Measuring implicit sequence learning and dual task ability in mild to moderate Parkinson´s disease: A feasibility study.
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ABSTRACT:
SUBMITTER: Freidle M
PROVIDER: S-EPMC8139474 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Dual-task performance holds significant relevance in real-world scenarios. Implicit learning is a possible approach for improving dual-task performance. Analogy learning, utilizing a single metaphor to convey essential information about motor skills, has emerged as a practical method for fostering implicit learning. However, evidence supporting the effect of implicit learning on gait-cognitive dual-task performance is insufficient. This exploratory study aimed to examine the effects of implicit and explicit learning on dual-task performance in both gait and cognitive tasks. Tandem gait was employed on a treadmill to assess motor function, whereas serial seven subtraction tasks were used to gauge cognitive performance. Thirty healthy community-dwelling older individuals were randomly assigned to implicit or explicit learning groups. Each group learned the tandem gait task according to their individual learning styles. The implicit learning group showed a significant improvement in gait performance under the dual-task condition compared with the explicit learning group. Furthermore, the implicit learning group exhibited improved dual-task interference for both tasks. Our findings suggest that implicit learning may offer greater advantages than explicit learning in acquiring autonomous motor skills. Future research is needed to uncover the mechanisms underlying implicit learning and to harness its potential for gait-cognitive dual-task performance in clinical settings.
| S-EPMC11306735 | biostudies-literature
Project description:The concept of mentalizing has been widely studied, but almost exclusively through tasks with explicit instructions. Recent studies suggest that people also mentalize on a more implicit level. However, to our knowledge, no study to date has directly contrasted the effects of implicit and explicit mentalizing processes on an implicit dependent measure within-subjects. We implemented this by using two versions of an object detection task, differing only on secondary catch questions. We hypothesized that if explicit mentalizing relies on complementary processes beyond those underlying implicit mentalizing, this would be reflected in enhanced belief effects in the explicit version. Twenty-eight healthy adults watched movies in which, during the first phase, both they themselves and another agent formed a belief about the location of a ball, and although irrelevant, these beliefs could influence their ball detection reaction times in the second phase. After this response phase, there were occasional catch questions that were different for the explicit and implicit task version. Finally, self-report measures of autism spectrum disorder (ASD) symptomatology were included, as the literature suggests that ASD is related to a specific deficit in implicit mentalizing. Both in the explicit and implicit version, belief conditions had a significant effect on reaction times, with responses being slower when neither the participant nor the other agent expected the ball to be present compared to all other conditions. Importantly, after the implicit version, participants reported no explicit mentalizing awareness. In our neurotypical sample, ASD symptoms were not found to correlate with either explicit or implicit mentalizing. In conclusion, the reaction time patterns in the explicit and implicit version of the task show strikingly similar effects of mentalizing, indicating that participants processed beliefs to the same extent regardless of whether they mentalized explicitly or implicitly, with no additional effects for explicit processing.
| S-EPMC5056736 | biostudies-literature
Project description:Background/aims:Dual-task training may improve dual-task gait performance, balance, and cognition in older adults with and without cognitive impairment. Although music has been widely utilized in dementia management, there are no existing protocols for music-based dual-task training. This randomized controlled study developed a Musical Dual-Task Training (MDTT) protocol that patients with dementia can use to practice walking and making music simultaneously, to enhance attention control in patients during dual-tasking. Methods:Twenty-eight adults diagnosed with mild-to-moderate dementia were assigned to the MDTT (n=15) or control groups (n=13). The MDTT group received MDTT, while the control group participated in non-musical cognitive and walking activities. The effects of MDTT were evaluated through the primary outcome of attention control, and secondary outcomes of dual-task performance, balance, falls efficacy, and agitation. Results:The MDTT group showed a significant improvement in attention control, while the control group did not (P<0.001). A significant effect favored MDTT over control treatment for the secondary outcome of falls efficacy (P=0.02) and agitation (P<0.01). Conclusion:MDTT, a music therapy intervention that demands a high level of cognitive processing, enhances attention control, falls efficacy, and helps alleviate agitation in patients with mild-to-moderate dementia.
