Department of Rehabilitation Sciences, Katholieke Universiteit, Leuven, Belgium.
Parkinsonism Relat Disord. 2009 Dec;15 Suppl 3:S53-8. doi: 10.1016/S1353-8020(09)70781-3.
The striatum is very much involved in learning motor sequences particularly in the consolidation phase, predicting that motor learning is affected in Parkinson's disease (PD). We conducted a literature review on this question and showed that behavioural studies indicate a relatively preserved acquisition as well as retention of motor learning in PD. Persons with PD did demonstrate slower learning-rates than controls. Brain imaging studies highlighted that much more brain activity is needed and different neural networks are recruited in PD, suggesting a reduced efficiency of learning. Using additional sensory information may optimize motor learning in PD. There is abundant evidence that cueing helps to achieve better movement performance and that these effects are retained immediately after withdrawal, possibly indicating the first signs of consolidation. Also, automatization of cued learning was demonstrated, as cues not only enhanced dual-task performance but these increments were retained after cue withdrawal. However, the effect of longer periods of cued training on retention of cued and uncued performance is not well established and some studies suggest that learning effects may be cue-dependent. The results of this review support the notion that adopting motor learning principles could benefit rehabilitation in PD. Even so, the limitations of reduced flexibility, efficiency and increased context-specificity of motor learning in PD need to be taken into account.
纹状体在运动序列的学习中起着非常重要的作用，特别是在巩固阶段，这表明帕金森病（PD）会影响运动学习。我们对这个问题进行了文献综述，结果表明行为研究表明，PD 患者的运动学习获得和保留相对较好。PD 患者的学习速度比对照组慢。脑成像研究强调，PD 需要更多的大脑活动，并招募不同的神经网络，这表明学习效率降低。使用额外的感觉信息可能会优化 PD 中的运动学习。有大量证据表明线索提示有助于获得更好的运动表现，并且这些效果在撤回后立即保留，这可能表明巩固的早期迹象。此外，已证明线索学习的自动化，因为线索不仅增强了双重任务的表现，而且在撤回线索后保留了这些增量。然而，线索训练时间延长对线索和非线索表现保留的影响尚未得到很好的证实，一些研究表明学习效果可能取决于线索。本综述的结果支持这样一种观点，即采用运动学习原则可以使 PD 康复受益。即便如此，仍需要考虑到 PD 运动学习灵活性降低、效率降低和对特定环境的依赖性增加的局限性。
