The implicit sequence learning deficit in patients with Parkinson's disease: a matter of impaired sequence integration?

Despite the wealth of research investigating the serial reaction time (SRT) learning abilities of people with Parkinson's disease (PD), the role of the basal ganglia in implicit sequence learning remains largely unclear. The present research sought to examine the ability of people with PD to implicitly learn simultaneously operating sequences and integrate patterned information from each sequence dimension. Using a version of the SRT which reduced motor demands, the present experiment investigated the implicit learning of a spatial sequence, a stimulus-response sequence, and an integrated spatial/stimulus-response sequence, all of which are usually confounded in the standard SRT task. Whereas both PD and control groups demonstrated robust learning for the individual spatial and response sequences, only control participants evidenced learning for the integrated sequence. Further, unlike implicit learning for the spatial and object sequences, impaired integrated sequence acquisition was specifically related to the severity of patients' PD symptomatology. The implicit learning deficits of PD patients are discussed with regard to the role played by the basal ganglia in integrative sequence learning in the SRT.