Neocortical mechanisms in motor learning

Neuromechanisms of simulation-based arthroscopic skills assessment: a fNIRS study

BACKGROUND

The neural mechanisms underlying differences in the performance of simulated arthroscopic skills across various skill levels remain unclear. Our primary objective is to investigate the learning mechanisms of simulated arthroscopic skills using functional near-infrared spectroscopy (fNIRS).

METHODS

We recruited 27 participants, divided into three groups: novices (n = 9), intermediates (n = 9), and experts (n = 9). Participants completed seven arthroscopic tasks on a simulator, including diagnostic navigation, triangulation, grasping stars, diagnostic exploration, meniscectomy, synovial membrane cleaning, and loose body removal. All tasks were videotaped and assessed via the simulator system and the Arthroscopic Surgical Skill Evaluation Tool (ASSET), while cortical activation data were collected using fNIRS. Simulator scores and ASSET scores were analyzed to identify different level of performance of all participants. Brain region activation and functional connectivity (FC) of different types of participants were analyzed from fNIRS data.

RESULTS

Both the expert and intermediate groups scored significantly higher than the novice group (p < 0.001). There were significant differences in ASSET scores between experts and intermediates, experts and novices, and intermediates and novices (p = 0.0047, p < 0.0001, p < 0.0001), with the trend being experts > intermediates > novices. The intermediate group exhibited significantly greater activation in the left primary motor cortex (LPMC) and left prefrontal cortex (LPFC) compared to the novice group (p = 0.0152, p = 0.0021). Compared to experts, the intermediate group demonstrated significantly increased FC between the presupplementary motor area (preSMA) and the right prefrontal cortex (RPFC; p < 0.001). Additionally, the intermediate group showed significantly increased FC between the preSMA and LPFC, RPFC and LPFC, and LPMC and LPFC compared to novices (p = 0.0077, p = 0.0285, p = 0.0446).

CONCLUSION

Cortical activation and functional connectivity reveal varying levels of activation intensity in the PFC, PMC, and preSMA among novices, intermediates, and experts. The intermediate group exhibited the highest activation intensity.

Sleep and Learning: A Systematic Review

Introduction  Sleep deprivation has a great impact on the learning process in physicians in training. Therefore, inquiring on this phenomenon in the most recent investigations will facilitate the provision of evidence on the influence regarding the absence of sleep on the learning process in health personnel. Objectives  The aim of this systematic review is to review, analyze and discuss the current literature that shows the impact of sleep on the learning process on doctors in training. Data Synthesis  A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A search of the existing literature between the years of 2000 and 2022 was performed in the PubMed and Elsevier databases, taking into account the inclusion criteria of articles in English or Spanish and the established timeframe. As a result, 128 articles distributed in the databases were obtained and 23 articles that met the inclusion criteria were selected. Conclusion  Sleep is a fundamental factor for the consolidation, processing and functioning of memory and learning. Health professionals are a population at risk of sleep deprivation, thus it is important to take into account the effects it has on patients and health personnel.

Disruption of somatosensory cortex impairs motor learning and retention

This study tests for a function of the somatosensory cortex, that, in addition to its role in processing somatic afferent information, somatosensory cortex contributes both to motor learning and the stabilization of motor memory. Continuous theta-burst magnetic stimulation (cTBS) was applied, before force-field training to disrupt activity in either the primary somatosensory cortex, primary motor cortex, or a control zone over the occipital lobe. Tests for retention and relearning were conducted after a 24 h delay. Analysis of movement kinematic measures and force-channel trials found that cTBS to somatosensory cortex disrupted both learning and subsequent retention, whereas cTBS to motor cortex had little effect on learning but possibly impaired retention. Basic movement variables are unaffected by cTBS suggesting that the stimulation does not interfere with movement but instead disrupts changes in the cortex that are necessary for learning. In all experimental conditions, relearning in an abruptly introduced force field, which followed retention testing, showed extensive savings, which is consistent with previous work suggesting that more cognitive aspects of learning and retention are not dependent on either of the cortical zones under test. Taken together, the findings are consistent with the idea that motor learning is dependent on learning-related activity in the somatosensory cortex.NEW & NOTEWORTHY This study uses noninvasive transcranial magnetic stimulation to test the contribution of somatosensory and motor cortex to human motor learning and retention. Continuous theta-burst stimulation is applied before learning; participants return 24 h later to assess retention. Disruption of the somatosensory cortex is found to impair both learning and retention, whereas disruption of the motor cortex has no effect on learning. The findings are consistent with the idea that motor learning is dependent upon learning-related plasticity in somatosensory cortex.

Motor learning and tDCS: A systematic review on the dependency of the stimulation effect on motor task characteristics or tDCS assembly specifications

TDCS is one of the most commonly used methods among studies with transcranial electrical stimulation and motor skills learning. Differences between study results suggest that the effect of tDCS on motor learning is dependent on the motor task performed or on the tDCS assembly specification used in the learning process. This systematic review aimed to analyze the tDCS effect on motor learning and verify whether this effect is dependent on the task or tDCS assembly specifications. Searches were performed in PubMed, SciELO, LILACS, Web of Science, CINAHL, Scopus, SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and PsycINFO. Articles were included that analyzed the effect of tDCS on motor learning through pre-practice, post-practice, retention, and/or transfer tests (period ≥24 h). The tDCS was most frequently applied to the primary motor cortex (M1) or the cerebellar cortex (CC) and the majority of studies found significant stimulation effects. Studies that analyzed identical or similar motor tasks show divergent results for the tDCS effect, even when the assembly specifications are the same. The tDCS effect is not dependent on motor task characteristics or tDCS assembly specifications alone but is dependent on the interaction between these factors. This interaction occurs between uni and bimanual tasks with anodal uni and bihemispheric (bilateral) stimulations at M1 or with anodal unihemispheric stimulations (unilateral and centrally) at CC, and between tasks of greater or lesser difficulty with single or multiple tDCS sessions. Movement time seems to be more sensitive than errors to indicate the effects of tDCS on motor learning, and a sufficient amount of motor practice to reach the "learning plateau" also seems to determine the effect of tDCS on motor learning.

The Effects of Virtual Reality Nonphysical Mental Training on Balance Skills and Functional Near-Infrared Spectroscopy Activity in Healthy Adults

CONTEXT

Athletic skills such as balance are considered physical skills. However, these skills may not just improve by physical training, but also by mental training. The purpose of this study was to investigate the effects of mental training programs on balance skills and hemodynamic responses of the prefrontal cortex.

DESIGN

Randomized controlled trial.

METHODS

Fifty-seven healthy adults (28 females, 29 males), aged between 18-25 years, participated in this study. Participants were randomly assigned to 3 groups: virtual reality mental training (VRMT) group, conventional mental training (CMT) group, and control group. The training program included action observation and motor imagery practices with balance exercise videos. The VRMT group trained with a VR head-mounted display, while the CMT group trained with a non-immersive computer screen, for 30 minutes, 3 days per week for 4 weeks. At baseline and after 4 weeks of training, balance was investigated with stabilometry and Star Excursion Balance Test (SEBT). Balance tests were performed with simultaneous functional near-infrared spectroscopy (fNIRS) imaging to measure prefrontal cortex oxygenation.

