Neuroplasticity Subserving Motor Skill Learning

Recent years have seen significant progress in our understanding of the neural substrates of motor skill learning. Advances in neuroimaging provide new insight into functional reorganization associated with the acquisition, consolidation, and retention of motor skills. Plastic changes involving structural reorganization in gray and white matter architecture that occur over shorter time periods than previously thought have been documented as well. Data from experimental animals provided crucial information on plausible cellular and molecular substrates contributing to brain reorganization underlying skill acquisition in humans. Here, we review findings demonstrating functional and structural plasticity across different spatial and temporal scales that mediate motor skill learning while identifying converging areas of interest and possible avenues for future research

Principles of sensorimotor learning.

The exploits of Martina Navratilova and Roger Federer represent the pinnacle of motor learning. However, when considering the range and complexity of the processes that are involved in motor learning, even the mere mortals among us exhibit abilities that are impressive. We exercise these abilities when taking up new activities - whether it is snowboarding or ballroom dancing - but also engage in substantial motor learning on a daily basis as we adapt to changes in our environment, manipulate new objects and refine existing skills. Here we review recent research in human motor learning with an emphasis on the computational mechanisms that are involved

Motor imagery and motor illusion: from plasticity to a translational approach

Motor imagery e illusione motoria: dalla plasticit\ue0 ad un approccio traslazional

Spatio-Temporal and Multisensory Integration: the relationship between sleep and the cerebellum

Does the cerebellum sleep? If so, does sleep contribute to cerebellar cognition? In this thesis, the sleep contribution to the consolidation process of spatial-temporal and multisensory integration was investigated in relation to the human cerebellum. Multiple experimental approaches were used to answer research questions addressed in the various chapters. Summarizing the evidence of the electrophysiology and neuroimaging studies, in Chapter1 we present intriguing evidence that the cerebellum is involved in sleep physiology, and that cerebellar-dependent memory formation can be consolidated during sleep. In Chapter 2, using functional neuroimaging in healthy participants during various forms of the Serial interception sequential learning (SISL) task, i.e., predictive timing, motor coordination, and motor imagination, we assessed the cerebellar involvement in spatio-temporal predictive timing; and possible cerebellar interactions with other regions, most notably the hippocampus. In Chapter 3, we add to the findings of Chapter 2 that indicate the cerebellum and hippocampus are involved in the task, by showing that more than simply activated, the cerebellum is a necessary and responsible region for the establishment of the spatio-temporal prediction. This follows from the deficits in behavioral properties of the predictive and reactive timing in the cerebellar ataxia type 6 patients, using the modified version of the SISL task. In Chapter 4, we assessed the subsequent post-interval behavioral performances on the learning of the fixed and random timing sequences in the SISL task, comparing a sleep group and wake group in healthy participants. Our findings show that sleep consolidates the process of cerebellar-dependent spatio-temporal integration. In Chapter 5, we investigated the establishment of visual-tactile integration during sleep through the examination of tactile motion stimulation during sleep and showed that, subsequent to sleep, directional visual motion discrimination i

Fast convergence of learning requires plasticity between inferior olive and deep cerebellar nuclei in a manipulation task: a closed-loop robotic simulation

The cerebellum is known to play a critical role in learning relevant patterns of activity for adaptive motor control, but the underlying network mechanisms are only partly understood. The classical long-term synaptic plasticity between parallel fibers (PFs) and Purkinje cells (PCs), which is driven by the inferior olive (IO), can only account for limited aspects of learning. Recently, the role of additional forms of plasticity in the granular layer, molecular layer and deep cerebellar nuclei (DCN) has been considered. In particular, learning at DCN synapses allows for generalization, but convergence to a stable state requires hundreds of repetitions. In this paper we have explored the putative role of the IO-DCN connection by endowing it with adaptable weights and exploring its implications in a closed-loop robotic manipulation task. Our results show that IO-DCN plasticity accelerates convergence of learning by up to two orders of magnitude without conflicting with the generalization properties conferred by DCN plasticity. Thus, this model suggests that multiple distributed learning mechanisms provide a key for explaining the complex properties of procedural learning and open up new experimental questions for synaptic plasticity in the cerebellar network.This work was supported by grants from the European Union, Egidio D'Angelo and Eduardo Ros (CEREBNET FP7-ITN238686, REALNET FP7-ICT270434) and by grants from the Italian Ministry of Health to Egidio D'Angelo (RF-2009-1475845) and the Spanish Regional Government, Niceto R. Luque (PYR-2014-16). We thank G. Ferrari and M. Rossin for their technical support

