Fast but fleeting: adaptive motor learning processes associated with aging and cognitive decline

Not fleeting but lasting: limited influence of aging on implicit adaptative motor learning and its short-term retention

In motor adaptation, learning is thought to rely on a combination of several processes. Two of these are implicit learning (incidental updating of the movement due to sensory prediction error) and explicit learning (intentional adjustment to reduce target error). The explicit component is thought to be fast adapting, whereas the implicit one is slow. The dynamic integration of such fast and slow components can lead to spontaneous recovery. That is, after prolonged adaptation of movement to a given perturbation, the learning is extinguished by presenting a perturbation in the opposite direction for a few trials. After such extinction, the learned adaptation can reappear in the absence of any further training, a phenomenon called spontaneous recovery. Trewartha et al. (Trewartha KM, Garcia A, Wolpert DM, Flanagan JR. J Neurosci 34: 13411-13421, 2014) found that older adults show less spontaneous recovery than their younger controls, indicating impairments in short-term retention of force-field adaptation. This disagrees with evidence suggesting that the implicit component and its retention do not decline with aging. To clarify this discrepancy, we performed a conceptual replication of that result. Twenty-eight healthy young and 20 healthy older adults learned to adapt to a forcefield perturbation in a paradigm known to elicit spontaneous recovery. Both groups adapted equally well to the perturbation. Implicit adaptation of the older subjects was indistinguishable from that of their younger counterparts. In addition, our conceptual replication failed to reproduce the result of Trewartha et al. (Trewartha KM, Garcia A, Wolpert DM, Flanagan JR. J Neurosci 34: 13411-13421, 2014) and found that the spontaneous recovery was also similar across groups. Our results reconcile previous studies by showing that both spontaneous recovery and implicit adaptation are unaffected by aging.NEW & NOTEWORTHY In this study, we tested whether aging influences the ability to learn to counteract a perturbation during reaching movements and to recall previously learned motor memories. In contrast to a previously published paper, we found that the ability of older participants to adapt to a perturbation and to recall motor memories remains unimpaired.

Effect of intensive water resistance phonation therapy for people with presbyphonia: A pilot study

Purpose: The aim of this pilot study was to explore the efficacy of an intensive 3 week water resistance phonation (WRP) therapy program for people with presbyphonia.Method: Participants included 13 people with presbyphonia who received intensive WRP therapy. All participants completed eight sessions of therapy over 3 weeks. Auditory perceptual ratings, and acoustic and aerodynamic assessments were performed before and after treatment. Participants also completed the voice-related quality of life questionnaire before and after the treatment.Result: After 3 weeks of intensive voice therapy, significant improvements were demonstrated in acoustic, aerodynamic, and auditory perceptual parameters, as well as patient perceptions of voice-related quality of life. Acoustically, it was found there were significant decreases in shimmer (p = 0.019), noise-to-harmonic ratio (p = 0.016), and smoothed cepstral peak prominence (p = 0.001). Perceptually, the clients with presbyphonia showed significant reductions in the ratings of the overall grade, roughness, asthenia, and strain. Moreover, there was a significant increase in the total score of the Mandarin version of the Voice-Related Quality of Life measure post-therapy.Conclusion: The investigation provides preliminary evidence that people with presbyphonia can improve their vocal function and voice-related quality of life through intensive WRP therapy within a short period of time.

Early-Stage Alzheimer's Disease Affects Fast But Not Slow Adaptive Processes in Motor Learning

Alzheimer's disease (AD) is characterized by an initial decline in declarative memory, while nondeclarative memory processing remains relatively intact. Error-based motor adaptation is traditionally seen as a form of nondeclarative memory, but recent findings suggest that it involves both fast, declarative, and slow, nondeclarative adaptive processes. If the declarative memory system shares resources with the fast process in motor adaptation, it can be hypothesized that the fast, but not the slow, process is disturbed in AD patients. To test this, we studied 20 early-stage AD patients and 21 age-matched controls of both sexes using a reach adaptation paradigm that relies on spontaneous recovery after sequential exposure to opposing force fields. Adaptation was measured using error clamps and expressed as an adaptation index (AI). Although patients with AD showed slightly lower adaptation to the force field than the controls, both groups demonstrated effects of spontaneous recovery. The time course of the AI was fitted by a hierarchical Bayesian two-state model in which each dynamic state is characterized by a retention and learning rate. Compared to controls, the retention rate of the fast process was the only parameter that was significantly different (lower) in the AD patients, confirming that the memory of the declarative, fast process is disturbed by AD. The slow adaptive process was virtually unaffected. Since the slow process learns only weakly from an error, our results provide neurocomputational evidence for the clinical practice of errorless learning of everyday tasks in people with dementia.

The independence of impairments in proprioception and visuomotor adaptation after stroke

BACKGROUND

Proprioceptive impairments are common after stroke and are associated with worse motor recovery and poor rehabilitation outcomes. Motor learning may also be an important factor in motor recovery, and some evidence in healthy adults suggests that reduced proprioceptive function is associated with reductions in motor learning. It is unclear how impairments in proprioception and motor learning relate after stroke. Here we used robotics and a traditional clinical assessment to examine the link between impairments in proprioception after stroke and a type of motor learning known as visuomotor adaptation.

METHODS

We recruited participants with first-time unilateral stroke and controls matched for overall age and sex. Proprioceptive impairments in the more affected arm were assessed using robotic arm position- (APM) and movement-matching (AMM) tasks. We also assessed proprioceptive impairments using a clinical scale (Thumb Localization Test; TLT). Visuomotor adaptation was assessed using a task that systematically rotated hand cursor feedback during reaching movements (VMR). We quantified how much participants adapted to the disturbance and how many trials they took to adapt to the same levels as controls. Spearman's rho was used to examine the relationship between proprioception, assessed using robotics and the TLT, and visuomotor adaptation. Data from healthy adults were used to identify participants with stroke who were impaired in proprioception and visuomotor adaptation. The independence of impairments in proprioception and adaptation were examined using Fisher's exact tests.

RESULTS

Impairments in proprioception (58.3%) and adaptation (52.1%) were common in participants with stroke (n = 48; 2.10% acute, 70.8% subacute, 27.1% chronic stroke). Performance on the APM task, AMM task, and TLT scores correlated weakly with measures of visuomotor adaptation. Fisher's exact tests demonstrated that impairments in proprioception, assessed using robotics and the TLT, were independent from impairments in visuomotor adaptation in our sample.

CONCLUSION

Our results suggest impairments in proprioception may be independent from impairments in visuomotor adaptation after stroke. Further studies are needed to understand factors that influence the relationship between motor learning, proprioception and other rehabilitation outcomes throughout stroke recovery.

Age-related differences of cerebellar cortex and nuclei: MRI findings in healthy controls and its application to spinocerebellar ataxia (SCA6) patients

