Motor Learning in Parkinson's Disease: Underlying Effective Connectivity and Influential Factors

NCT04269577 | Unknown

• 1 other identifier: 12F4719N
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

Parkinson's disease (PD) is characterized by severe motor symptoms that can only be partially alleviated by medication. It was shown previously 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. Using a combination of behavioral assessment and functional magnetic resonance imaging, the investigators aim to contribute to the understanding of upper limb motor learning in patients with PD for the development of individualized rehabilitation programs.

Conditions

Parkinson Disease

Keywords

Neurologic rehabilitation; Motor learning; Disease progression

Outcome Measures

Primary Outcomes (5)

• Change in movement time (s) of trained pattern

  Using the behavioral data gathered during task-based fMRI, the learning index and retention index, as described in Nackaerts et al. 2020, will be determined and compared between groups (early PD vs mid PD vs HC).

  7 days

• Change in dual task effect

  Using the behavioral data gathered before and immediately after task-based fMRI, as well as at immediate and delayed retention, dual task interference will be calculated and compared between groups (early PD vs mid PD vs HC) and time points

  7 days

• Change in brain activity during performance of trained pattern

  The BOLD activity pattern will be determined and compared between the 3 training phases (i.e. early learning, late learning and retention) and groups (early PD vs mid PD vs HC).

  7 days

• Change in brain connectivity during performance of trained pattern

  The BOLD activity pattern will be determined and connectivity measures will be extracted. Neural network changes will be compared between the 3 training phases (i.e. early learning, late learning and retention) and groups (early PD vs mid PD vs HC).

  7 days

• Diffusion weighted imaging as a predictor

  Anatomical connectivity at baseline will be calculated and investigated as a predictive factor for learning capacity.

  7 days

Secondary Outcomes (5)

• Change in Euclidean distance of trained pattern

  7 days

• Change in movement time (s) of the untrained pattern

  7 days

• Change in Euclidean distance of the untrained pattern

  7 days

• Change in brain activity during performance of untrained pattern

  7 days

• Change in brain connectivity during performance of untrained pattern

  7 days

Study Arms (3)

SSP training - early PD

EXPERIMENTAL

Practice of the Swipe Slide Pattern task alone for a group of patients with early Parkinson's disease (PD)

Behavioral: SSP training

SSP training - mid PD

EXPERIMENTAL

Practice of the Swipe Slide Pattern task alone for a group of patients with mid-stage Parkinson's disease (PD)

Behavioral: SSP training

SSP training - HC

EXPERIMENTAL

Practice of the Swipe Slide Pattern task alone for a group of healthy age-matched controls (HC)

Behavioral: SSP training

Interventions

SSP training BEHAVIORAL

Participants will practice the Swipe Slide Pattern (SSP) task. On day 1, participants perform two runs of the SSP-task (only one pattern), each lasting approx. 10 min, within an MR scanner. During each run, nine trials of 30s are performed, alternated with rest periods of 14s. In addition, instructions are provided before each trial (i.e. view of the pattern, 4s), as well as an answer option (i.e. participants have circle a random number from zero to nine, 6s). For the following four days (day 2-5), participants will continue practice of the SSP-task at home. During the at-home-sessions, participants will perform nine trials of 12 patterns each, alternated with rest periods of 14s. Instruction are also included. During at home practice, the same pattern as during scans is included, in combination with two new patterns.

SSP training - HC; SSP training - early PD; SSP training - mid PD

Eligibility Criteria

• Age: 50 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Diagnosis of Parkinson's disease based on the 'UK Brain Bank' criteria
• Right handed
• No dementia (Mini Mental State Examination \> 24/30)
• Early PD group: disease duration of ≤ 2 year since appearance of first symptoms in combination with a maximum score of 2 on each of the upper limb items of the MDS-UPDRS-III
• Mid stage PD group: patients are considered as mid-stage in case one of the criteria for early PD is not fulfilled

You may not qualify if:

• Comorbidities of the upper limb that could interfere with the study and are not caused by Parkinson's disease (e.g. arthritis, fractures of the hand, etc.)
• Other medical or psychiatric impairments that could interfere with the study protocol
• Contra-indications for Magnetic Resonance Imaging
• Tremor of the head or right hand, as determined by the Movement Disorders Society Unified Parkinson's disease Rating scale part III
• Color blindness as determined by the Ishihara test for color deficiency

Sponsors & Collaborators

• KU Leuven: lead
• Research Foundation Flanders: collaborator

Study Sites (1)

Department of Rehabilitation Sciences KU Leuven

Leuven, 3001, Belgium

Location

Related Publications (4)

• Nackaerts E, Ginis P, Heremans E, Swinnen SP, Vandenberghe W, Nieuwboer A. Retention of touchscreen skills is compromised in Parkinson's disease. Behav Brain Res. 2020 Jan 27;378:112265. doi: 10.1016/j.bbr.2019.112265. Epub 2019 Sep 27.

  PMID: 31568836 BACKGROUND

• Lin CH, Chiang MC, Wu AD, Iacoboni M, Udompholkul P, Yazdanshenas O, Knowlton BJ. Age related differences in the neural substrates of motor sequence learning after interleaved and repetitive practice. Neuroimage. 2012 Sep;62(3):2007-20. doi: 10.1016/j.neuroimage.2012.05.015. Epub 2012 May 11.

  PMID: 22584226 BACKGROUND

• Sidaway B, Ala B, Baughman K, Glidden J, Cowie S, Peabody A, Roundy D, Spaulding J, Stephens R, Wright DL. Contextual Interference Can Facilitate Motor Learning in Older Adults and in Individuals With Parkinson's Disease. J Mot Behav. 2016 Nov-Dec;48(6):509-518. doi: 10.1080/00222895.2016.1152221. Epub 2016 Jun 24.

  PMID: 27340809 BACKGROUND

• Dan X, King BR, Doyon J, Chan P. Motor Sequence Learning and Consolidation in Unilateral De Novo Patients with Parkinson's Disease. PLoS One. 2015 Jul 29;10(7):e0134291. doi: 10.1371/journal.pone.0134291. eCollection 2015.

  PMID: 26222151 BACKGROUND

MeSH Terms

Conditions

Parkinson Disease; Disease Progression

Condition Hierarchy (Ancestors)

Parkinsonian Disorders; Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Alice Nieuwboer, PhD

  KU Leuven

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Full professor

Study Record Dates

• First Submitted: February 10, 2020
• First Posted: February 17, 2020
• Study Start: May 10, 2021
• Primary Completion: March 1, 2024
• Study Completion: March 1, 2024
• Last Updated: November 18, 2023

Record last verified: 2023-11

Data Sharing

• IPD Sharing: Will not share

Locations

BE (1)