Levodopa Improves Procedural Motor Learning in Chronic Stroke Patients Nina Rösser, MA, Peter Heuschmann, MD, MPH, Heike Wersching, MD, Caterina Breitenstein, PhD, Stefan Knecht, MD, Agnes Flöel, MD  Archives of Physical Medicine and Rehabilitation  Volume 89, Issue 9, Pages 1633-1641 (September 2008) DOI: 10.1016/j.apmr.2008.02.030 Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 1 Overview of the study design: (A) Prestudy day: examination and familiarization; (B) study day 1: dose 1 (left) and dose 2 (right); and (C) study day 2: dose 3 and motor tasks. Abbreviations: PA, psychophysical assessment, taken every 30 minutes, starting at time 0 after medication, including systolic and diastolic blood pressure, heart rate, PANAS, and side effects (fatigue, dizziness, nausea); post, posttraining. Archives of Physical Medicine and Rehabilitation 2008 89, 1633-1641DOI: (10.1016/j.apmr.2008.02.030) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 2 The procedural motor learning task. The left side of the figure shows a patient performing the procedural motor learning task. Patients sat in front of a monitor and were asked to press the key on a special keypad corresponding to a given asterisk on the screen as fast as possible. The right side of the figure shows the schematic setup of the task. Note that the correct button in the presented arrangement is highlighted in gray. Archives of Physical Medicine and Rehabilitation 2008 89, 1633-1641DOI: (10.1016/j.apmr.2008.02.030) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 3 Results for procedural motor learning (procedural motor learning task). Abbreviation: RT, reaction time. Note that conditions differed significantly in block 2, the primary outcome measure, with larger procedural motor learning in the levodopa condition. Error bars indicate the standard error of the mean. *P<.05. Archives of Physical Medicine and Rehabilitation 2008 89, 1633-1641DOI: (10.1016/j.apmr.2008.02.030) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 4 Reaction times to random elements (procedural motor learning task). Abbreviation: RT, reaction time. Note that the overall reaction time did not differ between conditions in block 2. Error bars indicate the standard error of the mean. Archives of Physical Medicine and Rehabilitation 2008 89, 1633-1641DOI: (10.1016/j.apmr.2008.02.030) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 5 Results of the finger-tapping task. Error bars indicate the standard error of the mean. Archives of Physical Medicine and Rehabilitation 2008 89, 1633-1641DOI: (10.1016/j.apmr.2008.02.030) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions