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Moondra P, Rubin L, McCrossin M, Persaud A, Di Rocco A, Quartarone A, Ghilardi MF. In-Patient Multimodal Intensive Neurorehabilitation and Care Improve Motor and Non-Motor Functions in the Moderately Advanced Stages of Parkinson's Disease: A Retrospective Study in a U.S. Facility. Biomedicines 2024; 12:1658. [PMID: 39200123 PMCID: PMC11351900 DOI: 10.3390/biomedicines12081658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/09/2024] [Accepted: 07/19/2024] [Indexed: 09/01/2024] Open
Abstract
(1) Background: Previous studies, mostly performed in European centers, have shown that in-patient multimodal intensive rehabilitation treatments lasting for two to four weeks can improve both motor and non-motor symptoms of Parkinson's disease (PD) with long-lasting effects. Here, we ascertain the effects of a similar in-patient program in a U.S. center with a retrospective study in a cohort of 153 patients in the moderately advanced stage of PD. (2) Methods: We compared indices of motor and non-motor functions before and immediately after such treatment and investigated the possible differences between men and women. We used the available records of the Beck Depression Inventory, PDQ39, PD Sleep Scale, Timed Up and Go, Vocal Volume, Voice Handicap, and total UPDRS scores. (3) Results: We found that at the end of treatment, which lasted an average of 14 days, all outcome measures significantly improved independently of sex. (4) Conclusions: These results confirm the previous findings with a similar in-patient approach in European centers. They further suggest that this in-patient treatment is a care model that is feasible in U.S. centers and can provide a more immediate benefit to the motor function and quality of life of patients with moderately advanced PD.
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Affiliation(s)
- Priyanka Moondra
- Department of Neurology, Movement Disorders Division, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Long Island, NY 11542, USA; (P.M.); (L.R.); (M.M.); (A.P.); (A.D.R.)
| | - Lyubov Rubin
- Department of Neurology, Movement Disorders Division, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Long Island, NY 11542, USA; (P.M.); (L.R.); (M.M.); (A.P.); (A.D.R.)
| | - Mara McCrossin
- Department of Neurology, Movement Disorders Division, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Long Island, NY 11542, USA; (P.M.); (L.R.); (M.M.); (A.P.); (A.D.R.)
| | - Amanda Persaud
- Department of Neurology, Movement Disorders Division, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Long Island, NY 11542, USA; (P.M.); (L.R.); (M.M.); (A.P.); (A.D.R.)
| | - Alessandro Di Rocco
- Department of Neurology, Movement Disorders Division, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Long Island, NY 11542, USA; (P.M.); (L.R.); (M.M.); (A.P.); (A.D.R.)
| | | | - Maria Felice Ghilardi
- Department of Molecular, Cellular and Biomedical Sciences, CUNY School of Medicine, New York, NY 10031, USA
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2
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Murueta-Goyena A, Muiño O, Gómez-Esteban JC. Prognostic factors for falls in Parkinson's disease: a systematic review. Acta Neurol Belg 2024; 124:395-406. [PMID: 38015306 PMCID: PMC10965733 DOI: 10.1007/s13760-023-02428-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Falls represent a critical concern in Parkinson's disease (PD), contributing to increased morbidity and reduced quality of life. PURPOSE We conducted a systematic review to assess the prognostic factors associated with falls in PD, aiming to provide a comprehensive overview of relevant demographic and clinical parameters, and aid neurologists in identifying subsets of PD patients most susceptible to falls and associated injuries. METHODS PubMed and Web of Science databases were searched for prospective studies assessing factors associated with falls in ambulatory PD patients across different settings, from inception to August 2023. Data extraction was conducted using CHARMS-PF checklist and risk of bias was assessed with QUIPS tool. PRISMA guidelines were followed. RESULTS The initial search yielded 155 references. Thirty-four studies, involving a total of 3454 PD patients, were included in the final analysis. The mean pooled age was 67.6 years, and 45.1% were women. PD patients presented mild motor impairment (UPDRS III score 27.8) with mean pooled disease duration of 5.7 years. Gait and balance disorders and history of prior falls emerged as the most consistent predictors of falls across studies. Disease duration, disease severity, dysautonomic symptoms, freezing of gait, frontal cognitive functions, and PD medication dosages yielded inconsistent findings. Conversely, dyskinesias, age, sex, and depression were unrelated to future falls in PD. Logistic regression models were most commonly employed to identify factors significantly associated with falls in PD. Substantial heterogeneity prevailed in the inclusion of confounding factors. CONCLUSION The evidence suggests that previous history of falls, gait disorders, and poor balance are robust prognostic markers for falls in PD.
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Affiliation(s)
- Ane Murueta-Goyena
- Department of Neurosciences, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Barrio Sarriena S/N, 48940, Leioa, Bizkaia, Spain.
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain.
| | - Oier Muiño
- Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Juan Carlos Gómez-Esteban
- Department of Neurosciences, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Barrio Sarriena S/N, 48940, Leioa, Bizkaia, Spain
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
- Department of Neurology, Cruces University Hospital, Osakidetza, Barakaldo, Bizkaia, Spain
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3
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Swainson A, Woodward KM, Boca M, Rolinski M, Collard P, Cerminara NL, Apps R, Whone AL, Gilchrist ID. Slower rates of prism adaptation but intact aftereffects in patients with early to mid-stage Parkinson's disease. Neuropsychologia 2023; 189:108681. [PMID: 37709193 DOI: 10.1016/j.neuropsychologia.2023.108681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023]
Abstract
There is currently mixed evidence on the effect of Parkinson's disease on motor adaptation. Some studies report that patients display adaptation comparable to age-matched controls, while others report a complete inability to adapt to novel sensory perturbations. Here, early to mid-stage Parkinson's patients were recruited to perform a prism adaptation task. When compared to controls, patients showed slower rates of initial adaptation but intact aftereffects. These results support the suggestion that patients with early to mid-stage Parkinson's disease display intact adaptation driven by sensory prediction errors, as shown by the intact aftereffect. But impaired facilitation of performance through cognitive strategies informed by task error, as shown by the impaired initial adaptation. These results support recent studies that suggest that patients with Parkinson's disease retain the ability to perform visuomotor adaptation, but display altered use of cognitive strategies to aid performance and generalises these previous findings to the classical prism adaptation task.
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Affiliation(s)
- Alex Swainson
- University of Bristol, School of Physiology, Pharmacology and Neuroscience, Bristol, BS8 1TD, United Kingdom.
| | - Kathryn M Woodward
- Bristol Medical School, University of Bristol, Bristol, BS8 1UD, United Kingdom
| | - Mihaela Boca
- Bristol Brain Centre, Southmead Hospital, Bristol, BS10 5FN, United Kingdom
| | - Michal Rolinski
- Bristol Brain Centre, Southmead Hospital, Bristol, BS10 5FN, United Kingdom
| | - Philip Collard
- University of Bristol, School of Psychological Science, Bristol, BS8 1TU, United Kingdom
| | - Nadia L Cerminara
- University of Bristol, School of Physiology, Pharmacology and Neuroscience, Bristol, BS8 1TD, United Kingdom
| | - Richard Apps
- University of Bristol, School of Physiology, Pharmacology and Neuroscience, Bristol, BS8 1TD, United Kingdom
| | - Alan L Whone
- Bristol Brain Centre, Southmead Hospital, Bristol, BS10 5FN, United Kingdom
| | - Iain D Gilchrist
- University of Bristol, School of Psychological Science, Bristol, BS8 1TU, United Kingdom
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4
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Cristini J, Parwanta Z, De las Heras B, Medina-Rincon A, Paquette C, Doyon J, Dagher A, Steib S, Roig M. Motor Memory Consolidation Deficits in Parkinson's Disease: A Systematic Review with Meta-Analysis. JOURNAL OF PARKINSON'S DISEASE 2023; 13:865-892. [PMID: 37458048 PMCID: PMC10578244 DOI: 10.3233/jpd-230038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The ability to encode and consolidate motor memories is essential for persons with Parkinson's disease (PD), who usually experience a progressive loss of motor function. Deficits in memory encoding, usually expressed as poorer rates of skill improvement during motor practice, have been reported in these patients. Whether motor memory consolidation (i.e., motor skill retention) is also impaired is unknown. OBJECTIVE To determine whether motor memory consolidation is impaired in PD compared to neurologically intact individuals. METHODS We conducted a pre-registered systematic review (PROSPERO: CRD42020222433) following PRISMA guidelines that included 46 studies. RESULTS Meta-analyses revealed that persons with PD have deficits in retaining motor skills (SMD = -0.17; 95% CI = -0.32, -0.02; p = 0.0225). However, these deficits are task-specific, affecting sensory motor (SMD = -0.31; 95% CI -0.47, -0.15; p = 0.0002) and visuomotor adaptation (SMD = -1.55; 95% CI = -2.32, -0.79; p = 0.0001) tasks, but not sequential fine motor (SMD = 0.17; 95% CI = -0.05, 0.39; p = 0.1292) and gross motor tasks (SMD = 0.04; 95% CI = -0.25, 0.33; p = 0.7771). Importantly, deficits became non-significant when augmented feedback during practice was provided, and additional motor practice sessions reduced deficits in sensory motor tasks. Meta-regression analyses confirmed that deficits were independent of performance during encoding, as well as disease duration and severity. CONCLUSION Our results align with the neurodegenerative models of PD progression and motor learning frameworks and emphasize the importance of developing targeted interventions to enhance motor memory consolidation in PD.
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Affiliation(s)
- Jacopo Cristini
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Zohra Parwanta
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Bernat De las Heras
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Almudena Medina-Rincon
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
- Grupo de investigación iPhysio, San Jorge University, Zaragoza, Aragón, Spain
- Department of Physiotherapy, San Jorge University, Zaragoza, Aragón, Spain
| | - Caroline Paquette
- Department of Kinesiology & Physical Education, McGill University, Montreal, QC,Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
| | - Julien Doyon
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Alain Dagher
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Simon Steib
- Department of Human Movement, Training and Active Aging, Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
| | - Marc Roig
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
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5
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Thompson E, Reisman DS. Split-Belt Adaptation and Savings in People With Parkinson Disease. J Neurol Phys Ther 2022; 46:293-301. [PMID: 35980730 PMCID: PMC9529810 DOI: 10.1097/npt.0000000000000411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Upper extremity studies suggest that implicit adaptation is less impaired than explicit learning in persons with Parkinson disease (PD). Little work has explored implicit locomotor adaptation and savings in this population, yet implicit locomotor learning is critical for everyday function. This cross-sectional study examined adaptation and savings in individuals with PD during split-belt treadmill walking. METHODS Fourteen participants completed the following treadmill protocol: Baseline (6 minutes belts tied), Adaptation (10 minutes split), Washout (10 minutes tied), and Readaptation (10 minutes split). Step length and step symmetry index (SSI) were calculated to determine magnitude and rate of adaptation and savings. Rate was calculated as strides to reach SSI plateau during Adaptation and Readaptation. RESULTS During Early Adaptation and Early Readaptation, SSI was perturbed from Baseline ( P < 0.001 and P = 0.002, respectively). Less perturbation in Early Readaptation ( P < 0.001) demonstrated savings. In Late Adaptation and Late Readaptation, participants returned to Baseline symmetry ( P = 0.026 and P = 0.022, respectively, with adjusted level of significance = 0.007). Adaptation was also seen in reverse asymmetry observed in Early Washout ( P = 0.003 vs Baseline). Readaptation rate was faster than in Adaptation ( P = 0.015), demonstrating savings. DISCUSSION AND CONCLUSIONS Individuals with PD showed locomotor adaptation in an implicit sensorimotor adaptation task. They also demonstrated savings, with less perturbation and faster adaptation during the second split-belt exposure. However, performance was variable; some individuals showed minimal adaptation. Variations in learning, savings, and clinical presentation highlight the need to further explore characteristics of individuals with PD most likely to benefit from adaptation-based locomotor training.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A395 ).
