Skill Learning

The ability to learn skilled motor behavior is not impaired in AD patients, at least in the early stages. This is shown by normal rates of learning on a variety of different tests. One is the pursuit rotor test, in which a handheld stylus has to be held so that it maintains contact with a rotating metal disc. Over a series of trials, accuracy increases and the rate of learning is taken as the measure of learning ability. In AD patients, the rate of learning is the same as that in controls, and this is true when the initial error rates on the task are carefully matched across groups by varying the speed of the disc to suit each person. Another task is mirror-reversed reading of text, which in normal circumstances improves with practice. Again, the rate of improvement appears to be normal in AD. In order to test more complex visuomotor skill learning, a serial reaction time test has been used. Here, a typical task consists of four lights being presented and each time a light comes on a key in front of it must be pressed as quickly as possibly. A random sequence is presented, but embedded in this sequence is an order that is repeated several times. Visuomotor skill learning is shown by the increase in response time following repetition of the sequence, contrasting with a relative decline in response time with novel sequences. In AD, the normal pattern of learning is found, in the context of slower overall responses.

In all of the skill learning tasks described previously, the preserved learning ability suggests that AD patients rely on a different neuranatomical substrate than, for example, episodic memory. Comparison studies have been performed using other neurological conditions. These show a consistent learning deficit in Huntington's chorea, indicating that the neostriatal system is involved at the level of modification of central motor programs following sensorimotor feedback.

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