RESULTS

For the stabilometry test, at least 1 variable improved significantly in both VRMT and CMT groups but not in the control group. For SEBT, composite reach distance significantly increased in both VRMT and CMT groups but significantly decreased in the control group. For separate directional scores, reach distance was significantly increased in both mental training groups for nondominant leg posterolateral and posteromedial directions, and dominant leg posterolateral direction, while nondominant posteromedial score was significantly increased only in the VRMT group. Between-group comparisons showed that dominant leg posteromedial and posterolateral score improvements were significantly higher than control group for both mental training groups, while nondominant leg improvements were significantly higher than control group only for the VRMT group. The fNIRS oxyhemoglobin levels were not significantly changed during stabilometry tests. However, oxyhemoglobin levels significantly reduced only in the control group during SEBT.

CONCLUSIONS

Our findings suggest that both mental training interventions can significantly improve balance test results. Additionally, VRMT may have some advantages over CMT. These findings are promising for the use of mental training in prevention and rehabilitation for special populations such as athletes and older adults.

Default mode and dorsal attention network involvement in visually guided motor sequence learning

Motor sequence learning (MSL) paradigms are often used to investigate the neural processes underlying the acquisition of complex motor skills. Behavioral and neuroimaging studies have indicated an early stage in which spatial learning is prominent and a late stage of automatized performance after multiple training periods. Functional magnetic resonance imaging (fMRI) studies yielded both decreased and increased activations of the sensorimotor and association areas. However, task-negative and task-positive intrinsic connectivity networks (ICNs), the default mode (DMN) and dorsal attention (DAN) networks involved in governing attention demands during various task conditions were not specifically addressed in most studies. In the present fMRI study, a visually guided MSL (VMSL) task was used for bringing roles of visuospatial and motor attention into foreground in order to investigate the role of attention-related ICNs in MSL. Seventeen healthy, right-handed participants completed training and test sessions of VMSL during fMRI on the 1st day. Then, after daily training for three consecutive days outside the scanner, they were re-tested during the 5th day's scanning session. When test session after early learning period was compared with training session, activation decrease was observed in the occipito-temporal fusiform cortex, while task-related suppression of DMN was reduced. Reduced deactivation after early learning was correlated with decreased error rates. After late learning stage we observed activation decreases in bilateral superior parietal lobules of task-positive DAN, dorsal precunei, and cerebellum. Reduced activity in left posterior parietal and right cerebellar regions were correlated with gains in speed, error rate, respectively. This dissociation in activity changes of DMN and DAN related areas suggests that DAN shows high contribution during both early and late MSL stages, possibly due to attention requirement for automatization of spatial and temporal aspects of motor sequence. In contrast, spatial learning occurring during early MSL stage was sufficient for releasing DMN resources.

Evidence for a Window of Enhanced Plasticity in the Human Motor Cortex Following Ischemic Stroke

BACKGROUND

In preclinical models, behavioral training early after stroke produces larger gains compared with delayed training. The effects are thought to be mediated by increased and widespread reorganization of synaptic connections in the brain. It is viewed as a period of spontaneous biological recovery during which synaptic plasticity is increased.

OBJECTIVE

To look for evidence of a similar change in synaptic plasticity in the human brain in the weeks and months after ischemic stroke.

METHODS

We used continuous theta burst stimulation (cTBS) to activate synapses repeatedly in the motor cortex. This initiates early stages of synaptic plasticity that temporarily reduces cortical excitability and motor-evoked potential amplitude. Thus, the greater the effect of cTBS on the motor-evoked potential, the greater the inferred level of synaptic plasticity. Data were collected from separate cohorts (Australia and UK). In each cohort, serial measurements were made in the weeks to months following stroke. Data were obtained for the ipsilesional motor cortex in 31 stroke survivors (Australia, 66.6 ± 17.8 years) over 12 months and the contralesional motor cortex in 29 stroke survivors (UK, 68.2 ± 9.8 years) over 6 months.

RESULTS

Depression of cortical excitability by cTBS was most prominent shortly after stroke in the contralesional hemisphere and diminished over subsequent sessions (P = .030). cTBS response did not differ across the 12-month follow-up period in the ipsilesional hemisphere (P = .903).

CONCLUSIONS

Our results provide the first neurophysiological evidence consistent with a period of enhanced synaptic plasticity in the human brain after stroke. Behavioral training given during this period may be especially effective in supporting poststroke recovery.

Determinants of Neural Plastic Changes Induced by Motor Practice

Short-term motor practice leads to plasticity in the primary motor cortex (M1). The purpose of this study is to investigate the factors that determine the increase in corticospinal tract (CST) excitability after motor practice, with special focus on two factors; “the level of muscle activity” and “the presence/absence of a goal of keeping the activity level constant.” Fifteen healthy subjects performed four types of rapid thumb adduction in separate sessions. In the “comfortable task” (C) and “forceful task” (F), the subjects adducted their thumb using comfortable and strong forces. In the “comfortable with a goal task” (CG) and “forceful with a goal task” (FG), subjects controlled the muscle activity at the same level as in the C and F, respectively, by adjusting the peak electromyographic amplitude within the target ranges. Paired associative stimulation (PAS), which combines peripheral nerve (median nerve) stimulation and transcranial magnetic stimulation (TMS), with an inter-stimulus interval of 25 ms (PAS25) was also done. Before and after the motor tasks and PAS25, TMS was applied to the M1. None of the four tasks showed any temporary changes in behavior, meaning no learning occurred. Motor-evoked potential (MEP) amplitude increased only after the FG and it exhibited a positive correlation with the MEP increase after PAS25, suggesting that FG and PAS25 share at least similar plasticity mechanisms in the M1. Resting motor threshold (RMT) decreased only after FG, suggesting that FG would also be associated with the membrane depolarization of M1 neurons. These results suggest task-dependent plasticity from the synergistic effect of forceful muscle activity and of setting a goal of keeping the activity level constant.

Functional brain connectivity related to surgical skill dexterity in physical and virtual simulation environments

Significance: Surgical simulators, both virtual and physical, are increasingly used as training tools for teaching and assessing surgical technical skills. However, the metrics used for assessment in these simulation environments are often subjective and inconsistent. Aim: We propose functional activation metrics, derived from brain imaging measurements, to objectively assess the correspondence between brain activation with surgical motor skills for subjects with varying degrees of surgical skill. Approach: Cortical activation based on changes in the oxygenated hemoglobin (HbO) of 36 subjects was measured using functional near-infrared spectroscopy at the prefrontal cortex (PFC), primary motor cortex, and supplementary motor area (SMA) due to their association with motor skill learning. Inter-regional functional connectivity metrics, namely, wavelet coherence (WCO) and wavelet phase coherence were derived from HbO changes to correlate brain activity to surgical motor skill levels objectively. Results: One-way multivariate analysis of variance found a statistically significant difference in the inter-regional WCO metrics for physical simulator based on Wilk's Λ for expert versus novice, F ( 10,1 ) = 7495.5 , p < 0.01 . Partial eta squared effect size for the inter-regional WCO metrics was found to be highest between the central prefrontal cortex (CPFC) and SMA, CPFC-SMA ( η 2 = 0.257 ). Two-tailed Mann-Whitney U tests with a 95% confidence interval showed baseline equivalence and a statistically significant ( p < 0.001 ) difference in the CPFC-SMA WPCO metrics for the physical simulator training group ( 0.960 ± 0.045 ) versus the untrained control group ( 0.735 ± 0.177 ) following training for 10 consecutive days in addition to the pretest and posttest days. Conclusion: We show that brain functional connectivity WCO metric corresponds to surgical motor skills in the laparoscopic physical simulators. Functional connectivity between the CPFC and the SMA is lower for subjects that exhibit expert surgical motor skills than untrained subjects in laparoscopic physical simulators.