Investigating the neurobiological changes associated with cerebellar transcranial direct current stimulation (TDCS) using magnetic resonance imaging (MRI)

Anodal cerebellar transcranial direct current stimulation (tDCS) is known to enhance motor learning and it is suggested to hold promise as a therapeutic intervention. However, the neural mechanisms underpinning the effects of cerebellar tDCS are unknown. In addition, it is unclear whether this effect is robust across varying task parameters as if cerebellar tDCS is to be used clinically it must have a consistent effect across a relatively wide range of behaviours. Therefore, I performed four studies to address these questions. In the first three studies, I investigated the neural changes associated with cerebellar tDCS using magnetic resonance spectroscopy (MRS) and resting state functional magnetic resonance imaging (fMRI). My goal was to understand how cerebellar tDCS affected the metabolites within the cerebellum and functional connectivity between the cerebellum and distant brain areas. In addition, I wanted to understand if individual differences in how cerebellar tDCS influenced visuomotor adaptation could be explained by the effect tDCS had on neurobiology. Therefore, healthy participants underwent 3 sessions in which they received concurrent anodal cerebellar tDCS during visuomotor adaptation, MRS and resting state fMRI. I found that in 21% of participants cerebellar tDCS caused enhanced visuomotor adaptation, a decrease in GABA and increase in functional connectivity between the cerebellum and parietal cortex. This work suggests an ‘all-or-nothing’ type effect of cerebellar tDCS. In my final study, I examined the consistency of the cerebellar tDCS effect on visuomotor adaptation across a wide range of task parameters which were systematically varied. Each experiment examined whether cerebellar tDCS had a positive effect on adaptation when a unique feature of the task was altered. I found cerebellar tDCS to have an inconsistent effect on visuomotor adaptation. I conclude that such inconsistencies could be dependent on the amount of participants in each group that are receptive to cerebellar tDCS and suggest that at the very least it warrants substantially large sample size in cerebellar tDCS studies

Role of reward and punishment in motor learning in health and after stroke

Is the carrot more effective than the stick? Through a combination of behavioural experiments, pharmacological manipulations and computational modelling, this thesis investigates the effects of reward and punishment feedback on adaptive motor learning, in both healthy subjects and stroke survivors. The role of error-based motor learning in neurorehabilitation is still unclear partly because, although it leads to fast and large changes in behaviour, these changes are often short-lived once the perturbation is removed. Nevertheless, recent evidence shows that motivational feedback can increase adaptation to a perturbation and retention of the motor memory in healthy subjects. In the first study presented in this thesis I show that these effects partially apply also to stroke survivors. In particular, reward or punishment-based feedback enhance error-correction during adaptation, and reward increases the retention of the new motor memory in stroke survivors. I then moved to investigate the role of dopamine in error-based motor learning under reward or punishment in healthy young subjects. Consistently with results in stroke patients, reward increased motor memory retention. In addition, I show here that this effect of reward on retention is mediated by dopaminergic pathways. Finally, I investigated if pharmacologic dopaminergic stimulation can potentiate the positive effect of reward on retention in dopamine-deficient subjects, such as older adults. Unfortunately, likely due to the dopaminergic deficit, reward had no effect on elderly participants, and this study failed to show a benefit of dopaminergic stimulation in the elderly. However, this evidence is not sufficient to rule out possible positive effects of pharmacologic dopaminergic stimulation on motor learning in brain injured patients, such as stroke survivors. Taken together, these results represent a step further toward the combined use of reward feedback, pharmacological stimulation and motor learning paradigms in clinical rehabilitation. Indeed, as shown by the qualitative survey presented at the beginning of this thesis, an evidence-based guide to the use of reward and punishment feedback during rehabilitation would be welcome by stroke professionals