Understanding cerebellar alterations due to healthy aging provides a reference point against which pathological findings in late-onset disease, for example spinocerebellar ataxia type 6 (SCA6), can be contrasted. In the present study, we investigated the impact of aging on the cerebellar nuclei and cerebellar cortex in 109 healthy controls (age range: 16 - 78 years) using 3 Tesla magnetic resonance imaging (MRI). Findings were compared with 25 SCA6 patients (age range: 38 - 78 years). A subset of 16 SCA6 (included: 14) patients and 50 controls (included: 45) received an additional MRI scan at 7 Tesla and were re-scanned after one year. MRI included T1-weighted, T2-weighted FLAIR, and multi-echo T2*-weighted imaging. The T2*-weighted phase images were converted to quantitative susceptibility maps (QSM). Since the cerebellar nuclei are characterized by elevated iron content with respect to their surroundings, two independent raters manually outlined them on the susceptibility maps. T1-weighted images acquired at 3T were utilized to automatically identify the cerebellar gray matter (GM) volume. Linear correlations revealed significant atrophy of the cerebellum due to tissue loss of cerebellar cortical GM in healthy controls with increasing age. Reduction of the cerebellar GM was substantially stronger in SCA6 patients. The volume of the dentate nuclei did not exhibit a significant relationship with age, at least in the age range between 18 and 78 years, whereas mean susceptibilities of the dentate nuclei increased with age. As previously shown, the dentate nuclei volumes were smaller and magnetic susceptibilities were lower in SCA6 patients compared to age- and sex-matched controls. The significant dentate volume loss in SCA6 patients could also be confirmed with 7T MRI. Linear mixed effects models and individual paired t-tests accounting for multiple comparisons revealed no statistical significant change in volume and susceptibility of the dentate nuclei after one year in neither patients nor controls. Importantly, dentate volumes were more sensitive to differentiate between SCA6 (Cohen's d = 3.02) and matched controls than the cerebellar cortex volume (d = 2.04). In addition to age-related decline of the cerebellar cortex and atrophy in SCA6 patients, age-related increase of susceptibility of the dentate nuclei was found in controls, whereas dentate volume and susceptibility was significantly decreased in SCA6 patients. Because no significant changes of any of these parameters was found at follow-up, these measures do not allow to monitor disease progression at short intervals.

Whole-brain dynamics of human sensorimotor adaptation

Humans vary greatly in their motor learning abilities, yet little is known about the neural processes that underlie this variability. We identified distinct profiles of human sensorimotor adaptation that emerged across 2 days of learning, linking these profiles to the dynamics of whole-brain functional networks early on the first day when cognitive strategies toward sensorimotor adaptation are believed to be most prominent. During early learning, greater recruitment of a network of higher-order brain regions, involving prefrontal and anterior temporal cortex, was associated with faster learning. At the same time, greater integration of this "cognitive network" with a sensorimotor network was associated with slower learning, consistent with the notion that cognitive strategies toward adaptation operate in parallel with implicit learning processes of the sensorimotor system. On the second day, greater recruitment of a network that included the hippocampus was associated with faster learning, consistent with the notion that declarative memory systems are involved with fast relearning of sensorimotor mappings. Together, these findings provide novel evidence for the role of higher-order brain systems in driving variability in adaptation.

Learning vs. minding: How subjective costs can mask motor learning

When learning new movements some people make larger kinematic errors than others, interpreted as a reduction in motor-learning ability. Consider a learning task where error-cancelling strategies incur higher effort costs, specifically where subjects reach to targets in a force field. Concluding that those with greater error have learned less has a critical assumption: everyone uses the same error-canceling strategy. Alternatively, it could be that those with greater error may be choosing to sacrifice error reduction in favor of a lower effort movement. Here, we test this hypothesis in a dataset that includes both younger and older adults, where older adults exhibited greater kinematic errors. Utilizing the framework of optimal control theory, we infer subjective costs (i.e., strategies) and internal model accuracy (i.e., proportion of the novel dynamics learned) by fitting a model to each population's trajectory data. Our results demonstrate trajectories are defined by a combination of the amount learned and strategic differences represented by relative cost weights. Based on the model fits, younger adults could have learned between 65-90% of the novel dynamics. Critically, older adults could have learned between 60-85%. Each model fit produces trajectories that match the experimentally observed data, where a lower proportion learned in the model is compensated for by increasing costs on kinematic errors relative to effort. This suggests older and younger adults could be learning to the same extent, but older adults have a higher relative cost on effort compared to younger adults. These results call into question the proposition that older adults learn less than younger adults and provide a potential explanation for the equivocal findings in the literature. Importantly, our findings suggest that the metrics commonly used to probe motor learning paint an incomplete picture, and that to accurately quantify the learning process the subjective costs of movements should be considered.

Testing and evaluation of lower limb prosthesis prototypes in people with a transfemoral amputation: a scoping review on research protocols

BACKGROUND

When developing new lower limb prostheses, prototypes are tested to obtain insights into the performance. However, large variations between research protocols may complicate establishing the potential added value of newly developed prototypes over other prostheses.

OBJECTIVE

This review aims at identifying participant characteristics, research protocols, reference values, aims, and corresponding outcome measures used during prosthesis prototype testing on people with a transfemoral amputation.

METHODS

A systematic search was done on PubMed and Scopus from 2000 to December 2020. Articles were included if testing was done on adults with transfemoral or knee disarticulation amputation; testing involved walking with a non-commercially available prototype leg prosthesis consisting of at least a knee component; and included evaluations of the participants' functioning with the prosthesis prototype.

RESULTS

From the initial search of 2027 articles, 48 articles were included in this review. 20 studies were single-subject studies and 4 studies included a cohort of 10 or more persons with a transfemoral amputation. Only 5 articles reported all the pre-defined participant characteristics that were deemed relevant. The familiarization time with the prosthesis prototype prior to testing ranged from 5 to 10 min to 3 months; in 25% of the articles did not mention the extent of the familiarization period. Mobility was most often mentioned as the development or testing aim. A total of 270 outcome measures were identified, kinetic/kinematic gait parameters were most often reported. The majority of outcome measures corresponded to the mobility aim. For 48% of the stated development aims and 4% of the testing aims, no corresponding outcome measure could be assigned. Results indicated large inconsistencies in research protocols and outcome measures used to validate pre-determined aims.

CONCLUSIONS

The large variation in prosthesis prototype testing and reporting calls for the development of a core set of reported participant characteristics, testing protocols, and specific and well-founded outcome measures, tailored to the various aims and development phases. The use of such a core set can give greater insights into progress of developments and determine which developments have additional benefits over the state-of-the-art. This review may contribute as initial input towards the development of such a core set.

Rey-Osterrieth complex figure recall scores and motor skill learning in older adults: A non-linear mixed effect model-based analysis

Age-related declines in motor learning are well documented. Visuospatial memory has been proposed as a key factor explaining age-related declines in sensorimotor adaptation, but most studies have not used standardized visuospatial memory tests nor controlled for age-related visuospatial memory declines. The present study explores the relationship between visuospatial memory and motor learning in older adults while also controlling for age and utilizing a standardized visuospatial memory test. Forty-nine nondemented older adults repetitively practiced a functional upper-extremity motor task and were re-assessed one week later. Training data were modeled with mixed-effect exponential decay functions, with parameters representing amount of performance change, rate of improvement, and final performance. Age and visuospatial memory were included as possible covariates for the parameter measuring rate of improvement (τ). After controlling for age, higher visuospatial memory scores were associated with faster rates of skill acquisition and better short-term retention one week later. These associations with visuospatial memory were dependent, however, on the level of initial skill. These findings suggest that the extent of re-learning motor skills in geriatric physical rehabilitation may depend on intact visuospatial memory.

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.

Personalized practice dosages may improve motor learning in older adults compared to "standard of care" practice dosages: A randomized controlled trial

Standard dosages of motor practice in clinical physical rehabilitation are insufficient to optimize motor learning, particularly for older patients who often learn at a slower rate than younger patients. Personalized practice dosing (i.e., practicing a task to or beyond one's plateau in performance) may provide a clinically feasible method for determining a dose of practice that is both standardized and individualized, and may improve motor learning. The purpose of this study was to investigate whether personalized practice dosages [practice to plateau (PtP) and overpractice (OVP)] improve retention and transfer of a motor task, compared to low dose [LD] practice that mimics standard clinical dosages. In this pilot randomized controlled trial (NCT02898701, ClinicalTrials.gov), community-dwelling older adults (n = 41, 25 female, mean age 68.9 years) with a range of balance ability performed a standing serial reaction time task in which they stepped to specific targets. Presented stimuli included random sequences and a blinded repeating sequence. Participants were randomly assigned to one of three groups: LD (n = 15, 6 practice trials equaling 144 steps), PtP (n = 14, practice until reaching an estimated personal plateau in performance), or OVP (n = 12, practice 100% more trials after reaching an estimated plateau in performance). Measures of task-specific learning (i.e., faster speed on retention tests) and transfer of learning were performed after 2-4 days of no practice. Learning of the random sequence was greater for the OVP group compared to the LD group (p = 0.020). The OVP (p = 0.004) and PtP (p = 0.010) groups learned the repeated sequence more than the LD group, although the number of practice trials across groups more strongly predicted learning (p = 0.020) than did group assignment (OVP vs. PtP, p = 0.270). No group effect was observed for transfer, although significant transfer was observed in this study as a whole (p < 0.001). Overall, high and personalized dosages of postural training were well-tolerated by older adults, suggesting that this approach is clinically feasible. Practicing well-beyond standard dosages also improved motor learning. Further research should determine the clinical benefit of this personalized approach, and if one of the personalized approaches (PtP vs. OVP) is more beneficial than the other for older patients.