Cortical Processing of Multimodal Sensory Learning in Human Neonates

Following birth, infants must immediately process and rapidly adapt to the array of unknown sensory experiences associated with their new ex-utero environment. However, although it is known that unimodal stimuli induce activity in the corresponding primary sensory cortices of the newborn brain, it is unclear how multimodal stimuli are processed and integrated across modalities. The latter is essential for learning and understanding environmental contingencies through encoding relationships between sensory experiences; and ultimately likely subserves development of life-long skills such as speech and language. Here, for the first time, we map the intracerebral processing which underlies auditory-sensorimotor classical conditioning in a group of 13 neonates (median gestational age at birth: 38 weeks + 4 days, range: 32 weeks + 2 days to 41 weeks + 6 days; median postmenstrual age at scan: 40 weeks + 5 days, range: 38 weeks + 3 days to 42 weeks + 1 days) with blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (MRI) and magnetic resonance (MR) compatible robotics. We demonstrate that classical conditioning can induce crossmodal changes within putative unimodal sensory cortex even in the absence of its archetypal substrate. Our results also suggest that multimodal learning is associated with network wide activity within the conditioned neural system. These findings suggest that in early life, external multimodal sensory stimulation and integration shapes activity in the developing cortex and may influence its associated functional network architecture.

A single high-intensity exercise bout during early consolidation does not influence retention or relearning of sensorimotor locomotor long-term memories

A single exercise bout has been found to improve the retention of a skill-based upper extremity motor task up to a week post-practice. This effect is the greatest when exercise intensity is high and exercise is administered immediately after motor practice (i.e., early in consolidation). Whether exercise can affect other motor learning types (e.g., sensorimotor adaptation) and tasks (e.g., walking) is still unclear as previous studies have not optimally refined the exercise parameters and long-term retention testing. Therefore, we investigated whether a single high-intensity exercise bout during early consolidation would improve the long-term retention and relearning of sensorimotor adaptation during split-belt treadmill walking. Twenty-six neurologically intact adults attended three sessions; sessions 2 and 3 were 1 day and 7 days after session 1, respectively. Participants were allocated either to Rest (REST) or to Exercise (EXE) group. In session 1, all groups walked on a split-belt treadmill in a 2:1 speed ratio (1.5:0.75 m/s). Then, half of the participants exercised for 5 min (EXE), while the other half rested for 5 min (REST). A short exercise bout during early consolidation did not improve retention or relearning of locomotor memories one or seven days after session 1. This result reinforces previous findings that the effect of exercise on motor learning may differ between sensorimotor locomotor adaptation and skilled-based upper extremity tasks; thus, the utility of exercise as a behavioral booster of motor learning may depend on the type of motor learning and task.

Opening the "Black Box": Functions of the Frontal Lobes and Their Implications for Sociology

Previous research has provided theoretical frameworks for building inter-disciplinary bridges between sociology and the neurosciences; yet, more anatomically, or functionally focused perspectives offering detailed information to sociologists are largely missing from the literature. This manuscript addresses this gap by offering a comprehensive review of the functions of the frontal lobes, arguably the most important brain region involved in various "human" skills ranging from abstract thinking to language. The paper proposes that the functions of the frontal lobe sub-regions can be divided into three inter-related hierarchical systems with varying degrees of causal proximity in regulating human behavior and social connectedness: (a) the most proximate, voluntary, controlled behavior-including motor functions underlying action-perception and mirror neurons, (b) more abstract motivation and emotional regulation-such as Theory of Mind and empathy, and (c) the higher-order executive functioning-e.g., inhibition of racial bias. The paper offers insights from the social neuroscience literature on phenomena that lie at the core of social theory and research including moral cognition and behavior, and empathy and inter-group attitudes and provides future research questions for interdisciplinary research.

Adult Gross Motor Learning and Sleep: Is There a Mutual Benefit?

Posttraining consolidation, also known as offline learning, refers to neuroplastic processes and systemic reorganization by which newly acquired skills are converted from an initially transient state into a more permanent state. An extensive amount of research on cognitive and fine motor tasks has shown that sleep is able to enhance these processes, resulting in more stable declarative and procedural memory traces. On the other hand, limited evidence exists concerning the relationship between sleep and learning of gross motor skills. We are particularly interested in this relationship with the learning of gross motor skills in adulthood, such as in the case of sports, performing arts, devised experimental tasks, and rehabilitation practice. Thus, the present review focuses on sleep and gross motor learning (GML) in adults. The literature on the impact of sleep on GML, the consequences of sleep deprivation, and the influence of GML on sleep architecture were evaluated for this review. While sleep has proven to be beneficial for most gross motor tasks, sleep deprivation in turn has not always resulted in performance decay. Furthermore, correlations between motor performance and sleep parameters have been found. These results are of potential importance for integrating sleep in physiotherapeutic interventions, especially for patients with impaired gross motor functions.

A single exercise bout and locomotor learning after stroke: physiological, behavioural, and computational outcomes

KEY POINTS

Previous work demonstrated an effect of a single high-intensity exercise bout coupled with motor practice on the retention of a newly acquired skilled arm movement, in both neurologically intact and impaired adults. In the present study, using behavioural and computational analyses we demonstrated that a single exercise bout, regardless of its intensity and timing, did not increase the retention of a novel locomotor task after stroke. Considering both present and previous work, we postulate that the benefits of exercise effect may depend on the type of motor learning (e.g. skill learning, sensorimotor adaptation) and/or task (e.g. arm accuracy-tracking task, walking).

ABSTRACT

Acute high-intensity exercise coupled with motor practice improves the retention of motor learning in neurologically intact adults. However, whether exercise could improve the retention of locomotor learning after stroke is still unknown. Here, we investigated the effect of exercise intensity and timing on the retention of a novel locomotor learning task (i.e. split-belt treadmill walking) after stroke. Thirty-seven people post stroke participated in two sessions, 24 h apart, and were allocated to active control (CON), treadmill walking (TMW), or total body exercise on a cycle ergometer (TBE). In session 1, all groups exercised for a short bout (∼5 min) at low (CON) or high (TMW and TBE) intensity and before (CON and TMW) or after (TBE) the locomotor learning task. In both sessions, the locomotor learning task was to walk on a split-belt treadmill in a 2:1 speed ratio (100% and 50% fast-comfortable walking speed) for 15 min. To test the effect of exercise on 24 h retention, we applied behavioural and computational analyses. Behavioural data showed that neither high-intensity group showed greater 24 h retention compared to CON, and computational data showed that 24 h retention was attributable to a slow learning process for sensorimotor adaptation. Our findings demonstrated that acute exercise coupled with a locomotor adaptation task, regardless of its intensity and timing, does not improve retention of the novel locomotor task after stroke. We postulate that exercise effects on motor learning may be context specific (e.g. type of motor learning and/or task) and interact with the presence of genetic variant (BDNF Val66Met).

