The importance of different learning stages for motor sequence learning after stroke

Abstract

The task of learning predefined sequences of interrelated motor actions is of everyday importance and has also strong clinical importance for regaining motor function after brain lesions. A solid understanding of sequence learning in stroke patients can help clinicians to optimize and individualize rehabilitation strategies. Moreover, to investigate the impact of a focal lesion on the ability to successfully perform motor sequence learning can enhance our comprehension of the underlying physiological principles of motor sequence learning. In this article, we will first provide an overview of current concepts related to motor sequence learning in healthy subjects with focus on the involved brain areas and their assumed functions according to the temporal stage model. Subsequently, we will consider the question of what we can learn from studies investigating motor sequence learning in stroke patients. We will first focus on the implications of lesion location. Then, we will analyze whether distinct lesion locations affect specific learning stages. Finally, we will discuss the implications for clinical rehabilitation and suggest directions for further research.

Sequential Finger-tapping Learning Mediated by the Primary Motor Cortex and Fronto-parietal Network: A Combined MRI-MRS Study

“…7). This nding concurs with the notion that the PPC is necessary for early and late learning phases, whereas the PFC is primarily involved in early learning phases 45 . The PFC processes sensory inputs, motor outputs, and working memory [46][47][48] .…”

Neural substrates of Motor Learning Strategies in Stroke

“…According to the theory of Neural Darwinism [2], the nervous system is capable of developing synaptic connections, from one nerve cell to another, which are strengthened or weakened depending on environmental stimuli, resulting in a huge number of repertoires of variance [3,4]". This adaptation of human body is a continuous process which is observed as a learning process after central nervous system (CNS) injury.…”

Decreased thalamo-cortico connectivity during an implicit sequence motor learning task and 7 days escitalopram intake

“…While these studies have provided promising insights regarding motor performance in terms of behavioral outcomes, neural activation, or task-independent fMRI, the effect of SSRI-administration on functional connectivity during motor learning is still largely unknown. One area of interest is sequence motor learning, a domain which, despite heterogenous findings in stroke patients 19 , 20 , is generally thought to be impaired 21 . Given the central role of sequence skill movement in the performance of everyday tasks, assessing the effects of SSRIs on the functional connectivity patterns underlying normal sequence motor learning thus represents a critical target for preclinical stroke research in human participants.…”