Reward timing matters in motor learning

Reward timing, that is, the delay after which reward is delivered following an action is known to strongly influence reinforcement learning. Here, we asked if reward timing could also modulate how people learn and consolidate new motor skills. In 60 healthy participants, we found that delaying reward delivery by a few seconds influenced motor learning. Indeed, training with a short reward delay (1 s) induced continuous improvements in performance, whereas a long reward delay (6 s) led to initially high learning rates that were followed by an early plateau in the learning curve and a lower performance at the end of training. Participants who learned the skill with a long reward delay also exhibited reduced overnight memory consolidation. Overall, our data show that reward timing affects the dynamics and consolidation of motor learning, a finding that could be exploited in future rehabilitation programs.

Random Practice Enhances Retention and Spatial Transfer in Force Field Adaptation

The contextual-interference effect is a frequently examined phenomenon in motor skill learning but has not been extensively investigated in motor adaptation. Here, we first tested experimentally if the contextual-interference effect is detectable in force field adaptation regarding retention and spatial transfer, and then fitted state-space models to the data to relate the findings to the “forgetting-and-reconstruction hypothesis”. Thirty-two participants were divided into two groups with either a random or a blocked practice schedule. They practiced reaching to four targets and were tested 10 min and 24 h afterward for motor retention and spatial transfer on an interpolation and an extrapolation target, and on targets which were shifted 10 cm away. The adaptation progress was participant-specifically fitted with 4-slow-1-fast state-space models accounting for generalization and set breaks. The blocked group adapted faster (p = 0.007) but did not reach a better adaptation at practice end. We found better retention (10 min), interpolation transfer (10 min), and transfer to shifted targets (10 min and 24 h) for the random group (each p < 0.05). However, no differences were found for retention or for the interpolation target after 24 h. Neither group showed transfer to the extrapolation target. The extended state-space model could replicate the behavioral results with some exceptions. The study shows that the contextual-interference effect is partially detectable in practice, short-term retention, and spatial transfer in force field adaptation; and that state-space models provide explanatory descriptions for the contextual-interference effect in force field adaptation.

Perception and control: individual difference in the sense of agency is associated with learnability in sensorimotor adaptation

Adaptive motor learning refers to the ability to adjust to novel disturbances in the environment as a way of minimizing sensorimotor errors. It is known that such processes show large individual differences and are linked to multiple perceptual and cognitive processes. On the other hand, the sense of agency refers to the subjective feeling of control during voluntary motor control. Is the sense of agency just a by-product of the control outcome, or is it actually important for motor control and learning? To answer this question, this study takes an approach based on individual differences to investigate the relationship between the sense of agency and learnability in sensorimotor adaptation. Specifically, we use an adaptive motor learning task to measure individual differences in the efficiency of motor learning. Regarding the sense of agency, we measure the perceptual sensitivity of detecting an increase or a decrease in control when the actual level of control gradually increases or decreases, respectively. The results of structure equation modelling reveal a significant influence of perceptual sensitivity to increased control on motor learning efficiency. On the other hand, the link between perceptual sensitivity to decreased control and motor learning is nonsignificant. The results show that the sense of agency in detecting increased control is associated with the actual ability of sensorimotor adaptation: people who are more sensitive in detecting their control in the environment can also more quickly adjust their behaviors to novel disturbances to acquire better control, compared to people who have a less sensitive sense of agency. Finally, the results also reveal that the processes of increasing control and decreasing control may be partially independent.

Cognition and motor learning in a Parkinson's disease cohort: importance of recall in episodic memory

Impaired motor learning in individuals with Parkinson's disease is often attributed to deficits in executive function, which serves as an important cognitive process supporting motor learning. However, less is known about the role of other cognitive domains and its association with motor learning in Parkinson's disease. The objective of this study was to investigate the associations between motor learning and multiple domains of cognitive performance in individuals with Parkinson's disease. Twenty-nine participants with Parkinson's disease received comprehensive neuropsychological testing, followed by practice of a bimanual finger sequence task. A retention test of the finger sequence task was completed 24 h later. Hierarchical linear regressions were used to examine the associations between motor learning (acquisition rate and retention) and cognitive performance in five specific cognitive domains, while controlling for age, sex, and years of Parkinson's disease diagnosis. We found that a higher acquisition rate was associated with better episodic memory, specifically better recall in visual episodic memory, in individuals with Parkinson's disease. No significant associations were observed between retention and cognitive performance in any domains. The association between motor acquisition and episodic memory indicates an increased dependency on episodic memory as a potential compensatory cognitive strategy used by individuals with Parkinson's disease during motor learning.

Normal Aging Affects the Short-Term Temporal Stability of Implicit, But Not Explicit, Motor Learning following Visuomotor Adaptation

Normal aging is associated with a decline in memory and motor learning ability. However, the exact form of these impairments (e.g., the short-term temporal stability and affected learning mechanisms) is largely unknown. Here, we used a sensorimotor adaptation task to examine changes in the temporal stability of two forms of learning (explicit and implicit) because of normal aging. Healthy young subjects (age range, 19–28 years; 20 individuals) and older human subjects (age range, 63–85 years; 19 individuals) made reaching movements in response to altered visual feedback. On each trial, subjects turned a rotation dial to select an explicit aiming direction. Once selected, the display was removed and subjects moved the cursor from the start position to the target. After initial training with the rotational feedback perturbation, subjects completed a series of probe trials at different delay periods to systematically assess the short-term retention of learning. For both groups, the explicit aiming showed no significant decrease over 1.5 min. However, this was not the case for implicit learning; the decay pattern was markedly different between groups. Older subjects showed a linear decrease of the implicit component of adaptation over time, while young subjects showed an exponential decay over the same period (time constant, 25.61 s). Although older subjects adapted at a similar rate, these results suggest natural aging selectively impacts the short-term (seconds to minutes) temporal stability of implicit motor learning mechanisms. This understanding may provide a means to dissociate natural aging memory impairments from deficits caused by brain disorders that progress with aging.

Measuring age differences in executive control using rapid motor decisions in a robotic object hit and avoid task

Age-related declines in executive control are commonly assessed with neuropsychological tests that also rely on sensory and motor processes that are not typically measured in those tasks. It is therefore difficult to isolate the cognitive contributions from sensorimotor contributions to performance impairments. Rapid motor decision-making tasks may also be sensitive to age differences in executive control but allow for the measurement of sensorimotor contributors to task performance. Recently developed object hit (OH) and object hit and avoid (OHA) tasks using a robotic manipulandum are sensitive to motor and cognitive aspects of performance in stroke and Parkinson's disease. However, the impact of healthy aging, and the specific cognitive mechanisms involved in these tasks has not been assessed. We administered the OH and OHA tasks to 77 younger and 59 healthy older adults to evaluate the relative age differences in the perceptual-motor/sensory, movement coordination, and cognitive measures of performance. The Trail Making Test (TMT) Parts A and B were administered to assess the extent to which the cognitive contributors to OHA task performance are associated with executive functioning. After controlling for hand movement speed, age differences were largest for cognitive measures, with smaller differences in perceptual-motor speed and sensory measures, and little differences in bimanual and spatial coordination measures of performance. The cognitive measures were associated with executive functioning measures from the TMT task. These findings provide evidence that rapid motor decision-making tasks are sensitive to age differences in executive control and can isolate the cognitive from the sensorimotor contributions to task performance. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Adaptive control of movement deceleration during saccades

As you read this text, your eyes make saccades that guide your fovea from one word to the next. Accuracy of these movements require the brain to monitor and learn from visual errors. A current model suggests that learning is supported by two different adaptive processes, one fast (high error sensitivity, low retention), and the other slow (low error sensitivity, high retention). Here, we searched for signatures of these hypothesized processes and found that following experience of a visual error, there was an adaptive change in the motor commands of the subsequent saccade. Surprisingly, this adaptation was not uniformly expressed throughout the movement. Rather, after experience of a single error, the adaptive response in the subsequent trial was limited to the deceleration period. After repeated exposure to the same error, the acceleration period commands also adapted, and exhibited resistance to forgetting during set-breaks. In contrast, the deceleration period commands adapted more rapidly, but suffered from poor retention during these same breaks. State-space models suggested that acceleration and deceleration periods were supported by a shared adaptive state which re-aimed the saccade, as well as two separate processes which resembled a two-state model: one that learned slowly and contributed primarily via acceleration period commands, and another that learned rapidly but contributed primarily via deceleration period commands.

Cognitive and Motor Perseveration Are Associated in Older Adults

Aging causes perseveration (difficulty to switch between actions) in motor and cognitive tasks, suggesting that the same neural processes could govern these abilities in older adults. To test this, we evaluated the relation between independently measured motor and cognitive perseveration in young (21.4 ± 3.7 y/o) and older participants (76.5 ± 2.9 y/o). Motor perseveration was measured with a locomotor task in which participants had to transition between distinct walking patterns. Cognitive perseveration was measured with a card matching task in which participants had to switch between distinct matching rules. We found that perseveration in the cognitive and motor domains were positively related in older, but not younger individuals, such that participants exhibiting greater perseveration in the motor task also perseverated more in the cognitive task. Additionally, exposure reduces motor perseveration: older adults who had practiced the motor task could transition between walking patterns as proficiently as naïve, young individuals. Our results suggest an overlap in neural processes governing cognitive and motor perseveration with aging and that exposure can counteract the age-related motor perseveration.

Examining modifications of execution strategies during a continuous task

How strategies are formulated during a performance is an important aspect of motor control. Knowledge of the strategy employed in a task may help subjects achieve better performances, as it would help to evidence other possible strategies that could be used as well as help perfect a certain strategy. We sought to investigate how much of a performance is conditioned by the initial state and whether behavior throughout the performance is modified within a short timescale. In other words, we focus on the process of execution and not on the outcome. To this scope we used a repeated continuous circle tracing task. Performances were decomposed into different components (i.e., execution variables) whose combination is able to numerically determine movement outcome. By identifying execution variables of speed and duration, we created an execution space and a solution manifold (i.e., combinations of execution variables yielding zero discrepancy from the desired outcome) and divided the subjects according to their initial performance in that space into speed preference, duration preference, and no-preference groups. We demonstrated that specific strategies may be identified in a continuous task, and strategies remain relatively stable throughout the performance. Moreover, as performances remained stable, the initial location in the execution space can be used to determine the subject’s strategy. Finally, contrary to other studies, we demonstrated that, in a continuous task, performances were associated with reduced exploration of the execution space.

Cerebellar contribution to sensorimotor adaptation deficits in humans with spinal cord injury

Humans with spinal cord injury (SCI) show deficits in associating motor commands and sensory feedback. Do these deficits affect their ability to adapt movements to new demands? To address this question, we used a robotic exoskeleton to examine learning of a sensorimotor adaptation task during reaching movements by distorting the relationship between hand movement and visual feedback in 22 individuals with chronic incomplete cervical SCI and 22 age-matched control subjects. We found that SCI individuals showed a reduced ability to learn from movement errors compared with control subjects. Sensorimotor areas in anterior and posterior cerebellar lobules contribute to learning of movement errors in intact humans. Structural brain imaging showed that sensorimotor areas in the cerebellum, including lobules I-VI, were reduced in size in SCI compared with control subjects and cerebellar atrophy increased with increasing time post injury. Notably, the degree of spared tissue in the cerebellum was positively correlated with learning rates, indicating participants with lesser atrophy showed higher learning rates. These results suggest that the reduced ability to learn from movement errors during reaching movements in humans with SCI involves abnormalities in the spinocerebellar structures. We argue that this information might help in the rehabilitation of people with SCI.

How aging affects visuomotor adaptation and retention in a precision walking paradigm

Motor learning is a lifelong process. However, age-related changes to musculoskeletal and sensory systems alter the relationship (or mapping) between sensory input and motor output, and thus potentially affect motor learning. Here we asked whether age affects the ability to adapt to and retain a novel visuomotor mapping learned during overground walking. We divided participants into one of three groups (n = 12 each) based on chronological age: a younger-aged group (20–39 years old); a middle-aged group (40–59 years old); and an older-aged group (60–80 years old). Participants learned a new visuomotor mapping, induced by prism lenses, during a precision walking task. We assessed retention one-week later. We did not detect significant effects of age on measures of adaptation or savings (defined as faster relearning). However, we found that older adults demonstrated reduced initial recall of the mapping, reflected by greater foot-placement error during the first adaptation trial one-week later. Additionally, we found that increased age significantly associated with reduced initial recall. Overall, our results suggest that aging does not impair adaptation and that older adults can demonstrate visuomotor savings. However, older adults require some initial context during relearning to recall the appropriate mapping.

Use of explicit processes during a visually guided locomotor learning task predicts 24-h retention after stroke

Implicit and explicit processes can occur within a single locomotor learning task. The combination of these learning processes may impact how individuals acquire/retain the task. Because these learning processes rely on distinct neural pathways, neurological conditions may selectively impact the processes that occur, thus, impacting learning and retention. Thus, our purpose was to examine the contribution of implicit and explicit processes during a visually guided walking task and characterize the relationship between explicit processes and performance/retention in stroke survivors and age-matched healthy adults. Twenty chronic stroke survivors and twenty healthy adults participated in a 2-day treadmill study. Day 1 included baseline, acquisition1, catch, acquisition2, and immediate retention phases, and day 2 included 24-h retention. During acquisition phases, subjects learned to take a longer step with one leg through distorted visual feedback. During catch and retention phases, visual feedback was removed and subjects were instructed to walk normally (catch) or how they walked during the acquisition phases (retention). Change in step length from baseline to catch represented implicit processes. Change in step length from catch to the end of acquisition2 represented explicit processes. A mixed ANOVA found no difference in the type of learning between groups (P = 0.74). There was a significant relationship between explicit processes and 24-h retention in stroke survivors (r = 0.47, P = 0.04) but not in healthy adults (r = 0.34, P = 0.15). These results suggest that stroke may not affect the underlying learning mechanisms used during locomotor learning, but that these mechanisms impact how well stroke survivors retain the new walking pattern.NEW & NOTEWORTHY This study found that stroke survivors used implicit and explicit processes similar to age-matched healthy adults during a visually guided locomotion learning task. The amount of explicit processes was related to how well stroke survivors retained the new walking pattern but not to how well they performed during the task. This work illustrates the importance of understanding the underlying learning mechanisms to maximize retention of a newly learned motor behavior.

Adaptation of reach action to a novel force-field is not predicted by acuity of dynamic proprioception in either older or younger adults

Healthy ageing involves degeneration of the neuromuscular system which impacts movement control and proprioception. Yet the relationship between these sensory and motor deficits in upper limb reaching has not been examined in detail. Recently, we reported that age-related proprioceptive deficits were unrelated to accuracy in rapid arm movements, but whether this applied in motor tasks more heavily dependent on proprioceptive feedback was not clear. To address this, we have tested groups of younger and older adults on a force-field adaptation task under either full or limited visual feedback conditions and examined how performance was related to dynamic proprioceptive acuity. Adaptive performance was similar between the age groups, regardless of visual feedback condition, although older adults showed increased after-effects. Physically inactive individuals made larger systematic (but not variable) proprioceptive errors, irrespective of age. However, dynamic proprioceptive acuity was unrelated to adaptation and there was no consistent evidence of proprioceptive recalibration with adaptation to the force-field for any group. Finally, in spite of clear age-dependent loss of spatial working memory capacity, we found no relationship between memory capacity and adaptive performance or proprioceptive acuity. Thus, non-clinical levels of deficit in dynamic proprioception, due to age or physical inactivity, do not affect force-field adaptation, even under conditions of limited visual feedback that might require greater proprioceptive control.

Single versus dual-rate learning when exposed to Coriolis forces during reaching movements

When we reach for an object during a passive whole body rotation, a tangential Coriolis force is generated on the arm. Yet, within a few trials, the brain adapts to this force so it does not disrupt the reach. Is this adaptation governed by a single-rate or dual-rate learning process? Here, guided by state-space modeling, we studied human reach adaptation in a fully-enclosed rotating room. After 90 pre-rotation reaches (baseline), participants were trained to make 240 to-and-fro reaches while the room rotated at 10 rpm (block A), then performed 6 reaches under opposite room rotation (block B), and subsequently made 100 post-rotation reaches (washout). A control group performed the same paradigm, but without the reaches during rotation block B. Single-rate and dual-rate models can be best dissociated if there would be full un-learning of compensation A during block B, but minimal learning of B. From the perspective of a dual-rate model, the un-learning observed in block B would mainly be caused by the faster state, such that the washout reaches would show retention effects of the slower state, called spontaneous recovery. Alternatively, following a single-rate model, the same state would govern the learning in block A and un-learning in block B, such that the washout reaches mimic the baseline reaches. Our results do not provide clear signs of spontaneous recovery in the washout reaches. Model fits further show that a single-rate process outperformed a dual-rate process. We suggest that a single-rate process underlies Coriolis force reach adaptation, perhaps because these forces relate to familiar body dynamics and are assigned to an internal cause.

The effect of age on visuomotor learning processes

Knowing where our limbs are in space is essential for moving and for adapting movements to various changes in our environments and bodies. The ability to adapt movements declines with age, and age-related cognitive decline can explain a decreased ability to adopt and deploy explicit, cognitive strategies in motor learning. Age-related sensory decline could also lead to a reduced fidelity of sensory position signals and error signals, each of which can affect implicit motor adaptation. Here we investigate two estimates of limb position; one based on proprioception, the other on predicted sensory consequences of movements. Each is considered a measure of an implicit adaptation process and may be affected by both age and cognitive strategies. Both older (n = 38) and younger (n = 42) adults adapted to a 30° visuomotor rotation in a centre-out reaching task. We make an explicit, cognitive strategy available to half of participants in each age group with a detailed instruction. After training, we first quantify the explicit learning elicited by instruction. Instructed older adults initially use the provided strategy slightly less than younger adults but show a similar ability to evoke it after training. This indicates that cognitive explanations for age-related decline in motor learning are limited. In contrast, training induced much larger shifts of state estimates of hand location in older adults compared to younger adults. This is not modulated by strategy instructions, and appears driven by recalibrated proprioception, which is almost twice as large in older adults, while predictions might not be updated in older adults. This means that in healthy aging, some implicit processes may be compensating for other changes to maintain motor capabilities, while others also show age-related decline (data: https://osf.io/qzhmy).

Motor memories in manipulation tasks are linked to contact goals between objects

Skillful manipulation requires forming memories of object dynamics, linking applied force to motion. Although it has been assumed that such memories are linked to objects, a recent study showed that people can form separate memories when these are linked to different controlled points on an object (Heald JB, Ingram JN, Flanagan JR, Wolpert DM. Nat Hum Behav 2: 300-311, 2018). In that study, participants controlled the handle of a robotic device to move a virtual bar with circles (control points) on the left and right sides. Participants were instructed to move either the left or right control point to a target on the left or right, respectively, such that the required movement was constant. When these control points were paired with opposing force fields, adaptation was observed. In this previous study, both the controlled point and the target changed between contexts. To assess which of these factors is critical for learning, here, we used a similar paradigm but with a bar that automatically rotated as it was moved. In the first experiment, the bar rotated, such that the left and right control points moved to a common target. In the second experiment, the bar rotated such that a single control point moved to a target located on either the left or right. In both experiments, participants were able to learn opposing force fields applied in the two contexts. We conclude that separate memories of dynamics can be formed for different "contact goals," involving a unique combination of the controlled point on an object and the target location this point "contacts."NEW & NOTEWORTHY Skilled manipulation requires forming memories of object dynamics, previously assumed to be associated with entire objects. However, we recently demonstrated that people can form multiple motor memories when explicitly instructed to move different locations on an object to different targets. Here, we show that separate motor memories can be learned for different contact goals, which involve a unique combination of a control point and target.

Age-related reduction in motor adaptation: brain structural correlates and the role of explicit memory

The adaption of movement to changes in the environment varies across life span. Recent evidence has linked motor adaptation and its reduction with age to differences in "explicit" learning processes. We examine differences in brain structure and cognition underlying motor adaptation in a population-based cohort (n = 322, aged 18-89 years) using a visuomotor learning task and structural magnetic resonance imaging. Reduced motor adaptation with age was associated with reduced volume in striatum, prefrontal, and sensorimotor cortical regions, but not cerebellum. Medial temporal lobe volume, including the hippocampus, became a stronger determinant of motor adaptation with age. Consistent with the role of the medial temporal lobes, declarative long-term memory showed a similar interaction, whereby memory was more positively correlated with motor adaptation with increasing age. By contrast, visual short-term memory was related to motor adaptation, independently of age. These results support the hypothesis that cerebellar learning is largely unaffected in old age, and the reduction in motor adaptation with age is driven by a decline in explicit memory systems.

A general theory of consciousness I: Consciousness and adaptation

This paper examines how cognitive processes in living beings become conscious. Consciousness is often assumed to be a human quality only. While the basis of this paper is that consciousness is as much present in animals as it is in humans, the human form is shown to be fundamentally different. Animal consciousness expresses itself in sensory images, while human consciousness is largely verbal. Because spoken language is not an individual quality - thoughts are shared with others via communication - consciousness in humans is complex and difficult to understand. The theory proposed postulates that consciousness is an inseparable part of the body's adaptation mechanism. In adaptation to a new environmental disturbance, the outcome of the neural cognitive process - a possible solution to the problem posed by the disturbance - is transformed into a sensory image. Sensory images are essentially conscious as they are the way living creatures experience new environmental information. Through the conversion of neural cognitive activity - thoughts - about the state of the outside world into the way that world is experienced through the senses, the thoughts gain the reality that sensory images have. The translation of thoughts into sensory images makes them real and understandable which is experienced as consciousness. The theory proposed in this paper is corroborated by functional block diagrams of the processes involved in the complex regulated mechanism of adaptation and consciousness during an environmental disturbance. All functions in this mechanism and their interrelations are discussed in detail.

Age effects on sensorimotor predictions: What drives increased tactile suppression during reaching?

