Relearning of writing skills in Parkinson's disease: a literature review on influential factors and optimal strategies.

Patients with Parkinson's disease (PD) suffer from severe motor symptoms which can only be partly alleviated by means of dopaminergic medication. Motor rehabilitation, i.e. relearning of a known motor skill through intensive practice, can be an effective and lasting therapeutic supplement in chronic neurodegenerative diseases. Recent studies on motor learning in PD provide insights for the development of optimal motor rehabilitation strategies, with a particular focus on achieving consolidated learning and retention. In this review, findings from the last couple of years are discussed with specific interest in the potential benefits from cueing and feedback strategies as means to achieve lasting changes. In addition, current neuroscientific insights on the impact of dopamine and cognitive functioning on learning are summarized. Finally, the knowledge on these topics is combined to propose an optimal strategy for relearning of writing skills in PD, a frequently reported motor deficit also known as micrographia.