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Affiliation(s)
- Elizabeth Thompson
- Department of Physical Therapy, University of Delaware, Newark, Delaware 19713
| | - Darcy S. Reisman
- Department of Physical Therapy, University of Delaware, Newark, Delaware 19713
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Machado S, Teixeira D, Monteiro D, Imperatori C, Murillo-Rodriguez E, da Silva Rocha FP, Yamamoto T, Amatriain-Fernández S, Budde H, Carta MG, Caixeta L, de Sá Filho AS. Clinical applications of exercise in Parkinson's disease: what we need to know? Expert Rev Neurother 2022; 22:771-780. [PMID: 36168890 DOI: 10.1080/14737175.2022.2128768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Exploring the potential of exercise in the rehabilitation process of patients with Parkinson's (PD) may be an interesting treatment perspective. Exercise-induced responses derived from neurotrophic elements appear to ameliorate the decline in neurodegeneration. Despite this understanding, the literature needs to be updated. AREAS COVERED Our review focuses on: a) the key mechanisms of exercise on PD, highlighting mainly the responses related to neuroplasticity; b) the effects induced by different traditional types of exercise, also highlighting the effects of complementary therapies related to movement; c) the volume of exercise required to support efficient results are explored in the context of PD. Additionally, the proposition of new clinical application strategies in the context of PD will also be determined. EXPERT OPINION It is suggested that different intensities of aerobic exercise be explored for the treatment of PD. The results associated with high intensity seem promising for performance, physiological and clinical parameters, such as BDNF production and cognition. On the other hand, the diversification of tasks and repetition of motor gestures appear as consistent arguments to exercise prescription. Finally, for future investigations, the neuromodulation strategy in association with aerobic exercise appears as a potential inducer of benefits on gait and cognitive function.
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Affiliation(s)
- Sergio Machado
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil.,Physical Activity Neuroscience Laboratory (LABNAF), Neurodiversity Institute, Queimados-RJ, Brazil.,Intercontinental Neuroscience Research Group, Mérida, Mexico
| | - Diogo Teixeira
- Universidade Lusófona, Faculty of Physical Education and Sport, Lisbon, Portugal; Research Center in Sport, Physical Education, and Exercise and Health (CIDEFES), Lisbon, Portugal
| | - Diogo Monteiro
- ESECS, Polytechnic of Leiria, 2411-901 Leiria, Portugal; Research Center in Sport, Health and Human Development (CIDESD), 5000-558, Vila Real, Portugal.,Life Quality Research Centre (CIEQV), Leiria, Portugal
| | - Claudio Imperatori
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Cognitive and Clinical Psychology Laboratory, Department of Human Sciences European University of Rome, Rome, Italy
| | - Eric Murillo-Rodriguez
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud, Universidad Anáhuac Mayab, Mexico
| | | | - Tetsuya Yamamoto
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan
| | - Sandra Amatriain-Fernández
- Institute for Systems Medicine (ISM) at the Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
| | - Henning Budde
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Institute for Systems Medicine (ISM) at the Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
| | - Mauro Giovanni Carta
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Leonardo Caixeta
- Neurology and Neuropsychiatry Department of Clinical Medicine, Federal University of Goiás, School of Medicine, Goiânia, Brazil
| | - Alberto Souza de Sá Filho
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud, Universidad Anáhuac Mayab, Mexico.,Department of Physical Education, Paulista University, Goiânia, Brazil
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Ferrazzoli D, Ortelli P, Iansek R, Volpe D. Rehabilitation in movement disorders: From basic mechanisms to clinical strategies. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:341-355. [PMID: 35034747 DOI: 10.1016/b978-0-12-819410-2.00019-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Movement disorders encompass a variety of conditions affecting the nervous system at multiple levels. The pathologic processes underlying movement disorders alter the normal neural functions and could lead to aberrant neuroplastic changes and to clinical phenomenology that is not expressed only through mere motor symptoms. Given this complexity, the responsiveness to pharmacologic and surgical therapies is often disappointing. Growing evidence supports the efficacy of neurorehabilitation for the treatment of movement disorders. Specific form of training involving both goal-based practice and aerobic training could drive and modulate neuroplasticity in order to restore the circuitries dysfunctions and to achieve behavioral gains. This chapter provides an overview of the alterations expressed in some movement disorders in terms of clinical signs and symptoms and plasticity, and suggests which ones and why tailored rehabilitation strategies should be adopted for the management of the different movement disorders.
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Affiliation(s)
- Davide Ferrazzoli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy; Department of Parkinson's Disease, Fresco Parkinson Center, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital-Gravedona ed Uniti, Como, Italy
| | - Paola Ortelli
- Department of Parkinson's Disease, Fresco Parkinson Center, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital-Gravedona ed Uniti, Como, Italy; Department of Parkinson's Disease, Fresco Parkinson Center, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital-Gravedona ed Uniti, Como, Italy
| | - Robert Iansek
- Clinical Research Centre for Movement Disorders and Gait, National Parkinson Foundation Center of Excellence, Monash Health, Cheltenham, VIC, Australia; School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Daniele Volpe
- Department of Rehabilitation, Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy
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8
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Parkinson's disease: Alterations of motor plasticity and motor learning. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:135-151. [PMID: 35034730 DOI: 10.1016/b978-0-12-819410-2.00007-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This chapter reviews the alterations in motor learning and motor cortical plasticity in Parkinson's disease (PD), the most common movement disorder. Impairments in motor learning, which is a hallmark of basal ganglia disorders, influence the performance of motor learning-related behavioral tasks and have clinical implications for the management of disturbance in gait and posture, and for rehabilitative management of PD. Although plasticity is classically induced and assessed in sliced preparation in animal models, in this review we have concentrated on the results from non-invasive brain stimulation techniques such as transcranial magnetic stimulation (TMS), transcranial alternating current stimulation (tACS) and transcranial direct current stimulation (tDCS) in patients with PD, in addition to a few animal electrophysiologic studies. The chapter summarizes the results from different cortical and subcortical plasticity investigations. Plasticity induction protocols reveal deficient plasticity in PD and these plasticity measures are modulated by medications and deep brain stimulation. There is considerable variability in these measures that are related to inter-individual variations, different disease characteristics and methodological considerations. Nevertheless, these pathophysiologic studies expand our knowledge of cortical excitability, plasticity and the effects of different treatments in PD. These tools of modulating plasticity and motor learning improve our understanding of PD pathophysiology and help to develop new treatments for this disabling condition.
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9
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Therrien AS, Wong AL. Mechanisms of Human Motor Learning Do Not Function Independently. Front Hum Neurosci 2022; 15:785992. [PMID: 35058767 PMCID: PMC8764186 DOI: 10.3389/fnhum.2021.785992] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Human motor learning is governed by a suite of interacting mechanisms each one of which modifies behavior in distinct ways and rely on different neural circuits. In recent years, much attention has been given to one type of motor learning, called motor adaptation. Here, the field has generally focused on the interactions of three mechanisms: sensory prediction error SPE-driven, explicit (strategy-based), and reinforcement learning. Studies of these mechanisms have largely treated them as modular, aiming to model how the outputs of each are combined in the production of overt behavior. However, when examined closely the results of some studies also suggest the existence of additional interactions between the sub-components of each learning mechanism. In this perspective, we propose that these sub-component interactions represent a critical means through which different motor learning mechanisms are combined to produce movement; understanding such interactions is critical to advancing our knowledge of how humans learn new behaviors. We review current literature studying interactions between SPE-driven, explicit, and reinforcement mechanisms of motor learning. We then present evidence of sub-component interactions between SPE-driven and reinforcement learning as well as between SPE-driven and explicit learning from studies of people with cerebellar degeneration. Finally, we discuss the implications of interactions between learning mechanism sub-components for future research in human motor learning.
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10
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Rothwell J, Antal A, Burke D, Carlsen A, Georgiev D, Jahanshahi M, Sternad D, Valls-Solé J, Ziemann U. Central nervous system physiology. Clin Neurophysiol 2021; 132:3043-3083. [PMID: 34717225 PMCID: PMC8863401 DOI: 10.1016/j.clinph.2021.09.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022]
Abstract
This is the second chapter of the series on the use of clinical neurophysiology for the study of movement disorders. It focusses on methods that can be used to probe neural circuits in brain and spinal cord. These include use of spinal and supraspinal reflexes to probe the integrity of transmission in specific pathways; transcranial methods of brain stimulation such as transcranial magnetic stimulation and transcranial direct current stimulation, which activate or modulate (respectively) the activity of populations of central neurones; EEG methods, both in conjunction with brain stimulation or with behavioural measures that record the activity of populations of central neurones; and pure behavioural measures that allow us to build conceptual models of motor control. The methods are discussed mainly in relation to work on healthy individuals. Later chapters will focus specifically on changes caused by pathology.
