Motor learning in Parkinson's disease: limitations and potential for rehabilitation
Motor learning in Parkinson's disease: limitations and potential for rehabilitation
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DOI：
10.1016/s1353-8020(09)70781-3
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发表时间：
2009-12-01
影响因子：
4.1
通讯作者：
Swinnen, Stephan P.
中科院分区：
文献类型：
--
作者：
Nieuwboer, Alice;Rochester, Lynn;Swinnen, Stephan P.
纹状体非常参与学习运动序列，特别是在巩固阶段，预测运动学习在帕金森病（PD）中受到影响。我们对这个问题进行了文献综述，并表明，行为研究表明，一个相对保存的收购以及保留运动学习PD。PD患者的学习速度确实比对照组慢。脑影像学研究表明，PD患者需要更多的脑活动，不同的神经网络参与其中，提示学习效率降低，使用额外的感觉信息可以优化PD患者的运动学习。有大量的证据表明，暗示有助于实现更好的运动表现，这些效果在撤退后立即保留，可能表明巩固的第一个迹象。此外，自动化的线索学习证明，线索不仅提高了双任务的性能，但这些增量后线索撤回保留。然而，长时间的线索化训练对线索化和非线索化表现的保持效果还没有很好的确定，一些研究表明，学习效果可能是线索依赖的。本综述的结果支持采用运动学习原则有利于PD康复的观点。即便如此，PD中运动学习的灵活性降低、效率降低和情境特异性增加的局限性也需要考虑在内。(C)2009爱思唯尔有限公司保留所有权利。
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. (C) 2009 Elsevier Ltd. All rights reserved.