset of these subjects (n = 11) was evaluated after extensive practice of a motor sequence [i.e., slow learning (SL) phase]. As expected, late middle adults improved motor performance from FL to SL. Learning-related brain activity patterns replicated most of the findings reported previously in young subjects except for the lack of hippocampal activity during FL and the involvement of cerebellum during SL. Regarding functional connectivity, precuneus and sensorimotor lobule VI of the cerebellum showed a central role during improvement of novel motor performance. In the sample of subjects evaluated, connectivity between the posterior putamen and parietal and frontal regions was significantly decreased with aging during SL. This age-related connectivity pattern may reflect losses in network efficiency when approaching late adulthood. Altogether, these results may have important applications, for instance, in motor rehabilitation programs.

New roles for dopamine in motor skill acquisition: lessons from primates, rodents, and songbirds

Motor learning is a core aspect of human life and appears to be ubiquitous throughout the animal kingdom. Dopamine, a neuromodulator with a multifaceted role in synaptic plasticity, may be a key signaling molecule for motor skill learning. Though typically studied in the context of reward-based associative learning, dopamine appears to be necessary for some types of motor learning. Mesencephalic dopamine structures are highly conserved among vertebrates, as are some of their primary targets within the basal ganglia, a subcortical circuit important for motor learning and motor control. With a focus on the benefits of cross-species comparisons, this review examines how "model-free" and "model-based" computational frameworks for understanding dopamine's role in associative learning may be applied to motor learning. The hypotheses that dopamine could drive motor learning either by functioning as a reward prediction error, through passive facilitating of normal basal ganglia activity, or through other mechanisms are examined in light of new studies using humans, rodents, and songbirds. Additionally, new paradigms that could enhance our understanding of dopamine's role in motor learning by bridging the gap between the theoretical literature on motor learning in humans and other species are discussed.

Attenuation of access to internal states in high obsessive-compulsive individuals might increase susceptibility to false feedback: Evidence from a visuo-motor hand-reaching task

BACKGROUND AND OBJECTIVES

The Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD) posits that obsessive-compulsive (OC) individuals have attenuated access to their internal states. Hence, they seek and rely on proxies, or discernible substitutes for these internal states. In previous studies, participants with high OC tendencies and OCD patients, compared to controls, showed increased reliance on external proxies and were more influenced by false feedback when judging their internal states. This study is the first to examine the effects of false feedback on performance of hand movements in participants with high and low OC tendencies.

METHOD

Thirty-four participants with high OC tendencies and 34 participants with low OC tendencies were asked to perform accurate hand reaches without visual feedback in two separate sessions of a computerized hand-reaching task: once after valid feedback training of their hand location and once with false-rotated feedback. We assessed the accuracy and directional adaptation of participants' reaches.

RESULTS

As predicted, high OC participants evidenced a larger decrease in their hand positioning accuracy after training with false feedback compared to low OC participants.

LIMITATIONS

The generalization of our findings to OCD requires replication with a clinical sample.

CONCLUSIONS

These results suggest that in addition to self-perceptions, motor performance of OC individuals is prone to be overly influenced by false feedback, possibly due to attenuated access to proprioceptive cues. These findings may be particularly relevant to understanding the distorted sense of agency in OCD.

Dopamine Depletion Affects Vocal Acoustics and Disrupts Sensorimotor Adaptation in Songbirds

Dopamine is hypothesized to convey error information in reinforcement learning tasks with explicit appetitive or aversive cues. However, during motor skill learning feedback signals arise from an animal's evaluation of sensory feedback resulting from its own behavior, rather than any external reward or punishment. It has previously been shown that intact dopaminergic signaling from the ventral tegmental area/substantia nigra pars compacta (VTA/SNc) complex is necessary for vocal learning when songbirds modify their vocalizations to avoid hearing distorted auditory feedback (playbacks of white noise). However, it remains unclear whether dopaminergic signaling underlies vocal learning in response to more naturalistic errors (pitch-shifted feedback delivered via headphones). We used male Bengalese finches (Lonchura striata var. domestica) to test the hypothesis that the necessity of dopamine signaling is shared between the two types of learning. We combined 6-hydroxydopamine (6-OHDA) lesions of dopaminergic terminals within Area X, a basal ganglia nucleus critical for song learning, with a headphones learning paradigm that shifted the pitch of auditory feedback and compared their learning to that of unlesioned controls. We found that 6-OHDA lesions affected song behavior in two ways. First, over a period of days lesioned birds systematically lowered their pitch regardless of the presence or absence of auditory errors. Second, 6-OHDA lesioned birds also displayed severe deficits in sensorimotor learning in response to pitch-shifted feedback. Our results suggest roles for dopamine in both motor production and auditory error processing, and a shared mechanism underlying vocal learning in response to both distorted and pitch-shifted auditory feedback.

Sensorimotor adaptation of voice fundamental frequency in Parkinson's disease

OBJECTIVE

This study examined adaptive responses to auditory perturbation of fundamental frequency (fo) in speakers with Parkinson's disease (PD) and control speakers.

METHOD

Sixteen speakers with PD and nineteen control speakers produced sustained vowels while they received perturbed auditory feedback (i.e., fo shifted upward or downward). Speakers' pitch acuity was quantified using a just-noticeable-difference (JND) paradigm. Twelve listeners provided estimates of the speech intelligibility for speakers with PD.

RESULTS

Fifteen responses from each speaker group for each shift direction were included in analyses. While control speakers generally showed consistent adaptive responses opposing the perturbation, speakers with PD showed no compensation on average, with individual PD speakers showing highly variable responses. In the PD group, the degree of compensation was not significantly correlated with age, disease progression, pitch acuity, or intelligibility.

CONCLUSIONS

These findings indicate reduced adaptation to sustained fo perturbation and higher variability in PD compared to control participants. No significant differences were seen in pitch acuity between groups, suggesting that the fo adaptation deficit in PD is not the result of purely perceptual mechanisms.

SIGNIFICANCE

These results suggest there is an impairment in vocal motor control in PD. Building on these results, contributions can be made to developing targeted voice treatments for PD.

Over facilitation of unadapted cognitive processes in obsessive compulsive disorder as assessed with the computerized mirror pointing task

Response inhibition has been suggested to be dysfunctional in obsessive-compulsive disorder (OCD). However, this process involves intentional cognitive control, which does not correspond to the automatic emergence of stereotyped thoughts and behaviours usually reported by patients with OCD. In the present study, the excessive facilitation of unintentional processes was assessed in OCD by using the Computerized Mirror Pointing Task (CMPT). Seventy-six volunteers participated in this study, including 39 patients with OCD and 37 healthy controls. The CMPT was administered to all participants, and a score of appropriateness of the sensorimotor adaptation to the mirror inversion was computed from the initial deviation angle (IDA), that precedes the intentional readjustment of movement. Results showed that throughout the 40 trials of the CMPT, the IDA score remained significantly abnormal in patients with OCD in comparison with control participants. Further analyses of IDA scores in OCD revealed a clear tendency to keep a natural visuomotor processing that is rigid and unadapted to the mirror condition. Irrespective of the physical requirements of the environment, patients with OCD showed a strong tendency to initiate movements as per a previously consolidated - although unadapted - sensorimotor mapping. This suggests a tendency for an excessive facilitation of unintentional stereotyped processes. Further studies should be conducted on this question by using tasks sensitive to cognitive processes other than visuo-spatial abilities.

Reward-dependent modulation of movement variability

Movement variability is often considered an unwanted byproduct of a noisy nervous system. However, variability can signal a form of implicit exploration, indicating that the nervous system is intentionally varying the motor commands in search of actions that yield the greatest success. Here, we investigated the role of the human basal ganglia in controlling reward-dependent motor variability as measured by trial-to-trial changes in performance during a reaching task. We designed an experiment in which the only performance feedback was success or failure and quantified how reach variability was modulated as a function of the probability of reward. In healthy controls, reach variability increased as the probability of reward decreased. Control of variability depended on the history of past rewards, with the largest trial-to-trial changes occurring immediately after an unrewarded trial. In contrast, in participants with Parkinson's disease, a known example of basal ganglia dysfunction, reward was a poor modulator of variability; that is, the patients showed an impaired ability to increase variability in response to decreases in the probability of reward. This was despite the fact that, after rewarded trials, reach variability in the patients was comparable to healthy controls. In summary, we found that movement variability is partially a form of exploration driven by the recent history of rewards. When the function of the human basal ganglia is compromised, the reward-dependent control of movement variability is impaired, particularly affecting the ability to increase variability after unsuccessful outcomes.

