Implicit Motor Learning in Parkinson's Disease.

Objective: This study examined whether disruption of performance is moderated in Parkinson's disease (PD) patients who acquire their motor behaviors in an implicit manner. Method: Twenty-seven patients with PD learned a hammering task in errorless (implicit) or errorful (explicit) conditions and were tested for robustness of motor performance under a secondary task load, which required them to continuously count backward as they performed the hammering task. Results: Patients in the errorless (implicit) motor learning condition exhibited robustness to secondary task loading, whereas patients in the errorful (explicit) motor learning condition did not. Conclusions: Implicit motor learning techniques should be considered by PD rehabilitation specialists in cases in which existing disruption to movements is exacerbated by conscious control. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Study of Verbal Working Memory in Patients With Parkinson's Disease.

The authors examined the nature of the working memory deficit in persons with Parkinson's disease (PD). Three hypotheses were tested: a limited storage capacity, an impaired executive component, and a reduction of psychomotor speed. Verbal working memory was assessed in 14 PD patients without dementia and 14 matched control participants. Participants were administered a classical verbal span test, working memory tasks that required either updating or manipulation capacities, and motor and psychomotor speed tasks. Patients' performance was comparable to that of control participants on the verbal span test. However, results on the working memory tasks indicated a deficit in manipulation with normal updating capacities. Motor and psychomotor slowing were found in the patient group, but slowing could not fully account for the impairment observed in the manipulation task. Results indicated that there is a genuine but selective working memory impairment in patients with PD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An Implicit Learning Task Activates Medial Temporal Lobe in Patients With Parkinson's Disease.

Recent studies provide evidence for an interaction between a declarative memory system, dependent on the medial temporal lobe (MTL), and a habit memory system, dependent on the basal ganglia. Using functional MRI, the authors studied this interaction when 1 system was compromised by neurological disease. Neural activity when performing a habit-learning task was compared in normal controls and subjects with Parkinson's disease (PD). Patients with PD showed less activation in the caudate nucleus and greater activation in a region of prefrontal cortex that has been associated with explicit memory retrieval. Patients with PD also showed activation of the MTL during the weather-prediction task. These findings are consistent with an interaction between memory systems of the MTL and the striatum. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impressions of Personality in Parkinson's Disease: Can Rehabilitation Practitioners See Beyond the Symptoms?

Objective: To explore rehabilitation practitioners' use of observable cues of personality to form accurate impressions of persons with Parkinson's disease. Participants: Ninety-nine practitioners from disciplines of occupational, physical, and speech therapy and nursing and medicine. Procedure: Participants viewed excerpts of videotaped interviews of 6 men and 6 women with mild-to-moderate Parkinson's disease and formed impressions of the targets' personality. Main Outcome Measure: NEO Five Factor Inventory personality test. Analysis: Brunswik lens model correlational analysis of the associations between expressive behavior and personality judgments. Results: Practitioners were accurate in judging Openness to Experience, Agreeableness, and Conscientiousness but were unable to detect interparticipant differences in levels of Extraversion and Neuroticism. Conclusion: Accuracy in judging some traits suggests that future research may identify interventions, such as sensitizing practitioners to valid behavioral cues or modifying contextual features, to maximize a practitioner's ability to understand a client's personality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of the Basal Ganglia in Category Learning: How Do Patients With Parkinson's Disease Learn?

The purpose of the present study was to gain a deeper understanding of the role of the basal ganglia in learning and memory by examining learning strategies among patients with basal ganglia dysfunction. Using a probabilistic category learning task (the "weather prediction" task) previously shown to be sensitive to basal ganglia function, the authors examined patterns of performance during learning and used mathematical models to capture different learning strategies. Results showed that patients with Parkinson's disease exhibit different patterns of strategy use. Specifically, most controls initially used a simple, but suboptimal, strategy that focused on single-cue-outcome associations; eventually, however, most controls adopted a more complex, optimal learning strategy, integrating single-cue associations to predict outcomes for multiple-cue stimuli. In contrast, the majority of individuals with Parkinson's disease continued to rely on simple single-cue learning strategies throughout the experiment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maintenance of Response Readiness in Patients With Parkinson's Disease: Evidence From a Simple Reaction Time Task.

The authors explored the effect of Parkinson's disease (PD) on the generation and maintenance of response readiness in a simple reaction time task. They compared performance of idiopathic PD patients without dementia, age-matched controls, and younger controls over short (1-, 3-, and 6-s) and long (12- and 18-s) foreperiod intervals. After each trial, the authors probed memory for visual information that also had to be maintained during the trial interval. Patients and controls did not differ overall in their ability to maintain readiness over long delays. However, within the PD group only, errors in maintaining visual information were correlated with difficulty in maintaining readiness, suggesting that systems impaired in PD may facilitate the maintenance of processing in both motor and cognitive domains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

S-methylation in Parkinson's disease

We report thiolmethyltransferase (TMT) activity in RBC membrane preparations from patients with Parkinson's disease (PD), normal controls, and patients with symptomatic parkinsonism. Unlike previous reports, our report found no significant decrease in TMT activity in PD patients compared with normal controls. Low S-methylation capacity does not appear to be a risk factor for PD in Japanese patients.     