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Affiliation(s)
- John Rothwell
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, London, UK,Corresponding author at: Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK, (J. Rothwell)
| | - Andrea Antal
- Department of Neurology, University Medical Center Göttingen, Germany
| | - David Burke
- Department of Neurology, Royal Prince Alfred Hospital, University of Sydney, Sydney 2050, Australia
| | - Antony Carlsen
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Dejan Georgiev
- Department of Neurology, University Medical Centre Ljubljana, Slovenia
| | - Marjan Jahanshahi
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, London, UK
| | - Dagmar Sternad
- Departments of Biology, Electrical & Computer Engineering, and Physics, Northeastern University, Boston, MA 02115, USA
| | - Josep Valls-Solé
- Institut d’Investigació Biomèdica August Pi I Sunyer, Villarroel, 170, Barcelona, Spain
| | - Ulf Ziemann
- Department of Neurology and Stroke, and Hertie Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany
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11
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Rossi C, Roemmich RT, Schweighofer N, Bastian AJ, Leech KA. Younger and Late Middle-Aged Adults Exhibit Different Patterns of Cognitive-Motor Interference During Locomotor Adaptation, With No Disruption of Savings. Front Aging Neurosci 2021; 13:729284. [PMID: 34899267 PMCID: PMC8664558 DOI: 10.3389/fnagi.2021.729284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022] Open
Abstract
It has been proposed that motor adaptation and subsequent savings (or faster relearning) of an adapted movement pattern are mediated by cognitive processes. Here, we evaluated the pattern of cognitive-motor interference that emerges when young and late middle-aged adults perform an executive working memory task during locomotor adaptation. We also asked if this interferes with savings of a newly learned walking pattern, as has been suggested by a study of reaching adaptation. We studied split-belt treadmill adaptation and savings in young (21 ± 2 y/o) and late middle-aged (56 ± 6 y/o) adults with or without a secondary 2-back task during adaptation. We found that young adults showed similar performance on the 2-back task during baseline and adaptation, suggesting no effect of the dual-task on cognitive performance; however, dual-tasking interfered with adaptation over the first few steps. Conversely, dual-tasking caused a decrement in cognitive performance in late middle-aged adults with no effect on adaptation. To determine if this effect was specific to adaptation, we also evaluated dual-task interference in late middle-aged adults that dual-tasked while walking in a complex environment that did not induce motor adaptation. This group exhibited less cognitive-motor interference than late middle-aged adults who dual-tasked during adaptation. Savings was unaffected by dual-tasking in both young and late middle-aged adults, which may indicate different underlying mechanisms for savings of reaching and walking. Collectively, our findings reveal an age-dependent effect of cognitive-motor interference during dual-task locomotor adaptation and no effect of dual-tasking on savings, regardless of age. Young adults maintain cognitive performance and show a mild decrement in locomotor adaptation, while late middle-aged adults adapt locomotion at the expense of cognitive performance.
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Affiliation(s)
- Cristina Rossi
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Ryan T. Roemmich
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Nicolas Schweighofer
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
| | - Amy J. Bastian
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kristan A. Leech
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
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12
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Hill CM, Waddell DE, Del Arco A. Cortical preparatory activity during motor learning reflects visuomotor retention deficits after punishment feedback. Exp Brain Res 2021; 239:3243-3254. [PMID: 34453554 DOI: 10.1007/s00221-021-06200-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 08/17/2021] [Indexed: 10/20/2022]
Abstract
Previous studies have shown that reinforcement-based motor learning requires the brain to process feedback-related information after movement execution. However, whether reinforcement feedback changes how the brain processes motor preparation before movement execution is unclear. By using electroencephalography (EEG), this study investigates whether reinforcement feedback changes cortical preparatory activity to modulate motor learning and memory. Human subjects were divided in three groups [reward, punishment, control] to perform a visuomotor rotation task under different conditions that assess adaptation (learning) and retention (memory) during the task. Reinforcement feedback was provided in the form of points after each trial that signaled monetary gains (reward) or losses (punishment). EEG was utilized to evaluate the amplitude of movement readiness potentials (MRPs) at the beginning of each trial for each group during the adaptation and retention conditions of the task. The results show that punishment feedback significantly decreased MRPs amplitude during both task conditions compared to Reward and Control groups. Moreover, the punishment-related decrease in MRPs amplitude paralleled decreases in motor performance during the retention but not the adaptation condition. No changes in MRPs or motor performance were observed in the Reward group. These results support the idea that reinforcement feedback modulates motor preparation and suggest that changes in cortical preparatory activity contribute to the visuomotor retention deficits observed after punishment feedback.
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Affiliation(s)
- Christopher M Hill
- Kinesiology and Physical Education, Northern Illinois University, 228 Anderson Hall, DeKalb, IL, 60115, USA.
| | - Dwight E Waddell
- Biomedical Engineering, University of Mississippi, Oxford, MS, USA
| | - Alberto Del Arco
- Health, Exercise Science, and Recreation Management, University of Mississippi, Oxford, MS, USA.,Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS, USA
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13
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Palidis DJ, McGregor HR, Vo A, MacDonald PA, Gribble PL. Null effects of levodopa on reward- and error-based motor adaptation, savings, and anterograde interference. J Neurophysiol 2021; 126:47-67. [PMID: 34038228 DOI: 10.1152/jn.00696.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Dopamine signaling is thought to mediate reward-based learning. We tested for a role of dopamine in motor adaptation by administering the dopamine precursor levodopa to healthy participants in two experiments involving reaching movements. Levodopa has been shown to impair reward-based learning in cognitive tasks. Thus, we hypothesized that levodopa would selectively impair aspects of motor adaptation that depend on the reinforcement of rewarding actions. In the first experiment, participants performed two separate tasks in which adaptation was driven either by visual error-based feedback of the hand position or binary reward feedback. We used EEG to measure event-related potentials evoked by task feedback. We hypothesized that levodopa would specifically diminish adaptation and the neural responses to feedback in the reward learning task. However, levodopa did not affect motor adaptation in either task nor did it diminish event-related potentials elicited by reward outcomes. In the second experiment, participants learned to compensate for mechanical force field perturbations applied to the hand during reaching. Previous exposure to a particular force field can result in savings during subsequent adaptation to the same force field or interference during adaptation to an opposite force field. We hypothesized that levodopa would diminish savings and anterograde interference, as previous work suggests that these phenomena result from a reinforcement learning process. However, we found no reliable effects of levodopa. These results suggest that reward-based motor adaptation, savings, and interference may not depend on the same dopaminergic mechanisms that have been shown to be disrupted by levodopa during various cognitive tasks.NEW & NOTEWORTHY Motor adaptation relies on multiple processes including reinforcement of successful actions. Cognitive reinforcement learning is impaired by levodopa-induced disruption of dopamine function. We administered levodopa to healthy adults who participated in multiple motor adaptation tasks. We found no effects of levodopa on any component of motor adaptation. This suggests that motor adaptation may not depend on the same dopaminergic mechanisms as cognitive forms or reinforcement learning that have been shown to be impaired by levodopa.
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Affiliation(s)
- Dimitrios J Palidis
- Brain and Mind Institute, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada.,Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Heather R McGregor
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | - Andrew Vo
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Penny A MacDonald
- Brain and Mind Institute, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada.,Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
| | - Paul L Gribble
- Brain and Mind Institute, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada.,Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Haskins Laboratories, New Haven, Connecticut
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14
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Wood AN. New roles for dopamine in motor skill acquisition: lessons from primates, rodents, and songbirds. J Neurophysiol 2021; 125:2361-2374. [PMID: 33978497 DOI: 10.1152/jn.00648.2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
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.
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Affiliation(s)
- A N Wood
- Department of Biology and Graduate Program in Neuroscience, Emory University, Atlanta, Georgia
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15
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Meloni M, Saibene FL, Di Tella S, Di Cesare M, Borgnis F, Nemni R, Baglio F. Functional and Cognitive Improvement After an Intensive Inpatient Multidisciplinary Rehabilitation Program in Mild to Severe Parkinson's Disease: A Retrospective and Observational Study. Front Neurol 2021; 12:626041. [PMID: 33815253 PMCID: PMC8012662 DOI: 10.3389/fneur.2021.626041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/03/2021] [Indexed: 01/03/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor (resting tremor, rigidity, bradykinesia, postural instability, and gait disturbances) and nonmotor symptoms (cognitive, neuropsychiatric, and autonomic problems). In recent years, several studies demonstrated that neurorehabilitation therapy is an effective treatment in addition to pharmacological personalized interventions in persons with PD (PwPD). The main aim of this study was to explore the short-term changes in functional, cognitive, and geriatric domains after a multidimensional rehabilitation program in PwPD (as primary condition) in mild-moderate (M-Ms) to severe (Ss) stages. Our second aim was to compare the effects of multidimensional rehabilitation in M-Ms versus Ss of PD. Twenty-four PwPD in M-Ms to Ss [age (mean ± SD) = 76.25 ± 9.42 years; male/female = 10/14; Hoehn and Yahr (median; IQR) = 4.00; 1.75] were included in a retrospective, observational study. Motor, cognitive, functional, and neuropsychiatric aspects were collected in admission (T0) and in discharge (T1). PwPD were involved in a person-tailored (to individual's needs), inpatient, intensive (5-7 days per week), multidisciplinary (combining cognitive, physical, occupational, and speech therapies), comprehensive, and rehabilitative program. According to Movement Disorders Society Unified Parkinson's Disease Rating Scale III cutoff, PwPD were classified in M-Ms or Ss (M-Ms ≤59; Ss >59); 87.50% of our sample reported significant reduction of functional disability at Barthel Index (p < 0.001). A significant improvement in Token test (p = 0.021), semantic fluency (p = 0.036), Rey's Figure-Copy (p < 0.001), and Raven's Colored Progressive Matrices (p = 0.004) was observed. The pain intensity perception (p < 0.001) and the risk of developing pressure ulcers (p < 0.001) as assessed, respectively, by the Numeric Rating Scale and by the Norton Scale were improved. With regard to the second aim, in M-Ms group, we found a positive correlation between the number of neuromotor sessions and the change in functional disability and language comprehension; in the Ss group, on the other hand, despite a higher number of hospitalization days, the total number of completed sessions was positively associated with the change in visuoconstructional abilities. Our findings suggest that an intensive, inpatient, and multidisciplinary rehabilitation program may improve functional abilities, some strategic cognitive functions, and geriatric aspects in PwPD with mild-moderate motor impairment.
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Affiliation(s)
- Mario Meloni
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | | | | | - Francesca Borgnis
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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16
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Cressman EK, Salomonczyk D, Constantin A, Miyasaki J, Moro E, Chen R, Strafella A, Fox S, Lang AE, Poizner H, Henriques DYP. Proprioceptive recalibration following implicit visuomotor adaptation is preserved in Parkinson's disease. Exp Brain Res 2021; 239:1551-1565. [PMID: 33688984 DOI: 10.1007/s00221-021-06075-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/26/2021] [Indexed: 10/21/2022]
Abstract
Individuals with Parkinson's disease (PD) and healthy adults demonstrate similar levels of visuomotor adaptation provided that the distortion is small or introduced gradually, and hence, implicit processes are engaged. Recently, implicit processes underlying visuomotor adaptation in healthy individuals have been proposed to include proprioceptive recalibration (i.e., shifts in one's proprioceptive sense of felt hand position to match the visual estimate of their hand experienced during reaches with altered visual feedback of the hand). In the current study, we asked if proprioceptive recalibration is preserved in PD patients. PD patients tested during their "off" and "on" medication states and age-matched healthy controls reached to visual targets, while visual feedback of their unseen hand was gradually rotated 30° clockwise or translated 4 cm rightwards of their actual hand trajectory. As expected, PD patients and controls produced significant reach aftereffects, indicating visuomotor adaptation after reaching with the gradually introduced visuomotor distortions. More importantly, following visuomotor adaptation, both patients and controls showed recalibration in hand position estimates, and the magnitude of this recalibration was comparable between PD patients and controls. No differences for any measures assessed were observed across medication status (i.e., PD off vs PD on). Results reveal that patients are able to adjust their sensorimotor mappings and recalibrate proprioception following adaptation to a gradually introduced visuomotor distortion, and that dopaminergic intervention does not affect this proprioceptive recalibration. These results suggest that proprioceptive recalibration does not involve striatal dopaminergic pathways and may contribute to the preserved visuomotor adaptation that arises implicitly in PD patients.