Visuomotor adaptation in Parkinson's disease: effects of perturbation type and medication state

To perform simple everyday tasks, we use visual feedback from our external environment to generate and guide movements. However, tasks like reaching for a cup may become extremely difficult in movement disorders such as Parkinson's disease (PD), and it is unknown whether PD patients use visual information to compensate for motor deficiencies. We tested adaptation to changes in visual feedback of the hand in three subject groups, PD patients on daily levodopa (l-dopa) therapy (PD ON), PD patients off l-dopa (PD OFF), and age-matched control subjects, to determine the effects of PD on the visual control of movement. Subjects were tested on two classes of visual perturbations, one that altered visual direction of movement and one that altered visual extent of movement, allowing us to test adaptive sensitivity to changes in both movement direction (visual rotations) and extent (visual gain). The PD OFF group displayed more complete adaptation to visuomotor rotations compared with control subjects but initial, transient difficulty with adaptation to visual gain perturbations. The PD ON group displayed feedback control more sensitive to visual error compared with control subjects but compared with the PD OFF group had mild impairments during adaptation to changes in visual extent. We conclude that PD subjects can adapt to changes in visual information but that l-dopa may impair visual-based motor adaptation.

Association of COMT val158met and DRD2 G>T genetic polymorphisms with individual differences in motor learning and performance in female young adults

Individuals learn new skills at different rates. Given the involvement of corticostriatal pathways in some types of learning, variations in dopaminergic transmission may contribute to these individual differences. Genetic polymorphisms of the catechol-O-methyltransferase (COMT) enzyme and dopamine receptor D2 (DRD2) genes partially determine cortical and striatal dopamine availability, respectively. Individuals who are homozygous for the COMT methionine (met) allele show reduced cortical COMT enzymatic activity, resulting in increased dopamine levels in the prefrontal cortex as opposed to individuals who are carriers of the valine (val) allele. DRD2 G-allele homozygotes benefit from a higher striatal dopamine level compared with T-allele carriers. We hypothesized that individuals who are homozygous for COMT met and DRD2 G alleles would show higher rates of motor learning. Seventy-two young healthy females (20 ± 1.9 yr) performed a sensorimotor adaptation task and a motor sequence learning task. A nonparametric mixed model ANOVA revealed that the COMT val-val group demonstrated poorer performance in the sequence learning task compared with the met-met group and showed a learning deficit in the visuomotor adaptation task compared with both met-met and val-met groups. The DRD2 TT group showed poorer performance in the sequence learning task compared with the GT group, but there was no difference between DRD2 genotype groups in adaptation rate. Although these results did not entirely come out as one might predict based on the known contribution of corticostriatal pathways to motor sequence learning, they support the role of genetic polymorphisms of COMT val158met (rs4680) and DRD2 G>T (rs 1076560) in explaining individual differences in motor performance and motor learning, dependent on task type.

Sensorimotor adaptation of speech in Parkinson's disease

The basal ganglia are involved in establishing motor plans for a wide range of behaviors. Parkinson's disease (PD) is a manifestation of basal ganglia dysfunction associated with a deficit in sensorimotor integration and difficulty in acquiring new motor sequences, thereby affecting motor learning. Previous studies of sensorimotor integration and sensorimotor adaptation in PD have focused on limb movements using visual and force-field alterations. Here, we report the results from a sensorimotor adaptation experiment investigating the ability of PD patients to make speech motor adjustments to a constant and predictable auditory feedback manipulation. Participants produced speech while their auditory feedback was altered and maintained in a manner consistent with a change in tongue position. The degree of adaptation was associated with the severity of motor symptoms. The patients with PD exhibited adaptation to the induced sensory error; however, the degree of adaptation was reduced compared with healthy, age-matched control participants. The reduced capacity to adapt to a change in auditory feedback is consistent with reduced gain in the sensorimotor system for speech and with previous studies demonstrating limitations in the adaptation of limb movements after changes in visual feedback among patients with PD.

Neural correlates of the age-related changes in motor sequence learning and motor adaptation in older adults

As the world's population ages, a deeper understanding of the relationship between aging and motor learning will become increasingly relevant in basic research and applied settings. In this context, this review aims to address the effects of age on motor sequence learning (MSL) and motor adaptation (MA) with respect to behavioral, neurological, and neuroimaging findings. Previous behavioral research investigating the influence of aging on motor learning has consistently reported the following results. First, the initial acquisition of motor sequences is not altered, except under conditions of increased task complexity. Second, older adults demonstrate deficits in motor sequence memory consolidation. And, third, although older adults demonstrate deficits during the exposure phase of MA paradigms, the aftereffects following removal of the sensorimotor perturbation are similar to young adults, suggesting that the adaptive ability of older adults is relatively intact. This paper will review the potential neural underpinnings of these behavioral results, with a particular emphasis on the influence of age-related dysfunctions in the cortico-striatal system on motor learning.