Neural substrates and functional connectivity associated with sleep-dependent and independent consolidation of new motor skills

La mémoire n’est pas un processus unitaire et est souvent divisée en deux catégories majeures: la mémoire déclarative (pour les faits) et procédurale (pour les habitudes et habiletés motrices). Pour perdurer, une trace mnésique doit passer par la consolidation, un processus par lequel elle devient plus robuste et moins susceptible à l’interférence. Le sommeil est connu comme jouant un rôle clé pour permettre le processus de consolidation, particulièrement pour la mémoire déclarative. Depuis plusieurs années cependant, son rôle est aussi reconnu pour la mémoire procédurale. Il est par contre intéressant de noter que ce ne sont pas tous les types de mémoire procédurale qui requiert le sommeil afin d’être consolidée. Entre autres, le sommeil semble nécessaire pour consolider un apprentissage de séquences motrices (s’apparentant à l’apprentissage du piano), mais pas un apprentissage d’adaptation visuomotrice (tel qu’apprendre à rouler à bicyclette). Parallèlement, l’apprentissage à long terme de ces deux types d’habiletés semble également sous-tendu par des circuits neuronaux distincts; c’est-à-dire un réseau cortico-striatal et cortico-cérébelleux respectivement. Toutefois, l’implication de ces réseaux dans le processus de consolidation comme tel demeure incertain. Le but de cette thèse est donc de mieux comprendre le rôle du sommeil, en contrôlant pour le simple passage du temps, dans la consolidation de ces deux types d’apprentissage, à l’aide de l’imagerie par résonnance magnétique fonctionnelle et d’analyses de connectivité cérébrale. Nos résultats comportementaux supportent l’idée que seul l’apprentissage séquentiel requiert le sommeil pour déclencher le processus de consolidation. Nous suggérons de plus que le putamen est fortement associé à ce processus. En revanche, les performances d’un apprentissage visuomoteur s’améliorent indépendamment du sommeil et sont de plus corrélées à une plus grande activation du cervelet. Finalement, en explorant l’effet du sommeil sur la connectivité cérébrale, nos résultats démontrent qu’en fait, un système cortico-striatal semble être plus intégré suite à la consolidation. C’est-à-dire que l’interaction au sein des régions du système est plus forte lorsque la consolidation a eu lieu, après une nuit de sommeil. En opposition, le simple passage du temps semble nuire à l’intégration de ce réseau cortico-striatal. En somme, nous avons pu élargir les connaissances quant au rôle du sommeil pour la mémoire procédurale, notamment en démontrant que ce ne sont pas tous les types d’apprentissages qui requièrent le sommeil pour amorcer le processus de consolidation. D’ailleurs, nous avons également démontré que cette dissociation de l’effet du sommeil est également reflétée par l’implication de deux réseaux cérébraux distincts. À savoir, un réseau cortico-striatal et un réseau cortico-cérébelleux pour la consolidation respective de l’apprentissage de séquence et d’adaptation visuomotrice. Enfin, nous suggérons que la consolidation durant le sommeil permet de protéger et favoriser une meilleure cohésion au sein du réseau cortico-striatal associé à notre tâche; un phénomène qui, s’il est retrouvé avec d’autres types d’apprentissage, pourrait être considéré comme un nouveau marqueur de la consolidation.Memory in humans is generally divided into two broad categories: declarative (for facts and events) and procedural (for skills and motor abilities). To persist, memories undergo a process referred to as consolidation, where a fresh, initially labile memory trace becomes more robust and stable. Sleep is known to play an important role in declarative memory consolidation, and in the past decade, there has been increasing evidence for a role of sleep in the consolidation of procedural memory as well. Interestingly, however, the beneficial effects of sleep do not seem to be homogenous. Motor sequence learning consolidation, in particular, has been found to be particularly sensitive to sleep effects, while the consolidation of motor adaptation has not. Moreover, neuroimaging research, has demonstrated that the long term retention of these two types of motor abilities rely on different neuronal networks, namely the cortico-striatal and cortico-cerebellar systems, respectively. Yet the implication of these networks in the consolidation of these two types of motor memory remains unclear. The aim of the present doctoral thesis was thus to determine the influence of sleep, while controlling for the simple passage of daytime, on the consolidation of a motor sequence learning task vs. a motor adaptation task. We further aimed to bring new insights into the underlying brain regions involved in consolidating these two forms of motor skills. Consistent with previous research, we found off-line improvements in performance for motor adaptation learning, independent of whether participants had a night of sleep or remained awake during daytime. Furthermore, these improvements were correlated with activity in the cerebellum. In contrast, we found that off-line increases in performance in motor sequence learning were evident after a night of sleep but not over the day; and the putamen was strongly associated with this sleep-dependent consolidation process. Finally, while measuring brain changes in connectivity associated with the latter process, we observed that sleep-dependent consolidation is reflected by an increased level of integration within the cortico-striatal system, but not in other functional networks. Conversely, the simple passage of daytime in the wake state seems to result in decreased cortico-striatal integration. In sum our results highlight that not all motor memories undergo sleep-dependent consolidation. We demonstrated that these different paths to consolidation are also reflected by distinct underlying neuronal systems, namely a cortico-striatal and cortico-cerebellar network associated with the consolidation of motor sequence and motor adaptation learning respectively. Furthermore, we propose that consolidation of motor sequences during sleep protects and favors cohesion within the cortico-striatal system, a phenomenon that, if replicated in other types of memories, may be considered as a new marker of sleep-dependent consolidation

