Neurocognitive contributions to motor skill learning: the role of working memory

Distinct mechanisms for online and offline motor skill learning across human development

The human central nervous system (CNS) undergoes tremendous changes from childhood to adulthood and this may affect how individuals at different stages of development learn new skills. Here, we studied motor skill learning in children, adolescents, and young adults to test the prediction that differences in the maturation of different learning mechanisms lead to distinct temporal patterns of motor learning during practice and overnight. We found that overall learning did not differ between children, adolescents, and young adults. However, we demonstrate that adult-like skill learning is characterized by rapid and large improvements in motor performance during practice (i.e., online) that are susceptible to forgetting and decay over time (i.e., offline). On the other hand, child-like learning exhibits slower and less pronounced improvements in performance during practice, but these improvements are robust against forgetting and lead to gains in performance overnight without further practice. The different temporal dynamics of motor skill learning suggest an engagement of distinct learning mechanisms in the human CNS during development. In conclusion, adult-like skill learning mechanisms favor online improvements in motor performance whereas child-like learning mechanisms favors offline behavioral gains. RESEARCH HIGHLIGHTS: Many essential motor skills, like walking, talking, and writing, are acquired during childhood, and it is colloquially thought that children learn better than adults. We investigated dynamics of motor skill learning in children, adolescents, and young adults. Adults displayed substantial improvements during practice that was susceptible to forgetting over time. Children displayed smaller improvements during practice that were resilient against forgetting. The distinct age-related characteristics of these processes of acquisition and consolidation suggest that skill learning relies on different mechanisms in the immature and mature central nervous system.

Neural correlates of working memory training: An fMRI meta-analysis

Working memory (WM) can be improved by cognitive training. Numerous studies examined neural mechanisms underlying WM training, although with differing conclusions. Therefore, we conducted a meta-analysis to examine the neural substrates underlying WM training in healthy adults. Findings from global analyses showed substantial neural changes in the frontoparietal and subcortical regions. Results from training dosage analyses of WM training showed that shorter WM training could produce neural changes in the frontoparietal regions, whereas longer WM training could produce changes in the subcortical regions (striatum, anterior cingulate cortex, and insula). WM training-induced neural changes were also moderated by the type of training task, with updating tasks inducing neural changes in more regions than maintenance tasks. Overall, these results indicate that the neural changes associated with WM training occur in the frontoparietal network and dopamine-related brain areas, extending previous meta-analyses on WM training and advancing our understanding of the neural underpinnings of WM training effects.

Writing in two different scripts promotes fine motor control

Biscriptuality is the ability to write in two different scripts. Achieving handwriting expertise in a single script demands years of intensive practice, and these demands are even stronger when two scripts must be mastered. Biscriptuality could thus impact the cognitive and motor skills underlying graphomotor control. Here, we aimed at establishing that biscriptuality enhances graphomotor control, and at testing whether biscriptuals have better fine motor skills and working memory performance compared to Latin monoscriptuals. We found that biscriptuals perform better than monoscriptuals on graphomotor tasks, and on 3 types of fine motor control tasks indexing dexterity, motor timing under spatial constraints, and spontaneous motor tempo; the two groups did not significantly differ in their working memory performance. These results demonstrate that writing expertise widely impacts the organization of the motor system.

Explicit and implicit locomotor learning in individuals with chronic hemiparetic stroke

Motor learning involves both explicit and implicit processes that are fundamental for acquiring and adapting complex motor skills. However, stroke may damage the neural substrates underlying explicit and/or implicit learning, leading to deficits in overall motor performance. Although both learning processes are typically used in concert in daily life and rehabilitation, no gait studies have determined how these processes function together after stroke when tested during a task that elicits dissociable contributions from both. Here, we compared explicit and implicit locomotor learning in individuals with chronic stroke to age- and sex-matched neurologically intact controls. We assessed implicit learning using split-belt adaptation (where two treadmill belts move at different speeds). We assessed explicit learning (i.e., strategy-use) using visual feedback during split-belt walking to help individuals explicitly correct for step length errors created by the split-belts. After the first 40 strides of split-belt walking, we removed the visual feedback and instructed individuals to walk comfortably, a manipulation intended to minimize contributions from explicit learning. We used a multirate state-space model to characterize individual explicit and implicit process contributions to overall behavioral change. The computational and behavioral analyses revealed that, compared with controls, individuals with chronic stroke demonstrated deficits in both explicit and implicit contributions to locomotor learning, a result that runs counter to prior work testing each process individually during gait. Since poststroke locomotor rehabilitation involves interventions that rely on both explicit and implicit motor learning, future work should determine how locomotor rehabilitation interventions can be structured to optimize overall motor learning. NEW & NOTEWORTHY Motor learning involves both implicit and explicit processes, the underlying neural substrates of which could be damaged after stroke. Although both learning processes are typically used in concert in daily life and rehabilitation, no gait studies have determined how these processes function together after stroke. Using a locomotor task that elicits dissociable contributions from both processes and computational modeling, we found evidence that chronic stroke causes deficits in both explicit and implicit locomotor learning.

Differences in working memory function are associated with motor imagery-induced changes in spinal motor nerve excitability and subsequent motor skill changes

Verification of the effectiveness of motor imagery (MI) has mainly focused on the method of implementing MI, and few studies have assessed individual factors. This study examined the individual differences in MI effects from the viewpoint of the multiple components of working memory. Forty-six healthy subjects (mean age 20.8 years) performed the Stroop Test (central executive within working memory) and reverse chanting (phonological loop within working memory). Then, F-waves were measured at rest for 30 s, the Purdue Pegboard was performed with the non-dominant hand to evaluate finger dexterity (Peg score) before MI, F-waves were measured during 30 s of kinesthetic MI, and the Peg score was evaluated after MI. For statistical analysis, the amplitude F/M ratio and Peg score were used as dependent variables, and the subjects were divided into Good and Poor groups according to cognitive function. The results showed an interaction for the amplitude F/M ratio and Peg score when grouped by reverse inverse chanting. In the subsequent simple main effect analysis, the Peg score was significantly improved after MI in both groups. The amplitude F/M ratio was significantly increased during MI compared to the resting state only in the Poor phonological loop group. Conversely, there was no interaction when the groups were divided by Stroop interference. No relationship was found between individual differences in central executive and changes in hand finger dexterity and spinal motor nerve excitability induced by MI. However, there may be a relationship between individual differences in phonological loops and changes in MI-induced finger dexterity and spinal motor nerve excitability.

Cognitive Function of Climbers: An Exploratory Study of Working Memory and Climbing Performance

Sport climbing requires a combination of physical and cognitive skills, with working memory (WM) playing a crucial role in performance. This study aimed to investigate the association between WM capacity and climbing ability, while considering potential confounding factors including sex, age, education level, and climbing experience. Additionally, the study compared prefrontal cortex (PFC) hemodynamic responses among different climbing ability groups and sex during WM performance. Twenty-eight climbers participated, with WM assessed using the eCorsi task and PFC hemodynamic responses measured with near infrared spectroscopy (NIRS). Initial linear regression analyses revealed no association between WM and climbing ability. However, significant associations were found after adjustment for covariates. Specifically, sex (p = .014), sex in conjunction with age (p = .026), sex combined with climbing experience (p = .022), and sex along with education level (p = .038) were identified as significant predictors of differences in WM between Expert and Elite climbers. Additionally, notable differences in PFC hemodynamic responses were observed between Expert and Elite climbers, as well as between sexes during the WM task, providing support for differences in WM capacity. This study contributes to understanding the complex relationship between WM capacity and climbing performance, emphasizing the need to account for influencing factors in assessments.

