This randomized yoked-controlled study found that self-controlled feedback during a finger-press trajectory task improved 7-day motor retention and was associated with increased corticomotor excitability in people with Parkinson disease compared with yoked feedback.

The paper identifies a simple, implementable rehabilitation strategy that enhances motor learning and a neurophysiological marker of plasticity in PD, offering actionable guidance for clinical therapy design though it does not address disease-modifying mechanisms.

BACKGROUND AND PURPOSE: People with Parkinson disease (PD) experience impaired motor learning. Although numerous studies have shown that self-controlled feedback can facilitate motor learning in healthy young adults, whether similar benefits can be observed in people with PD has been less investigated. This study thus aimed to examine whether self-controlled feedback could benefit motor learning for individuals with PD, and to determine the associated behavioral and neurophysiological mechanisms. METHODS: Thirty-two participants with PD, matched in pairs, were recruited into a self-control group (SELF) and a yoked group (YOKE) to practice a finger-pressing trajectory-matching task. All participants visited the laboratory on day 1 (D1) and day 2 (D2) to practice the trajectory-matching task. The SELF group could decide when to receive feedback, whereas the YOKE group received feedback based on their counterparts' choices. Retention tests were performed on D2 after practice and on day 7 (D7). Additionally, motivation questionnaires, error estimation ability, and corticomotor excitability were examined. RESULTS: Both groups showed improvements in the trajectory-matching task throughout practice. On D7, the SELF group retained its trajectory-matching task performance and showed an increase in corticomotor excitability, whereas these changes were not observed in the YOKE group. There were no significant group differences in the motivation questionnaire or error estimation results. DISCUSSION AND CONCLUSIONS: Self-controlled feedback facilitated motor learning accompanied by increased corticomotor excitability in people with PD. Clinicians may consider incorporating self-control practices into the PD rehabilitation regimen to enhance training benefits. CLINICALTRIALGOV ID: NCT05960331.