Triggering Motor Memory Consolidation in PD: Complex Practice of Fine Motor Tasks and Brain Activity During Learning

NCT04269590 | Completed

• 1 other identifier: G0A5619N
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

Parkinson's disease (PD) is characterized by severe motor symptoms, including upper limb dysfunction, that is only partially alleviated by medication. PD is also a motor learning disease due to the degradation of the striatum, involved in the consolidation of motor memory. We showed earlier that motor practice improves writing deficits and that there is long term potential when it is applied in a focused manner. However, retention difficulties were also apparent. What is currently unclear, is which learning method leads to optimal retention in PD and how it is expressed in underlying neural network changes. In healthy controls, retention is improved by incorporating dual task (DT) conditions or by loading cognition during learning. Our own work showed that DT training also led to better retention than single task (ST) learning, at least in a subgroup of PD. Using a combination of behavioral assessment, functional magnetic resonance imaging and upper limb task training, this project aims to understand how to boost the robustness of practice in PD. Throughout, we will contrast ST with DT learning. As complex practice can now easily be delivered via novel technology, this study will set out future avenues for rehabilitation targeted at specific neural circuitry.

Conditions

Parkinson Disease

Keywords

Neurologic rehabilitation; Dual tasking; Motor learning

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 training types (ST vs DT) and groups (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 training types (ST vs DT), groups (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), between training types (ST vs DT) and groups (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), between training types (ST vs DT) and groups (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 (4)

Dual Task (DT) training - PD

EXPERIMENTAL

Combination of practicing the Swipe Slide Pattern task and a secondary task for a group of patients with Parkinson's disease (PD)

Behavioral: Dual Task (DT) training

Single Task (ST) training - PD

ACTIVE COMPARATOR

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

Behavioral: Single Task (ST) training

Dual Task (DT) training - HC

EXPERIMENTAL

Combination of practicing the Swipe Slide Pattern task and a secondary task for a group of healthy age-matched controls.

Behavioral: Dual Task (DT) training

Single Task (ST) training - HC

ACTIVE COMPARATOR

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

Behavioral: Single Task (ST) training

Interventions

Single Task (ST) training BEHAVIORAL

Participants will practice the Swipe Slide Pattern (SSP) task without the presence of a secondary 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.

Single Task (ST) training - HC; Single Task (ST) training - PD

Dual Task (DT) training BEHAVIORAL

Participants will practice the Swipe Slide Pattern (SSP) task in combination with a secondary task, i.e. counting red or green lights. On day 1, participants perform 2 runs of the SSP-task (only one pattern), each lasting approx. 10 min, within an MR scanner. During each run, 9 trials of 30s are performed, alternated with rest periods of 14s. Instructions are provided before each trial (i.e. view of the pattern in combination with instruction to count red or green lights, 4s), as well as an answer option (i.e. participants have to indicate how many red or green lights they counted by circling a number from zero to nine, 6s). For the following 4 days, participants will continue practice of the SSP-task at home. During the at-home-sessions, participants will perform 9 trials of 12 patterns each, alternated with rest periods of 14s. Instruction and answers are also included. During at home practice, the same pattern as during scans is included, in combination with 2 new patterns.

Dual Task (DT) training - HC; Dual Task (DT) training - 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
• Hoehn and Yahr (H\&Y) stage I-III
• Without a history of intervening co-morbidities
• Right handed
• Participants in H\&Y stage I should have the right side as the most affected side

You may not qualify if:

• Cognitive decline (Mini Mental State Examination \< 24)
• Visual impairments that impede the following of visual targets
• Comorbidities of the upper limb that could interfere with the study and are not caused by Parkinson's disease
• Contra-dinidcations for Magnetic Resonance Imaging (MRI)
• 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

Study Sites (1)

Department of Rehabilitation Sciences KU Leuven

Leuven, Belgium

Location

Related Publications (3)

• 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

MeSH Terms

Conditions

Parkinson Disease

Interventions

potassium channel subfamily K member 3

Condition Hierarchy (Ancestors)

Parkinsonian Disorders; Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases

Study Officials

• Alice Nieuwboer, PhD

  KU Leuven

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• 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 3, 2021
• Primary Completion: May 16, 2023
• Study Completion: May 16, 2023
• Last Updated: December 18, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

BE (1)