Abstract
Using the remarkable overlap between brain circuits affected in Parkinson’s disease (PD) and those underlying motor sequence learning, we may improve the effectiveness of motor rehabilitation interventions by identifying motor learning facilitators in PD. For instance, additional sensory stimulation and task cueing enhanced motor learning in people with PD, whereas exercising using musical rhythms or console computer games improved gait and balance, and reduced some motor symptoms, in addition to increasing task enjoyment. Yet, despite these advances, important knowledge gaps remain. Most studies investigating motor learning in PD used laboratory-specific tasks and equipment, with little resemblance to real life situations. Thus, it is unknown whether similar results could be achieved in more ecological setups and whether individual’s task engagement could further improve motor learning capacity. Moreover, the role of social interaction in motor skill learning process has not yet been investigated in PD and the role of mind-set and self-regulatory mechanisms have been sporadically examined. Here, we review evidence suggesting that these psychosocial factors may be important modulators of motor learning in PD. We propose their incorporation in future research, given that it could lead to development of improved non-pharmacological interventions aimed to preserve or restore motor function in PD.
Highlights
In Parkinson’s disease (PD) research much effort is devoted nowadays to the development of complementary, non-pharmacological interventions, which could help alleviate the symptoms and slow down the neurodegenerative progression of the disease
A common factor underlying the facilitatory motivational effects on motor performance across the various domains we described above are the emotions associated with the learning process
We provided a brief overview of the psycho-social factors that may affect motor learning in general and its impact in PD, in particular
Summary
In Parkinson’s disease (PD) research much effort is devoted nowadays to the development of complementary, non-pharmacological interventions, which could help alleviate the symptoms and slow down the neurodegenerative progression of the disease. There is much evidence indicating that motor learning and performance can be improved in PD via additional sensory stimulation (visual or rhythmical) and task cueing, most likely through increased activity in basal ganglia and the cortico-striatal circuits (Nieuwboer et al, 2009; de Bruin et al, 2010). Striatum is involved in all stages of motor sequence learning with different parts of it deemed essential in each stage (Doyon and Benali, 2005) This indicates a remarkable overlap between PD neuropathology and neuronal correlates of motor sequence learning (see Figure 1). Given this overlap and the fact that cerebral plasticity is maintained or increased through repeated practice and enhanced stimulation from the environment (Hultsch et al, 1999; Vance et al, 2010), it is conceivable that practicing or learning motor sequences in a rich and stimulating context may increase the effectiveness of non-pharmacological interventions aimed to preserve or restore motor function in Parkinson’s
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