Objective: To investigate the efficacy of a novel videogame to identify the early alterations in implicit learning (IL) in people with PD (PPD)

Background: Although Parkinson’s Disease is mostly considered a motor disorder, it can present at early stages as a non-motor pathology. Among the non-motor alterations, the decline in implicit learning (IL) capacity has been considered an important feature of PD, which could be associated to lack in automatic control. The developing of ludic and easy test able to identify the early alterations in IL may became an useful tool to develop new treatment to slow down the alterations in automaticity, which has progressive negative impact in performance in routine activities.

Methods: Thirty PPD in stage 1, 30 PPD in stages 2 and 3 according to the Hoehn and Yahr classification, undergoing treatment with levodopa, and 30 healthy matched volunteers assigned as control group (CT), following adequate inclusion criteria, took part in the study. Performance of each participant in “Goalkeeper Game” (GG) was assessed in an individual session. After the presentation about the purpose and rules of videogame, the participants were instructed to tap the one of three-key associated to possible directions of soccer ball (right, left, center), using their preferential hand.  During the five-level of computer game, the participants assumed the role of a goalkeeper that faces a penalty taker who is ready to shoot. As the real soccer game situation, the expectation is that the goalkeeper will be able to identify as fast as possible the strategy of the penalty taker to avoid the goal.  The GG collected several of the player performance data. The scientific questions that are associated to this game revolve around the of IL and explicit learning (EL) strategies behind the decision-making process of the goalkeeper. The performance in the each of five-level of GG was analyzed by RM-ANOVA. 

Results: The performance of PPD, even in early stage of disease, were statistically inferior to CT in  level 2, 3 and 4, which involved predominately IL  (p<.01, ES=.90). In  the 1 and 5 level, which involved motor and EL respectively, only PPD in intermediate stage presented  deficit statistically significant in comparison with CT (p<.05, ES=0.80). 

Conclusions: The GG is a ludic, easy and efficient tool to identify early alterations in IL in PPD, independent the motor and EL components.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/goalkeeper-game-a-novel-test-to-identify-early-implicit-learning-alterations-in-people-with-parkinsons-disease/