Implicit motor sequence learning (IMSL) is affected in Parkinson's disease (PD). Research in healthy young participants shows the potential for transcranial direct‐current stimulation (tDCS) over the primary motor cortex (M1) to enhance IMSL. In PD, only null effects have been reported to date. We determined concurrent, short‐term, and long‐term effects of anodal tDCS over M1 on IMSL, as measured by the serial reaction time (SRT) task, in persons with PD with mild cognitive impairment (MCI). Concurrent (anodal/sham tDCS intervention during the SRT task), short‐term (5 min post‐intervention), and long‐term (1 week post‐intervention) effects on IMSL were evaluated in persons with idiopathic PD (Hoehn and Yahr stage II‐III) with MCI. Results of 11 persons with PD (8 men and 3 women; mean age = 77.1 years; mean disease duration = 7.7 years) showed significant IMSL in the anodal (p = .016), but not in the sham tDCS condition (p = .937). Post‐hoc analyses showed that IMSL reached statistical significance at 1 week post‐intervention (p < .001). Anodal tDCS over M1 exerted beneficial effects on IMSL in persons with PD with MCI, in particular one week post‐intervention. Our study is the first to report a positive effect of tDCS on IMSL in PD. Further research should include a larger, more cognitively diverse sample and additional follow‐up periods.

Implicit motor sequence learning (IMSL) is a cognitive function that is known to be directly associated with impaired motor function in Parkinson's disease (PD).Research on healthy young participants shows the potential for transcranial direct current stimulation (tDCS), a noninvasive brain stimulation technique, over the primary motor cortex (M1) to enhance IMSL. tDCS has direct effects on the underlying cortex, but also induces distant (basal ganglia) network effects-hence its potential value in PD, a prime model of basal ganglia dysfunction. To date, only null effects have been reported in persons with PD. However, these studies did not determine the reacquisition effects, although previous studies in healthy young adults suggest that tDCS specifically exerts its beneficial effects on IMSL on reacquisition rather than acquisition. In the current study, we will therefore establish possible reacquisition effects, which are of a particular interest, as long-term effects are vital for the successful functional rehabilitation of persons with PD. Using a sham-controlled, counterbalanced design, we will investigate the potential of tDCS delivered over M1 to enhance IMSL, as measured by the serial reaction time task, in persons with PD and a neurologically healthy age-and sex-matched control (HC) group. Multilevel Mixed Models will be implemented to analyze the sequence-specific aspect of IMSL (primary outcome) and general learning (secondary outcome). We will determine not only the immediate effects that may occur concurrently with the application of tDCS but also the short-term (5 min post-tDCS) and long-term (1 week post-tDCS) reacquisition effects.

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BACKGROUND: Walking difficulties put an individual at high risk of falling, institutionalisation and even death. The use of robotical rehabilitation or assistive devices for walking has gained considerable interest as a means of improving patients’ gait abilities. OBJECTIVE: The aim of this research was to examine patients’ intrinsic motivation to train with a wearable hip exoskeleton (Honda Walking Assist). METHODS: Rehabilitation patients (stroke, medullar lesion, orthopaedic surgery) and elderly (> 65 yrs) with walking difficulties were recruited for this study (n= 23). Each walked with the Honda Walking Assist for 30 minutes during one therapy session and completed the Intrinsic Motivation Inventory (IMI) afterwards. RESULTS: All participants presented with high scores on the IMI, in particular for the items ‘interest/enjoyment’ (median: 43; 25th–75th perc.: 37–46; maximal score: 49), ‘perceived competence of walking’ (35 [31–38]; max. score 42) and ‘value/usefulness’ (44 [35–49]; max. score 49). CONCLUSIONS: This robotic exoskeleton for assisted walking was considered a valuable device by the majority of participants, eliciting a high degree of motivation and enjoyment.