Dementia in Parkinson's disease

The occurrence of dementia in patients with Parkinson's disease was studied in a Parkinsonian population consisting of all traceable patients residing in a defined area. The prevalence of dementia was found to be 29 per cent in 444 patients studied. The frequency of dementia increased with advancing age and the patients showing signs of clinical arteriosclerosis were more often demented than the patients without arteriosclerosis. There was, however, an evident association between the stage of the disease and the frequency of dementia. The most severely disabled patients displayed dementia more often than the mildly affected, both among the patients with and without arteriosclerosis. The demented patients showed significantly more severe rigidity and hypokinesia when compared with the non-demented. Increasing severity of rigidity and hypolinesia, in particular was found to have a positive correlation with the degree of dementia. The association between dementia and the degree of motor involvement is considered to suggest the role of subcortical structures in the patholophysiology of dementia in Parkinson's disease.     

The European Congress on Cobalt and Hard Metal Disease. Conclusions, highlights and need of future studies

This article summarizes the present state of the art and some recommendations for solutions to problems identified by the European Congress on Cobalt and Hard Metal Disease on the basis of the papers and posters presented, as well as a round table discussion which produced several dominant questions and revealed areas of weakness and uncertainty. The round table discussion (chairman, Professor E. Capodaglio) focussed on the following aspects: (i) Monitoring (opinion leaders: R. Lauwerys, E. Sabbioni). (ii) Mechanisms of toxicity (opinion leaders: B. Nemery, N.L. Sprince, G. Scansetti). (iii) Health effects (opinion leaders: G. Nordberg, I.B. Andersen). (iv) Diagnosis/health surveillance (opinion leaders: G. Chiappino, S. Hernberg, S. Brown).     

Tyrosine hydroxylase and Parkinson's disease

A consistent neurochemical abnormality in Parkinson's disease (PD) is degeneration of dopaminergic neurons in substantia nigra, leading to a reduction of striatal dopamine (DA) levels. As tyrosine hydroxylase (TH) catalyses the formation of L-DOPA, the rate-limiting step in the biosynthesis of DA, the disease can be considered as a TH-deficiency syndrome of the striatum. Similarly, some patients with hereditary L-DOPA-responsive dystonia, a neurological disorder with clinical similarities to PD, have mutations in the TH gene and decreased TH activity and/or stability. Thus, a logical and efficient treatment strategy for PD is based on correcting or bypassing the enzyme deficiency by treatment with L-DOPA, DA agonists, inhibitors of DA metabolism, or brain grafts with cells expressing TH. A direct pathogenetic role of TH has also been suggested, as the enzyme is a source of reactive oxygen species (ROS) in vitro and a target for radical-mediated oxidative injury. Recently, it has been demonstrated that L-DOPA is effectively oxidized by mammalian TH in vitro, possibly contributing to the cytotoxic effects of DOPA. This enzyme may therefore be involved in the pathogenesis of PD at several different levels, in addition to being a promising candidate for developing new treatments of this disease.     

Genetic polymorphisms in Parkinson's disease

The search for genetic polymorphisms relevant to Parkinson's disease etiology and pathogenesis has been motivated by recent thinking emphasizing the potential significance of gene-environment interactions. Especially influential to this research have been the MPTP model of PD induction, hypotheses concerning oxidative stressor reactions, and epidemiological observations of an inverse relation between cigarette smoking and PD risk. This brief review summarizes trends in genetic polymorphism research, with examples provided by investigations of cytochrome P450 enzymes, monoamine oxidase, superoxide dismutase, and mitochondrial genes.     

Memory disturbances in Parkinson's disease

Disturbances in memory belong to the most frequent cognitive impairments in Parkinson patients. This review treats problematical aspects in the clinical diagnosis of these memory disturbances, which are particularly evident in free recall, immediate reproduction, the chronological sequencing of events and the initiation of meaningful strategies. These selective impairments are discussed within a theoretical frame of reference. Finally, considering the time demands and work loading in contemporary psychological practice, recommendations are given for economical and multidimensional routine diagnostic testing.     

Sleep benefit in Parkinson's disease

Sleep benefit (SB) In Parkinson's disease (PD) is not well characterized. To determine SB frequency, as well as to characterize and correlate it with other disease variables, we evaluated prospectively a consecutive series of 312 PD patients by means of a structured questionnaire: 55% reported having SB and 35% reported that awakening was their best time of the day. Because of SB, 21% of the entire population were able to skip or delay medication. The mean duration of the phenomenon was 85.4 +/- 67 min. Patients with SB were significantly older (p < 0.0002), had disease longer (p < 0.05), and were often men (chi 2 = 3.5, df 1, p = 0.05). Patients with SB took sleep medication with similar frequency as those without SB. There were no differences in hours of sleep or sleep latency. Sleep problems such as nightmares or somnambulism, but not the number of sleep awakenings, were similar in both groups. In conclusion, SB is a frequent phenomenon, especially in men, elderly patients, and patients with longer disease duration. SB enables the morning L-dopa dose to be postponed in approximately 50% of patients.