Implicit sequence learning in individuals with Parkinson's disease: The added value of using an ocular version of the serial reaction time (O-SRT) task

Introduction: Though the majority of studies reported impaired sequence learning in individuals with Parkinson's disease (PD) tested with the Serial Reaction Time (SRT) task, findings are inconclusive. To elucidate this point, we used an eye tracker in an ocular SRT task version (O-SRT) that in addition to RT, enables extraction of two measures reflecting different cognitive processes, namely, Correct Anticipation (CA) and number of Stucks. Methods: Individuals with PD (n = 29) and matched controls (n = 31) were tested with the O-SRT task, consisting of a repeated sequence of six blocks, then a block with an interference sequence followed by an original sequence block. Results: Unlike controls, patients with PD did not improve in CA rate across learning trials, did not show an increase in RT when presented with the interference sequence, and showed a significantly higher rate of Stucks. Conclusions: Low CA rate and high Stucks rate emerge as the cardinal deficits leading to impaired sequence learning following PD. These are viewed as reflecting difficulty in exploration for an efficient learning strategy. This study highlights the advantage in using the O-SRT task, which enables the generation of several informative measures of learning, allowing better characterization of the PD effect on sequence learning.