Tactile suppression refers to the phenomenon that tactile signals are attenuated during movement planning and execution when presented on a moving limb compared to rest. It is usually explained in the context of the forward model of movement control that predicts the sensory consequences of an action. Recent research suggests that aging increases reliance on sensorimotor predictions resulting in stronger somatosensory suppression. However, the mechanisms contributing to this age effect remain to be clarified. We measured age-related differences in tactile suppression during reaching and investigated the modulation by cognitive processes. A total of 23 younger (18-27 years) and 26 older (59-78 years) adults participated in our study. We found robust suppression of tactile signals when executing reaching movements. Age group differences corroborated stronger suppression in old age. Cognitive task demands during reaching, although overall boosting suppression effects, did not modulate the age effect. Across age groups, stronger suppression was associated with lower individual executive capacities. There was no evidence that baseline sensitivity had a prominent impact on the magnitude of suppression. We conclude that aging alters the weighting of sensory signals and sensorimotor predictions during movement control. Our findings suggest that individual differences in tactile suppression are critically driven by executive functions.

Advanced spatial knowledge of target location eliminates age-related differences in early sensorimotor learning

Motor learning has been shown to decline in healthy aging, particularly in the early stages of acquisition. There is now ample evidence that motor learning relies on multiple interacting learning processes that operate on different timescales, but the specific cognitive mechanisms that contribute to motor learning remain unclear. Working memory resources appear to be particularly important during the early stages of motor learning, and declines in early motor learning have been associated with working memory performance in older adults. We examined whether age differences in the early stages of motor learning could be reduced or eliminated by reducing the spatial working memory demands during a force-field adaptation task. Groups of younger and older adults made center-out reaching movements to spatial targets either in a repeating four-element sequence, or in a random order. Participants also performed a battery of cognitive tests to further investigate the potential involvement of associative memory, spatial working memory, and procedural learning mechanisms in the early stage of motor learning. Although all groups adapted their movements equally well by the end of the learning phase, older adults only adapted as quickly as younger adults in the sequence condition, with the older adults in the random group exhibiting slower learning in the earliest stage of motor learning. Across all participants, early motor learning performance was correlated with recognition memory performance on an associative memory test. Within the younger random group, who were able to adapt as quickly as the sequence groups, early motor learning performance was also correlated with performance on a test of procedural learning. These findings suggest that age differences in early stages of motor learning can be eliminated if the spatial working memory demands involved in a motor learning task are limited. Moreover, the results suggest that multiple cognitive resources may be utilized during the early stage of learning, and younger adults may be more flexible than older adults in the recruitment of additional cognitive resources to support learning when spatial working memory demands are high.

Both fast and slow learning processes contribute to savings following sensorimotor adaptation

Recent work suggests that the rate of learning in sensorimotor adaptation is likely not fixed, but rather can change based on previous experience. One example is savings, a commonly observed phenomenon whereby the relearning of a motor skill is faster than the initial learning. Sensorimotor adaptation is thought to be driven by sensory prediction errors, which are the result of a mismatch between predicted and actual sensory consequences. It has been proposed that during motor adaptation the generation of sensory prediction errors engages two processes (fast and slow) that differ in learning and retention rates. We tested the idea that a history of errors would influence both the fast and slow processes during savings. Participants were asked to perform the same force field adaptation task twice in succession. We found that adaptation to the force field a second time led to increases in estimated learning rates for both fast and slow processes. While it has been proposed that savings is explained by an increase in learning rate for the fast process, here we observed that the slow process also contributes to savings. Our work suggests that fast and slow adaptation processes are both responsive to a history of error and both contribute to savings. NEW & NOTEWORTHY We studied the underlying mechanisms of savings during motor adaptation. Using a two-state model to represent fast and slow processes that contribute to motor adaptation, we found that a history of error modulates performance in both processes. While previous research has attributed savings to only changes in the fast process, we demonstrated that an increase in both processes is needed to account for the measured behavioral data.

Can patients with cerebellar disease switch learning mechanisms to reduce their adaptation deficits?

Systematic perturbations in motor adaptation tasks are primarily countered by learning from sensory-prediction errors, with secondary contributions from other learning processes. Despite the availability of these additional processes, particularly the use of explicit re-aiming to counteract observed target errors, patients with cerebellar degeneration are surprisingly unable to compensate for their sensory-prediction error deficits by spontaneously switching to another learning mechanism. We hypothesized that if the nature of the task was changed-by allowing vision of the hand, which eliminates sensory-prediction errors-patients could be induced to preferentially adopt aiming strategies to solve visuomotor rotations. To test this, we first developed a novel visuomotor rotation paradigm that provides participants with vision of their hand in addition to the cursor, effectively setting the sensory-prediction error signal to zero. We demonstrated in younger healthy control subjects that this promotes a switch to strategic re-aiming based on target errors. We then showed that with vision of the hand, patients with cerebellar degeneration could also switch to an aiming strategy in response to visuomotor rotations, performing similarly to age-matched participants (older controls). Moreover, patients could retrieve their learned aiming solution after vision of the hand was removed (although they could not improve beyond what they retrieved), and retain it for at least 1 year. Both patients and older controls, however, exhibited impaired overall adaptation performance compared to younger healthy controls (age 18-33 years), likely due to age-related reductions in spatial and working memory. Patients also failed to generalize, i.e. they were unable to adopt analogous aiming strategies in response to novel rotations. Hence, there appears to be an inescapable obligatory dependence on sensory-prediction error-based learning-even when this system is impaired in patients with cerebellar disease. The persistence of sensory-prediction error-based learning effectively suppresses a switch to target error-based learning, which perhaps explains the unexpectedly poor performance by patients with cerebellar degeneration in visuomotor adaptation tasks.

Proprioceptive deficits in inactive older adults are not reflected in fast targeted reaching movements

During normal healthy ageing there is a decline in the ability to control simple movements, characterised by increased reaction times, movement durations and variability. There is also growing evidence of age-related proprioceptive loss which may contribute to these impairments. However, this relationship has not been studied in detail for the upper limb. We recruited 20 younger adults (YAs) and 31 older adults (OAs) who each performed 2 tasks on a 2D robotic manipulandum. The first assessed dynamic proprioceptive acuity using active, multi-joint movements constrained by the robot to a pre-defined path. Participants made perceptual judgements of the lateral position of the unseen arm. The second task required fast, accurate and discrete movements to the same targets in the absence of visual feedback of the hand, and without robotic intervention. We predicted that the variable proprioceptive error (uncertainty range) assessed in Task 1 would be increased in physically inactive OAs and would predict increased movement variability in Task 2. Instead we found that physically inactive OAs had larger systematic proprioceptive errors (bias) than YAs (t[33] = 2.8, p = 0.009), and neither proprioceptive uncertainty nor bias was related to motor performance in either age group (all regression model R2 ≤ 0.06). We suggest that previously reported estimates of proprioceptive decline with ageing may be exaggerated by task demands and that the extent of these deficits is unrelated to control of discrete, rapid movement. The relationship between dynamic proprioceptive acuity and movement control in other tasks with greater emphasis on online feedback is still unclear and warrants further investigation.

Separate motor memories are formed when controlling different implicitly specified locations on a tool

Skillful manipulation requires forming and recalling memories of the dynamics of objects linking applied force to motion. It has been assumed that such memories are associated with entire objects. However, we often control different locations on an object, and these locations may be associated with different dynamics. We have previously demonstrated that multiple memories can be formed when participants are explicitly instructed to control different visual points marked on an object. A key question is whether this novel finding generalizes to more natural situations in which control points are implicitly defined by the task. To answer this question, we used objects with no explicit control points and tasks designed to encourage the use of distinct implicit control points. Participants moved a handle, attached to a robotic interface, to control the position of a rectangular object ("eraser") in the horizontal plane. Participants were required to move the eraser straight ahead to wipe away a column of dots ("dust"), located to either the left or right. We found that participants adapted to opposing dynamics when linked to the left and right dust locations, even though the movements required for these two contexts were the same. Control conditions showed this learning could not be accounted for by contextual cues or the fact that the task goal required moving in a straight line. These results suggest that people naturally control different locations on manipulated objects depending on the task context and that doing so affords the formation of separate motor memories. NEW & NOTEWORTHY Skilled manipulation requires forming motor memories of object dynamics, which have been assumed to be associated with entire objects. However, we recently demonstrated that people can form multiple memories when explicitly instructed to control different visual points on an object. In this article we show that this novel finding generalizes to more natural situations in which control points are implicitly defined by the task.