Electroencephalographic connectivity measures predict learning of a motor sequencing task

Individuals vary significantly with respect to rate and degree of improvement with motor practice. While the regions that underlie motor learning have been well described, neurophysiological factors underlying differences in response to motor practice are less well understood. The present study examined both resting-state and event-related EEG coherence measures of connectivity as predictors of response to motor practice on a motor sequencing task using the dominant hand. Thirty-two healthy young right-handed participants underwent resting EEG before motor practice. Response to practice was evaluated both across the single session of motor practice and 24 h later at a retention test of short-term motor learning. Behaviorally, the group demonstrated statistically significant gains both in single-session "motor improvement" and across-session "motor learning." A resting-state measure of whole brain coherence with primary motor cortex (M1) at baseline robustly predicted subsequent motor improvement (validated R² = 0.55) and motor learning (validated R² = 0.68) in separate partial least-squares regression models. Specifically, greater M1 coherence with left frontal-premotor cortex (PMC) at baseline was characteristic of individuals likely to demonstrate greater gains in both motor improvement and motor learning. Analysis of event-related coherence with respect to movement found the largest changes occurring in areas implicated in planning and preparation of movement, including PMC and frontal cortices. While event-related coherence provided a stronger prediction of practice-induced motor improvement (validated R² = 0.73), it did not predict the degree of motor learning (validated R² = 0.16). These results indicate that connectivity in the resting state is a better predictor of consolidated learning of motor skills. NEW & NOTEWORTHY Differences in response to motor training have significant societal implications across a lifetime of motor skill practice. By evaluating both resting-state and event-related measures of brain function, our findings highlight interindividual differences in brain connectivity providing unique insights into differences in response to motor training. These findings have wide-ranging implications in settings ranging from advanced professional motor training to rehabilitation after brain injury.

Children benefit differently from night- and day-time sleep in motor learning

Motor skill acquisition occurs while practicing (on-line) and when asleep or awake (off-line). However, developmental questions still remain about whether children of various ages benefit similarly or differentially from night- and day-time sleeping. The likely circadian effects (time-of-day) and the possible between-test-interference (order effects) associated with children's off-line motor learning are currently unknown. Therefore, this study examines the contributions of over-night sleeping and mid-day napping to procedural skill learning. One hundred and eight children were instructed to practice a finger sequence task using computer keyboards. After an equivalent 11-h interval in one of the three states (sleep, nap, wakefulness), children performed the same sequence in retention tests and a novel sequence in transfer tests. Changes in the movement time and sequence accuracy were evaluated between ages (6-7, 8-9, 10-11years) during practice, and from skill training to retrievals across three states. Results suggest that night-time sleeping and day-time napping improved the tapping speed, especially for the 6-year-olds. The circadian factor did not affect off-line motor learning in children. The interference between the two counter-balanced retrieval tests was not found for the off-line motor learning. This research offers possible evidence about the age-related motor learning characteristics in children and a potential means for enhancing developmental motor skills. The dynamics between age, experience, memory formation, and the theoretical implications of motor skill acquisition are discussed.

Motor sequence learning-induced neural efficiency in functional brain connectivity

Previous studies have shown the functional neural circuitry differences before and after an explicitly learned motor sequence task, but have not assessed these changes during the process of motor skill learning. Functional magnetic resonance imaging activity was measured while participants (n=13) were asked to tap their fingers to visually presented sequences in blocks that were either the same sequence repeated (learning block) or random sequences (control block). Motor learning was associated with a decrease in brain activity during learning compared to control. Lower brain activation was noted in the posterior parietal association area and bilateral thalamus during the later periods of learning (not during the control). Compared to the control condition, we found the task-related motor learning was associated with decreased connectivity between the putamen and left inferior frontal gyrus and left middle cingulate brain regions. Motor learning was associated with changes in network activity, spatial extent, and connectivity.

Online and Offline Performance Gains Following Motor Imagery Practice: A Comprehensive Review of Behavioral and Neuroimaging Studies

There is now compelling evidence that motor imagery (MI) promotes motor learning. While MI has been shown to influence the early stages of the learning process, recent data revealed that sleep also contributes to the consolidation of the memory trace. How such "online" and "offline" processes take place and how they interact to impact the neural underpinnings of movements has received little attention. The aim of the present review is twofold: (i) providing an overview of recent applied and fundamental studies investigating the effects of MI practice (MIP) on motor learning; and (ii) detangling applied and fundamental findings in support of a sleep contribution to motor consolidation after MIP. We conclude with an integrative approach of online and offline learning resulting from intense MIP in healthy participants, and underline research avenues in the motor learning/clinical domains.

Development and testing of a new system for assessing wheel-running behaviour in rodents

Background

Wheel running is one of the most widely studied behaviours in laboratory rodents. As a result, improved approaches for the objective monitoring and gathering of more detailed information is increasingly becoming important for evaluating rodent wheel-running behaviour. Here our aim was to develop a new quantitative wheel-running system that can be used for most typical wheel-running experimental protocols.

Findings

Here we devise a system that can provide a continuous waveform amenable to real-time integration with a high-speed video ideal for wheel-running experimental protocols. While quantification of wheel running behaviour has typically focused on the number of revolutions per unit time as an end point measure, the approach described here allows for more detailed information like wheel rotation fluidity, directionality, instantaneous velocity, and acceleration, in addition to total number of rotations, and the temporal pattern of wheel-running behaviour to be derived from a single trace. We further tested this system with a running-wheel behavioural paradigm that can be used for investigating the neuronal mechanisms of procedural learning and postural stability, and discuss other potentially useful applications.

Conclusions

This system and its ability to evaluate multiple wheel-running parameters may become a useful tool for screening new potentially important therapeutic compounds related to many neurological conditions.

Electronic supplementary material

The online version of this article (doi:10.1186/s13104-016-2059-6) contains supplementary material, which is available to authorized users.

Effects of anodal transcranial direct current stimulation on visually guided learning of grip force control

Anodal transcranial Direct Current Stimulation (tDCS) has been shown to be an effective non-invasive brain stimulation method for improving cognitive and motor functioning in patients with neurological deficits. tDCS over motor cortex (M1), for instance, facilitates motor learning in stroke patients. However, the literature on anodal tDCS effects on motor learning in healthy participants is inconclusive, and the effects of tDCS on visuo-motor integration are not well understood. In the present study we examined whether tDCS over the contralateral motor cortex enhances learning of grip-force output in a visually guided feedback task in young and neurologically healthy volunteers. Twenty minutes of 1 mA anodal tDCS were applied over the primary motor cortex (M1) contralateral to the dominant (right) hand, during the first half of a 40 min power-grip task. This task required the control of a visual signal by modulating the strength of the power-grip for six seconds per trial. Each participant completed a two-session sham-controlled crossover protocol. The stimulation conditions were counterbalanced across participants and the sessions were one week apart. Performance measures comprised time-on-target and target-deviation, and were calculated for the periods of stimulation (or sham) and during the afterphase respectively. Statistical analyses revealed significant performance improvements over the stimulation and the afterphase, but this learning effect was not modulated by tDCS condition. This suggests that the form of visuomotor learning taking place in the present task was not sensitive to neurostimulation. These null effects, together with similar reports for other types of motor tasks, lead to the proposition that tDCS facilitation of motor learning might be restricted to cases or situations where the motor system is challenged, such as motor deficits, advanced age, or very high task demand.