Motor Learning and the Interactions Between Working Memory and Practice Schedule

The benefits of less repetitive practice schedules on motor learning are usually described in terms of greater demand for memory processes. The present study aimed to investigate the interactions between working memory and practice schedule and their effects on motor learning. Forty female participants had their WMC evaluated by the N-back test and were randomly allocated to either the variable random (VP) or the constant practice (CP) groups. In the acquisition phase, participants practiced 120 trials of a sequential key-pressing task with two goals: learning the relative and the absolute timing. Delayed retention and transfer tests occurred 24 h after the acquisition phase. Participants performed 12 trials of the motor task. Results showed that in the CP, learners with a high level of WMC presented better motor performance in the transfer test than learners with a low level of WMC. In the RP, no difference between WMC levels was found. Learners with a high level of WMC in the CP presented the same motor performance as learners in the RP regardless of the WMC level in the transfer test. In conclusion, learners with a high WMC could compensate for the poor working memory stimulation of a more repetitive practice schedule. The high WMC did not seem to exert an additional benefit when learners were well stimulated by a less repetitive practice schedule.

Explicit and implicit locomotor learning in individuals with chronic hemiparetic stroke

Motor learning involves both explicit and implicit processes that are fundamental for acquiring and adapting complex motor skills. However, stroke may damage the neural substrates underlying explicit and/or implicit learning, leading to deficits in overall motor performance. While both learning processes are typically used in concert in daily life and rehabilitation, no gait studies have determined how these processes function together after stroke when tested during a task that elicits dissociable contributions from both. Here, we compared explicit and implicit locomotor learning in individuals with chronic stroke to age- and sex-matched neurologically intact controls. We assessed implicit learning using split-belt adaptation (where two treadmill belts move at different speeds). We assessed explicit learning (i.e., strategy-use) using visual feedback during split-belt walking to help individuals explicitly correct for step length errors created by the split-belts. The removal of visual feedback after the first 40 strides of split-belt walking, combined with task instructions, minimized contributions from explicit learning for the remainder of the task. We utilized a multi-rate state-space model to characterize individual explicit and implicit process contributions to overall behavioral change. The computational and behavioral analyses revealed that, compared to controls, individuals with chronic stroke demonstrated deficits in both explicit and implicit contributions to locomotor learning, a result that runs counter to prior work testing each process individually during gait. Since post-stroke locomotor rehabilitation involves interventions that rely on both explicit and implicit motor learning, future work should determine how locomotor rehabilitation interventions can be structured to optimize overall motor learning.

Motor adaptation in deaf and hearing native signers

Previous studies have suggested that deafness could lead to deficits in motor skills and other body-related abilities. However, the literature regarding motor skills in deaf adults is scarce and existing studies often included participants with heterogeneous language backgrounds and deafness etiologies, thus making it difficult to delineate the effects of deafness. In this study, we investigated motor learning in deaf native signers and hearing nonsigners. To isolate the effects of deafness and those of acquiring a signed language, we additionally tested a group of hearing native signers. Two well-established paradigms of motor learning were employed, in which participants had to adapt their hand movements to a rotation of the visual feedback (Experiment 1) or to the introduction of a force field (Experiment 2). Proprioceptive estimates were assessed before and after adaptation. Like hearing nonsigners, deaf and hearing signers showed robust adaptation in both motor adaptation paradigms. No significant differences in motor adaptation and memory were observed between deaf signers and hearing nonsigners, as well as between hearing signers and hearing nonsigners. Moreover, no discernible group differences in proprioceptive accuracy were observed. These findings challenge the prevalent notion that deafness leads to deficits in motor skills and other body-related abilities.

Cortical and white matter substrates supporting visuospatial working memory

OBJECTIVE

In tasks involving new visuospatial information, we rely on working memory, supported by a distributed brain network. We investigated the dynamic interplay between brain regions, including cortical and white matter structures, to understand how neural interactions change with different memory loads and trials, and their subsequent impact on working memory performance.

METHODS

Patients undertook a task of immediate spatial recall during intracranial EEG monitoring. We charted the dynamics of cortical high-gamma activity and associated functional connectivity modulations in white matter tracts.

RESULTS

Elevated memory loads were linked to enhanced functional connectivity via occipital longitudinal tracts, yet decreased through arcuate, uncinate, and superior-longitudinal fasciculi. As task familiarity grew, there was increased high-gamma activity in the posterior inferior-frontal gyrus (pIFG) and diminished functional connectivity across a network encompassing frontal, parietal, and temporal lobes. Early pIFG high-gamma activity was predictive of successful recall. Including this metric in a logistic regression model yielded an accuracy of 0.76.

CONCLUSIONS

Optimizing visuospatial working memory through practice is tied to early pIFG activation and decreased dependence on irrelevant neural pathways.

SIGNIFICANCE

This study expands our knowledge of human adaptation for visuospatial working memory, showing the spatiotemporal dynamics of cortical network modulations through white matter tracts.

Visually-Induced Motor Imagery Effects on Motor Adaptation to Reverse Steering Cycling. A Randomized Controlled Trial

Purpose: First, testing an intervention of neuromodulation based on motor imagery and action observation as a promoter of motor adaptation of a complex motor task involving balance. Second, determining what prior balance factors can affect the motor adaptation task. Methods: A double-blind randomized controlled trial was performed. Forty-eight healthy subjects were recruited. The balance of all participants during gait and standing was assessed before adapting to the complex, multi-limb motor task of riding an inverse steering bicycle (ISB). Two interventions were carried out interleaved among trials of adaptation to the motor task: the experimental group (n = 24) was asked to perform neuromodulation (EN) by watching first-person ISB riding through immersive VR glasses and, simultaneously, mentally mimicking the movements. The control group (CG) was asked to watch a slideshow video of steady landscape images. Results: The results showed that the EN group did not improve the motor adaptation rate and induced higher adaptation times with respect to the CG. However, while the motor adaptation success showed a significant dependence on the prior proprioceptive participation in balance in the CG, the EN group did not present any relationship between the prior balance profile and motor adaptation outcome. Conclusions: Results point to a benefit of the visually guided neuromodulation for the motor adaptation of the subjects with low participation of proprioception in balance. Moreover, the results from the control group would allow to disclose prognostic factors about the success of the motor adaptation, and also prescription criteria for the proposed neuromodulation based on the balance profile.

C-SMB 2.0: Integrating over 25 years of motor sequencing research with the Discrete Sequence Production task

An exhaustive review is reported of over 25 years of research with the Discrete Sequence Production (DSP) task as reported in well over 100 articles. In line with the increasing call for theory development, this culminates into proposing the second version of the Cognitive framework of Sequential Motor Behavior (C-SMB 2.0), which brings together known models from cognitive psychology, cognitive neuroscience, and motor learning. This processing framework accounts for the many different behavioral results obtained with the DSP task and unveils important properties of the cognitive system. C-SMB 2.0 assumes that a versatile central processor (CP) develops multimodal, central-symbolic representations of short motor segments by repeatedly storing the elements of these segments in short-term memory (STM). Independently, the repeated processing by modality-specific perceptual and motor processors (PPs and MPs) and by the CP when executing sequences gradually associates successively used representations at each processing level. The high dependency of these representations on active context information allows for the rapid serial activation of the sequence elements as well as for the executive control of tasks as a whole. Speculations are eventually offered as to how the various cognitive processes could plausibly find their neural underpinnings within the intricate networks of the brain.

Dopamine D2 Receptor Modulates Exercise Related Effect on Cortical Excitation/Inhibition and Motor Skill Acquisition

Exercise is known to benefit motor skill learning in health and neurological disease. Evidence from brain stimulation, genotyping, and Parkinson's disease studies converge to suggest that the dopamine D2 receptor, and shifts in the cortical excitation and inhibition (E:I) balance, are prime candidates for the drivers of exercise-enhanced motor learning. However, causal evidence using experimental pharmacological challenge is lacking. We hypothesized that the modulatory effect of the dopamine D2 receptor on exercise-induced changes in the E:I balance would determine the magnitude of motor skill acquisition. To test this, we measured exercise-induced changes in excitation and inhibition using paired-pulse transcranial magnetic stimulation (TMS) in 22 healthy female and male humans, and then had participants learn a novel motor skill-the sequential visual isometric pinch task (SVIPT). We examined the effect of D2 receptor blockade (800 mg sulpiride) on these measures within a randomized, double-blind, placebo-controlled design. Our key result was that motor skill acquisition was driven by an interaction between the D2 receptor and E:I balance. Specifically, poorer skill learning was related to an attenuated shift in the E:I balance in the sulpiride condition, whereas this interaction was not evident in placebo. Our results demonstrate that exercise-primed motor skill acquisition is causally influenced by D2 receptor activity on motor cortical circuits.