Investigating the Cortical, Metabolic and Behavioral Effects of Transcranial Direct Current Stimulation in Preparation for Combined Rehabilitation

The goal of this thesis was to determine the cortical reorganization that occurs in patients with cervical spondylotic myelopathy (CSM) after surgical decompression and to implement this knowledge into a new rehabilitation strategy. Transcranial direct current stimulation (tDCS) is a non-invasive technique to modulate human behavior. Due to the novel electrode montage used, it was first pertinent that we determine how tDCS would modulate cortical, metabolic and motor behavior in healthy individuals. We observed the longitudinal functional adaptations that occur in patients with CSM using functional MRI. Enhanced excitation of supplementary motor area (SMA) was observed following surgical decompression and associated with increased function following surgery. This novel finding of enhanced excitation of motivated us to use a bihemispheric tDCS protocol, exciting bilateral motor areas to provide optimal motor enhancement. This novel tDCS electrode montage, targeting the SMA and primary motor cortex (M1) was implemented in healthy older adults to determine its effects on enhancing manual dexterity. Furthermore, to determine the frequency with which to apply tDCS, a single and tri session protocol was used. We observed a differential pattern of action with anti-phase and in-phase motor tasks during multisession tDCS. We used ultra-high field (7T) MRI to examined the metabolic changes that occur following tDCS. After the stimulation period we observed no significant metabolite modulation. A trend towards an increase in the NAA/tCr ratio, with a concomitant decrease in the absolute concentration of tCr was observed. Finally, we examined the functional connectivity before, during and after tDCS with the use of resting-state fMRI at 7T. We observed enhanced connectivity within right sensorimotor area after stimulation compared to during stimulation. This result confirmed that cortical modulations differ during versus after tDCS, signifying that optimal modulation of behaviour may be after the stimulation period. Furthermore, we observed an enhanced correlation between motor regions and the caudate, both during and after stimulation. In conclusion, we observed novel cortical adaptations in CSM patients after surgical decompression, which led us to believe that bihemispheric tDCS of M1-SMA network would result in optimal motor enhancement and warrants further investigation in CSM and other neurological disorders