Motor learning in individuals with autism spectrum disorder: activation in superior parietal lobule related to learning and repetitive behaviors

Motor-linked implicit learning is the learning of a sequence of movements without conscious awareness. Although motor symptoms are frequently reported in individuals with autism spectrum disorder (ASD), recent behavioral studies have suggested that motor-linked implicit learning may be intact in ASD. The serial reaction time (SRT) task is one of the most common measures of motor-linked implicit learning. The present study used a 3T functional magnetic resonance imaging scanner to examine the behavioral and neural correlates of real-time motor sequence learning in adolescents and adults with ASD (n = 15) compared with age- and intelligence quotient-matched individuals with typical development (n = 15) during an SRT task. Behavioral results suggested less robust motor sequence learning in individuals with ASD. Group differences in brain activation suggested that individuals with ASD, relative to individuals with typical development, showed decreased activation in the right superior parietal lobule (SPL) and right precuneus (Brodmann areas 5 and 7, and extending into the intraparietal sulcus) during learning. Activation in these areas (and in areas such as the right putamen and right supramarginal gyrus) was found to be significantly related to behavioral learning in this task. Additionally, individuals with ASD who had more severe repetitive behavior/restricted interest symptoms demonstrated greater decreased activation in these regions during motor learning. In conjunction, these results suggest that the SPL may play an important role in motor learning and repetitive behavior in individuals with ASD.

Brain plasticity and motor practice in cognitive aging

For more than two decades, there have been extensive studies of experience-based neural plasticity exploring effective applications of brain plasticity for cognitive and motor development. Research suggests that human brains continuously undergo structural reorganization and functional changes in response to stimulations or training. From a developmental point of view, the assumption of lifespan brain plasticity has been extended to older adults in terms of the benefits of cognitive training and physical therapy. To summarize recent developments, first, we introduce the concept of neural plasticity from a developmental perspective. Secondly, we note that motor learning often refers to deliberate practice and the resulting performance enhancement and adaptability. We discuss the close interplay between neural plasticity, motor learning and cognitive aging. Thirdly, we review research on motor skill acquisition in older adults with, and without, impairments relative to aging-related cognitive decline. Finally, to enhance future research and application, we highlight the implications of neural plasticity in skills learning and cognitive rehabilitation for the aging population.

Concurrent stable and unstable cortical correlates of human wrist movements

Cortical activity has been shown to correlate with different parameters of movement. However, the dynamic properties of cortico-motor mappings still remain unexplored in humans. Here, we show that during the repetition of simple stereotyped wrist movements both stable and unstable correlates simultaneously emerge in human sensorimotor cortex. Using visual feedback of wrist movement target inferred online from MEG, we assessed the dynamics of the tuning properties of two neuronal signals: the MEG signal below 1.6 Hz and within the 4 to 6 Hz range. We found that both components are modulated by wrist movement allowing for closed-loop inference of movement targets. Interestingly, while tuning of 4 to 6 Hz signals remained stable over time leading to stable inference of movement target using a static classifier, the tuning of cortical signals below 1.6 Hz significantly changed resulting in steadily decreasing inference accuracy. Our findings demonstrate that non-invasive neuronal population signals in human sensorimotor cortex can reflect a stable correlate of voluntary movements. Hence, we provide first evidence for a stable control signal in non-invasive human brain-machine interface research. However, as not all neuronal signals initially tuned to movement were stable across days, a careful selection of features for real-life applications seems to be mandatory.

Modulation of frontal and parietal neuronal activity by visuomotor learning. An ERP analysis of implicit and explicit pursuit tracking tasks

The present study investigated changes in frontal and parietal activity related to visuomotor learning. Improvement in task performance should be achieved by a transition from feedback control to feedforward control. Event-related potential (ERP) activity related to visual feedback analysis of successful error corrections was expected to decrease at parietal scalp locations. (Pre-) motor activity related to the execution of directional changes should increase and begin earlier. While using a mouse or a joystick for cursor control, subjects performed four different conditions of a pursuit tracking task in a between-subject design. To increase task difficulty, and to set up an implicit learning condition, the gain between mouse/joystick movement and cursor movement increased during the middle of each tracking trial. Subjects were informed about this manipulation in the explicit task only. Within the continuous movement of 12s duration, ERPs were assigned to phasic changes of target and cursor direction. Visuomotor learning was mainly achieved by a continuous reduction of target and cursor distance. A fronto-central positive ERP component related to the execution of a directional change increased earlier after learning. This indicates an anticipated directional change, improving task performance. ERP activity after error corrections decreased after learning, indicating either a higher efficiency or a reduced demand in visual feedback control. Activity difference was shifted from parietal to fronto-central sites later indicating a relation to improved feedforward control. No clear difference between implicit and explicit learning was observed for behavioural and ERP data.

White matter integrity of motor connections related to training gains in healthy aging

Impaired motor skill acquisition is a feature of older age. Acquisition of new motor skills requires the interplay between different cortical motor areas. Using diffusion tensor imaging we reconstructed cortico-cortical connections between the primary motor cortex (M1) and secondary motor areas in 11 older and 11 young participants who took part in a motor skill acquisition paradigm with the nondominant left hand. Examining the extent to which tract-related integrity correlated with training gains we found that white matter integrity of fibers connecting contralateral M1 with both contralateral (r = 0.85) and ipsilateral supplementary motor areas (r = 0.92) were positively associated in old participants. Also, fibers connecting contralateral M1 with ipsilateral dorsal premotor (r = 0.82) and fibers connecting ipsilateral dorsal premotor and supplementary motor area (r = 0.88) were positively related to skill acquisition (all p < 0.05). A similar structure-behavior relationship was not present in the young control subjects suggesting a critical role of brain structural integrity for motor learning in healthy aging.

Reinforcement learning of two-joint virtual arm reaching in a computer model of sensorimotor cortex

Neocortical mechanisms of learning sensorimotor control involve a complex series of interactions at multiple levels, from synaptic mechanisms to cellular dynamics to network connectomics. We developed a model of sensory and motor neocortex consisting of 704 spiking model neurons. Sensory and motor populations included excitatory cells and two types of interneurons. Neurons were interconnected with AMPA/NMDA and GABAA synapses. We trained our model using spike-timing-dependent reinforcement learning to control a two-joint virtual arm to reach to a fixed target. For each of 125 trained networks, we used 200 training sessions, each involving 15 s reaches to the target from 16 starting positions. Learning altered network dynamics, with enhancements to neuronal synchrony and behaviorally relevant information flow between neurons. After learning, networks demonstrated retention of behaviorally relevant memories by using proprioceptive information to perform reach-to-target from multiple starting positions. Networks dynamically controlled which joint rotations to use to reach a target, depending on current arm position. Learning-dependent network reorganization was evident in both sensory and motor populations: learned synaptic weights showed target-specific patterning optimized for particular reach movements. Our model embodies an integrative hypothesis of sensorimotor cortical learning that could be used to interpret future electrophysiological data recorded in vivo from sensorimotor learning experiments. We used our model to make the following predictions: learning enhances synchrony in neuronal populations and behaviorally relevant information flow across neuronal populations, enhanced sensory processing aids task-relevant motor performance and the relative ease of a particular movement in vivo depends on the amount of sensory information required to complete the movement.