What Does It Take to Play the Piano? Cognito-Motor Functions Underlying Motor Learning in Older Adults

The acquisition of skills, such as learning to play a musical instrument, involves various phases that make specific demands on the learner. Knowledge of the cognitive and motor contributions during learning phases can be helpful in developing effective and targeted interventions for healthy aging. Eighty-six healthy older participants underwent an extensive cognitive, motoric, and musical test battery. Within one session, one piano-related and one music-independent movement sequence were both learned. We tested the associations between skill performance and cognito-motor abilities with Bayesian mixed models accounting for individual learning rates. Results showed that performance was positively associated with all cognito-motor abilities. Learning a piano-related task was characterized by relatively strong initial associations between performance and abilities. These associations then weakened considerably before increasing exponentially from the second trial onwards, approaching a plateau. Similar performance-ability relationships were detected in the course of learning a music-unrelated motor task. Positive performance-ability associations emphasize the potential of learning new skills to produce positive cognitive and motor transfer effects. Consistent high-performance tasks that demand maximum effort from the participants could be very effective. However, interventions should be sufficiently long so that the transfer potential can be fully exploited.

The effect of reward on motor learning: different stage, different effect

Motor learning is a prominent and extensively studied subject in rehabilitation following various types of neurological disorders. Motor repair and rehabilitation often extend over months and years post-injury with a slow pace of recovery, particularly affecting the fine movements of the distal extremities. This extended period can diminish the motivation and persistence of patients, a facet that has historically been overlooked in motor learning until recent years. Reward, including monetary compensation, social praise, video gaming, music, and virtual reality, is currently garnering heightened attention for its potential to enhance motor motivation and improve function. Numerous studies have examined the effects and attempted to explore potential mechanisms in various motor paradigms, yet they have yielded inconsistent or even contradictory results and conclusions. A comprehensive review is necessary to summarize studies on the effects of rewards on motor learning and to deduce a central pattern from these existing studies. Therefore, in this review, we initially outline a framework of motor learning considering two major types, two major components, and three stages. Subsequently, we summarize the effects of rewards on different stages of motor learning within the mentioned framework and analyze the underlying mechanisms at the level of behavior or neural circuit. Reward accelerates learning speed and enhances the extent of learning during the acquisition and consolidation stages, possibly by regulating the balance between the direct and indirect pathways (activating more D1-MSN than D2-MSN) of the ventral striatum and by increasing motor dynamics and kinematics. However, the effect varies depending on several experimental conditions. During the retention stage, there is a consensus that reward enhances both short-term and long-term memory retention in both types of motor learning, attributed to the LTP learning mechanism mediated by the VTA-M1 dopaminergic projection. Reward is a promising enhancer to bolster waning confidence and motivation, thereby increasing the efficiency of motor learning and rehabilitation. Further exploration of the circuit and functional connections between reward and the motor loop may provide a novel target for neural modulation to promote motor behavior.

Associations between Gross and Fine Motor Skills, Physical Activity, Executive Function, and Academic Achievement: Longitudinal Findings from the UK Millennium Cohort Study

Accumulating evidence from behavioral studies and neuroscience suggests that motor and cognitive development are intrinsically intertwined. To explore the underlying mechanisms of this motor-cognition link, our study examined the longitudinal relationship of early motor skills and physical activity with later cognitive skills. The sample was 3188 children from the United Kingdom Millennium Cohort Study, followed at 9 months and 5, 7, and 11 years. Early motor skills were examined at 9 months. Children's daily physical activity level was measured using accelerometers at 7 years and a questionnaire was conducted at 11 years. Cognitive skills, including executive function and academic achievement, were measured at age 11. The results suggest that gross motor skills were positively associated with spatial working memory, whereas fine motor skills were predictive of good English and science outcomes. Moderate-to-vigorous activity was found to be negatively associated with English performance, although self-reported activity frequency was positively linked to math. Our results highlight the significant role of both gross and fine motor skills in cognitive development. This study also elucidates the limitations of using activity intensity to assess the impact of motor activity on children's cognitive development, suggesting that attention to the effects of specific types of physical activity would better elucidate the motor/cognition link.

Comparison of the Effects of Cognitive Dual-Task and Single-Task Balance Exercises on Static Balance among People with Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Objectives

The anterior cruciate ligament (ACL) reconstruction surgery improves mechanical stability; however, functional stability remains impaired. Balance exercises can help improve functional stability. The effect of cognitive dual-task balance exercises has not been studied in people with ACL reconstruction surgery; therefore, this study aimed to compare the effect of cognitive dual-task and single-task balance exercises on the static balance indices in these individuals.

Methods

This study was a randomized clinical trial. After a period of conventional physiotherapy and applying inclusion criteria, 28 patients with ACL reconstruction surgery were randomly divided into two groups of cognitive dual-task and single-task balance exercises. Each group received the relevant exercises for four weeks, three times a week, with each session lasting 20 min. Center of pressure variables, including mean displacement in anterior-posterior and medial-lateral directions, total path length, mean velocity of displacement, root mean square of displacement and velocity, and the elliptical area, were measured using the FDM pressure platform before and after the interventions as the primary outcomes. Knee Injury and Osteoarthritis Outcome Score (KOOS) scale was completed by the participants before and after the interventions.

Results

The measured static balance variables and KOOS subscales had significant differences before and after intervention in both groups (P<0.05); however, no statistically significant difference was observed in these variables between the two groups. There was no significant correlation between KOOS subscales and measured static balance variables.

Conclusion

Both cognitive dual-task and single-task balance exercises improved the indicators related to static balance and the level of functional disability of the knee. However, cognitive dual-task balance exercises had no superiority over single-task balance exercises in ACL-reconstructed individuals.

Internal states as a source of subject-dependent movement variability are represented by large-scale brain networks

Humans' ability to adapt and learn relies on reflecting on past performance. These experiences form latent representations called internal states that induce movement variability that improves how we interact with our environment. Our study uncovered temporal dynamics and neural substrates of two states from ten subjects implanted with intracranial depth electrodes while they performed a goal-directed motor task with physical perturbations. We identified two internal states using state-space models: one tracking past errors and the other past perturbations. These states influenced reaction times and speed errors, revealing how subjects strategize from trial history. Using local field potentials from over 100 brain regions, we found large-scale brain networks such as the dorsal attention and default mode network modulate visuospatial attention based on recent performance and environmental feedback. Notably, these networks were more prominent in higher-performing subjects, emphasizing their role in improving motor performance by regulating movement variability through internal states.

Acute exercise performed before and after motor practice enhances the positive effects on motor memory consolidation

Performing a single bout of exercise can enhance motor learning and long-term retention of motor skills. Parameters such as the intensity and when the exercise bout is performed in relation to skill practice (i.e., timing) likely influence the effectiveness. However, it is still not fully understood how exercise should be administered to maximize its effects and how exercise interacts with distinct components of skill learning. Here, we expand this knowledge by investigating the potential synergistic effects of performing acute exercise both prior to and following motor practice. Sixty-four, able-bodied, young adult male participants practiced a sequential visuomotor accuracy tracking (SVAT) task requiring rapid and accurate force modulation and high levels of precision control using intrinsic hand muscles. The task also contained a repeated pattern of targets that allowed sequence-specific skill improvements. Sequential and non-sequential motor performance was assessed at baseline, immediately after motor practice, and again seven days later. One group performed moderate-intensity exercise before practice (PREMO), a second group performed high-intensity exercise after practice (POSTHI), a third group exercised both before and after practice (PREMO + POSTHI), and a fourth group did not exercise during these periods (CON). Regardless of the exercise condition, acute exercise improved long-term retention of the skill by countering performance decay between experimental sessions (i.e., a 7-day interval). Furthermore, exercising both before and after motor practice led to the greatest improvements in skilled performance over time. We found that the effects of exercise were not specific to the practiced sequence. Namely, the effects of exercise generalized across sequential and non-sequential target positions and orders. This suggests that acute exercise works through mechanisms that promote general aspects of motor memory (e.g., lasting improvements in fast and accurate motor execution). The results demonstrate that various exercise protocols can promote the stabilization and long-term retention of motor skills. This effect can be enhanced when exercise is performed both before and after practice.