| S-EPMC5985768 | biostudies-literature
Project description:ObjectivesThe feasibility and safety of the use of neurorehabilitation technology (SMARTfit® Trainer system) by physical therapists in implementing a gamified physical-cognitive dual-task training (DTT) paradigm for individuals with Parkinson disease (IWPD) was examined. Additionally, the efficacy of this gamified DTT was compared to physical single-task training (STT), both of which were optimized using physio-motivational factors, on changes in motor and cognitive outcomes, and self-assessed disability in activities of daily living.MethodsUsing a cross-over study design, eight participants with mild-to-moderate idiopathic PD (including one with mild cognitive impairment) completed both training conditions (i.e., gamified DTT and STT). For each training condition, the participants attended 2-3 sessions per week over 8.8 weeks on average, with the total amount of training being equivalent to 24 1 h sessions. A washout period averaging 11.5 weeks was inserted between training conditions. STT consisted of task-oriented training involving the practice of functional tasks, whereas for gamified DTT, the same task-oriented training was implemented simultaneously with varied cognitive games using an interactive training system (SMARTfit®). Both training conditions were optimized through continual adaptation to ensure the use of challenging tasks and to provide autonomy support. Training hours, heart rate, and adverse events were measured to assess the feasibility and safety of the gamified DTT protocol. Motor and cognitive function as well as perceived disability were assessed before and after each training condition.ResultsGamified DTT was feasible and safe for this cohort. Across participants, significant improvements were achieved in more outcome measures after gamified DTT than they were after STT. Individually, participants with specific demographic and clinical characteristics responded differently to the two training conditions.ConclusionPhysical therapists' utilization of technology with versatile hardware configurations and customizable software application selections was feasible and safe for implementing a tailor-made intervention and for adapting it in real-time to meet the individualized, evolving training needs of IWPD. Specifically in comparison to optimized STT, there was a preliminary signal of efficacy for gamified DTT in improving motor and cognitive function as well as perceived disability in IWPD.
| S-EPMC8657071 | biostudies-literature
Project description:Recent studies have demonstrated that task success signals can modulate learning during sensorimotor adaptation tasks, primarily through engaging explicit processes. Here, we examine the influence of task outcome on implicit adaptation, using a reaching task in which adaptation is induced by feedback that is not contingent on actual performance. We imposed an invariant perturbation (rotation) on the feedback cursor while varying the target size. In this way, the cursor either hit or missed the target, with the former producing a marked attenuation of implicit motor learning. We explored different computational architectures that might account for how task outcome information interacts with implicit adaptation. The results fail to support an architecture in which adaptation operates in parallel with a model-free operant reinforcement process. Rather, task outcome may serve as a gain on implicit adaptation or provide a distinct error signal for a second, independent implicit learning process.Editorial noteThis article has been through an editorial process in which the authors decide how to respond to the issues raised during peer review. The Reviewing Editor's assessment is that all the issues have been addressed (see decision letter).
| S-EPMC6488295 | biostudies-literature
Project description:Although there is now substantial evidence that developmental change occurs in implicit learning abilities over the lifespan, disparate results exist regarding the specific developmental trajectory of implicit learning skills. One possible reason for discrepancies across implicit learning studies may be that younger children show an increased sensitivity to variations in implicit learning task procedures and demands relative to adults. Studies using serial-reaction time (SRT) tasks have suggested that in adults, measurements of implicit learning are robust across variations in task procedures. Most classic SRT tasks have used response-contingent pacing in which the participant's own reaction time determines the duration of each trial. However, recent paradigms with adults and children have used fixed trial pacing, which leads to alterations in both response and attention demands, accuracy feedback, perceived agency, and task motivation for participants. In the current study, we compared learning on fixed-paced and self-paced versions of a spatial sequence learning paradigm in 4-year-old children and adults. Results indicated that preschool-aged children showed reduced evidence of implicit sequence learning in comparison to adults, regardless of the SRT paradigm used. In addition, we found the preschoolers showed significantly greater learning when stimulus presentation was self-paced. These data provide evidence for developmental differences in implicit sequence learning that are dependent on specific task demands such as stimulus pacing, which may be related to developmental changes in the impact of broader constructs such as attention and task motivation on implicit learning.
| S-EPMC3934418 | biostudies-literature
Project description:A current controversy in the area of implicit statistical learning (ISL) is whether this process consists of a single, central mechanism or multiple modality-specific ones. To provide insight into this question, the current study involved three ISL experiments to explore whether multimodal input sources are processed separately in each modality or are integrated together across modalities. In Experiment 1, visual and auditory ISL were measured under unimodal conditions, with the results providing a baseline level of learning for subsequent experiments. Visual and auditory sequences were presented separately, and the underlying grammar used for both modalities was the same. In Experiment 2, visual and auditory sequences were presented simultaneously with each modality using the same artificial grammar to investigate whether redundant multisensory information would result in a facilitative effect (i.e., increased learning) compared to the baseline. In Experiment 3, visual and auditory sequences were again presented simultaneously but this time with each modality employing different artificial grammars to investigate whether an interference effect (i.e., decreased learning) would be observed compared to the baseline. Results showed that there was neither a facilitative learning effect in Experiment 2 nor an interference effect in Experiment 3. These findings suggest that participants were able to track simultaneously and independently two sets of sequential regularities under dual-modality conditions. These findings are consistent with the theories that posit the existence of multiple, modality-specific ISL mechanisms rather than a single central one.
