Effects of Motor Learning on Motor Function and Synaptic Plasticity of Cerebellar Injuries

BACKGROUND: Cerebral palsy (CP) is a neurodevelopmental disturbance characterized by impaired control of movement. Function often decreases and 15% of adults are classified as severely affected (Gross Motor Function Classification Scale III-V). Little is known about interventions that aim to improve functional abilities in this population. OBJECTIVE: To evaluate a 12-week intervention based on motor learning principles on functional ability in adults with severe CP. METHODS: 16 adults (36±10 years, GMFCS III-V) were enrolled and divided into an intervention group (Active group) and a standard care group (Control group). Primary outcome measure was Gross Motor Function Measure (GMFM-88). Secondary measures were neurological status. The Active group were measured at baseline, after the intervention and at one-month follow-up. The Control group were measured at baseline and after one month. RESULTS: Analysis showed statistically significant improvement in GMFM-88 for the Active group from baseline to post assessment compared with the Control group (group difference: 5 points, SE 14.5, p = 0.008, CI: 1.2 to 8.7). Improvements were maintained at follow-up. Results from the neurological screening showed no clear tendencies. CONCLUSIONS: The study provides support that activities based on motor learning principles may improve gross motor function in adults with severe CP.

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The role of calcium in synaptic plasticity and motor learning in the cerebellar cortex

Neuroscience & Biobehavioral Reviews ◽

10.1016/j.neubiorev.2012.01.005 ◽

2012 ◽

Vol 36 (4) ◽

pp. 1153-1162 ◽

Cited By ~ 36

Author(s):

Matthew G. Lamont ◽

John T. Weber

Keyword(s):

Synaptic Plasticity ◽

Motor Learning ◽

Cerebellar Cortex

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Synaptic Plasticity Underlying the Cerebellar Motor Learning Investigated in Rabbit’s Flocculus

Advances in Behavioral Biology - Conditioning ◽

10.1007/978-1-4757-0701-4_15 ◽

1982 ◽

pp. 213-222 ◽

Cited By ~ 1

Author(s):

Masao Ito

Keyword(s):

Synaptic Plasticity ◽

Motor Learning

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Neutralization of Nogo-A Enhances Synaptic Plasticity in the Rodent Motor Cortex and Improves Motor Learning in Vivo

Journal of Neuroscience ◽

10.1523/jneurosci.3817-13.2014 ◽

2014 ◽

Vol 34 (26) ◽

pp. 8685-8698 ◽

Cited By ~ 46

Author(s):

A. Zemmar ◽

O. Weinmann ◽

Y. Kellner ◽

X. Yu ◽

R. Vicente ◽

...

Keyword(s):

Synaptic Plasticity ◽

Motor Cortex ◽

Motor Learning

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Impaired Synaptic Plasticity and Motor Learning in Mice with a Point Mutation Implicated in Human Speech Deficits

Current Biology ◽

10.1016/j.cub.2008.01.060 ◽

2008 ◽

Vol 18 (5) ◽

pp. 354-362 ◽

Cited By ~ 185

Author(s):

Matthias Groszer ◽

David A. Keays ◽

Robert M.J. Deacon ◽

Joseph P. de Bono ◽

Shweta Prasad-Mulcare ◽

...

Keyword(s):

Synaptic Plasticity ◽

Motor Learning ◽

Point Mutation ◽

Human Speech

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Cdk5 Modulates Long-Term Synaptic Plasticity and Motor Learning in Dorsolateral Striatum

Scientific Reports ◽

10.1038/srep29812 ◽

2016 ◽

Vol 6 (1) ◽

Cited By ~ 11

Author(s):

Adan Hernandez ◽

Chunfeng Tan ◽

Gabriel Mettlach ◽

Karine Pozo ◽

Florian Plattner ◽

...

Keyword(s):

Synaptic Plasticity ◽

Motor Learning ◽

Dorsolateral Striatum

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Transcranial direct current stimulation for children with perinatal stroke and hemiparesis

Neurology ◽

10.1212/wnl.0000000000003518 ◽

2016 ◽

Vol 88 (3) ◽

pp. 259-267 ◽

Cited By ~ 51

Author(s):

Adam Kirton ◽

Patrick Ciechanski ◽

Ephrem Zewdie ◽

John Andersen ◽

Alberto Nettel-Aguirre ◽

...

