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Neural substrates underlying motor skill learning in chronic hemiparetic stroke patients

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Lefebvre, Stéphanie [UCL] Dricot, Laurence [UCL] Laloux, Patrice [UCL] Gradkowski, Wojciech Desfontaines, Philippe Peeters, André [UCL] Jamart, Jacques [UCL] Vandermeeren, Yves [UCL]

(eng) Motor skill learning is critical in post-stroke motor recovery, but little is known about its underlying neural substrates. Recently, using a new visuomotor skill learning paradigm involving a speed/accuracy trade-off in healthy individuals we identified three subpopulations based on their behavioral trajectories: fitters (in whom improvement in speed or accuracy coincided with deterioration in the other parameter), shifters (in whom speed and/or accuracy improved without degradation of the other parameter), and non-learners. We aimed to identify the neural substrates underlying the first stages of motor skill learning in chronic hemiparetic stroke patients and to determine whether specific neural substrates were recruited in shifters versus fitters. During functional magnetic resonance imaging (fMRI), 23 patients learned the visuomotor skill with their paretic upper limb. In the whole-group analysis, correlation between activation and motor skill learning was restricted to the dorsal prefrontal cortex of the damaged hemisphere (DLPFCdamh: r = -0.82) and the dorsal premotor cortex (PMddamh: r = 0.70); the correlations was much lesser (-0.16 < r > 0.25) in the other regions of interest. In a subgroup analysis, significant activation was restricted to bilateral posterior parietal cortices of the fitters and did not correlate with motor skill learning. Conversely, in shifters significant activation occurred in the primary sensorimotor cortexdamh and supplementary motor areadamh and in bilateral PMd where activation changes correlated significantly with motor skill learning (r = 0.91). Finally, resting-state activity acquired before learning showed a higher functional connectivity in the salience network of shifters compared with fitters (qFDR < 0.05). These data suggest a neuroplastic compensatory reorganization of brain activity underlying the first stages of motor skill learning with the paretic upper limb in chronic hemiparetic stroke patients, with a key role of bilateral PMd.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2015
Language Anglais
Journal information "Frontiers in Human Neuroscience" - Vol. 9, p. 320 [1-18] (2015)
Peer reviewed yes
Publisher Frontiers Research Foundation ((Switzerland ) Lausanne)
e-issn 1662-5161
Publication status Publié
Affiliations UCL - (MGD) Service de neurologie
Université catholique de Louvain - Louvain Bionics
UCL - SSS/IONS/NEUR - Clinical Neuroscience
UCL - (SLuc) Service de neurologie
UCL - SST/IMMC/MEED - Mechatronic, Electrical Energy, and Dynamics Systems
UCL - SSS/IREC/MONT - Pôle Mont Godinne
UCL - (MGD) Unité de support scientifique
Keywords Motor skill learning ; Stroke ; fMRI ; Neurorehabilitation ; Premotor cortex ; Resting-state fMRI ; Functional connectivity
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Bibliographic reference Lefebvre, Stéphanie ; Dricot, Laurence ; Laloux, Patrice ; Gradkowski, Wojciech ; Desfontaines, Philippe ; et. al. Neural substrates underlying motor skill learning in chronic hemiparetic stroke patients. In: Frontiers in Human Neuroscience, Vol. 9, p. 320 [1-18] (2015)
Permanent URL http://hdl.handle.net/2078.1/162463