Associations Between Cognitive Function and ACL Injury-Related Biomechanics: A Systematic Review

CONTEXT

Does lower baseline cognitive function predispose athletes to ACL injury risk, especially when performing unplanned or dual-task movements?

OBJECTIVE

To evaluate the association between cognitive function and biomechanics related to ACL injuries during cognitively challenging sports movements.

DATA SOURCES

PubMed (MEDLINE), Web of Science, Scopus, and SciELO databases were searched; additional hand searching was also conducted.

STUDY SELECTION

The following inclusion criteria had to be met: participants completed (1) a neurocognitive test, (2) a cognitively challenging sport-related task involving lower limbs, and (3) a biomechanical analysis. The following criteria determined exclusion from the review: studies involving participants with (1) recent or current musculoskeletal injuries; (2) recent or current concussion; (3) ACL surgical reconstruction, reviews of the literature, commentary or opinion articles, and case studies.

STUDY DESIGN

Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) statement and registered at the International Prospective Register of Systematic Reviews (PROSPERO).

LEVEL OF EVIDENCE

Level 3.

DATA EXTRACTION

Two of authors independently extracted data and assessed the methodological quality of the articles with the Downs and Black and ROBINS-I checklists, to assess methodological quality and risk of bias, respectively.

RESULTS

Six studies with different methodologies and confounding factors were included in this review. Of these 6 studies, 3 were ranked as high-quality, 3 demonstrated a low risk of bias, 2 a moderate risk, and 1 a severe risk. Five studies found a cognitive-motor relationship, with worse cognitive performance associated with increased injury risk, with 1 study reporting the opposite directionality for 1 variable. One study did not identify any interaction between cognitive function and biomechanical outcomes.

CONCLUSION

Worse cognitive performance is associated with an increased injury risk profile during cognitively challenging movements.

Differential features of early childhood motor skill development and working memory processing: evidence from fNIRS

Objective

The study investigated the differential characteristics associated with motor skill development and working memory processing during early childhood, thereby providing insights for understanding motor learning and cognitive development in young children.

Methods

In total, 101 preschool children (age: 4-6 years) were recruited for this study. The motor skill development level and the working memory capacity of the children were assessed using the MOBAK Motor Development Assessment Scale and a block task paradigm, respectively. Functional near-infrared spectroscopy brain imaging technology was used to monitor hemodynamic signals in the prefrontal cortex (PFC) of the children while they completed different memory tasks. MATLAB software and the Homer2 plugin were used to calculate the oxygenated hemoglobin (Oxy-Hb) concentration in relevant brain regions during the tasks.

Results

(1) The low motor skill group exhibited significantly lower accuracy during the three-memory load condition than during the two-memory load condition. Under both two-memory and three-memory load conditions, the high motor skill group exhibited significantly higher accuracy than the low motor skill group. (2) Significant differences in the Oxy-Hb concentration were observed in the left dorsolateral PFC (L-DLPFC), and right and left triangular part of the Broca's area (R-PTBA and L-PTBA, respectively) between the two memory difficulty levels for the high motor skill group. The Oxy-Hb concentration was significantly higher during the three-memory load condition than during the two-memory load condition. Under the two-memory load condition, the high motor skill group exhibited significantly higher Oxy-Hb concentration in the L-DLPFC and L-PTBA regions than in the low motor skill group. Under the three-memory load condition, the high motor skill group exhibited significantly higher Oxy-Hb concentration in the L-DLPFC, R-PTBA, and L-PTBA regions than the low motor skill group.

Conclusion

A close association was observed between the motor skill levels and working memory in young children, with higher motor skill levels being associated with more pronounced brain activation patterns during working memory tasks.

Neural representations for multi-context visuomotor adaptation and the impact of common representation on multi-task performance: a multivariate decoding approach

The human brain's remarkable motor adaptability stems from the formation of context representations and the use of a common context representation (e.g., an invariant task structure across task contexts) derived from structural learning. However, direct evaluation of context representations and structural learning in sensorimotor tasks remains limited. This study aimed to rigorously distinguish neural representations of visual, movement, and context levels crucial for multi-context visuomotor adaptation and investigate the association between representation commonality across task contexts and adaptation performance using multivariate decoding analysis with fMRI data. Here, we focused on three distinct task contexts, two of which share a rotation structure (i.e., visuomotor rotation contexts with -90° and +90° rotations, in which the mouse cursor's movement was rotated 90 degrees counterclockwise and clockwise relative to the hand-movement direction, respectively) and the remaining one does not (i.e., mirror-reversal context where the horizontal movement of the computer mouse was inverted). This study found that visual representations (i.e., visual direction) were decoded in the occipital area, while movement representations (i.e., hand-movement direction) were decoded across various visuomotor-related regions. These findings are consistent with prior research and the widely recognized roles of those areas. Task-context representations (i.e., either -90° rotation, +90° rotation, or mirror-reversal) were also distinguishable in various brain regions. Notably, these regions largely overlapped with those encoding visual and movement representations. This overlap suggests a potential intricate dependency of encoding visual and movement directions on the context information. Moreover, we discovered that higher task performance is associated with task-context representation commonality, as evidenced by negative correlations between task performance and task-context-decoding accuracy in various brain regions, potentially supporting structural learning. Importantly, despite limited similarities between tasks (e.g., rotation and mirror-reversal contexts), such association was still observed, suggesting an efficient mechanism in the brain that extracts commonalities from different task contexts (such as visuomotor rotations or mirror-reversal) at multiple structural levels, from high-level abstractions to lower-level details. In summary, while illuminating the intricate interplay between visuomotor processing and context information, our study highlights the efficiency of learning mechanisms, thereby paving the way for future exploration of the brain's versatile motor ability.

Visuomotor skill learning in young adults with Down syndrome

BACKGROUND

Individuals with Down syndrome (DS) have impaired general motor skills compared to typically developed (TD) individuals.

AIMS

To gain knowledge on how young adults with DS learn and retain new motor skills.

METHODS AND PROCEDURES

A DS-group (mean age = 23.9 ± 3 years, N = 11), and an age-matched TD-group (mean age 22.8 ± 1.8, N = 14) were recruited. The participants practiced a visuomotor accuracy tracking task (VATT) in seven blocks (10.6 min). Online and offline effects of practice were assessed based on tests of motor performance at baseline immediate and 7-day retention.

OUTCOMES AND RESULTS

The TD-group performed better than the DS-group on all blocks (all P < 0.001). Both groups improved VATT-performance online from baseline to immediate retention, (all P < 0.001) with no difference in online effect between groups. A significant between-group difference was observed in the offline effect (∆TD - ∆DS, P = 0.04), as the DS-group's performance at 7-day retention was equal to their performance at immediate retention (∆DS, P > 0.05), whereas an offline decrease in performance was found in the TD-group (∆TD, P < 0.001).

CONCLUSIONS AND IMPLICATIONS

Visuomotor pinch force accuracy is lower for adults with DS compared to TD. However, adults with DS display significant online improvements in performance with motor practice similar to changes observed for TD. Additionally, adults with DS demonstrate offline consolidation following motor learning leading to significant retention effects.