Automated functional upper limb evaluation of patients with Friedreich ataxia using serious games rehabilitation exercises

Background

Friedreich ataxia (FRDA) is a disease with neurological and systemic involvement. Clinical assessment tools commonly used for FRDA become less effective in evaluating decay in patients with advanced FRDA, particularly when they are in a wheelchair. Further motor worsening mainly impairs upper limb function. In this study, we tested if serious games (SG) developed for rehabilitation can be used as an assessment tool for upper limb function even in patients with advanced FRDA.

Methods

A specific SG has been developed for physical rehabilitation of patients suffering from neurologic diseases. The use of this SG, coupled with Kinect sensor, has been validated to perform functional evaluation of the upper limbs with healthy subjects across lifespan. Twenty-seven FRDA patients were included in the study. Patients were invited to perform upper limb rehabilitation exercises embedded in SG. Motions were recorded by the Kinect and clinically relevant parameters were extracted from the collected motions. We tested if the existence of correlations between the scores from the serious games and the severity of the disease using clinical assessment tools commonly used for FRDA. Results of patients were compared with a group a healthy subjects of similar age.

Results

Very highly significant differences were found for time required to perform the exercise (increase of 76%, t(68) = 7.22, P < 0.001) and for accuracy (decrease of 6%, t(68) = − 3.69, P < 0.001) between patients and healthy subjects. Concerning the patients significant correlations were found between age and time (R = 0.65, p = 0.015), accuracy (R = − 0.75, p = 0.004) and the total displacement of upper limbs. (R = 0.55, p = 0.031). Statistically significant correlations were found between the age of diagnosis and speed related parameters.

Conclusions

The results of this study indicate that SG reliably captures motor impairment of FRDA patients due to cerebellar and pyramidal involvement. Results also show that functional evaluation of FRDA patients can be performed during rehabilitation therapy embedded in games with the patient seated in a wheelchair.

Trial registration

The study was approved as a component of the EFACTS study (Clinicaltrials.gov identifier NCT02069509, registered May 2010) by the local institutional Ethics Committee (ref. P2010/132).

Corticospinal correlates of fast and slow adaptive processes in motor learning

Recent computational theories and behavioral observations suggest that motor learning is supported by multiple adaptation processes, operating on different timescales, but direct neural evidence is lacking. We tested this hypothesis by applying transcranial magnetic stimulation over motor cortex in 16 human subjects during a validated reach adaptation task. Motor-evoked potentials (MEPs) and cortical silent periods (CSPs) were recorded from the biceps brachii to assess modulations of corticospinal excitability as indices for corticospinal plasticity. Guided by a two-state adaptation model, we show that the MEP reflects an adaptive process that learns quickly but has poor retention, while the CSP correlates with a process that responds more slowly but retains information well. These results provide a physiological link between models of motor learning and distinct changes in corticospinal excitability. Our findings support the relationship between corticospinal gain modulations and the adaptive processes in motor learning. NEW & NOTEWORTHY Computational theories and behavioral observations suggest that motor learning is supported by multiple adaptation processes, but direct neural evidence is lacking. We tested this hypothesis by applying transcranial magnetic stimulation over human motor cortex during a reach adaptation task. Guided by a two-state adaptation model, we show that the motor-evoked potential reflects a process that adapts and decays quickly, whereas the cortical silent period reflects slow adaptation and decay.

The impact of using an upper-limb prosthesis on the perception of real and illusory weight differences

Little is known about how human perception is affected using an upper-limb prosthesis. To shed light on this topic, we investigated how using an upper-limb prosthesis affects individuals' experience of object weight. First, we examined how a group of upper-limb amputee prosthetic users experienced real mass differences and illusory weight differences in the context of the 'size-weight' illusion. Surprisingly, the upper-limb prosthetic users reported a markedly smaller illusion than controls, despite equivalent perceptions of a real mass difference. Next, we replicated this dissociation between real and illusory weight perception in a group of nonamputees who lifted the stimuli with an upper-limb myoelectric prosthetic simulator, again noting that the prosthetic users experienced illusory, but not real, weight differences as being weaker than controls. These findings not only validate the use of a prosthetic simulator as an effective tool for investigating perception and action but also highlight a surprising dissociation between the perception of real and illusory weight differences.

3D Analysis of Upper Limbs Motion during Rehabilitation Exercises Using the KinectTM Sensor: Development, Laboratory Validation and Clinical Application

Optoelectronic devices are the gold standard for 3D evaluation in clinics, but due to the complexity of this kind of hardware and the lack of access for patients, affordable, transportable, and easy-to-use systems must be developed to be largely used in daily clinics. The Kinect^TM sensor has various advantages compared to optoelectronic devices, such as its price and transportability. However, it also has some limitations: (in)accuracy of the skeleton detection and tracking as well as the limited amount of available points, which makes 3D evaluation impossible. To overcome these limitations, a novel method has been developed to perform 3D evaluation of the upper limbs. This system is coupled to rehabilitation exercises, allowing functional evaluation while performing physical rehabilitation. To validate this new approach, a two-step method was used. The first step was a laboratory validation where the results obtained with the Kinect^TM were compared with the results obtained with an optoelectronic device; 40 healthy young adults participated in this first part. The second step was to determine the clinical relevance of this kind of measurement. Results of the healthy subjects were compared with a group of 22 elderly adults and a group of 10 chronic stroke patients to determine if different patterns could be observed. The new methodology and the different steps of the validations are presented in this paper.

Greater neural responses to trajectory errors are associated with superior force field adaptation in older adults

Although age-related declines in cognitive, sensory and motor capacities are well documented, current evidence is mixed as to whether or not aging impairs sensorimotor adaptation to a novel dynamic environment. More importantly, the extent to which any deficits in sensorimotor adaptation are due to general impairments in neural plasticity, or impairments in the specific processes that drive adaptation is unclear. Here we investigated whether there are age-related differences in electrophysiological responses to reaching endpoint and trajectory errors caused by a novel force field, and whether markers of error processing relate to the ability of older adults to adapt their movements. Older and young adults (N = 24/group, both sexes) performed 600 reaches to visual targets, and received audio-visual feedback about task success or failure after each trial. A velocity-dependent curl field pushed the hand to one side during each reach. We extracted ERPs time-locked to movement onset [kinematic error-related negativity (kERN)], and the presentation of success/failure feedback [feedback error-related negativity (fERN)]. At a group level, older adults did not differ from young adults in the rate or extent of sensorimotor adaptation, but EEG responses to both trajectory errors and task errors were reduced in the older group. Most interestingly, the amplitude of the kERN correlated with the rate and extent of sensorimotor adaptation in older adults. Thus, older adults with an impaired capacity for encoding kinematic trajectory errors also have compromised abilities to adapt their movements in a novel dynamic environment.

Proprioceptive loss and the perception, control and learning of arm movements in humans: evidence from sensory neuronopathy

It is uncertain how vision and proprioception contribute to adaptation of voluntary arm movements. In normal participants, adaptation to imposed forces is possible with or without vision, suggesting that proprioception is sufficient; in participants with proprioceptive loss (PL), adaptation is possible with visual feedback, suggesting that proprioception is unnecessary. In experiment 1 adaptation to, and retention of, perturbing forces were evaluated in three chronically deafferented participants. They made rapid reaching movements to move a cursor toward a visual target, and a planar robot arm applied orthogonal velocity-dependent forces. Trial-by-trial error correction was observed in all participants. Such adaptation has been characterized with a dual-rate model: a fast process that learns quickly, but retains poorly and a slow process that learns slowly and retains well. Experiment 2 showed that the PL participants had large individual differences in learning and retention rates compared to normal controls. Experiment 3 tested participants’ perception of applied forces. With visual feedback, the PL participants could report the perturbation’s direction as well as controls; without visual feedback, thresholds were elevated. Experiment 4 showed, in healthy participants, that force direction could be estimated from head motion, at levels close to the no-vision threshold for the PL participants. Our results show that proprioceptive loss influences perception, motor control and adaptation but that proprioception from the moving limb is not essential for adaptation to, or detection of, force fields. The differences in learning and retention seen between the three deafferented participants suggest that they achieve these tasks in idiosyncratic ways after proprioceptive loss, possibly integrating visual and vestibular information with individual cognitive strategies.