Decorrelating action of inhibition in neocortical networks

Inhibitory GABAergic interneurons have been extensively studied but their contribution to circuit dynamics remain poorly understood. Although it has been suggested that interneurons, especially those belonging to the same subclass, synchronize their activity and impart this synchrony onto their local network, recent theoretical and experimental work have challenged this view. To better understand the activity of interneurons during cortical activity, we combined molecular identification, two-photon imaging, and electrophysiological recordings in thalamocortical slices from mouse somatosensory cortex. Using calcium imaging to monitor cortical activity, we found low spiking correlations among parvalbumin or somatostatin interneurons during cortical UP states, indicating that interneurons do not synchronize their firing. Intracellular recordings confirmed that nearby interneurons do not display more synchronous spiking than excitatory cells. The lack of interneuron synchrony was also evident during slow oscillations, even among interneurons that were electrically coupled via gap junctions, suggesting that their coupling does not function to synchronize their activity. Using voltage-clamp recordings from nearby pyramidal cells, we found that inhibitory currents (IPSCs) are more correlated than excitatory ones, but that correlated IPSCs arise from the activation of common presynaptic inhibitory cells, rather than from synchronization of interneuron activity. Finally, we demonstrate that pharmacologically reducing inhibitory currents increases correlated excitatory activity. We conclude that inhibitory interneurons do not have synchronous activity during UP states, and that their function may be to decorrelate rather than to synchronize the firing of neurons within the local network.

Task-specific effect of transcranial direct current stimulation on motor learning

Transcranial direct current stimulation (tDCS) is a relatively new non-invasive brain stimulation technique that modulates neural processes. When applied to the human primary motor cortex (M1), tDCS has beneficial effects on motor skill learning and consolidation in healthy controls and in patients. However, it remains unclear whether tDCS improves motor learning in a general manner or whether these effects depend on which motor task is acquired. Here we compare whether the effect of tDCS differs when the same individual acquires (1) a Sequential Finger Tapping Task (SEQTAP) and (2) a Visual Isometric Pinch Force Task (FORCE). Both tasks have been shown to be sensitive to tDCS applied over M1, however, the underlying processes mediating learning and memory formation might benefit differently from anodal transcranial direct current stimulation (anodal-tDCS). Thirty healthy subjects were randomly assigned to an anodal-tDCS group or sham-group. Using a double-blind, sham-controlled cross-over design, tDCS was applied over M1 while subjects acquired each of the motor tasks over three consecutive days, with the order being randomized across subjects. We found that anodal-tDCS affected each task differently: the SEQTAP task benefited from anodal-tDCS during learning, whereas the FORCE task showed improvements only at retention. These findings suggest that anodal-tDCS applied over M1 appears to have a task-dependent effect on learning and memory formation.

Different current intensities of anodal transcranial direct current stimulation do not differentially modulate motor cortex plasticity

Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates the excitability of neurons within the motor cortex (M1). Although the aftereffects of anodal tDCS on modulating cortical excitability have been described, there is limited data describing the outcomes of different tDCS intensities on intracortical circuits. To further elucidate the mechanisms underlying the aftereffects of M1 excitability following anodal tDCS, we used transcranial magnetic stimulation (TMS) to examine the effect of different intensities on cortical excitability and short-interval intracortical inhibition (SICI). Using a randomized, counterbalanced, crossover design, with a one-week wash-out period, 14 participants (6 females and 8 males, 22–45 years) were exposed to 10 minutes of anodal tDCS at 0.8, 1.0, and 1.2 mA. TMS was used to measure M1 excitability and SICI of the contralateral wrist extensor muscle at baseline, immediately after and 15 and 30 minutes following cessation of anodal tDCS. Cortical excitability increased, whilst SICI was reduced at all time points following anodal tDCS. Interestingly, there were no differences between the three intensities of anodal tDCS on modulating cortical excitability or SICI. These results suggest that the aftereffect of anodal tDCS on facilitating cortical excitability is due to the modulation of synaptic mechanisms associated with long-term potentiation and is not influenced by different tDCS intensities.

Brain activation patterns of motor imagery reflect plastic changes associated with intensive shooting training

Evidence from previous studies has suggested that motor imagery and motor action engage overlapping brain systems. As a result of this observation that motor imagery can activate brain regions associated with actual motor movement, motor imagery is expected to enhance motor skill performance and become an underlying principle for physical training in sports and physical rehabilitation. However, few studies have examined the effects of physical training on motor imagery in beginners. Also, differences in neural networks related to motor imagery before and after training have seldom been studied. In the current study, using functional magnetic resonance imaging (fMRI), we investigated the question of whether motor imagery can reflect plastic changes of neural correlates associated with intensive training. In fact, motor imagery was used in this study as a tool to assess the brain areas involved in shooting and involved in learning of shooting. We discovered that use of motor imagery resulted in recruitment of widely distributed common cortical areas, which were suggested to play a role in generation and maintenance of mental images before and after 90 h of shooting training. In addition to these common areas, brain activation before and after 90 h of shooting practice showed regionally distinct patterns of activity change in subcortical motor areas. That is, basal ganglia showed increased activity after 90 h of shooting practice, suggesting the occurrence of plastic change in association with gains in performance and reinforcement learning. Therefore, our results suggest that, in order to reach a level of expertise, the brain would change through initial reinforcement of preexistent connections during the training period and then use more focused neural correlates through formation of new connections.

Remembering forward: neural correlates of memory and prediction in human motor adaptation

We used functional MR imaging (FMRI), a robotic manipulandum and systems identification techniques to examine neural correlates of predictive compensation for spring-like loads during goal-directed wrist movements in neurologically-intact humans. Although load changed unpredictably from one trial to the next, subjects nevertheless used sensorimotor memories from recent movements to predict and compensate upcoming loads. Prediction enabled subjects to adapt performance so that the task was accomplished with minimum effort. Population analyses of functional images revealed a distributed, bilateral network of cortical and subcortical activity supporting predictive load compensation during visual target capture. Cortical regions--including prefrontal, parietal and hippocampal cortices--exhibited trial-by-trial fluctuations in BOLD signal consistent with the storage and recall of sensorimotor memories or "states" important for spatial working memory. Bilateral activations in associative regions of the striatum demonstrated temporal correlation with the magnitude of kinematic performance error (a signal that could drive reward-optimizing reinforcement learning and the prospective scaling of previously learned motor programs). BOLD signal correlations with load prediction were observed in the cerebellar cortex and red nuclei (consistent with the idea that these structures generate adaptive fusimotor signals facilitating cancelation of expected proprioceptive feedback, as required for conditional feedback adjustments to ongoing motor commands and feedback error learning). Analysis of single subject images revealed that predictive activity was at least as likely to be observed in more than one of these neural systems as in just one. We conclude therefore that motor adaptation is mediated by predictive compensations supported by multiple, distributed, cortical and subcortical structures.

