The influence of movement initiation deficits on the quantification of retention in Parkinson's disease.

In patients with an impaired motor system, like Parkinson's disease (PD), deficits in motor learning are expected and results of various studies seem to confirm these expectations. However, most studies in this regard are behaviorally based and quantify learning by performance changes between at least two points in time, e.g., baseline and retention. But, performance in a retention test is also dependent on other factors than learning. Especially in patients, the functional capacity of the control system might be altered unspecific to a certain task and learning episode. The aim of the study is to test whether characteristic temporal deficits exist in PD patients that affect retention performance. We tested the confounding effects of typical PD motor control deficits, here movement initiation deficits, on retention performance in the motor learning process. 12 PD patients and 16 healthy control participants practiced a virtual throwing task over 3 days with 24 h rest between sessions. Retention was tested comparing performance before rest with performance after rest. Movement initiation deficits were quantified by the timing of throwing release that should be affected by impairments in movement initiation. To scrutinize the influence of the initiation deficits on retention performance we gave participants a specific initiation intervention prior to practice on one of the three practice days. We found that only for the PD patients, post-rest performance as well as release timing was better with intervention as compared to without intervention. Their performance could be enhanced through a tuning of release initiation. Thus, we suggest that in PD patients, performance decline after rest that might be easily interpreted as learning deficits could rather result from disease-related deficiencies in motor control.