Influence of Autonomy on Motor Learning in People With Parkinson's Disease

Influence of Autonomy on Motor Learning in People With Parkinson's Disease

The goal of this clinical trial is to explore the benefits of autonomy supported learning in patients with Parkinson's disease. The main questions to answer are:

• Whether autonomy supported learning can benefit motor learning in PD patients
• Whether autonomy supported learning can enhance intrinsic motivation and/ or information processing of PD patients in learning a new task.
• Whether autonomy supported learning can facilitate cortical excitability change after practicing a new task.

Participants will be recruited into two groups (Self-control group, SC; and yoked group, YK) to learn a finger-pressing trajectory matching task

• Participants in SC group will have choice over feedback schedule during trial practice
• Participants in YK group will receive feedback with no-choice during trial practice Researchers will compare the retention test performance to see if autonomy supported learning will lead to better learning effect.

Autonomy is the sense of learner to actively participate in determining their own behaviour. The present study aims to investigate whether an autonomy supported practice (with self-controlled feedback) would benefit adults with Parkinson's disease (PD), along with increased intrinsic motivation, information processing and cortical excitability. Two groups of healthy adults and two groups of PD patients will be recruited to learn a finger-pressing trajectory matching task. Participants will be allocated in either a self-control group (choice over feedback schedule), or a yoked group (receive feedback with no-choice). Learning will be assessed on the second day and one week later, along with an error estimation of learners' own performance to represent their information processing ability. Cortical excitability and inhibition will be assessed via transcranial magnetic stimulation as indicators of cortical plasticity. Questionnaire regarding motivation will be assessed before and after practice trials. Study hypothesized that individual with PD would benefit from autonomy supported learning, with better performance, enhanced motivation and information processing, associates with change of cortical excitability

Inclusion Criteria:

• age above 20-years-old
• able to follow instructions to perform the tasks (Montreal Cognitive Assessment ≥ 24)
• no surgery and injury in upper extremities in recent 6 months

Exclusion Criteria:

• other neurological disorders in addition to Parkinson's disease
• Parkinson's disease dementia
• symptom of severe tremor in upper extremities (score ≥ 3 in Question 15 to 18 of UPDRS-III)
• deep brain stimulation or pacemaker implanted
• medical history of seizure
• a blood-relative with history of epilepsy
• unstable medical conditions
• pregnancy