Changes occur in resting state network of motor system during 4 weeks of motor skill learning

We tested whether the resting state functional connectivity of the motor system changed during 4 weeks of motor skill learning using functional magnetic resonance imaging (fMRI). Ten healthy volunteers learned to produce a sequential finger movement by daily practice of the task over a 4 week period. Changes in the resting state motor network were examined before training (Week 0), two weeks after the onset of training (Week 2), and immediately at the end of the training (Week 4). The resting state motor system was analyzed using group independent component analysis (ICA). Statistical Parametric Mapping (SPM) second-level analysis was conducted on independent z-maps generated by the group ICA. Three regions, namely right postcentral gyrus, and bilateral supramarginal gyri were found to be sensitive to the training duration. Specifically, the strength of resting state functional connectivity in the right postcentral gyrus and right supramarginal gyrus increased from Week 0 to Week 2, during which the behavioral performance improved significantly, and decreased from Week 2 to Week 4, during which there was no more significant improvement in behavioral performance. The strength of resting state functional connectivity in left supramarginal gyrus increased throughout the training. These results confirm changes in the resting state network during slow-learning stage of motor skill learning, and support the premise that the resting state networks play a role in improving performance.

Electrocortical dynamics reflect age-related differences in movement kinematics among children and adults

Previous neuroimaging and behavioral studies demonstrated structural and functional changes in the motor system across childhood. However, it is unclear what functionally relevant electrocortical processes underlie developmental differences in motor planning and control during multijoint, goal-directed movements. The current study characterized age-related differences in electrocortical processes during the performance of discrete aiming movements in children and adults. Electroencephalography and movement kinematics were recorded from 3 groups of participants (n = 15 each): young children (mean 6.7 years), older children (mean 10.2 years), and adults (mean 22.1 years). Age-related differences were evident in the electroencephalographic (EEG) signals. First, young children exhibited less movement-related activity in task-relevant motor areas compared with adults (movement-related cortical potentials). Second, young children exhibited greater activation (less alpha power) of the frontal areas and less activation of the parietal areas as compared with the other groups. At the behavioral level, young children made slower and jerkier movements, with less consistent directional planning compared with older children and adults. Significant correlations were also found between EEG and movement kinematic measures. Taken together, the results of this study provide evidence that age-related differences in the quality of motor planning and performance are reflected in the differences in electrocortical dynamics among children and adults.

Combined adaptiveness of specific motor cortical ensembles underlies learning

Learning motor skills entails adaptation of neural computations that can generate or modify associations between sensations and actions. Indeed, humans can use different strategies when adapting to dynamic loads depending on available sensory feedback. Here, we examined how neural activity in motor cortex was modified when monkeys made arm reaches to a visual target and locally adapted to curl force field with or without visual trajectory feedback. We found that firing rates of a large subpopulation of cells were consistently modulated depending on the distance of their preferred direction from the learned movement direction. The newly acquired activity followed a cosine-like function, with maximal increase in directions that opposed the perturbing force and decrease in opposite directions. As a result, the combined neuronal activity generated an adapted population vector. The results suggest that this could be achieved without changing the tuning properties of the cells. This population directional signal was however altered in the absence of visual feedback; while the cosine pattern of modulation was maintained, the population distributions of modulated cells differed across feedback consistent with the different trajectory shapes. Finally, we predicted generalization patterns of force-field learning based on the cosine-like modulation. These conformed to reported features of generalization in humans, suggesting that the generalization function was related to the observed rate modulations in the motor cortex. Overall, the findings suggest that the new combined activation of neuronal ensembles could underlie the change in the internal model of movement dynamics in a way that depends on available sensory feedback and chosen strategy.

Continuous motor sequence learning: cortical efficiency gains accompanied by striatal functional reorganization

The acquisition and generation of action sequences constitute essential elements of purposeful human behavior. However, there is still considerable debate on how experience-driven changes related to skill learning are expressed at the neural systems level. The current functional magnetic resonance imaging (fMRI) study focused on changes in the neural representation of continuous movement sequences as learning evolved. Behavioral and neural manifestations of nonvisual motor practice were studied both within the time frame of a single scanning session, as well as after several days of extended practice. Based on detailed behavioral recordings which enabled the continuous characterization of the ongoing learning process at the single subject level, sequence-specific decreases in activation throughout a learning-related network of cortical areas were identified. Furthermore, the spatial layout of this cortical network remained largely unchanged after extensive practice, although further decreases in activation levels could be observed as learning progressed. In contrast, the posterior part of the left putamen showed increased activation levels when an extensively trained sequence needed to be recalled. Overall, these findings imply that continuous motor sequence learning is mainly associated with more efficient processing in a network of consistently recruited cortical areas, together with co-occurring activation pattern changes at the subcortical level.

Mapping the central effects of methylphenidate in the rat using pharmacological MRI BOLD contrast

Methylphenidate (Ritalin) is a selective dopamine reuptake inhibitor and an effective treatment for attention deficit hyperactivity disorder (ADHD) however the anatomical foci and neuronal circuits involved in these therapeutic benefits are unclear. This study determines the temporal pattern of brain regional activity change produced by systemic administration of a therapeutically relevant dose of methylphenidate in anaesthetised Sprague-Dawley rats using BOLD MRI and a 2.35T Bruker magnet. Following 60 min basal recording separate rats received saline (n = 9) or +/- methylphenidate hydrochloride (2 mg/kg, i.p., n = 9) and BOLD changes were recorded for 90 min using statistical parametric maps. Methylphenidate produced significant positive random BOLD effects in the nucleus accumbens, substantia nigra, entorhinal cortex and medial orbital cortex. Negative random BOLD effects were more widespread and intense, occurring in the motor and somatosensory cortices, caudate putamen, lateral globus pallidus and bed nucleus of the stria terminalis, without accompanying changes in blood pressure or respiratory rate. Methylphenidate-induced negative BOLD in the striatum, and other dopamine terminal areas, may reflect post-synaptic changes produced by blockade of the neuronal dopamine reuptake transporter. While increased positive BOLD in the medial orbital cortex may reflect altered dopamine and/or noradrenaline release indirectly altering striatal activity. The overall pattern of BOLD changes is comparable to that seen in previous studies using guanfacine, amphetamine and atomoxetine, and suggests that although these compounds operate through distinct pharmacological mechanisms the BOLD changes may represent a 'fingerprint pattern' predictive of therapeutic benefit in ADHD.

Homeostatic and nonhomeostatic modulation of learning in human motor cortex

Motor learning is important throughout life for acquisition and adjustment of motor skill. The extent of motor learning may be modulated by the history of motor cortex activity, but little is known which metaplasticity rule (homeostatic vs nonhomeostatic) governs this interaction. Here, we explored in nine healthy adults the effects of three different paired associative stimulation (PAS) protocols on subsequent learning of rapid thumb flexion movements. PAS resulted in either a long-term potentiation (LTP)-like increase in excitability of the stimulated motor cortex (PAS(LTP)), or a long-term depression (LTD)-like decrease (PAS(LTD)), or no change (control condition, PAS(CON)). Learning was indexed by the increase in peak acceleration of the trained movement. Delays of 0 and 90 min between PAS and motor practice were tested. At the 0 min delay, PAS(LTD) strongly facilitated motor learning (homeostatic interaction), and PAS(LTP) also facilitated learning, although to a lesser extent (nonhomeostatic interaction). At the 90 min delay, PAS(LTD) facilitated learning, whereas PAS(LTP) depressed learning (interactions both homeostatic). Therefore, facilitation of learning by previous brain stimulation occurs primarily and most effectively through homeostatic interactions, but at the 0 min delay, nonhomeostatic mechanisms such as LTP-induced blockade of LTD and nonsaturated LTP-induced facilitation of learning might also play a role. The present findings demonstrate that motor learning in humans can be modulated by noninvasive brain stimulation and suggest the possibility of enhancing motor relearning in defined neurological patients.