Explicit benefits: Motor sequence acquisition and short-term retention in adults who do and do not stutter

Motor sequencing skills have been found to distinguish individuals who experience developmental stuttering from those who do not stutter, with these differences extending to non-verbal sequencing behaviour. Previous research has focused on measures of reaction time and practice under externally cued conditions to decipher the motor learning abilities of persons who stutter. Without the confounds of extraneous demands and sensorimotor processing, we investigated motor sequence learning under conditions of explicit awareness and focused practice among adults with persistent development stuttering. Across two consecutive practice sessions, 18 adults who stutter (AWS) and 18 adults who do not stutter (ANS) performed the finger-to-thumb opposition sequencing (FOS) task. Both groups demonstrated significant within-session performance improvements, as evidenced by fast on-line learning of finger sequences on day one. Additionally, neither participant group showed deterioration of their learning gains the following day, indicating a relative stabilization of finger sequencing performance during the off-line period. These findings suggest that under explicit and focused conditions, early motor learning gains and their short-term retention do not differ between AWS and ANS. Additional factors influencing motor sequencing performance, such as task complexity and saturation of learning, are also considered. Further research into explicit motor learning and its generalization following extended practice and follow-up in persons who stutter is warranted. The potential benefits of motor practice generalizability among individuals who stutter and its relevance to supporting treatment outcomes are suggested as future areas of investigation.

The unique contribution of motor ability to visuospatial working memory in school-age children: Evidence from event-related potentials

This study investigated the unique contribution of motor ability to visuospatial working memory (VSWM) and neuroelectric activity in school-age children. Seventy-six children aged 8.7 ± 1.1 years participated in this cross-sectional study. We assessed aerobic fitness using the 20-m endurance shuttle run test, muscular fitness (endurance, power) using a standard test battery, and motor ability (manual dexterity, ball skills, and static and dynamic balance) using the Movement Assessment Battery for Children. A modified delayed match-to-sample test was used to assess VSWM and the P3 component of event-related potentials. Hierarchical regression analyses indicated that greater aerobic fitness was associated with smaller coefficient of variation of reaction time (p = .008), greater muscular fitness was associated with higher response accuracy (p = .022), greater motor ability was associated with higher response accuracy (p < .001) and increased P3 mean amplitude (p < .001) after controlling for age. Furthermore, the positive associations of motor ability with response accuracy (p = .001) were independent of muscular fitness. The findings from this study provide new insight into the differential associations between health-related fitness domains and VSWM, highlighting the influence of motor ability on brain health and cognitive development during childhood.

Transcranial direct current stimulation to the left dorsolateral prefrontal cortex enhances early dexterity skills with the left non-dominant hand: a randomized controlled trial

BACKGROUND

The left dorsolateral prefrontal cortex (DLPFC) is involved in early-phase manual dexterity skill acquisition when cognitive control processes, such as integration and complexity demands, are required. However, the effectiveness of left DLPFC transcranial direct current stimulation (tDCS) on early-phase motor learning and whether its effectiveness depends on the cognitive demand of the target task are unclear. This study aimed to investigate whether tDCS over the left DLPFC improves non-dominant hand dexterity performance and determine if its efficacy depends on the cognitive demand of the target task.

METHODS

In this randomized, double-blind, sham-controlled trial, 70 healthy, right-handed, young adult participants were recruited. They were randomly allocated to the active tDCS (2 mA for 20 min) or sham groups and repeatedly performed the Purdue Pegboard Test (PPT) left-handed peg task and left-handed assembly task three times: pre-tDCS, during tDCS, and post tDCS.

RESULTS

The final sample comprised 66 healthy young adults (mean age, 22.73 ± 1.57 years). There were significant interactions between group and time in both PPT tasks, indicating significantly higher performance of those in the active tDCS group than those in the sham group post tDCS (p < 0.001). Moreover, a greater benefit was observed in the left-handed assembly task performance than in the peg task performance (p < 0.001). No significant correlation between baseline performance and benefits from tDCS was observed in either task.

CONCLUSIONS

These results demonstrated that prefrontal tDCS significantly improved early-phase manual dexterity skill acquisition, and its benefits were greater for the task with high cognitive demands. These findings contribute to a deeper understanding of the underlying neurophysiological mechanisms of the left DLPFC in the modulation of early-phase dexterity skill acquisition.

TRIAL REGISTRATION

This study was registered in the University Hospital Medical Information Network Clinical Trial Registry in Japan (UMIN000046868), Registered February 8, 2022 https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000053467.

Exploring the relationships between visuospatial working memory, math, letter-sound knowledge, motor competence, and gender in first grade children: A correlational study

Introduction

Development of crucial skills accelerates at the start of formal schooling, although, more knowledge is needed about the relationships between such skills. The current study explored the relationships between visuospatial working memory, letter-sound knowledge, math competence and motor competence, as well as potential effects of gender.

Materials and methods

The sample consisted of 85 (42 girls) 6 to 7 years old first grade children, and was measured with a test battery consisting of tests designed for each skill domain.

Results

Results demonstrated weak to moderate statistically significant correlations between visuospatial working memory, letter-sound knowledge, math competence, with no statistically significant gender differences. Two motor tasks measuring manual dexterity, placing bricks and building bricks, showed a weak statistically significant correlation.

Discussion

We argue that the findings demonstrate the relationships between these skills are low to moderate in first grade. Furthermore, we argue that these skills ought to be trained deliberately. The potential role of visuospatial working memory in procurement of novel skills in early childhood ought to be explored further in future studies.

Working Memory and Manual Dexterity in Dyslexic Children: A Systematic Review and Meta-Analysis

Dyslexic children have impairments in working memory and manual dexterity. Studies have shown that when cognitive development has deficits, motor development is often impaired, indicating a strong interconnection between both domains, and the possibility of interference with each other's proper functioning. Thus, a new literature review is necessary to understand which components of working memory and manual dexterity are affected in dyslexic children and the possible relationship between them. This review aimed to perform a systematic review and meta-analysis to analyze both skills in dyslexic children. The protocol was carried out according to the criteria established by PRISMA being registered at PROSPERO under number CRD 42021238901. Six literature databases were searched to locate studies published between 2001 and 2021: EMBASE, ERIC, ISI Web of Science, PubMed, PsycINFO, and Scopus. 21 studies met the inclusion criteria. The findings suggest that dyslexic children have significantly poorer visuospatial and verbal working memory with more impairments in the phonological loop. No significant differences were found in manual dexterity.

Failure to improve task performance after visuomotor training with error reduction feedback for young adults

Visual feedback that reinforces accurate movements may motivate skill acquisition by promoting self-confidence. This study investigated neuromuscular adaptations to visuomotor training with visual feedback with virtual error reduction. Twenty-eight young adults (24.6 ± 1.6 years) were assigned to error reduction (ER) (n = 14) and control (n = 14) groups to train on a bi-rhythmic force task. The ER group received visual feedback and the displayed errors were 50% of the real errors in size. The control group was trained with visual feedback with no reduction in errors. Training-related differences in task accuracy, force behaviors, and motor unit discharge were contrasted between the two groups. The tracking error of the control group progressively declined, whereas the tracking error of the ER group was not evidently reduced in the practice sessions. In the post-test, only the control group exhibited significant task improvements with smaller error size (p = .015) and force enhancement at the target frequencies (p = .001). The motor unit discharge of the control group was training-modulated, as indicated by a reduction of the mean inter-spike interval (p = .018) and smaller low-frequency discharge fluctuations (p = .017) with enhanced firing at the target frequencies of the force task (p = .002). In contrast, the ER group showed no training-related modulation of motor unit behaviors. In conclusion, for young adults, ER feedback does not induce neuromuscular adaptations to the trained visuomotor task, which is conceptually attributable to intrinsic error dead-zones.

Individual differences in processing ability to transform visual stimuli during the mental rotation task are closely related to individual motor adaptation ability

Mental rotation (MR) is a well-established experimental paradigm for exploring human spatial ability. Although MR tasks are assumed to be involved in several cognitive processes, it remains unclear which cognitive processes are related to the individual ability of motor adaptation. Therefore, we aimed to elucidate the relationship between the response time (RT) of MR using body parts and the adaptive motor learning capability of gait. In the MR task, dorsal hand, palmar plane, dorsal foot, and plantar plane images rotated in 45° increments were utilized to measure the RTs required for judging hand/foot laterality. A split-belt treadmill paradigm was applied, and the number of strides until the value of the asymmetrical ground reaction force reached a steady state was calculated to evaluate the individual motor adaptation ability. No significant relationship was found between the mean RT of the egocentric perspectives (0°, 45°, and 315°) or allocentric perspectives (135°, 180°, and 225°) and adaptive learning ability of gait, irrespective of body parts or image planes. Contrarily, the change rate of RTs obtained by subtracting the RT of the egocentric perspective from that of the allocentric perspective in dorsal hand/foot images that reflect the time to mentally transform a rotated visual stimulus correlated only with adaptive learning ability. Interestingly, the change rate of RTs calculated using the palmar and plantar images, assumed to reflect the three-dimensional transformation process, was not correlated. These findings suggest that individual differences in the processing capability of visual stimuli during the transformation process involved in the pure motor simulation of MR tasks are precisely related to individual motor adaptation ability.