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Affiliation(s)
- Erin K Cressman
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Danielle Salomonczyk
- Department of Psychology, York University, Toronto, Canada.,Centre for Vision Research, York University, Toronto, Canada
| | | | - Janis Miyasaki
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Elena Moro
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Robert Chen
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Antonio Strafella
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Susan Fox
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Howard Poizner
- Institute for Neural Computation, University of California, San Diego, USA
| | - Denise Y P Henriques
- Centre for Vision Research, York University, Toronto, Canada. .,Department of Kinesiology, School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
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17
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Larger, but not better, motor adaptation ability inherent in medicated Parkinson's disease patients revealed by a smart-device-based study. Sci Rep 2020; 10:7113. [PMID: 32346067 PMCID: PMC7188883 DOI: 10.1038/s41598-020-63717-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 02/09/2020] [Indexed: 11/08/2022] Open
Abstract
Generating appropriate motor commands is an essential brain function. To achieve proper motor control in diverse situations, predicting future states of the environment and body and modifying the prediction are indispensable. The internal model is a promising hypothesis about brain function for generating and modifying the prediction. Although several findings support the involvement of the cerebellum in the internal model, recent results support the influence of other related brain regions on the internal model. A representative example is the motor adaptation ability in Parkinson’s disease (PD) patients. Although this ability provides some hints about how dopamine deficits and other PD symptoms affect the internal model, previous findings are inconsistent; some reported a deficit in the motor adaptation ability in PD patients, but others reported that the motor adaptation ability of PD patients is comparable to that of healthy controls. A possible factor causing this inconsistency is the difference in task settings, resulting in different cognitive strategies in each study. Here, we demonstrate a larger, but not better, motor adaptation ability in PD patients than in healthy controls while reducing the involvement of cognitive strategies and concentrating on implicit motor adaptation abilities. This study utilizes a smart-device-based experiment that enables motor adaptation experiments anytime and anywhere with less cognitive strategy involvement. The PD patients showed a significant response to insensible environmental changes, but the response was not necessarily suitable for adapting to the changes. Our findings support compensatory cerebellar functions in PD patients from the perspective of motor adaptation.
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18
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Palmisano C, Brandt G, Vissani M, Pozzi NG, Canessa A, Brumberg J, Marotta G, Volkmann J, Mazzoni A, Pezzoli G, Frigo CA, Isaias IU. Gait Initiation in Parkinson's Disease: Impact of Dopamine Depletion and Initial Stance Condition. Front Bioeng Biotechnol 2020; 8:137. [PMID: 32211390 PMCID: PMC7068722 DOI: 10.3389/fbioe.2020.00137] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/11/2020] [Indexed: 01/14/2023] Open
Abstract
Postural instability, in particular at gait initiation (GI), and resulting falls are a major determinant of poor quality of life in subjects with Parkinson’s disease (PD). Still, the contribution of the basal ganglia and dopamine on the feedforward postural control associated with this motor task is poorly known. In addition, the influence of anthropometric measures (AM) and initial stance condition on GI has never been consistently assessed. The biomechanical resultants of anticipatory postural adjustments contributing to GI [imbalance (IMB), unloading (UNL), and stepping phase) were studied in 26 unmedicated subjects with idiopathic PD and in 27 healthy subjects. A subset of 13 patients was analyzed under standardized medication conditions and the striatal dopaminergic innervation was studied in 22 patients using FP-CIT and SPECT. People with PD showed a significant reduction in center of pressure (CoP) displacement and velocity during the IMB phase, reduced first step length and velocity, and decreased velocity and acceleration of the center of mass (CoM) at toe off of the stance foot. All these measurements correlated with the dopaminergic innervation of the putamen and substantially improved with levodopa. These results were not influenced by anthropometric parameters or by the initial stance condition. In contrast, most of the measurements of the UNL phase were influenced by the foot placement and did not correlate with putaminal dopaminergic innervation. Our results suggest a significant role of dopamine and the putamen particularly in the elaboration of the IMB phase of anticipatory postural adjustments and in the execution of the first step. The basal ganglia circuitry may contribute to defining the optimal referent body configuration for a proper initiation of gait and possibly gait adaptation to the environment.
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Affiliation(s)
- Chiara Palmisano
- Department of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, Germany.,MBMC Lab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Gregor Brandt
- Department of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, Germany
| | - Matteo Vissani
- Translational Neural Engineering Area, The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Nicoló G Pozzi
- Department of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, Germany
| | - Andrea Canessa
- Fondazione Europea di Ricerca Biomedica (FERB Onlus), Cernusco s/N (Milan), Italy
| | - Joachim Brumberg
- Department of Nuclear Medicine, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, Germany
| | - Giorgio Marotta
- Department of Nuclear Medicine, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Jens Volkmann
- Department of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, Germany
| | - Alberto Mazzoni
- Translational Neural Engineering Area, The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | | | - Carlo A Frigo
- MBMC Lab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Ioannis U Isaias
- Department of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, Germany
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19
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Task Errors Drive Memories That Improve Sensorimotor Adaptation. J Neurosci 2020; 40:3075-3088. [PMID: 32029533 DOI: 10.1523/jneurosci.1506-19.2020] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 01/20/2020] [Accepted: 01/25/2020] [Indexed: 11/21/2022] Open
Abstract
Traditional views of sensorimotor adaptation (i.e., adaptation of movements to perturbed sensory feedback) emphasize the role of automatic, implicit correction of sensory prediction errors. However, latent memories formed during sensorimotor adaptation, manifest as improved relearning (e.g., savings), have recently been attributed to strategic corrections of task errors (failures to achieve task goals). To dissociate contributions of task errors and sensory prediction errors to latent sensorimotor memories, we perturbed target locations to remove or enforce task errors during learning and/or test, with male/female human participants. Adaptation improved after learning in all conditions where participants were permitted to correct task errors, and did not improve whenever we prevented correction of task errors. Thus, previous correction of task errors was both necessary and sufficient to improve adaptation. In contrast, a history of sensory prediction errors was neither sufficient nor obligatory for improved adaptation. Limiting movement preparation time showed that the latent memories driven by learning to correct task errors take at least two forms: a time-consuming but flexible component, and a rapidly expressible, inflexible component. The results provide strong support for the idea that movement corrections driven by a failure to successfully achieve movement goals underpin motor memories that manifest as savings. Such persistent memories are not exclusively mediated by time-consuming strategic processes but also comprise a rapidly expressible but inflexible component. The distinct characteristics of these putative processes suggest dissociable underlying mechanisms, and imply that identification of the neural basis for adaptation and savings will require methods that allow such dissociations.SIGNIFICANCE STATEMENT Latent motor memories formed during sensorimotor adaptation manifest as improved adaptation when sensorimotor perturbations are reencountered. Conflicting theories suggest that this "savings" is underpinned by different mechanisms, including a memory of successful actions, a memory of errors, or an aiming strategy to correct task errors. Here we show that learning to correct task errors is sufficient to show improved subsequent adaptation with respect to naive performance, even when tested in the absence of task errors. In contrast, a history of sensory prediction errors is neither sufficient nor obligatory for improved adaptation. Finally, we show that latent sensorimotor memories driven by task errors comprise at least two distinct components: a time-consuming, flexible component, and a rapidly expressible, inflexible component.
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20
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Marchesi G, Albanese GA, Ferrazzoli D, George S, Ricci S, Tatti E, Di Rocco A, Quartarone A, Frazzitta G, Ghilardi MF. Effects of rTMS and intensive rehabilitation in Parkinson's Disease on learning and retention. IEEE Int Conf Rehabil Robot 2020; 2019:1260-1265. [PMID: 31374802 DOI: 10.1109/icorr.2019.8779471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Movement is accompanied by modulation of oscillatory activity in different ranges over the sensorimotor areas. This increase is more evident in normal subjects and less in patients with Parkinson's Disease (PD), a disorder associated with deficits in the formation of new motor skills. Here, we investigated whether such EEG changes improved in a group of PD patients, after two different treatments and whether this relates to performance. Subjects underwent either a session of 5 Hz repetitive Transcranial Magnetic Stimulation (rTMS) over the right posterior parietal cortex or a 4-week Multidisciplinary Intensive Rehabilitation Treatment (MIRT). We used a reaching task with visuo-motor adaptation to a rotated display in incremental 10° steps up to 60°. Retention of the learned rotation was tested before and after either intervention over two consecutive days. High-density EEG was recorded throughout the testing. We found that patients adapted their movements to the rotated display similarly to controls, although retention was poorer. Both rTMS and MIRT lead to improvement in retention of the learned rotation. Mean beta modulation levels changed significantly after MIRT and not after rTMS. These results suggest that rTMS produced local improvement reflected in enhanced short-term skill retention; on the other hand, MIRT determined changes across the contralateral sensorimotor area, reflected in beta EEG changes.
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21
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Paul SS, Dibble LE, Olivier GN, Walter C, Duff K, Schaefer SY. Dopamine replacement improves motor learning of an upper extremity task in people with Parkinson disease. Behav Brain Res 2020; 377:112213. [PMID: 31526767 PMCID: PMC7398159 DOI: 10.1016/j.bbr.2019.112213] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 08/13/2019] [Accepted: 09/04/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dopamine replacement medication has positive effects on existing motor skills for people with Parkinson disease (PD), but may have detrimental effects on the learning of motor skills necessary for effective rehabilitation according to the dopamine overdose hypothesis. OBJECTIVES This study aimed to determine whether dopamine replacement medication (i.e. levodopa) affects: learning of a novel upper extremity task, decrements in skill following withdrawal of practice, the rate of learning, and the transfer of movement skill to untrained upper extremity tasks compared to training "off" medication, in people with PD. METHODS Participants with mild-moderate PD (Hoehn and Yahr stage 2) were randomized to train "on" (n = 12) or "off" (n = 11) levodopa medication. Participants practiced 10 blocks of five trials of a functional motor task with their non-dominant upper extremity over three consecutive days (acquisition period), followed by a single block of five trials two and nine days later. Participants were also assessed "on" levodopa with two transfer tasks (the nine-hole peg test and a functional dexterity task) prior to any practice and nine days after the end of the acquisition period. RESULTS Participants who practiced "on" levodopa medication learned the upper extremity task to a greater extent that those who practiced "off" medication, as determined by retained performance two days after practice. Skill decrement and skill transfer were not significantly different between groups. Rate of learning was unable to be modelled in this sample. CONCLUSIONS Levodopa medication improved the learning of an upper extremity task in people with mild-moderate PD.
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Affiliation(s)
- Serene S Paul
- Department of Physical Therapy and Athletic Training, University of Utah, 520 Wakara Way, Salt Lake City, UT, 84108, USA; Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, 75 East St, Lidcombe, NSW, 2141, Australia.
| | - Leland E Dibble
- Department of Physical Therapy and Athletic Training, University of Utah, 520 Wakara Way, Salt Lake City, UT, 84108, USA
| | - Genevieve N Olivier
- Department of Physical Therapy and Athletic Training, University of Utah, 520 Wakara Way, Salt Lake City, UT, 84108, USA
| | - Christopher Walter
- Department of Physical Therapy and Athletic Training, University of Utah, 520 Wakara Way, Salt Lake City, UT, 84108, USA; Department of Physical Therapy, University of Arkansas for Medical Sciences, 1125 N College Ave, Fayetteville, AR, 72703, USA
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging & Research, Department of Neurology, University of Utah, 650 Komas Dr 106A, Salt Lake City, UT, 84108, USA
| | - Sydney Y Schaefer
- Department of Physical Therapy and Athletic Training, University of Utah, 520 Wakara Way, Salt Lake City, UT, 84108, USA; Department of Biological and Health Systems Engineering, Arizona State University, 501 E Tyler Mall, MC 9709, Tempe, AZ, 85287, USA
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22
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Zečević I, Vaselić N. Visuomotor characteristics and differences between the tremor-dominant and akinetic-rigid type of Parkinson’s disease. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:745-751. [DOI: 10.1080/23279095.2019.1699097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ivan Zečević
- Faculty of Philosophy, Psychology, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Nada Vaselić
- Faculty of Philosophy, Psychology, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
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23
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Singh P, Lenka A, Stezin A, Jhunjhunwala K, Pal PK, Ghosal A, Murthy A. Basal ganglia contributions during the learning of a visuomotor rotation: Effect of dopamine, deep brain stimulation and reinforcement. Eur J Neurosci 2019; 50:3349-3364. [DOI: 10.1111/ejn.14494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 05/17/2019] [Accepted: 05/29/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Puneet Singh
- Centre for Biosystems Science and Engineering Indian Institute of Science Bengaluru India
| | - Abhishek Lenka
- Department of Neurology National Institute of Mental Health and Neurosciences Bengaluru India
| | - Albert Stezin
- Department of Neurology National Institute of Mental Health and Neurosciences Bengaluru India
| | - Ketan Jhunjhunwala
- Department of Neurology National Institute of Mental Health and Neurosciences Bengaluru India
| | - Pramod Kumar Pal
- Department of Neurology National Institute of Mental Health and Neurosciences Bengaluru India
| | - Ashitava Ghosal
- Department of Mechanical Engineering Indian Institute of Science Bengaluru India
| | - Aditya Murthy
- Centre for Neuroscience Indian Institute of Science Bengaluru India
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Retention of touchscreen skills is compromised in Parkinson's disease. Behav Brain Res 2019; 378:112265. [PMID: 31568836 DOI: 10.1016/j.bbr.2019.112265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/11/2019] [Accepted: 09/26/2019] [Indexed: 12/21/2022]
Abstract
Fine motor skill impairments likely have a severe impact on the use of touchscreens in Parkinson's disease (PD). Although recent work showed positive effects of intensive writing training, many questions remained regarding the consolidation of motor learning in PD. The current study examined the effects of PD on practicing the manipulation of touchscreen technology and whether this can lead to 24h-retention and transfer. We developed the Swipe-Slide Pattern (SSP)-task, similar to handling a touchscreen unlock-trace. On day 1, 11 patients and 10 healthy, age-matched controls underwent two consecutive runs of early and late learning (9 × 36 s SSP and 36 s rest). This was followed by a retention test after 24 h, including the assessment of transfer. Movement time (MT, s), Euclidean distance (ED) and a performance index (PI = MT/ED) were compared across the learning phases (early, late, retention and transfer) for both groups. Additionally, a learning, retention and transfer index were compared between groups and correlated to clinical characteristics. Both groups significantly improved in MT and PI across practice. However, while healthy adults showed further improvements after a 24h-retention period, patients presented with impaired retention indices. This was correlated with disease duration, disease severity and performance on a daily life mobile phone task. Finally, transfer to a similar, but untrained pattern was comparable between both groups. Overall, short-term practice of the SSP-task results in improvements for PD patients, albeit with impaired retention. Future work should investigate whether prolonged touchscreen skill training can be retained in motor memory in PD.
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Aging Does Not Affect Beta Modulation during Reaching Movements. Neural Plast 2019; 2019:1619290. [PMID: 31223306 PMCID: PMC6541950 DOI: 10.1155/2019/1619290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/09/2019] [Accepted: 04/17/2019] [Indexed: 12/24/2022] Open
Abstract
During movement, modulation of beta power occurs over the sensorimotor areas, with a decrease just before its start (event-related desynchronization, ERD) and a rebound after its end (event-related synchronization, ERS). We have recently found that the depth of ERD-to-ERS modulation increases during practice in a reaching task and the following day decreases to baseline levels. Importantly, the magnitude of the beta modulation increase during practice is highly correlated with the retention of motor skill tested the following day. Together with other evidence, this suggests that the increase of practice-related modulation depth may be the expression of sensorimotor cortex's plasticity. Here, we determine whether the practice-related increase of beta modulation depth is equally present in a group of younger and a group of older subjects during the performance of a 30-minute block of reaching movements. We focused our analyses on two regions of interest (ROIs): the left sensorimotor and the frontal region. Performance indices were significantly different in the two groups, with the movements of older subjects being slower and less accurate. Importantly, both groups presented a similar increase of the practice-related beta modulation depth in both ROIs in the course of the task. Peak latency analysis revealed a progressive delay of the ERS peak that correlated with the total movement time. Altogether, these findings support the notion that the depth of beta modulation in a reaching movement task does not depend on age and confirm previous findings that only ERS peak latency but not ERS magnitude is related to performance indices.
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Whitfield JA, Delong C, Goberman AM, Blomgren M. Fluency adaptation in speakers with Parkinson disease: a motor learning perspective. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:699-707. [PMID: 28665156 DOI: 10.1080/17549507.2017.1341549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 05/27/2017] [Accepted: 06/01/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Fluency adaptation is characterised by a reduction in stuttering-like behaviours over successive readings of the same speech material and is an effect that is typically observed in developmental stuttering. Prominent theories suggest that short-term motor learning associated with practice explain, in part, fluency adaptation. The current investigation examined the fluency adaptation effect in a group of speakers with Parkinson disease (PD) who exhibited stuttering-like disfluencies. METHOD Individuals with PD (n = 21) and neurologically healthy controls (n = 19) read a passage five times. Per cent syllables stuttered was measured and calculated for each reading passage. RESULT Participants in the PD group exhibited significantly more stuttering-like disfluencies than control speakers. Twelve individuals in the PD group exhibited at least three per cent syllable stuttered on at least one reading. Statistical trends revealed that the subgroup of individuals with PD who stuttered exhibited a significant reduction in stuttering moments over the five successive readings. CONCLUSION A significant fluency adaptation effect was observed for the group of speakers with PD who exhibited stuttering-like disfluencies. Results of the current study are discussed within the framework of the motor learning hypothesis of fluency adaptation.
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Affiliation(s)
- Jason A Whitfield
- a Department of Communication Sciences and Disorders , Bowling Green State University , Bowling Green , OH , USA and
| | - Catharine Delong
- b Department of Communication Sciences and Disorders , University of Utah , Salt Lake City , UT , USA
| | - Alexander M Goberman
- a Department of Communication Sciences and Disorders , Bowling Green State University , Bowling Green , OH , USA and
| | - Michael Blomgren
- b Department of Communication Sciences and Disorders , University of Utah , Salt Lake City , UT , USA
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Neural correlates of multi-day learning and savings in sensorimotor adaptation. Sci Rep 2018; 8:14286. [PMID: 30250049 PMCID: PMC6155344 DOI: 10.1038/s41598-018-32689-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 09/10/2018] [Indexed: 11/08/2022] Open
Abstract
In the present study we evaluated changes in neural activation that occur over the time course of multiple days of sensorimotor adaptation, and identified individual neural predictors of adaptation and savings magnitude. We collected functional MRI data while participants performed a manual adaptation task during four separate test sessions over a three-month period. This allowed us to examine changes in activation and associations with adaptation and savings at subsequent sessions. Participants exhibited reliable savings of adaptation across the four sessions. Brain activity associated with early adaptation increased across the sessions in a variety of frontal, parietal, cingulate, and temporal cortical areas, as well as various subcortical areas. We found that savings was positively associated with activation in several striatal, parietal, and cingulate cortical areas including the putamen, precuneus, angular gyrus, dorsal anterior cingulate cortex (dACC), and cingulate motor area. These findings suggest that participants may learn how to better engage cognitive processes across days, potentially reflecting improvements in action selection. We propose that such improvements may rely on action-value assignments, which previously have been linked to the dACC and striatum. As correct movements are assigned a higher value than incorrect movements, the former are more likely to be performed again.
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Resting-state connectivity after visuo-motor skill learning is inversely associated with offline consolidation in Parkinson's disease and healthy controls. Cortex 2018; 106:237-247. [DOI: 10.1016/j.cortex.2018.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/02/2018] [Accepted: 06/08/2018] [Indexed: 01/22/2023]
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Nicastro N, Manuel AL, Garibotto V, Burkhard PR, Schnider A. Consolidation of a Learned Skill Correlates with Dopamine SPECT Uptake in Early Parkinson's Disease. J Clin Neurol 2018; 14:505-512. [PMID: 30198222 PMCID: PMC6172506 DOI: 10.3988/jcn.2018.14.4.505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/01/2018] [Accepted: 05/02/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND AND PURPOSE Basal ganglia play a pivotal role in procedural memory. However, the correlation between skill learning and striatal ¹²³I-ioflupane uptake in Parkinson's disease (PD) has not been reported previously. Our objective was to determine whether visuomotor skill learning is associated with striatal ¹²³I-ioflupane uptake in early PD. METHODS We designed a case-control study to assess learning and consolidation of a visuomotor learning task (mirrored drawing of star-shaped figures) performed on two consecutive days by early-PD patients (disease duration <2 years) and age-matched healthy subjects. Outcomes were the error rate and time per trial, as well as performance indices to assess the relative improvement on the first day (learning) and the retention on the second day (consolidation). For PD patients, we evaluated the correlation of skill learning with semiquantitative ¹²³I-ioflupane uptake. RESULTS We included 9 PD patients and 10 control subjects with the same baseline characteristics (age, male/female ratio, educational level, Mini Mental State Examination score, and Hospital Anxiety and Depression Scale score, all p>0.18) other than the score on part III of the Movement Disorders Society Unified Parkinson's Disease Rating Scale, which was higher in the PD patients (mean±SD: 15.0±10.4 vs. 1.3±1.1, p<0.001). The learning indices were the same in the two groups (p>0.5), whereas PD patients showed a lower consolidation index for the time per trial (p=0.009). Moreover, this performance was correlated with uptake in the right caudate nucleus (Spearman's rho=0.82, p=0.007) and the right striatum (Spearman's rho=0.67, p=0.049), including when multiple linear regression adjusting for the levodopa equivalent daily dose was performed (p=0.005 for the caudate nucleus and p=0.024 for the striatum). CONCLUSIONS This study provides evidence of a correlation between procedural memory impairment and striatal dopaminergic dysfunction in early PD.
