The impact of Parkinson's disease on sequence learning: Perceptual pattern learning and executive function

The current study examined the contribution of brain areas affected by Parkinson's disease (PD) to sequence learning, with a specific focus on response-related processes, spatial attentional control, and executive functioning. Patients with mild PD, patients with moderate PD, and healthy age-matched participants performed three tasks-a sequence learning task with a spatial pattern that was incidental to response selection, a spatial cuing task, and neuropsychological tests of executive function. Whereas moderate PD patients failed to show significant sequence learning, mild PD patients performed comparably with controls. Neither group of PD patients was impaired in the control of spatial attention. Sequence learning was correlated with neuropsychological measures of executive function but not with the ability to control spatial attention. These results suggest that the contribution of the brain areas affected by PD to sequence learning extends beyond motor learning to include the learning of perceptual patterns and involves executive function, including cognitive flexibility and set shifting. (C) 2008 Elsevier Inc. All rights reserved.