4.7 Article

Motor training-related brain reorganization in patients with cerebellar degeneration

Journal

HUMAN BRAIN MAPPING
Volume 43, Issue 5, Pages 1611-1629

Publisher

WILEY
DOI: 10.1002/hbm.25746

Keywords

cerebellar ataxia; motor learning; physical therapy; plasticity; rehabilitation

Funding

  1. German Research Foundation [DFG TI 239/14-1]
  2. Bernd Fink Foundation

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The study found that cerebellar patients can improve motor performance through practice, but the impact of different types of feedback on learning remains unclear. After training, differences in gray matter volume changes were observed between the control group and cerebellar patients, indicating that compensatory remodeling manifests differently in different brain regions.
Cerebellar degeneration progressively impairs motor function. Recent research showed that cerebellar patients can improve motor performance with practice, but the optimal feedback type (visual, proprioceptive, verbal) for such learning and the underlying neuroplastic changes are unknown. Here, patients with cerebellar degeneration (N = 40) and age- and sex-matched healthy controls (N = 40) practiced single-joint, goal-directed forearm movements for 5 days. Cerebellar patients improved performance during visuomotor practice, but a training focusing on either proprioceptive feedback, or explicit verbal feedback and instruction did not show additional benefits. Voxel-based morphometry revealed that after training gray matter volume (GMV) was increased prominently in the visual association cortices of controls, whereas cerebellar patients exhibited GMV increase predominantly in premotor cortex. The premotor cortex as a recipient of cerebellar efferents appears to be an important hub in compensatory remodeling following damage of the cerebro-cerebellar motor system.

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