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Affiliation(s)
- Nicolas Nicastro
- Division of Neurorehabilitation, Geneva University Hospitals, Geneva, Switzerland.,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
| | - Aurélie L Manuel
- Laboratory of Cognitive Neurorehabilitation, Geneva University Hospitals, Geneva, Switzerland
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzlerland
| | - Pierre R Burkhard
- Faculty of Medicine, Geneva University, Geneva, Switzlerland.,Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Armin Schnider
- Division of Neurorehabilitation, Geneva University Hospitals, Geneva, Switzerland.,Laboratory of Cognitive Neurorehabilitation, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzlerland
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Smaili SM, Bueno MEB, Barboza NM, Terra MB, Almeida IAD, Ferraz HB. Efficacy of neurofunctional versus resistance training in improving gait and quality of life among patients with Parkinson’s disease: a randomized clinical trial. MOTRIZ: REVISTA DE EDUCACAO FISICA 2018. [DOI: 10.1590/s1980-6574201800020004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Abstract
OBJECTIVE Characterize the onset and timing of cognitive decline in Parkinson disease (PD) from the first recognizable stage of cognitively symptomatic PD-mild cognitive impairment (PD-MCI) to PD dementia (PDD). Thirty-nine participants progressed from PD to PDD and 25 remained cognitively normal. METHODS Bayesian-estimated disease-state models described the onset of an individual's cognitive decline across 12 subtests with a change point. RESULTS Subtests measuring working memory, visuospatial processing ability, and crystalized memory changed significantly 3 to 5 years before their first nonzero Clinical Dementia Rating and progressively worsened from PD to PD-MCI to PDD. Crystalized memory deficits were the hallmark feature of imminent conversion of cognitive status. Episodic memory tasks were not sensitive to onset of PD-MCI. For cognitively intact PD, all 12 subtests showed modest linear decline without evidence of a change point. CONCLUSIONS Longitudinal disease-state models support a prodromal dementia stage (PD-MCI) marked by early declines in working memory and visuospatial processing beginning 5 years before clinical diagnosis of PDD. Cognitive declines in PD affect motor ability (bradykinesia), working memory, and processing speed (bradyphrenia) resulting in PD-MCI where visuospatial imagery and memory retrieval deficits manifest before eventual development of overt dementia. Tests of episodic memory may not be sufficient to detect and quantify cognitive decline in PD.
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Learning "How to Learn": Super Declarative Motor Learning Is Impaired in Parkinson's Disease. Neural Plast 2017; 2017:3162087. [PMID: 28828186 PMCID: PMC5554559 DOI: 10.1155/2017/3162087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 07/09/2017] [Indexed: 11/18/2022] Open
Abstract
Learning new information is crucial in daily activities and occurs continuously during a subject's lifetime. Retention of learned material is required for later recall and reuse, although learning capacity is limited and interference between consecutively learned information may occur. Learning processes are impaired in Parkinson's disease (PD); however, little is known about the processes related to retention and interference. The aim of this study is to investigate the retention and anterograde interference using a declarative sequence learning task in drug-naive patients in the disease's early stages. Eleven patients with PD and eleven age-matched controls learned a visuomotor sequence, SEQ1, during Day1; the following day, retention of SEQ1 was assessed and, immediately after, a new sequence of comparable complexity, SEQ2, was learned. The comparison of the learning rates of SEQ1 on Day1 and SEQ2 on Day2 assessed the anterograde interference of SEQ1 on SEQ2. We found that SEQ1 performance improved in both patients and controls on Day2. Surprisingly, controls learned SEQ2 better than SEQ1, suggesting the absence of anterograde interference and the occurrence of learning optimization, a process that we defined as “learning how to learn.” Patients with PD lacked such improvement, suggesting defective performance optimization processes.
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Whitfield JA, Goberman AM. Speech Motor Sequence Learning: Acquisition and Retention in Parkinson Disease and Normal Aging. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:1477-1492. [PMID: 28586815 DOI: 10.1044/2016_jslhr-s-16-0104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 11/29/2016] [Indexed: 06/07/2023]
Abstract
PURPOSE The aim of the current investigation was to examine speech motor sequence learning in neurologically healthy younger adults, neurologically healthy older adults, and individuals with Parkinson disease (PD) over a 2-day period. METHOD A sequential nonword repetition task was used to examine learning over 2 days. Participants practiced a sequence of 6 monosyllabic nonwords that was retested following nighttime sleep. The speed and accuracy of the nonword sequence were measured, and learning was inferred by examining performance within and between sessions. RESULTS Though all groups exhibited comparable improvements of the nonword sequence performance during the initial session, between-session retention of the nonword sequence differed between groups. Younger adult controls exhibited offline gains, characterized by an increase in the speed and accuracy of nonword sequence performance across sessions, whereas older adults exhibited stable between-session performance. Individuals with PD exhibited offline losses, marked by an increase in sequence duration between sessions. CONCLUSIONS The current results demonstrate that both PD and normal aging affect retention of speech motor learning. Furthermore, these data suggest that basal ganglia dysfunction associated with PD may affect the later stages of speech motor learning. Findings from the current investigation are discussed in relation to studies examining consolidation of nonspeech motor learning.
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Affiliation(s)
- Jason A Whitfield
- Department of Communication Sciences and Disorders, Bowling Green State University, OH
| | - Alexander M Goberman
- Department of Communication Sciences and Disorders, Bowling Green State University, OH
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Abstract
This chapter describes the visual problems likely to be encountered in Parkinson's disease (PD) and whether such signs are useful in differentiating the parkinsonian syndromes. Visual dysfunction in PD may involve visual acuity, contrast sensitivity, color discrimination, pupil reactivity, saccadic and pursuit eye movements, motion perception, visual fields, and visual processing speeds. In addition, disturbance of visuospatial orientation, facial recognition problems, rapid eye movement (REM) sleep behavior disorder, and chronic visual hallucinations may be present. Problems affecting pupil reactivity, stereopsis, pursuit eye movement, and visuomotor adaptation, when accompanied by REM sleep behavior disorder, could be early features of PD. Dementia associated with PD is associated with enhanced eye movement problems, visuospatial deficits, and visual hallucinations. Visual dysfunction may be a useful diagnostic feature in differentiating PD from other parkinsonian symptoms, visual hallucinations, visuospatial dysfunction, and variation in saccadic eye movement problems being particularly useful discriminating features.
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Marinelli L, Quartarone A, Hallett M, Frazzitta G, Ghilardi MF. The many facets of motor learning and their relevance for Parkinson's disease. Clin Neurophysiol 2017; 128:1127-1141. [PMID: 28511125 DOI: 10.1016/j.clinph.2017.03.042] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 02/14/2017] [Accepted: 03/19/2017] [Indexed: 12/16/2022]
Abstract
The final goal of motor learning, a complex process that includes both implicit and explicit (or declarative) components, is the optimization and automatization of motor skills. Motor learning involves different neural networks and neurotransmitters systems depending on the type of task and on the stage of learning. After the first phase of acquisition, a motor skill goes through consolidation (i.e., becoming resistant to interference) and retention, processes in which sleep and long-term potentiation seem to play important roles. The studies of motor learning in Parkinson's disease have yielded controversial results that likely stem from the use of different experimental paradigms. When a task's characteristics, instructions, context, learning phase and type of measures are taken into consideration, it is apparent that, in general, only learning that relies on attentional resources and cognitive strategies is affected by PD, in agreement with the finding of a fronto-striatal deficit in this disease. Levodopa administration does not seem to reverse the learning deficits in PD, while deep brain stimulation of either globus pallidus or subthalamic nucleus appears to be beneficial. Finally and most importantly, patients with PD often show a decrease in retention of newly learned skill, a problem that is present even in the early stages of the disease. A thorough dissection and understanding of the processes involved in motor learning is warranted to provide solid bases for effective medical, surgical and rehabilitative approaches in PD.
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Affiliation(s)
- Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Italy
| | - Angelo Quartarone
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Department of Neuroscience, University of Messina, Italy; The Fresco Institute for Parkinson's & Movement Disorders, NYU-Langone School of Medicine, New York, NY, USA
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Giuseppe Frazzitta
- Department of Parkinson's Disease and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Gravedona ed Uniti, Como, Italy
| | - Maria Felice Ghilardi
- Department of Physiology, Pharmacology & Neuroscience, CUNY School of Medicine, New York, NY, USA; The Fresco Institute for Parkinson's & Movement Disorders, NYU-Langone School of Medicine, New York, NY, USA.
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Nelson AB, Moisello C, Lin J, Panday P, Ricci S, Canessa A, Di Rocco A, Quartarone A, Frazzitta G, Isaias IU, Tononi G, Cirelli C, Ghilardi MF. Beta Oscillatory Changes and Retention of Motor Skills during Practice in Healthy Subjects and in Patients with Parkinson's Disease. Front Hum Neurosci 2017; 11:104. [PMID: 28326029 PMCID: PMC5339296 DOI: 10.3389/fnhum.2017.00104] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 02/20/2017] [Indexed: 11/20/2022] Open
Abstract
Recently we found that modulation depth of beta power during movement increases with practice over sensory-motor areas in normal subjects but not in patients with Parkinson's disease (PD). As such changes might reflect use-dependent modifications, we concluded that reduction of beta enhancement in PD represents saturation of cortical plasticity. A few questions remained open: What is the relation between these EEG changes and retention of motor skills? Would a second task exposure restore beta modulation enhancement in PD? Do practice-induced increases of beta modulation occur within each block? We thus recorded EEG in patients with PD and age-matched controls in two consecutive days during a 40-min reaching task divided in fifteen blocks of 56 movements each. The results confirmed that, with practice, beta modulation depth over the contralateral sensory-motor area significantly increased across blocks in controls but not in PD, while performance improved in both groups without significant correlations between behavioral and EEG data. The same changes were seen the following day in both groups. Also, beta modulation increased within each block with similar values in both groups and such increases were partially transferred to the successive block in controls, but not in PD. Retention of performance improvement was present in the controls but not in the patients and correlated with the increase in day 1 modulation depth. Therefore, the lack of practice-related increase beta modulation in PD is likely due to deficient potentiation mechanisms that permit between-block saving of beta power enhancement and trigger mechanisms of memory formation.