Neural substrates for the motivational regulation of motor recovery after spinal-cord injury

It is believed that depression impedes and motivation enhances functional recovery after neuronal damage such as spinal-cord injury and stroke. However, the neuronal substrate underlying such psychological effects on functional recovery remains unclear. A longitudinal study of brain activation in the non-human primate model of partial spinal-cord injury using positron emission tomography (PET) revealed a contribution of the primary motor cortex (M1) to the recovery of finger dexterity through the rehabilitative training. Here, we show that activity of the ventral striatum, including the nucleus accumbens (NAc), which plays a critical role in processing of motivation, increased and its functional connectivity with M1 emerged and was progressively strengthened during the recovery. In addition, functional connectivities among M1, the ventral striatum and other structures belonging to neural circuits for processing motivation, such as the orbitofrontal cortex, anterior cingulate cortex and pedunculopontine tegmental nucleus were also strengthened during the recovery. These results give clues to the neuronal substrate for motivational regulation of motor learning required for functional recovery after spinal-cord injury.

Visuo-motor gain adaptation and generalization following left hemisphere stroke

During gain adaptation, participants must learn to adapt to novel visuo-motor mappings in which the movement amplitudes they produce do not match the visual feedback they receive. The aim of the present study was to investigate the neural substrates of gain adaptation by examining its possible disruption following left hemisphere stroke. Thirteen chronic left hemisphere stroke patients and five healthy right-handed control subjects completed three experimental phases involving reaching with the left hand, which was the less-affected hand in patients. First, participants reached without visual feedback to six different target locations (baseline phase). Next, in the adaptation phase, participants executed movements to one target under conditions in which the perceived movement distance was 70% of the produced movement distance. Last, in order to test the generalization of this new visuomotor mapping, participants made movements without visual feedback to untrained target locations (generalization phase). Significant between-patient differences were observed during adaptation. Lesion analyses indicated that these between-patient differences were predicted by the amount of damage to the supramarginal gyrus (Brodmann area 40). In addition, patients performed more poorly than controls in the generalization phase, suggesting that different processes are involved in adaptation and generalization periods.

Basal ganglia-dependent processes in recalling learned visual-motor adaptations

Humans learn and remember motor skills to permit adaptation to a changing environment. During adaptation, the brain develops new sensory-motor relationships that become stored in an internal model (IM) that may be retained for extended periods. How the brain learns new IMs and transforms them into long-term memory remains incompletely understood since prior work has mostly focused on the learning process. A current model suggests that basal ganglia, cerebellum, and their neocortical targets actively participate in forming new IMs but that a cerebellar cortical network would mediate automatization. However, a recent study (Marinelli et al. 2009) reported that patients with Parkinson's disease (PD), who have basal ganglia dysfunction, had similar adaptation rates as controls but demonstrated no savings at recall tests (24 and 48 h). Here, we assessed whether a longer training session, a feature known to increase long-term retention of IM in healthy individuals, could allow PD patients to demonstrate savings. We recruited PD patients and age-matched healthy adults and used a visual-motor adaptation paradigm similar to the study by Marinelli et al. (2009), doubling the number of training trials and assessed recall after a short and a 24-h delay. We hypothesized that a longer training session would allow PD patients to develop an enhanced representation of the IM as demonstrated by savings at the recall tests. Our results showed that PD patients had similar adaptation rates as controls but did not demonstrate savings at both recall tests. We interpret these results as evidence that fronto-striatal networks have involvement in the early to late phase of motor memory formation, but not during initial learning.

Conceptual change and preschoolers' theory of mind: evidence from load-force adaptation

Prominent theories of preschoolers' theory of mind development have included a central role for changing or adapting existing conceptual structures in response to experiences. Because of the relatively protracted timetable of theory of mind development, it has been difficult to test this assumption about the role of adaptation directly. To gain evidence that cognitive adaptation is particularly important for theory of mind development, we sought to determine whether individual differences in cognitive adaptation in a non-social domain predicted preschoolers' theory of mind development. Twenty-five preschoolers were tested on batteries of theory of mind tasks, executive functioning tasks, and on their ability to adapt their lifting behavior to smoothly lift an unexpectedly heavy object. Results showed that children who adapted their lifting behavior more rapidly performed better on theory of mind tasks than those who adapted more slowly. These findings held up when age and performance on the executive functioning battery were statistically controlled. Although preliminary, we argue that this relation is attributable to individual differences in children's domain general abilities to efficiently change existing conceptual structures in response to experience.