Enhanced cognitive performance after multiple adaptations to visuomotor transformations

Several studies reported that adaptation to a visuomotor transformation correlates with the performance in cognitive performance tests. However, it is unclear whether there is a causal relationship between sensorimotor adaptation and cognitive performance. The present study examined whether repeated adaptations to double steps and rotated feedback increase cognitive performance assessed by neuropsychological tests in a pre-post design. The participants of the intervention group adapted in 24 sessions their hand movements to visuomotor transformations with increasing size. Pre-post changes were significantly larger in the intervention group than in a control group without training. This result suggests a causal relationship between sensorimotor adaptation training and cognitive performance.

Behavioral and neurocognitive effects of judo training on working memory capacity in children with ADHD: A randomized controlled trial

BACKGROUND

Children with Attention Deficit Hyperactivity Disorder (ADHD) face deficits in working memory capacity that often persist into adulthood. In healthy peers, exercise targeting motor skill acquisition benefits visuospatial working memory, but its potential to reduce ADHD-related deficits remains unclear. We investigated the effect of a judo training program targeting motor skills on behavioral and neurocognitive indices of working memory capacity in children with ADHD.

METHODS

Children with ADHD aged 8 to 12 years (N = 57) were randomly allocated to a judo training group and a wait-list control group. The training program encompassed 120 min of judo per week over three months. Before and after the intervention period, participants completed a bilateral Change Detection task with low and high memory load conditions and the Movement Assessment Battery for Children-2 (MABC-2). The contralateral delay activity (CDA) elicited by the cognitive task was recorded using electroencephalography.

RESULTS

Compared to the control group, the judo training group showed a higher K-score on the Change Detection task and an increased negativity of the CDA on the high load condition following the intervention, when pretest scores (and confounders) were accounted for. In contrast, no group differences were found for MABC-2 score.

CONCLUSION

In children with ADHD, judo training may complement the pharmacological treatment by increasing the effectiveness of working memory maintenance processes. On a behavioral level, this improvement is accompanied with an increased capacity to store visuospatial information.

Human Variation in Error-Based and Reinforcement Motor Learning Is Associated With Entorhinal Volume

Error-based and reward-based processes are critical for motor learning and are thought to be mediated via distinct neural pathways. However, recent behavioral work in humans suggests that both learning processes can be bolstered by the use of cognitive strategies, which may mediate individual differences in motor learning ability. It has been speculated that medial temporal lobe regions, which have been shown to support motor sequence learning, also support the use of cognitive strategies in error-based and reinforcement motor learning. However, direct evidence in support of this idea remains sparse. Here we first show that better overall learning during error-based visuomotor adaptation is associated with better overall learning during the reward-based shaping of reaching movements. Given the cognitive contribution to learning in both of these tasks, these results support the notion that strategic processes, associated with better performance, drive intersubject variation in both error-based and reinforcement motor learning. Furthermore, we show that entorhinal cortex volume is larger in better learning individuals-characterized across both motor learning tasks-compared with their poorer learning counterparts. These results suggest that individual differences in learning performance during error and reinforcement learning are related to neuroanatomical differences in entorhinal cortex.

Mediation Analysis of the Effect of Visuospatial Memory on Motor Skill Learning in Older Adults

There is high inter-individual variability in motor skill learning among older adults. Identifying the nature of these individual differences remains challenging due to interactions between participant characteristics (e.g., age, cognition) and task-related factors (e.g., nature of task, level of skill pre-training), making it difficult to determine plausibly causal relationships. This study addresses these competing explanations by using mediation analysis to examine plausible causal inference between visuospatial memory and one-month retention of both gross and fine motor components of a functional upper-extremity task following training. Results suggest that better visuospatial memory results in more retention of fine but not gross motor skill, expanding on previous correlational studies in older adults and informing future interventions for maximizing motor learning in geriatric populations.

Additional cognitive load decreases performance but not adaptation to a visuomotor transformation

Dual-task paradigms are procedures for investigating interference with two tasks performed simultaneously. Studies that previously addressed dual-task paradigms within a visuomotor reaching task yielded mixed results. While some of the studies found evidence of cognitive interference, called dual-task costs, other studies did not. We assume that dual-task costs only manifest themselves within the explicit component of adaptation, as it involves cognitive resources for processing. We suspect the divergent findings to be due to the lack of differentiation between the explicit and implicit component. In this study, we aimed to investigate how a cognitive secondary task affects visuomotor adaptation overall and its different components, both during and after adaptation. In a series of posttests, we examined the explicit and implicit components separately. Eighty participants performed a center-outward reaching movement with a 30° cursor perturbation. Participants were either assigned to a single task group (ST) or a dual-task group (DT) with an additional auditory 1-back task. To further enhance our predicted effect of dual-task interference on the explicit component, we added a visual feedback delay condition to both groups (ST/DT_DEL). In the other condition, participants received visual feedback immediately after movement termination (ST/DT_NoDEL). While there were clear dual-task costs during the practice phase, there were no dual-task effects on any of the posttest measures. On one hand, our findings suggest that dual-task costs in visuomotor adaptation tasks can occur with sufficient cognitive demand, and on the other hand, that cognitive constraints may affect motor performance but not necessarily motor adaptation.

Continuous 2D trajectory decoding from attempted movement: across-session performance in able-bodied and feasibility in a spinal cord injured participant

OBJECTIVE

In people with a cervical spinal cord injury (SCI) or degenerative diseases leading to limited motor function, restoration of upper limb movement has been a goal of the brain-computer interface (BCI) field for decades. Recently, research from our group investigated non-invasive and real-time decoding of continuous movement in able-bodied participants from low-frequency brain signals during a target-tracking task. To advance our setup towards motor-impaired end users, we consequently chose a new paradigm based on attempted movement.

APPROACH

Here, we present the results of two studies. During the first study, data of ten able-bodied participants completing a target-tracking/shape-tracing task on-screen were investigated in terms of improvements in decoding performance due to user training. In a second study, a spinal cord injured participant underwent the same tasks. To investigate the merit of employing attempted movement in end users with SCI, data of the spinal cord injured participant were recorded twice; once within an observation only condition, and once while simultaneously attempting movement.

MAIN RESULTS

We observed mean correlation well above chance level for continuous motor decoding based on attempted movement in able-bodied participants. No global improvement over three sessions, both in sensor and source space, could be observed across all participants and movement parameters. In the participant with SCI, decoding performance well above chance was found.

SIGNIFICANCE

No presence of a learning effect in continuous attempted movement decoding in able-bodied participants could be observed. In contrast, non-significantly varying decoding patterns may promote the use of source space decoding in terms of generalized decoders utilizing transfer learning. Furthermore, above-chance correlations for attempted movement decoding ranging between those of observation only and executed movement were seen in one spinal cord injured participant, suggesting attempted movement decoding as a possible link between feasibility studies in able-bodied and actual applications in motor impaired end users.

Evidence of Motor Skill Learning in Acute Stroke Patients Without Lesions to the Thalamus and Internal Capsule

Background:

It is currently unknown whether motor skill learning (MSkL) with the paretic upper limb is possible during the acute phase after stroke and whether lesion localization impacts MSkL. Here, we investigated MSkL in acute (1–7 days post) stroke patients compared with healthy individuals (HIs) and in relation to voxel-based lesion symptom mapping.