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Affiliation(s)
- Aaron B Nelson
- Department of Physiology, Pharmacology and Neuroscience, City University of New York School of Medicine New York, NY, USA
| | - Clara Moisello
- Department of Physiology, Pharmacology and Neuroscience, City University of New York School of Medicine New York, NY, USA
| | - Jing Lin
- Department of Physiology, Pharmacology and Neuroscience, City University of New York School of Medicine New York, NY, USA
| | - Priya Panday
- Department of Physiology, Pharmacology and Neuroscience, City University of New York School of Medicine New York, NY, USA
| | - Serena Ricci
- Department of Physiology, Pharmacology and Neuroscience, City University of New York School of MedicineNew York, NY, USA; Department of Informatics, Bioengineering, Robotics and System Engineering, University of GenoaGenoa, Italy
| | - Andrea Canessa
- Department of Informatics, Bioengineering, Robotics and System Engineering, University of GenoaGenoa, Italy; Fondazione Europea di Ricerca BiomedicaCernusco sul Naviglio, Milan, Italy
| | - Alessandro Di Rocco
- The Fresco Institute at New York University School of Medicine New York, NY, USA
| | - Angelo Quartarone
- The Fresco Institute at New York University School of MedicineNew York, NY, USA; Centro Neurolesi, University of MessinaMessina, Italy
| | | | - Ioannis U Isaias
- The Fresco Institute at New York University School of MedicineNew York, NY, USA; Department of Neurology, University Hospital and Julius-Maximillian-UniversityWuerzburg, Germany; Parkinson Institute ASST Gaetano Pini-CTOMilan, Italy
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin-Madison Madison, WI, USA
| | - Chiara Cirelli
- Department of Psychiatry, University of Wisconsin-Madison Madison, WI, USA
| | - M Felice Ghilardi
- Department of Physiology, Pharmacology and Neuroscience, City University of New York School of MedicineNew York, NY, USA; The Fresco Institute at New York University School of MedicineNew York, NY, USA
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Fernandes HA, Park NW, Almeida QJ. Effects of practice and delays on learning and retention of skilled tool use in Parkinson's disease. Neuropsychologia 2017; 96:230-239. [DOI: 10.1016/j.neuropsychologia.2017.01.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 01/12/2017] [Accepted: 01/18/2017] [Indexed: 11/28/2022]
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Maeda RS, McGee SE, Marigold DS. Consolidation of visuomotor adaptation memory with consistent and noisy environments. J Neurophysiol 2016; 117:316-326. [PMID: 27784800 DOI: 10.1152/jn.00178.2016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 10/22/2016] [Indexed: 11/22/2022] Open
Abstract
Our understanding of how we learn and retain motor behaviors is still limited. For instance, there is conflicting evidence as to whether the memory of a learned visuomotor perturbation consolidates; i.e., the motor memory becomes resistant to interference from learning a competing perturbation over time. Here, we sought to determine the factors that influence consolidation during visually guided walking. Subjects learned a novel mapping relationship, created by prism lenses, between the perceived location of two targets and the motor commands necessary to direct the feet to their positions. Subjects relearned this mapping 1 wk later. Different groups experienced protocols with or without a competing mapping (and with and without washout trials), presented either on the same day as initial learning or before relearning on day 2 We tested identical protocols under constant and noisy mapping structures. In the latter, we varied, on a trial-by-trial basis, the strength of prism lenses around a non-zero mean. We found that a novel visuomotor mapping is retained at least 1 wk after initial learning. We also found reduced foot-placement error with relearning in constant and noisy mapping groups, despite learning a competing mapping beforehand, and with the exception of one protocol, with and without washout trials. Exposure to noisy mappings led to similar performance on relearning compared with the equivalent constant mapping groups for most protocols. Overall, our results support the idea of motor memory consolidation during visually guided walking and suggest that constant and noisy practices are effective for motor learning. NEW & NOTEWORTHY The adaptation of movement is essential for many daily activities. To interact with targets, this often requires learning the mapping to produce appropriate motor commands based on visual input. Here, we show that a novel visuomotor mapping is retained 1 wk after initial learning in a visually guided walking task. Furthermore, we find that this motor memory consolidates (i.e., becomes more resistant to interference from learning a competing mapping) when learning in constant and noisy mapping environments.
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Affiliation(s)
- Rodrigo S Maeda
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada; and
| | - Steven E McGee
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada; and
| | - Daniel S Marigold
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada; and .,Behavioural and Cognitive Neuroscience Institute, Simon Fraser University, Burnaby, British Columbia, Canada
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Leow LA, de Rugy A, Marinovic W, Riek S, Carroll TJ. Savings for visuomotor adaptation require prior history of error, not prior repetition of successful actions. J Neurophysiol 2016; 116:1603-1614. [PMID: 27486109 PMCID: PMC5144718 DOI: 10.1152/jn.01055.2015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 07/05/2016] [Indexed: 11/22/2022] Open
Abstract
When we move, perturbations to our body or the environment can elicit discrepancies between predicted and actual outcomes. We readily adapt movements to compensate for such discrepancies, and the retention of this learning is evident as savings, or faster readaptation to a previously encountered perturbation. The mechanistic processes contributing to savings, or even the necessary conditions for savings, are not fully understood. One theory suggests that savings requires increased sensitivity to previously experienced errors: when perturbations evoke a sequence of correlated errors, we increase our sensitivity to the errors experienced, which subsequently improves error correction (Herzfeld et al. 2014). An alternative theory suggests that a memory of actions is necessary for savings: when an action becomes associated with successful target acquisition through repetition, that action is more rapidly retrieved at subsequent learning (Huang et al. 2011). In the present study, to better understand the necessary conditions for savings, we tested how savings is affected by prior experience of similar errors and prior repetition of the action required to eliminate errors using a factorial design. Prior experience of errors induced by a visuomotor rotation in the savings block was either prevented at initial learning by gradually removing an oppositely signed perturbation or enforced by abruptly removing the perturbation. Prior repetition of the action required to eliminate errors in the savings block was either deprived or enforced by manipulating target location in preceding trials. The data suggest that prior experience of errors is both necessary and sufficient for savings, whereas prior repetition of a successful action is neither necessary nor sufficient for savings.
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Affiliation(s)
- Li-Ann Leow
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia;
| | - Aymar de Rugy
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia; Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, CNRS UMR 5287, Université de Bordeaux, Bordeaux, France
| | - Welber Marinovic
- School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia; and Centre of Clinical Research Excellent in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Stephan Riek
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Timothy J Carroll
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Jaywant A, Ellis TD, Roy S, Lin CC, Neargarder S, Cronin-Golomb A. Randomized Controlled Trial of a Home-Based Action Observation Intervention to Improve Walking in Parkinson Disease. Arch Phys Med Rehabil 2016; 97:665-73. [PMID: 26808782 PMCID: PMC4844795 DOI: 10.1016/j.apmr.2015.12.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 11/21/2015] [Accepted: 12/27/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the feasibility and efficacy of a home-based gait observation intervention for improving walking in Parkinson disease (PD). DESIGN Participants were randomly assigned to an intervention or control condition. A baseline walking assessment, a training period at home, and a posttraining assessment were conducted. SETTING The laboratory and participants' home and community environments. PARTICIPANTS Nondemented individuals with PD (N=23) experiencing walking difficulty. INTERVENTION In the gait observation (intervention) condition, participants viewed videos of healthy and parkinsonian gait. In the landscape observation (control) condition, participants viewed videos of moving water. These tasks were completed daily for 8 days. MAIN OUTCOME MEASURES Spatiotemporal walking variables were assessed using accelerometers in the laboratory (baseline and posttraining assessments) and continuously at home during the training period. Variables included daily activity, walking speed, stride length, stride frequency, leg swing time, and gait asymmetry. Questionnaires including the 39-item Parkinson Disease Questionnaire (PDQ-39) were administered to determine self-reported change in walking, as well as feasibility. RESULTS At posttraining assessment, only the gait observation group reported significantly improved mobility (PDQ-39). No improvements were seen in accelerometer-derived walking data. Participants found the at-home training tasks and accelerometer feasible to use. CONCLUSIONS Participants found procedures feasible and reported improved mobility, suggesting that observational training holds promise in the rehabilitation of walking in PD. Observational training alone, however, may not be sufficient to enhance walking in PD. A more challenging and adaptive task, and the use of explicit perceptual learning and practice of actions, may be required to effect change.
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Affiliation(s)
- Abhishek Jaywant
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
| | - Terry D Ellis
- Department of Physical Therapy and Athletic Training, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA
| | | | - Cheng-Chieh Lin
- Department of Physical Therapy and Athletic Training, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA
| | - Sandy Neargarder
- Department of Psychological and Brain Sciences, Boston University, Boston, MA; Department of Psychology, Bridgewater State University, Bridgewater, MA
| | - Alice Cronin-Golomb
- Department of Psychological and Brain Sciences, Boston University, Boston, MA.
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The single intake of levodopa modulates implicit learning in drug naïve, de novo patients with idiopathic Parkinson’s disease. J Neural Transm (Vienna) 2016; 123:601-10. [DOI: 10.1007/s00702-016-1557-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/12/2016] [Indexed: 11/25/2022]
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Musselman KE, Roemmich RT, Garrett B, Bastian AJ. Motor learning in childhood reveals distinct mechanisms for memory retention and re-learning. ACTA ACUST UNITED AC 2016; 23:229-37. [PMID: 27084930 PMCID: PMC4836637 DOI: 10.1101/lm.041004.115] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 02/04/2016] [Indexed: 12/03/2022]
Abstract
Adults can easily learn and access multiple versions of the same motor skill adapted for different conditions (e.g., walking in water, sand, snow). Following even a single session of adaptation, adults exhibit clear day-to-day retention and faster re-learning of the adapted pattern. Here, we studied the retention and re-learning of an adapted walking pattern in children aged 6–17 yr. We found that all children, regardless of age, showed adult-like patterns of retention of the adapted walking pattern. In contrast, children under 12 yr of age did not re-learn faster on the next day after washout had occurred—they behaved as if they had never adapted their walking before. Re-learning could be improved in younger children when the adaptation time on day 1 was increased to allow more practice at the plateau of the adapted pattern, but never to adult-like levels. These results show that the ability to store a separate, adapted version of the same general motor pattern does not fully develop until adolescence, and furthermore, that the mechanisms underlying the retention and rapid re-learning of adapted motor patterns are distinct.
