Motor learning in Parkinson’s disease: underlying effective connectivity and influential factors
Parkinson’s disease (PD) is characterized by severe motor symptoms that can only be partially alleviated by medication. We showed earlier that rehabilitation is an important therapeutic supplement for micrographia in early disease. However, what is unknown is how motor learning impacts on the underlying neural networks in patients with different disease progression and how this interacts with dopaminergic medication. Furthermore, difficulties with upper limb motor control has a severe impact on the daily lives of PD patients since fine motor skills become increasingly important for the use of smartphones and tablets. Therefore, the current project will include a newly developed Swipe-Slide Pattern test, resembling the pattern codes used to unlock smartphones and tablets. This task will be used to determine learning-induced neuroplasticity of cortico-striatal effective connectivity across disease stages in PD and ON and OFF dopaminergic medication. We will also investigate whether patients with PD benefit more from a random versus blocked practice order, as healthy elderly do. During random practice, tasks are presented in an interleaved manner, which will promote attentional motor control and the ability to switch between tasks. Using a combination of behavioral assessment and functional magnetic resonance imaging, we aim to contribute to the understanding of upper limb motor learning in patients with PD for the development of individualized rehabilitation programs.