Methods:

Twenty patients with acute stroke and 35 HIs were trained over 3 consecutive days on a neurorehabilitation robot measuring speed, accuracy, and movement smoothness variables. Patients used their paretic upper limb and HI used their nondominant upper limb on an MSkL task involving a speed/accuracy trade-off. Generalization was evaluated on day 3. All patients underwent a 3-dimensional magnetic resonance imaging used for VSLM.

Results:

Most patients achieved MSkL demonstrated by day-to-day retention and generalization of the newly learned skill on day 3. When comparing raw speed/accuracy trade-off values, HI achieved larger MSkL than patients. However, relative speed/accuracy trade-off values showed no significant differences in MSkL between patients and HI on day 3. In patients, MSkL progression correlated with acute motor and cognitive impairments. The voxel-based lesion symptom mapping showed that acute vascular damage to the thalamus or the posterior limb of the internal capsule reduced MSkL.

Conclusions:

Despite worse motor performance for acute stroke patients compared with HI, most patients were able to achieve MSkL with their paretic upper limb. Damage to the thalamus and posterior limb of the internal capsule, however, reduced MSkL. These data show that MSkL could be implemented into neurorehabilitation during the acute phase of stroke, particularly for patients without lesions to the thalamus and posterior limb of the internal capsule.

Registration:

URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01519843.

Psycho-Cognitive Model of Knowledge Creation Theory

Humans perform activities collaboratively or individually, and these activities, more often than not, involve both physical and mental processes. However, irrespective of whether individual or collective functioning, knowledge creation is a personal experience. Nevertheless, the general tenet of this paper is that knowledge is created in a human’s mind and resides in the head. Hence, it posits that knowledge creation is cognitive (associated with the neurological structures of the brain) and psychological (involving consciousness)—a psycho-cognitive process. This study thus employs a “Cognaction” mechanism that is based on the assumptions captured below. The mechanism premised that the human cognitive chamber consists of 3C modes of comprehension (for interpreting stimuli transmitted to the brain by sensory organs), contextualisation (for mindful connecting of chunks to existing schemas), and conceptualisation (for evaluative reflection in a manner that leads to drawing inference and building themes or new concepts). It demonstrates that as diverse skill sets are applied to a task, they generate varieties of effects and outcomes. The outcomes though are distinctive and at the same time are cospecialised. Thus, the psycho-cognitive perspective demonstrates knowledge creation as a cocreation process and sees knowledge as a mix of cocreated, cognitive structures. In view of these, the study provides the missing explanation on how the knowledge archetypes emerged. And it provides the missing link between the belief that “knowledge is created in the head” and knowledge creation theory.

Teacher-Rated Executive Functions, Gender and Relative Age: Independent and Interactive Effects on Observed Fundamental Motor Skills in Kindergarteners

Fundamental motor skills (FMS) of children can be affected by different variables, such as executive functions (EF), gender and relative age. However, the effects of these variables on FMS have been scarce studied, especially in early childhood, and show inconsistent results. To clarify these relationships, this study was carried out. Its aim was to analyze whether EF, gender and relative age influenced FMS in 43 Spanish kindergarteners. A multimethod and mixed methods approach was used. Kindergarteners' teachers completed the Childhood Executive Functioning Inventory to know the children level of EF (working memory and inhibition control). Kindergarteners' parents complimented ad hoc questionnaire reporting the children gender and birth data (to know their relative age). A Nomothetic/Punctual/Multidimensional observational design was used to observe children FMS in their habitual motor sessions at school. Two-way ANOVAs were performed to know the independent and interactive effects of working memory level (lower/higher), inhibition control level (lower/higher), gender (boys/girls) and relative age (according to the birth semester in the year) on FMS. Results showed these variables have independent and interactive effects on some FMS, but not on others. FMS influenced by these variables vary depending what independent variable(s) is/are considered. Therefore, it can be concluded that the influences of teacher-rated EF, gender and relative age on observed FMS in kindergarteners are complex and specific. Results obtained must be taken into to design and implement instructional and intervention strategies, as well as educational and sport policy changes, especially in early childhood, when FMS are more malleable.

Exercise types and working memory components during development

Working memory is crucial to learning and academic success. Exercise has been found to benefit working memory in late life, but its effects during cognitive development are less clear. Building on findings that working memory is supported by the motor system, we highlight the sensitivity of different working memory components to acute and long-term exercise in children and adolescents. We also consider how the specific skill demands of endurance and coordinative exercise influence this sensitivity. Distinct effects of these exercise types are further linked with neurocognitive and neuroendocrine pathways. Our review suggests long-term rather than acute benefits of exercise for children and adolescents' working memory, which are more pronounced and specific for exercise with high coordinative demands.

Separation of multiple motor memories through implicit and explicit processes

Acquisition of multiple motor skills without interference is a remarkable ability in daily life. During adaptation to opposing perturbations, a common paradigm to study this ability, each perturbation can be successfully learned when a contextual follow-through movement is associated with the direction of the perturbation. It is still unclear, however, to what extent this learning engages the cognitive explicit process and the implicit process. Here, we untangled the individual contributions of the explicit and implicit components while participants learned opposing visuomotor perturbations, with a second unperturbed follow-through movement. In Exp. 1 we replicated previous adaptation results and showed that follow-through movements also allow learning for opposing visuomotor rotations. For one group of participants in Exp. 2 we isolated strategic explicit learning, while for another group we isolated the implicit component. Our data showed that opposing perturbations could be fully learned by explicit strategies; but when strategy was restricted, distinct implicit processes contributed to learning. In Exp.3, we examined whether learning is influenced by the disparity between the follow-through contexts. We found that the location of follow-through targets had little effect on total learning, yet it led to more instances in which participants failed to learn the task. In Exp. 4, we explored the generalization capability to untrained targets. Participants showed near-flat generalization of the implicit and explicit processes. Overall, our results indicate that follow-through contextual cues might activate, in part, top-down cognitive factors that influence not only the dynamics of the explicit learning, but also the implicit process.

Aberrant Auditory and Visual Memory Development of Children with Upper Limb Motor Disorders

The current study aimed to compare differences in the cognitive development of children with and without upper limb motor disorders. The study involved 89 children from 3 to 15 years old; 57 children with similar upper limb motor disorders and 32 healthy children. Our results showed that motor disorders could impair cognitive functions, especially memory. In particular, we found that children between 8 and 11 years old with upper limb disorders differed significantly from their healthy peers in both auditory and visual memory scales. These results can be explained by the fact that the development of cognitive functions depends on the normal development of motor skills, and the developmental delay of motor skills affects cognitive functions. Correlation analysis did not reveal any significant relationship between other cognitive functions (attention, thinking, intelligence) and motor function. Altogether, these findings point to the need to adapt general habilitation programs for children with motor disorders, considering the cognitive impairment during their development. The evaluation of children with motor impairment is often limited to their motor dysfunction, leaving their cognitive development neglected. The current study showed the importance of cognitive issues for these children. Moreover, early intervention, particularly focused on memory, can prevent some of the accompanying difficulties in learning and daily life functioning of children with movement disorders.

Additive and interaction effects of working memory and motor sequence training on brain functional connectivity

Although shared behavioral and neural mechanisms between working memory (WM) and motor sequence learning (MSL) have been suggested, the additive and interactive effects of training have not been studied. This study aimed at investigating changes in brain functional connectivity (FC) induced by sequential (WM + MSL and MSL + WM) and combined (WM × MSL) training programs. 54 healthy subjects (27 women; mean age: 30.2 ± 8.6 years) allocated to three training groups underwent twenty-four 40-min training sessions over 6 weeks and four cognitive assessments including functional MRI. A double-baseline approach was applied to account for practice effects. Test performances were compared using linear mixed-effects models and t-tests. Resting state fMRI data were analysed using FSL. Processing speed, verbal WM and manual dexterity increased following training in all groups. MSL + WM training led to additive effects in processing speed and verbal WM. Increased FC was found after training in a network including the right angular gyrus, left superior temporal sulcus, right superior parietal gyrus, bilateral middle temporal gyri and left precentral gyrus. No difference in FC was found between double baselines. Results indicate distinct patterns of resting state FC modulation related to sequential and combined WM and MSL training suggesting a relevance of the order of training performance. These observations could provide new insight for the planning of effective training/rehabilitation.

