Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT04189887 |
| Other study ID # |
20190901RINC |
| Secondary ID |
|
| Status |
Completed |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
November 27, 2019 |
| Est. completion date |
December 31, 2022 |
Study information
| Verified date |
July 2022 |
| Source |
National Taiwan University Hospital |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational [Patient Registry]
|
Clinical Trial Summary
Parkinson's disease (PD) is a neurodegenerative disorder associated with a loss of dopamine
in the basal ganglia and is characterized by several cardinal motor signs. In addition to the
commonly recognized motor symptoms, cognitive impairments are also often observed in people
with PD. Unlike motor deficits, cognitive impairments are not always responsive to
dopaminergic treatment. While medication may ameliorate some cognitive dysfunctions (e.g.,
executive function), it may exacerbate others (e.g., motor learning). Therefore, it is
crucial for clinicians to look for treatment approaches, other than medication, to enhance
cognitive function. In this proposed study, the investigators are especially interested in
determining a method to enhance motor learning ability in people with PD.
Motor learning deficits in people with PD have been well established through different tasks
including motor adaptation task such as maintain balance on a stabilometer or motor sequence
task such as performing a serial reaction time task (SRTT). Motor sequence learning is
important in acquiring real-life motor skill such as tying shoes laces. Based on the past
evidences, people with PD have impairments in motor sequence learning, particularly in
implicit sequence learning. Since implicit motor sequence learning constitutes a critical
part of everyday activities such as typing and changing clothes, establishing an approach to
enhance implicit sequence learning is important.
In the literature conducted with non-disable adults, one of the most effective method to
enhance motor learning is aerobic exercise. Only one study, to the best of knowledge, has
investigated the effect of aerobic exercise on learning to maintain balance on a stabilometer
in people with PD. To date, no study has investigated whether a single bout of aerobic
exercise could improve implicit sequence learning in PD. Therefore, the goal of this proposed
study is to investigate the effect of a single bout of aerobic exercise on implicit sequence
learning and the associated neurophysiological changes in people with PD.
Description:
Parkinson's disease (PD) is a neurodegenerative disorder associated with loss of dopamine in
the basal ganglia and is characterized by several cardinal motor signs, such as tremor,
rigidity, bradykinesia, and postural instability. In addition to the commonly recognized
motor symptoms, non-motor symptoms such as olfactory dysfunction, emotional issues, autonomic
dysfunction and cognitive impairments are also often observed in people with PD. Among these
non-motor symptoms, cognitive dysfunction is the most disturbing deficit and can hugely
affect an individual's daily activity. Unlike motor deficits, these cognitive impairments are
not always responsive to dopaminergic treatment. While medication may ameliorate some
cognitive dysfunctions (e.g., executive function), it may exacerbate others (e.g., motor
learning).Therefore, it is crucial for clinicians to look for treatment approaches, other
than medication, to enhance cognitive function . In this proposed study, the investigators
are especially interested in determining a method to enhance motor learning ability and
reduce motor learning deficit in people with PD as motor learning is a crucial basis in
learning new skills and optimizing activities of daily living.
Motor learning deficits in people with PD have been well established through different tasks
including motor adaptation task such as maintain balance on a stabilometer or motor sequence
task such as performing a serial reaction time task (SRTT). Motor sequence learning is
important in acquiring real-life motor skill such as tying shoes laces and using chopsticks.
There are two types of experiment paradigms to assess motor sequence learning, they are
implicit sequence task and explicit sequence task. Compared with age-matched non-disable
adults, people with PD demonstrated different level of impairments in learning those tasks.
In this study, the investigators will especially focus on the impairment in motor sequence
learning in people with PD. Based on the evidences, implicit sequence learning is more
affected in people in PD compared to explicit sequence learning. Since implicit motor
sequence learning constitutes a critical part of everyday activities such as typing and
changing clothes, therefore the investigators are more interested in exploring implicit
sequence learning in people with PD.
As previously reviewed, motor learning dysfunction could not be ameliorated by dopaminergic
intake, thus several researchers aimed to find alternative method to improve motor learning
ability. In the literature conducted with non-disable adults, one of the most effective
method to enhance motor learning is aerobic exercise.7 Rhee et al. (2016) conducted a study
and showed that a single bout of 20 minutes high intensity aerobic exercise can improve the
performance of a finger sequence learning task in non-disable adults. Only one study, to the
best of our knowledge, has investigated the effect of aerobic exercise on learning to
maintain balance on a stabilometer in people with PD. The participants with PD were required
to perform a single bout of 30-minute moderate intensity (60-70% VO2max) cycling exercise
before practicing the stabilometer task. Their results found that compared to the non-aerobic
condition, 30 minutes of aerobic exercise led to great improvements in motor performance at
retention. However, there are some limitations of this study which may influence the result.
First of all, 30 minutes of aerobic exercise before skill learning might be too fatiguing for
people with PD, and might compromise subsequent practice of the stabilometer task.
Furthermore, the authors found improvements in maintaining balance on a stabilometer but the
related neurophysiological changes have not been determined. Therefore, the goal of this
proposed study is to modify the above limitations and to conduct a study to investigate the
effect of a single bout of aerobic exercise to implicit sequence learning and the related
neurophysiological changes in people with PD. More importantly, the investigatorse would like
to investigate whether corticomotor excitability will change along with motor learning
improvement in people with PD.
The purpose of this proposed study is to explore whether a single-bout aerobic exercise could
enhance implicit motor sequence learning in people with PD. Moreover, the neurophysiological
changes associated with aerobic exercise and learning will be determined.