| S-EPMC5835111 | biostudies-literature
Project description:ObjectivesLearning as measured by eyeblink classical conditioning is preserved in patients with idiopathic Parkinson's disease, but severely affected in patients with progressive supranuclear palsy. We here sought to clarify whether procedural learning is impaired in multiple system atrophy (MSA), and whether it may be helpful for the differentiation of parkinsonian syndromes.DesignWe investigated learning using (1) eyeblink classical conditioning with a delay (interstimulus interval 0 ms) and a trace (600 ms) paradigm and (2) a serial reaction time task.SettingParticipants were recruited from academic research centres.Participants11 patients with MSA and 11 healthy controls.ResultsImplicit learning in eyeblink classical conditioning (acquisition of conditioned responses) as well as the serial reaction time task measures of implicit learning (reaction time change) are impaired in patients with MSA as compared with controls, whereas explicit learning as measured by the sequence recall of the serial reaction time task is relatively preserved.AnalysisWe hypothesise that the learning deficits of patients with MSA are due to lesions of cerebellar and connected brainstem areas.ConclusionsA retrospective synopsis of these novel data on patients with MSA and groups of patients with idiopathic Parkinson's disease and progressive supranuclear palsy studied earlier suggest that eyeblink classical conditioning may contribute to the early differentiation of atypical Parkinson syndromes from idiopathic Parkinson's disease. This hypothesis should be tested in a prospective trial.
| S-EPMC3773641 | biostudies-literature
Project description:Neurostimulation of the dorsolateral prefrontal cortex (DLPFC) can modulate performance in cognitive tasks. In a recent study, however, transcranial direct current stimulation (tDCS) of the DLPFC did not affect implicit task sequence learning and consolidation in a paradigm that involved bimanual responses. Because bimanual performance increases the coupling between homologous cortical areas of the hemispheres and left and right DLPFC were stimulated separately the null findings may have been due to the bimanual setup. The aim of the present study was to test the effect of neuro-stimulation on sequence learning in a uni-manual setup. For this purpose two experiments were conducted. In Experiment 1, the DLPFC was stimulated with tDCS. In Experiment 2 the DLPFC was stimulated with transcranial magnetic stimulation (TMS). In both experiments, consolidation was measured 24?hours later. The results showed that sequence learning was present in all conditions and sessions, but it was not influenced by stimulation. Likewise, consolidation of sequence learning was robust across sessions, but it was not influenced by stimulation. These results replicate and extend previous findings. They indicate that established tDCS and TMS protocols on the DLPFC do not influence implicit task sequence learning and consolidation.
| S-EPMC5575284 | biostudies-literature
Project description:Background and objectiveClinical observations indicate that implicit procedural learning, a central component of physical and psychosocial rehabilitation, is impeded following spinal cord injury. In accordance, previous research has revealed a specific deficit in implicit sequence learning among individuals with paraplegia using a standard, manual version of the serial reaction time task. To extend these findings and shed light on the underlying sources of potential spinal cord injury-related deficits in sequence learning, we used an ocular activated serial reaction time task to compare sequence learning performance between individuals with tetraplegia and healthy controls.Participants and measuresTwelve participants with spinal cord injury in C5-T1 were compared to 12 matched control participants on measures derived from an ocular activated serial reaction time task. Depression and additional cognitive measures were assessed to explore the source and specificity of potential sequence learning deficits.ResultsLike controls, and in contrast with previous findings in paraplegia, the spinal cord injury group showed intact implicit sequence learning, evidenced by declining reaction times and improved anticipation over the first six blocks of the serial reaction time task, and an advantage for the initial learning sequence over a novel interference sequence.ConclusionsThe ocular activated serial reaction time task elicited a performance pattern similar to standard motor versions, such that participants with tetraplegia demonstrated unimpaired sequence learning. This suggests that previously reported implicit sequence learning deficits in spinal cord injury directly involved motor functioning rather than cognitive aspects of the task, and that the ocular activated sequence learning task could be a valid alternative for assessing implicit sequence learning in populations that cannot perform spinal-cord dependent motor tasks. Implications for post-spinal cord injury rehabilitation and adjustment are discussed.
| S-EPMC7179886 | biostudies-literature