Updates in Motor Learning: Implications for Physical Therapist Practice and Education

Over the past 3 decades, the volume of human motor learning research has grown enormously. As such, the understanding of motor learning (ie, sustained change in motor behavior) has evolved. It has been learned that there are multiple mechanisms through which motor learning occurs, each with distinctive features. These mechanisms include use-dependent, instructive, reinforcement, and sensorimotor adaptation-based motor learning. It is now understood that these different motor learning mechanisms contribute in parallel or in isolation to drive desired changes in movement, and each mechanism is thought to be governed by distinct neural substrates. This expanded understanding of motor learning mechanisms has important implications for physical therapy. It has the potential to facilitate the development of new, more precise treatment approaches that physical therapists can leverage to improve human movement. This Perspective describes scientific advancements related to human motor learning mechanisms and discusses the practical implications of this work for physical therapist practice and education.

Principles of Integrated Cognitive Training for Executive Attention: Application to an Instrumental Skill

One effective cognitive treatment is the rehabilitation of working memory (WM) using an integrated approach that targets the “executive attention” system. Recent neuroscientific literature has revealed that treatment efficacy depends on the presence of various features, such as adaptivity, empathy, customization, avoidance of automatism and stereotypies, and alertness activation. Over the last two decades, an Integrated Cognitive Training (ICT) protocol has been proposed and developed; ICT takes the above-mentioned features and existing literature into account, and has been used to promote the development of reading skills. ICT has been employed in several clinical settings and involves stimulation of a specific deteriorated system (e.g., reading) and the improvement of executive attention components, thus also increasing working memory capacity. In this context, we present two experiments. In Experiment 1, participants diagnosed with dyslexia (aged between 8 and 14 years) underwent two ICT sessions a week, with home supplements, for a duration of 7 months. The participants showed a significant improvement in the reading speed of text, words, and non-words, and in the reading accuracy of text and non-words. In Experiment 2, we replicated Experiment 1, but included a comparison between two groups (experimental group vs. control group) of young participants with diagnosis of dyslexia. The experimental group was subjected to 18 ICT sessions twice a week and with home supplements, using the same protocol as in Experiment 1. The control group was entrusted to the protocol of compensatory tools and dispense/helping procedures provided by the scholastic Personalized Educational Plan. After training, the experimental group gained about 0.5 syllables per second in text reading, and a marked decrease in error rate. The control group showed no significant improvement in reading skills after the same period. Moreover, the improvement observed in the experimental group remained stable 4 months after ICT had ended. The results of these two experiments support the efficacy of the integrated ICT protocol in improving reading skills in children with dyslexia and its sustained effect.

A multi-representation approach to the contextual interference effect: effects of sequence length and practice

The present study investigated the long-term benefit of Random-Practice (RP) over Blocked-Practice (BP) within the contextual interference (CI) effect for motor learning. We addressed the extent to which motor sequence length and practice amount factors moderate the CI effect given that previous reports, often in applied research, have reported no long-term advantage from RP. Based on predictions arising from the Cognitive framework of Sequential Motor Behavior (C-SMB) and using the Discrete Sequence Production (DSP) task, two experiments were conducted to compare limited and extended practice amounts of 4- and 7-key sequences under RP and BP schedules. Twenty-four-hour delayed retention performance confirmed the C-SMB prediction that the CI-effect occurs only with short sequences that receive little practice. The benefit of RP with limited practice was associated with overnight motor memory consolidation. Further testing with single-stimulus as well as novel and unstructured (i.e., random) sequences indicated that limited practice under RP schedules enhances both reaction and chunking modes of sequence execution with the latter mode benefitting from the development of implicit and explicit forms of sequence representation. In the case of 7-key sequences, extended practice with RP and BP schedules provided for equivalent development of sequence representations. Higher explicit awareness of sequence structures was associated with faster completion of practiced but also of novel and unstructured sequences.

Football Juggling Learning Alters the Working Memory and White Matter Integrity in Early Adulthood: A Randomized Controlled Study

Cross-sectional studies suggest that motor skill learning is associated with working memory (WM) and white matter integrity (WMI). However, it has not been established whether motor skill learning improves WM performance, and information on its neural mechanisms have not been clearly elucidated. Therefore, this study compared WM and WMI across time points prior to and following football juggling learning, in early adulthood (18–20 years old), relative to a control group. Study participants in the experimental group were subjected to football juggling for 10 weeks while participants in the control category went on with their routine life activities for the same period of time and were not involved in the learning-related activities. Data on cognitive measurements and that from diffusion tensor imaging (DTI) were collected before and after learning. There was a significant improvement in WM performance of the experimental group after motor learning, although no improvement was observed in the control group. Additionally, after learning, DTI data revealed a significant increase in functional anisotropy (FA) in the genu of corpus callosum (GOCC) and the right anterior corona radiata (R.ACR) in the experimental group. Moreover, the better WM associated with football juggling learning was correlated to a higher FA. Mediation analysis suggested that FA in the GOCC acts as a mediation variable between football juggling learning and WM. These findings show that motor skill learning improves the WM and remodels WMI in early adulthood. With a particular emphasis on the importance of WMI in motor skill learning and WM, this study also revealed the possible neural mechanisms mediated by WMI.

Gamma frequencies as a predictor for the accomplishment of a motor task guided through the action observation network

BACKGROUND

Action observation describes a concept where the subsequent motor behavior of an individual can be modulated though observing an action. This occurs through the activation of neurons in the action observation network, acting on a variety of motor learning processes. This network has been proven highly useful in the rehabilitation of patients with acquired brain injury, placing "action observation" as one of the most effective techniques for motor recovery in physical neurorehabilitation.

OBJECTIVE

The aim of this paper is to define an EEG marker for motor learning, guided through observation.

METHODS

Healthy subjects (n = 41) participated voluntarily for this research. They were asked to repeat an unknown motor behavior, immediately after observing a video. During the observation, EEG raw signals where collected with a portable EEG and the results were later compared with success and fail on repeating the motor procedure. The comparison was then analyzed with the Mann-Whitney U test for non-parametrical data, with a confidence interval of 95%.

RESULTS

A significant relation between motor performance and neural activity was found for Alpha (p = 0,0149) and Gamma (0,0005) oscillatory patterns.

CONCLUSION

Gamma oscillations with frequencies between 41 and 49,75 Hz, seem to be an adequate EEG marker for motor performance guided through the action observation network. The technology used for this paper is easy to use, low-cost and presents valid measurements for the recommended oscillatory frequencies, implying a possible use on rehabilitation, by collecting data in real-time during therapeutic interventions and assessments.

Functional Neural Correlates of the WAIS-IV Block Design Test in Older Adult with Mild Cognitive Impairment and Alzheimer's Disease

The Wechsler Adult intelligence scale-Revised (WAIS-R) Block design test (BDT) is a neuropsychological test widely used to assess cognitive declines in aging population. Previous studies suggest parietal lobe is the key region to influence the performance on the BDT; yet, it has not been clearly identified. The aim of the current study, therefore, is to identify the functional neural correlates of the BDT in older adults with mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia patients. The current study includes 213 cognitively impaired mid to old-aged community dwelling Korean. All participants underwent comprehensive clinical and neuropsychological assessments and 18F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) scans. Performance on the BDT was assessed using the WAIS-IV Korean version. Voxel-wise analyses were used to investigate the correlation between regional cerebral glucose metabolism and BDT performance. The same analyses were conducted on the subgroups categorized by clinical severity based on the Clinical Dementia Rating (CDR). Significant positive correlations between performance on the BDT and regional cerebral glucose metabolism were found bilaterally in the inferior parietal lobules, right thalamus and right middle frontal gyrus. Our results suggest that performance on the BDT in MCI and AD patients functionally relies on the brain regions known to be associated with motor and executive functions in addition to visuospatial function.