Exogenous Effects of Standard Medical Care (Dopamine) on Motor Learning of an Upper Limb Task in Parkinson Disease



Status:Completed
Conditions:Parkinsons Disease
Therapuetic Areas:Neurology
Healthy:No
Age Range:50 - 80
Updated:2/23/2018
Start Date:January 2016
End Date:January 2017

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The study determines whether standard medical care (dopamine) affects learning and retention
of an upper limb feeding task in people with Parkinson's disease (PD) and whether training on
the feeding task generalises to performance on an untrained upper limb buttoning task. Half
the participants will train on the feeding task after they have taken their first dose of
dopamine for the day (i.e. "on" medication state), while the other half will train on the
same feeding task before taking their first daily dose of dopamine (i.e. "off" medication
state).

Parkinson disease (PD) is an age related neurodegenerative disorder with symptomatic declines
in motor function due to a loss of dopaminergic neurons within the basal ganglia.

Ironically, treatment with exogenous dopamine-replacement medication (e.g. levodopa) may have
positive effects on existing motor skills such as handwriting or walking, but may have
detrimental effects on the learning of motor skills necessary for effective rehabilitation.

Although dopamine medications are routinely prescribed to replace lost dopamine in the
sensorimotor areas of the striatum, they may actually be "overdosing" the associative
striatum, a candidate neuroanatomical correlate for motor learning. To date, however, this
'overdose' hypothesis has not been widely tested, given that few studies of motor learning in
PD have reported or controlled for whether individuals were tested "on" or "off" their
dopamine replacement medication.

Inclusion Criteria:

- Idiopathic Parkinson's disease confirmed by neurologist

- Hoehn and Yahr stages 1 to 3

- On a stable dose of antiparkinsonian medication for the past month and will continue
on this regime for at least another subsequent month

- Walks unaided

Exclusion Criteria:

- Not taking dopamine replacement therapy

- With prior surgical management for PD (e.g. deep brain stimulation)

- With medication-resistant freezing of gait

- Significant cognitive impairment (Montreal Cognitive Assessment score <18)

- Unstable medical conditions

- Other neurological conditions

- Unable to follow instructions or safely complete the training tasks
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Salt Lake City, Utah 84108
801) 581-7200
Phone: 801-587-3181
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