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Affiliation(s)
- Kristin E Musselman
- The Solomon H. Snyder Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore Maryland 21205, USA Motion Analysis Laboratory, The Kennedy Krieger Institute, Baltimore, Maryland 21205, USA
| | - Ryan T Roemmich
- The Solomon H. Snyder Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore Maryland 21205, USA Motion Analysis Laboratory, The Kennedy Krieger Institute, Baltimore, Maryland 21205, USA
| | - Ben Garrett
- The Solomon H. Snyder Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore Maryland 21205, USA Motion Analysis Laboratory, The Kennedy Krieger Institute, Baltimore, Maryland 21205, USA
| | - Amy J Bastian
- The Solomon H. Snyder Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore Maryland 21205, USA Motion Analysis Laboratory, The Kennedy Krieger Institute, Baltimore, Maryland 21205, USA
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Ventre-Dominey J, Mollion H, Thobois S, Broussolle E. Distinct effects of dopamine vs STN stimulation therapies in associative learning and retention in Parkinson disease. Behav Brain Res 2016; 302:131-41. [PMID: 26778783 DOI: 10.1016/j.bbr.2016.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/24/2015] [Accepted: 01/05/2016] [Indexed: 02/02/2023]
Abstract
Evidence has been provided in Parkinson's disease patients of cognitive impairments including visual memory and learning which can be partially compensated by dopamine medication or subthalamic nucleus stimulation. The effects of these two therapies can differ according to the learning processes involving the dorsal vs ventral part of the striatum. Here we aimed to investigate and compare the outcomes of dopamine vs stimulation treatment in Parkinson patient's ability to acquire and maintain over successive days their performance in visual working memory. Parkinson patients performed conditional associative learning embedded in visual (spatial and non spatial) working memory tasks over two consecutive days either ON or OFF dopaminergic drugs or STN stimulation depending on the group of patients studied. While Parkinson patients were more accurate and faster in memory tasks ON vs OFF stimulation independent of the day of testing, performance in medicated patients differed depending on the medication status during the initial task acquisition. Patients who learnt the task ON medication the first day were able to maintain or even improve their memory performance both OFF and ON medication on the second day after consolidation. These effects were observed only in patients with dopamine replacement with or without motor fluctuations. This enhancement in memory performance after having learnt under dopamine medication and not under STN stimulation was mostly significant in visuo-spatial working memory tasks suggesting that dopamine replacement in the depleted dorsal striatum is essential for retention and consolidation of learnt skill.
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Affiliation(s)
- Jocelyne Ventre-Dominey
- INSERM Stem Cell and Brain Research Institute U846, Bron, France; Université Lyon 1, Lyon, France.
| | - Hélène Mollion
- Hospices Civils de Lyon, Hopital Neurologique, Centre Mémoire Ressources Recherche, Lyon, France; Université Lyon 1, Lyon, France
| | - Stephane Thobois
- Hospices Civils de Lyon, Hopital Neurologique, Neurologie C, Lyon, France; CNRS, Centre de Neurosciences Cognitives, UMR 5229, Bron, France; Université Lyon 1, Lyon, France
| | - Emmanuel Broussolle
- Hospices Civils de Lyon, Hopital Neurologique, Neurologie C, Lyon, France; CNRS, Centre de Neurosciences Cognitives, UMR 5229, Bron, France; Université Lyon 1, Lyon, France
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Interactive effects of age and multi-gene profile on motor learning and sensorimotor adaptation. Neuropsychologia 2016; 84:222-34. [PMID: 26926580 DOI: 10.1016/j.neuropsychologia.2016.02.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 02/03/2016] [Accepted: 02/17/2016] [Indexed: 01/29/2023]
Abstract
The interactive association of age and dopaminergic polymorphisms on cognitive function has been studied extensively. However, there is limited research on whether age interacts with the association between genetic polymorphisms and motor learning. We examined a group of young and older adults' performance in three motor tasks: explicit sequence learning, visuomotor adaptation, and grooved pegboard. We assessed whether individuals' motor learning and performance were associated with their age and genotypes. We selected three genetic polymorphisms: Catechol-O-Methyl Transferase (COMT val158met) and Dopamine D2 Receptor (DRD2 G>T), which are involved with dopaminergic regulation, and Brain Derived Neurotrophic Factor (BDNF val66met) that modulates neuroplasticity and has been shown to interact with dopaminergic genes. Although the underlying mechanisms of the function of these three genotypes are different, the high performance alleles of each have been linked to better learning and performance. We created a composite polygene score based on the Number of High Performance Alleles (NHPA) that each individual carried. We found several associations between genetic profile, motor performance, and sensorimotor adaptation. More importantly, we found that this association varies with age, task type, and engagement of implicit versus explicit learning processes.
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Panouillères MTN, Tofaris GK, Brown P, Jenkinson N. Intact Acquisition and Short-Term Retention of Non-Motor Procedural Learning in Parkinson's Disease. PLoS One 2016; 11:e0149224. [PMID: 26906905 PMCID: PMC4764369 DOI: 10.1371/journal.pone.0149224] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/28/2016] [Indexed: 11/18/2022] Open
Abstract
Procedural learning is a form of memory where people implicitly acquire a skill through repeated practice. People with Parkinson’s disease (PD) have been found to acquire motor adaptation, a form of motor procedural learning, similarly to healthy older adults but they have deficits in long-term retention. A similar pattern of normal learning on initial exposure with a deficit in retention seen on subsequent days has also been seen in mirror-reading, a form of non-motor procedural learning. It is a well-studied fact that disrupting sleep will impair the consolidation of procedural memories. Given the prevalence of sleep disturbances in PD, the lack of retention on following days seen in these studies could simply be a side effect of this well-known symptom of PD. Because of this, we wondered whether people with PD would present with deficits in the short-term retention of a non-motor procedural learning task, when the test of retention was done the same day as the initial exposure. The aim of the present study was then to investigate acquisition and retention in the immediate short term of cognitive procedural learning using the mirror-reading task in people with PD. This task involved two conditions: one where triads of mirror-inverted words were always new that allowed assessing the learning of mirror-reading skill and another one where some of the triads were presented repeatedly during the experiment that allowed assessing the word-specific learning. People with PD both ON and OFF their normal medication were compared to healthy older adults and young adults. Participants were re-tested 50 minutes break after initial exposure to probe for short-term retention. The results of this study show that all groups of participants acquired and retained the two skills (mirror-reading and word-specific) similarly. These results suggest that neither healthy ageing nor the degeneration within the basal ganglia that occurs in PD does affect the mechanisms that underpin the acquisition of these new non-motor procedural learning skills and their short-term memories.
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Affiliation(s)
- Muriel T. N. Panouillères
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
- * E-mail:
| | - George K. Tofaris
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Peter Brown
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Ned Jenkinson
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
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Cameron DJ, Pickett KA, Earhart GM, Grahn JA. The Effect of Dopaminergic Medication on Beat-Based Auditory Timing in Parkinson's Disease. Front Neurol 2016; 7:19. [PMID: 26941707 PMCID: PMC4761840 DOI: 10.3389/fneur.2016.00019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 02/08/2016] [Indexed: 11/25/2022] Open
Abstract
Parkinson’s disease (PD) adversely affects timing abilities. Beat-based timing is a mechanism that times events relative to a regular interval, such as the “beat” in musical rhythm, and is impaired in PD. It is unknown if dopaminergic medication influences beat-based timing in PD. Here, we tested beat-based timing over two sessions in participants with PD (OFF then ON dopaminergic medication) and in unmedicated control participants. People with PD and control participants completed two tasks. The first was a discrimination task in which participants compared two rhythms and determined whether they were the same or different. Rhythms either had a beat structure (metric simple rhythms) or did not (metric complex rhythms), as in previous studies. Discrimination accuracy was analyzed to test for the effects of beat structure, as well as differences between participants with PD and controls, and effects of medication (PD group only). The second task was the Beat Alignment Test (BAT), in which participants listened to music with regular tones superimposed, and responded as to whether the tones were “ON” or “OFF” the beat of the music. Accuracy was analyzed to test for differences between participants with PD and controls, and for an effect of medication in patients. Both patients and controls discriminated metric simple rhythms better than metric complex rhythms. Controls also improved at the discrimination task in the second vs. first session, whereas people with PD did not. For participants with PD, the difference in performance between metric simple and metric complex rhythms was greater (sensitivity to changes in simple rhythms increased and sensitivity to changes in complex rhythms decreased) when ON vs. OFF medication. Performance also worsened with disease severity. For the BAT, no group differences or effects of medication were found. Overall, these findings suggest that timing is impaired in PD, and that dopaminergic medication influences beat-based and non-beat-based timing differently. Judging the beat in music does not appear to be affected by PD or by dopaminergic medication.
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Affiliation(s)
- Daniel J Cameron
- Brain and Mind Institute, University of Western Ontario , London, ON , Canada
| | - Kristen A Pickett
- Occupational Therapy Program, Department of Kinesiology, University of Wisconsin-Madison , Madison, WI , USA
| | - Gammon M Earhart
- Program in Physical Therapy, Department of Neuroscience, Department of Neurology, Washington University School of Medicine in St. Louis , St. Louis, MO , USA
| | - Jessica A Grahn
- Brain and Mind Institute, University of Western Ontario, London, ON, Canada; Department of Psychology, University of Western Ontario, London, ON, Canada
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Rehabilitation for Parkinson's disease: Current outlook and future challenges. Parkinsonism Relat Disord 2016; 22 Suppl 1:S60-4. [DOI: 10.1016/j.parkreldis.2015.09.005] [Citation(s) in RCA: 207] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 09/01/2015] [Indexed: 11/19/2022]
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The Interaction between Obstructive Sleep Apnea and Parkinson's Disease: Possible Mechanisms and Implications for Cognitive Function. PARKINSONS DISEASE 2015; 2015:849472. [PMID: 26509097 PMCID: PMC4609874 DOI: 10.1155/2015/849472] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/06/2015] [Indexed: 12/18/2022]
Abstract
Parkinson's disease (PD) is a relentlessly progressive neurodegenerative disorder associated with hallmark motor and nonmotor symptoms (NMS) such as sleep disturbances and cognitive dysfunction. While dopaminergic treatments have improved the motor aspects of PD, progression remains inevitable. Research has recently increasingly focused on strategies to modify disease progression and on nonmotor manifestations of PD, given their impact on patients' quality of life. Obstructive sleep apnea (OSA) is a treatable sleep disorder, common in the general population, associated with excessive daytime sleepiness and neurocognitive deficits. Neuroimaging has demonstrated structural and functional changes in OSA patients; in animal models, OSA causes brain inflammation and oxidative injury, including in key areas involved in PD pathophysiology such as locus coeruleus. The prevalence of OSA in PD has been variable in studies to date, and potential consequences and interrelationship between the two disorders have not been well studied. There is however emerging evidence that OSA is associated with increased NMS in PD, particularly cognitive dysfunction. This review focuses on the possible interrelationship between OSA and PD. Mechanisms promoting OSA in PD will be reviewed, as well as mechanisms whereby OSA can affect the neurodegenerative process in PD.
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Broeder S, Nackaerts E, Heremans E, Vervoort G, Meesen R, Verheyden G, Nieuwboer A. Transcranial direct current stimulation in Parkinson's disease: Neurophysiological mechanisms and behavioral effects. Neurosci Biobehav Rev 2015; 57:105-17. [DOI: 10.1016/j.neubiorev.2015.08.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 07/16/2015] [Accepted: 08/17/2015] [Indexed: 10/23/2022]
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