Movement chunking during sequence learning is a dopamine-dependant process: a study conducted in Parkinson's disease

Chunking of single movements into integrated sequences has been described during motor learning, and we have recently demonstrated that this process involves a dopamine-dependant mechanism in animal (Levesque et al. in Exp Brain Res 182:499-508, 2007; Tremblay et al. in Behav Brain Res 198:231-239, 2009). However, there is no such evidence in human. The aim of the present study was to assess this question in Parkinson's disease (PD), a neurological condition known for its dopamine depletion in the striatum. Eleven PD patients were tested under their usual levodopa medication (ON state), and following a 12-h levodopa withdrawal (OFF state). Patients were compared with 12 healthy participants on a motor learning sequencing task, requiring pressing fourteen buttons in the correct order, which was determined by visual stimuli presented on a computer screen. Learning was assessed from three blocks of 20 trials administered successively. Chunks of movements were intrinsically created by each participant during this learning period. Then, the sequence was shuffled according to the participant's own chunks, generating two new sequences, with either preserved or broken chunks. Those new motor sequences had to be performed separately in a fourth and fifth blocks of 20 trials. Results showed that execution time improved in every group during the learning period (from blocks 1 to 3). However, while motor chunking occurred in healthy controls and ON-PD patients, it did not in OFF-PD patients. In the shuffling conditions, a significant difference was seen between the preserved and the broken chunks conditions for both healthy participants and ON-PD patients, but not for OFF-PD patients. These results suggest that movement chunking during motor sequence learning is a dopamine-dependent process in human.

L-dopa induces under-damped visually guided motor responses in Parkinson's disease

Parkinson's disease preferentially affects internally generated movements, e.g., movements recalled from memory, while externally cued movements are relatively preserved. However, L-dopa may have effects on visually guided movements as well as error-related processing. Fourteen Parkinson's disease (PD) subjects (on and off L-dopa medication) as well as ten normal controls performed a tracking task using a joystick. During discrete 30 s blocks, the visual feedback of the actual tracking errors were attenuated, amplified or unaltered. Second order dynamical system models, with the desired trajectory as the input and the actual motor performance as the output, were used to characterize the motor performance by the each subject under each condition. Although the overall root-mean-square tracking error did not significantly differ between groups, the nature of the motor performance differed significantly across groups. A clear dissociation was made between manipulations of error feedback--which altered the natural frequency of the models--and the effects of L-dopa, which affected damping. Compared to normal controls, PD subjects were significantly overdamped before medication and underdamped after medication. We interpret our results as being suggestive of L: -dopa normalization of compensatory overactive cerebellar activity in PD.

Motor sequence learning in primate: role of the D2 receptor in movement chunking during consolidation

Motor learning disturbances have been shown in diseases involving dopamine insufficiency such as Parkinson's disease and schizophrenic patients under antipsychotic drug treatment. In non-human primates, motor learning deficits have also been observed following systemic administration of raclopride, a selective D2-receptor antagonist. These deficits were characterized by persistent fluctuations of performance from trial to trial, and were described as difficulties in consolidating movements following a learning period. Moreover, it has been suggested that these raclopride-induced fluctuations can result from impediments in grouping separate movements into one fluent sequence. In the present study, we explore the hypothesis that such fluctuations during movement consolidation can be prevented through the use of sumanirole - a highly selective D2 agonist - if administered before raclopride. Two monkeys were trained to execute a well known sequence of movements, which was later recalled under three pharmacological conditions: (1) no drug, (2) raclopride, and (3) sumanirole+raclopride. The same three pharmacological conditions were repeated with the two monkeys, trained this time to learn new sequences of movements. Results show that raclopride has no deleterious effect on the well known sequence, nor the sumanirole+raclopride co-administration. However, results on the new sequence to be learned revealed continuous fluctuations of performances in the raclopride condition, but not in the sumanirole+raclopride condition. These fluctuations occurred concurrently with a difficulty in merging separate movement components, known as a "chunking deficit". D2 receptors seem therefore to be involved in the consolidation of new motor skills, and this might involve the chunking of separate movements into integrated motor sequences.