How Prior Expectations Influence Older Adults’ Perception and Action During Object Interaction

The apparent size of an object can influence how we interact with and perceive the weight of objects in our environment. Little is known, however, about how this cue affects behaviour across the lifespan. Here, in the context of the size–weight illusion, we examined how visual size cues influenced the predictive application of fingertip forces and perceptions of heaviness in a group of older participants. We found that our older sample experienced a robust size–weight illusion, which did not differ from that experienced by younger participants. Older and young participants also experienced a real weight difference to a similar degree. By contrast, compared to younger participants our older group showed no evidence that size cues influenced the way they initially gripped and lifted the objects. These results highlight a unique dissociation between how perception and action diverge across the lifespan, and suggest that deficits in the ability to use prediction to guide actions might underpin some of the manual interaction difficulties experienced by the older adults.

Functional performance comparison between real and virtual tasks in older adults: A cross-sectional study

INTRODUCTION

Ageing is usually accompanied by deterioration of physical abilities, such as muscular strength, sensory sensitivity, and functional capacity, making chronic diseases, and the well-being of older adults new challenges to global public health.

OBJECTIVE

The purpose of this study was to evaluate whether a task practiced in a virtual environment could promote better performance and enable transfer to the same task in a real environment.

METHOD

The study evaluated 65 older adults of both genders, aged 60 to 82 years (M = 69.6, SD = 6.3). A timing coincident task was applied to measure the perceptual-motor ability to perform a motor response. The participants were divided into 2 groups: started in a real interface and started in a virtual interface.

RESULTS

All subjects improved their performance during the practice, but improvement was not observed for the real interface, as the participants were near maximum performance from the beginning of the task. However, there was no transfer of performance from the virtual to real environment or vice versa.

CONCLUSIONS

The virtual environment was shown to provide improvement of performance with a short-term motor learning protocol in a timing coincident task. This result suggests that the practice of tasks in a virtual environment seems to be a promising tool for the assessment and training of healthy older adults, even though there was no transfer of performance to a real environment.

TRIAL REGISTRATION

ISRCTN02960165. Registered 8 November 2016.

An error-tuned model for sensorimotor learning

Current models of sensorimotor control posit that motor commands are generated by combining multiple modules which may consist of internal models, motor primitives or motor synergies. The mechanisms which select modules based on task requirements and modify their output during learning are therefore critical to our understanding of sensorimotor control. Here we develop a novel modular architecture for multi-dimensional tasks in which a set of fixed primitives are each able to compensate for errors in a single direction in the task space. The contribution of the primitives to the motor output is determined by both top-down contextual information and bottom-up error information. We implement this model for a task in which subjects learn to manipulate a dynamic object whose orientation can vary. In the model, visual information regarding the context (the orientation of the object) allows the appropriate primitives to be engaged. This top-down module selection is implemented by a Gaussian function tuned for the visual orientation of the object. Second, each module's contribution adapts across trials in proportion to its ability to decrease the current kinematic error. Specifically, adaptation is implemented by cosine tuning of primitives to the current direction of the error, which we show to be theoretically optimal for reducing error. This error-tuned model makes two novel predictions. First, interference should occur between alternating dynamics only when the kinematic errors associated with each oppose one another. In contrast, dynamics which lead to orthogonal errors should not interfere. Second, kinematic errors alone should be sufficient to engage the appropriate modules, even in the absence of contextual information normally provided by vision. We confirm both these predictions experimentally and show that the model can also account for data from previous experiments. Our results suggest that two interacting processes account for module selection during sensorimotor control and learning.

Research in motor learning has focused on how we acquire new motor memories for novel situations. However, in many real world motor tasks, the challenge is to select appropriate memories for a given context. In such tasks, we are guided by two key types of information. First, contextual information from vision (for example) is available before we perform the task. Second, movement errors are available as we begin to perform the task. Here we present a model that provides a mechanism by which these two processes operate in parallel to enable us to tune and adapt our motor commands. We show that a model consisting of multiple simple modules, each of which can correct errors in a single direction only, can account for learning in multidimensional tasks. The model makes predictions about which tasks should interfere and how experience of errors alone without any contextual information can drive learning. We confirm these predictions in a series of experiments. The model provides a new framework for understanding the interaction between task context and error feedback during sensorimotor control and learning.

Changes in Predictive Task Switching with Age and with Cognitive Load

Predictive control of movement is more efficient than feedback-based control, and is an important skill in everyday life. We tested whether the ability to predictively control movements of the upper arm is affected by age and by cognitive load. A total of 63 participants were tested in two experiments. In both experiments participants were seated, and controlled a cursor on a computer screen by flexing and extending their dominant arm. In Experiment 1, 20 young adults and 20 older adults were asked to continuously change the frequency of their horizontal arm movements, with the goal of inducing an abrupt switch between discrete movements (at low frequencies) and rhythmic movements (at high frequencies). We tested whether that change was performed based on a feed-forward (predictive) or on a feedback (reactive) control. In Experiment 2, 23 young adults performed the same task, while being exposed to a cognitive load half of the time via a serial subtraction task. We found that both aging and cognitive load diminished, on average, the ability of participants to predictively control their movements. Five older adults and one young adult under a cognitive load were not able to perform the switch between rhythmic and discrete movement (or vice versa). In Experiment 1, 40% of the older participants were able to predictively control their movements, compared with 70% in the young group. In Experiment 2, 48% of the participants were able to predictively control their movements with a cognitively loading task, compared with 70% in the no-load condition. The ability to predictively change a motor plan in anticipation of upcoming changes may be an important component in performing everyday functions, such as safe driving and avoiding falls.

Estimating properties of the fast and slow adaptive processes during sensorimotor adaptation

Experience of a prediction error recruits multiple motor learning processes, some that learn strongly from error but have weak retention and some that learn weakly from error but exhibit strong retention. These processes are not generally observable but are inferred from their collective influence on behavior. Is there a robust way to uncover the hidden processes? A standard approach is to consider a state space model where the hidden states change following experience of error and then fit the model to the measured data by minimizing the squared error between measurement and model prediction. We found that this least-squares algorithm (LMSE) often yielded unrealistic predictions about the hidden states, possibly because of its neglect of the stochastic nature of error-based learning. We found that behavioral data during adaptation was better explained by a system in which both error-based learning and movement production were stochastic processes. To uncover the hidden states of learning, we developed a generalized expectation maximization (EM) algorithm. In simulation, we found that although LMSE tracked the measured data marginally better than EM, EM was far more accurate in unmasking the time courses and properties of the hidden states of learning. In a power analysis designed to measure the effect of an intervention on sensorimotor learning, EM significantly reduced the number of subjects that were required for effective hypothesis testing. In summary, we developed a new approach for analysis of data in sensorimotor experiments. The new algorithm improved the ability to uncover the multiple processes that contribute to learning from error. NEW & NOTEWORTHY Motor learning is supported by multiple adaptive processes, each with distinct error sensitivity and forgetting rates. We developed a generalized expectation maximization algorithm that uncovers these hidden processes in the context of modern sensorimotor learning experiments that include error-clamp trials and set breaks. The resulting toolbox may improve the ability to identify the properties of these hidden processes and reduce the number of subjects needed to test the effectiveness of interventions on sensorimotor learning.