Keyword(s):

Cerebral Palsy ◽

Motor Learning ◽

Motor Function ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Primary Motor Cortex ◽

Intensive Therapy ◽

Performance Measure ◽

Perinatal Stroke ◽

Direct Current Stimulation

Objective:To determine whether the addition of transcranial direct current stimulation (tDCS) to intensive therapy increases motor function in children with perinatal stroke and hemiparetic cerebral palsy.Methods:This was a randomized, controlled, double-blind clinical trial. Participants were recruited from a population-based cohort with MRI-classified unilateral perinatal stroke, age of 6 to 18 years, and disabling hemiparesis. All completed a goal-directed, peer-supported, 2-week after-school motor learning camp (32 hours of therapy). Participants were randomized 1:1 to 1 mA cathodal tDCS over the contralesional primary motor cortex (M1) for the initial 20 minutes of daily therapy or sham. Primary subjective (Canadian Occupational Performance Measure [COPM]), objective (Assisting Hand Assessment [AHA]), safety, and secondary outcomes were measured at 1 week and 2 months after intervention. Analysis was by intention to treat.Results:Twenty-four participants were randomized (median age 11.8 ± 2.7 years, range 6.7–17.8). COPM performance and satisfaction scores doubled at 1 week with sustained gains at 2 months (p < 0.001). COPM scores increased more with tDCS compared to sham control (p = 0.004). AHA scores demonstrated only mild increases at both time points with no tDCS effects. Procedures were safe and well tolerated with no decrease in either arm function or serious adverse events.Conclusion:tDCS trials appear feasible and safe in hemiparetic children. Lack of change in objective motor function may reflect underdosing of therapy. Marked gains in subjective function with tDCS warrant further study.ClinicalTrials.gov identifier:NCT02170285.Classification of evidence:This study provides Class II evidence that for children with perinatal stroke and hemiparetic cerebral palsy, the addition of tDCS to moderate-dose motor learning therapy does not significantly improve motor function as measured by the AHA.

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The application of virtual reality in neuro-rehabilitation: motor re-learning supported by innovative technologies

Rehabilitacja Medyczna ◽

10.5604/01.3001.0009.3087 ◽

2014 ◽

Vol 17 (4) ◽

pp. 29-36 ◽

Cited By ~ 6

Author(s):

Paweł Kiper ◽

Andrzej Szczudlik ◽

Elżbieta Mirek ◽

Roman Nowobilski ◽

Józef Opara ◽

...

Keyword(s):

Virtual Reality ◽

Motor Learning ◽

Virtual Environment ◽

Motor Function ◽

Negative Impact ◽

Sensory Information ◽

Specific Treatment ◽

Innovative Technology ◽

Innovative Technologies ◽

Task Practice

The motor function impairment resulting from a stroke injury has a negative impact on autonomy, the activities of daily living thus the individuals affected by a stroke need long-term rehabilitation. Several studies have demonstrated that learning new motor skills is important to induce neuroplasticity and functional recovery. Innovative technologies used in rehabilitation allow one the possibility to enhance training throughout generated feedback. It seems advantageous to combine traditional motor rehabilitation with innovative technology in order to promote motor re-learning and skill re-acquisition by means of enhanced training. An environment enriched by feedback involves multiple sensory modalities and could promote active patient participation. Exercises in a virtual environment contain elements necessary to maximize motor learning, such as repetitive and diffe-rentiated task practice and feedback on the performance and results. The recovery of the limbs motor function in post-stroke subjects is one of the main therapeutic aims for patients and physiotherapist alike. Virtual reality as well as robotic devices allow one to provide specific treatment based on the reinforced feedback in a virtual environment (RFVE), artificially augmenting the sensory information coherent with the real-world objects and events. Motor training based on RFVE is emerging as an effective motor learning based techniques for the treatment of the extremities.

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