Procedural learning and striatofrontal dysfunction in Parkinson's disease.

The neural basis of procedural learning remains controversial. We further analyzed procedural learning in nondemented patients with Parkinson's disease (PD) according to the specific demands of the tasks and the severity of striatal and frontal lobe dysfunction. In the first experiment, the performance of 20 nondemented PD patients and matched normal control subjects was studied in two procedural learning tasks, rotor pursuit and mirror reading, that differ in terms of motor and cognitive involvement. A second experiment further assessed the relationship between learning in mirror reading and executive functions in a new group of 15 nondemented PD patients. In rotor pursuit, PD patients significantly progressed across the first sessions, although their asymptotic performance was inferior to that of controls. In mirror reading, both experiments showed substantial learning in PD patients considered as a group. However, subsequent analyses allowed us to distinguish PD patients without executive dysfunction, whose learning was normal, from PD patients with executive dysfunction, whose learning was severely impaired. These results confirm the involvement of striatofrontal circuits in procedural learning and indicate that the intervention of the frontal network may depend on the characteristics of the task. Copyright 2002 Movement Disorder Society.