Objective: To investigate the relation between implicit learning capacity and gait automaticity in patients with Parkinson’s disease (PD).

Background: Automaticity is the ability to perform movements without attention directed toward their subcomponents. The loss of automatic control has been claimed to be one of the symptoms of PD. Evidence from experimental and clinical studies has confirmed a progressive difficulty to perform learned movements automatically. This difficulty has been associated to several motor alterations of PD, including the deterioration in the gait performance under dual-task condition. Although all the neural processes of motor automaticity are not fully understood, the main role of implicit system for the process is a consensus.

Methods: Fifteen PD patients in stage 1 of Hoehn and Yahr classification, 15 patients in stages 2 and 3, and 15 healthy matched control individuals, were exposed to a probabilistic implicit learning experiment based on a computational game named Goalkeeper (GG) which simulated a soccer game and a gait assessment using accelerometers under single (ST) and dual-task (DT) condition. On session 1 the participants performed gait assessments both in a ST and concurrently with a verbal fluency task, therefore in a DT. On sessions 2, two days after the session 1, participants were exposed to five trials of GG. Finally, on session 3, seven days after the session 2, the performance in the GG was reassessed. All PD patients were tested in ON period of dopaminergic reposition medication.

Results: The ANOVA for repeated measure showed that PD were able to improve their performance in the GG. However, as expected, the improvement was relatively greater for the control subjects as compared to that seen for PD patients. Gait performance in the DT was disrupted for all groups, mainly for PD patients in intermediary stages of PD evolution. Most important, the deterioration of gait performance under dual-task condition was correlated to the ability to improve the performance in the Goalkeeper game.

Conclusions: The gait automaticity deterioration is associate to deficiency in probabilistic implicit learning in patients with PD. It seems important to consider this evidence in order to achieve the improved comprehension about the gait alterations and to plan more efficient therapeutic approaches to improve the gait performance in patients with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/is-the-defective-gait-automaticity-associated-to-deficiencies-in-implicit-learning-in-patients-with-parkinsons-disease/