Levodopa improves procedural motor learning in chronic stroke patients

OBJECTIVE

To test the hypothesis that administration of dopamine precursor levodopa improves procedural motor learning (defined as the ability to acquire novel movement patterns gradually through practice) in patients with residual motor deficits in the chronic phase after stroke (> or =1 y after stroke).

DESIGN

A double-blind, placebo-controlled, randomized crossover design.

SETTING

Neurology department in a German university.

PARTICIPANTS

Eighteen patients with chronic motor dysfunction because of stroke (13 men, 5 women; age range, 53-78 y; mean time poststroke +/- SD, 3.3+/-2.1 y).

INTERVENTION

Patients received 3 doses of levodopa (100mg of levodopa plus 25mg of carbidopa) or placebo before 1 session of procedural motor learning.

MAIN OUTCOME MEASURES

Procedural motor learning performed by using the paretic hand assessed by using a modified version of the serial reaction time task with a probabilistic sequence. The primary outcome measure was the difference in reaction times between random and sequential elements.

RESULTS

Levodopa significantly improved our primary outcome measure, procedural motor learning, compared with placebo (P<.05). Reaction times to random elements, analysis of error rates, psychophysical assessments, and performance in a simple motor task were comparable between conditions, indicating that better learning under levodopa was not caused by differences in response styles, arousal, mood, or motor reaction times but that levodopa modulated learning.

CONCLUSIONS

Our results show that levodopa may improve procedural motor learning in patients with chronic stroke, in line with our hypothesis. These findings suggest that this interventional strategy in combination with customary rehabilitative treatments could significantly improve the outcome of neurorehabilitation in the chronic stage after stroke. (Clinicaltrials.gov identifier NCT00126087.)

Treadmill exercise activates subcortical neural networks and improves walking after stroke: a randomized controlled trial

BACKGROUND AND PURPOSE

Stroke often impairs gait thereby reducing mobility and fitness and promoting chronic disability. Gait is a complex sensorimotor function controlled by integrated cortical, subcortical, and spinal networks. The mechanisms of gait recovery after stroke are not well understood. This study examines the hypothesis that progressive task-repetitive treadmill exercise (T-EX) improves fitness and gait function in subjects with chronic hemiparetic stroke by inducing adaptations in the brain (plasticity).

METHODS

A randomized controlled trial determined the effects of 6-month T-EX (n=37) versus comparable duration stretching (CON, n=34) on walking, aerobic fitness and in a subset (n=15/17) on brain activation measured by functional MRI.

RESULTS

T-EX significantly improved treadmill-walking velocity by 51% and cardiovascular fitness by 18% (11% and -3% for CON, respectively; P<0.05). T-EX but not CON affected brain activation during paretic, but not during nonparetic limb movement, showing 72% increased activation in posterior cerebellar lobe and 18% in midbrain (P<0.005). Exercise-mediated improvements in walking velocity correlated with increased activation in cerebellum and midbrain.

CONCLUSIONS

T-EX improves walking, fitness and recruits cerebellum-midbrain circuits, likely reflecting neural network plasticity. This neural recruitment is associated with better walking. These findings demonstrate the effectiveness of T-EX rehabilitation in promoting gait recovery of stroke survivors with long-term mobility impairment and provide evidence of neuroplastic mechanisms that could lead to further refinements in these paradigms to improve functional outcomes.

Decrease in cortical activation during learning of a multi-joint discrete motor task

Understanding how the brain learns motor skills remains a very challenging task. To elucidate the neural mechanism underlying motor learning, we assessed brain activation changes on a trial-by-trial basis during learning of a multi-joint discrete motor task (kendama task). We used multi-channel near-infrared spectroscopy (NIRS) while simultaneously measuring upper limb movement changes by using a 3D motion capture system. Fourteen right-handed participants performed the task using their right upper limb while sitting a chair. The task involved tossing a ball connected by a string to the kendama stick (picking up movement) and catching the ball in the cup attached to the stick (catching movement). Participants performed a trial every 20 s for 90 trials. We measured the hemodynamic responses [oxygenated hemoglobin (oxy-Hb) and deoxygenated hemoglobin (deoxy-Hb) signals] around the predicted location of the sensorimotor cortices on both hemispheres. Analysis of the NIRS data revealed that the magnitudes of the event-related oxy-Hb responses to each trial decreased significantly as learning progressed. Analysis of movement data revealed that integrated upper limb muscle torques decreased significantly only for the picking up movements as learning progressed, irrespective of the outcome of the trials. In contrast, dispersion of the movement patterns decreased significantly only for the catching movements in the unsuccessful trials. Furthermore, we found significant positive correlations between the changes in the magnitudes of the oxy-Hb responses and those of the integrated upper limb muscle torques during learning. Our results suggest that the decrease in cortical activation in the sensorimotor cortex reflects changes in motor commands during learning of a multi-joint discrete movement.

Dynamics of manual skill: a computerized analysis of single peg movements and stochastic resonance hypothesis of cerebral laterality

Hand skill was analyzed using a computerized peg moving task. The durations of single hand movements (PMTs) were accurately measured in right-hand (RH) and left-hand (LH) writers. One trial consisted of 10 movements of the right hand and 10 movements of the left hand. Each participant performed five trials. Women showed significantly higher percentage than men in right-handedness; men showed higher percentage than women in left-handedness. This sex difference completely disappeared after taking the same height range in participants. The mean RH- and LH-PMTs decreased in 5 successive trials, even within a single trial during 10 successive hand movements, indicating a learning effect of repeated hand movements. The LH- minus RH-PMTs exhibited fluctuations within a single trial between positive (faster right hand) and negative (faster left hand) values. LH-RH PMTs were significantly greater than zero, in favor of right hand, in RH-writers, but not significantly different from zero in LH-writers, exhibiting a true fluctuating asymmetry. Participants with no familial sinistrality (FS-) were preponderantly right-handed (ca. 90%), those with left-handed mother and right-handed father (FS+1) showed stochastic distribution of hand preference (50:50). Participants with right-handed mother and left-hander father (FS+2) were not different from FS- individuals. LH-RH PMT was significantly greater than zero in FS- participants, almost equal to zero in FS+1 participants, and greater than zero in FS+2 participants exhibiting greater asymmetry than that in FS- participants. These results suggest a genetic inheritance of direction and degree of handedness, being a a X-linked trait originating from mother's genotype. It was suggested that fluctuating asymmetries may reflect interactions between stochastic resonance phenomena within right and left brains. This property of brain may genetically transmitted from mother's X chromosome; a net effect of stochastic interactions between hemispheres may result in right- or left-handedness, a predominantly unidirectional coupling creating right-handedness, in favor of left brain, and a stochastic bi-directional coupling between hemispheres would be a main trait of left-handers. This new "stochastic resonance hypothesis of cerebral laterality" concerns with stochastic fluctuations in hand-skill asymmetry and inter-hemispheric coupling through corpus callosum, and seems to be important for new developments in handedness research.