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Implicit sequence-specific motor learning after subcortical stroke is associated with increased prefrontal brain activations: An fMRI Study

Authors

  • Sean K. Meehan,

    1. Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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  • Bubblepreet Randhawa,

    1. Graduate Programme in Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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  • Brenda Wessel,

    1. Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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  • Lara A. Boyd

    Corresponding author
    1. Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
    2. Graduate Programme in Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, Canada
    3. Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
    • Department of Physical Therapy, University of British Columbia, 212–2277 Wesbrook Mall, Vancouver, British Columbia, Canada V6T 2B5
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Abstract

Implicit motor learning is preserved after stroke, but how the brain compensates for damage to facilitate learning is unclear. We used a random effects analysis to determine how stroke alters patterns of brain activity during implicit sequence-specific motor learning as compared to general improvements in motor control. Nine healthy participants and nine individuals with chronic, right focal subcortical stroke performed a continuous joystick-based tracking task during an initial functional magnetic resonance images (fMRI) session, over 5 days of practice, and a retention test during a separate fMRI session. Sequence-specific implicit motor learning was differentiated from general improvements in motor control by comparing tracking performance on a novel, repeated tracking sequence during early practice and again at the retention test. Both groups demonstrated implicit sequence-specific motor learning at the retention test, yet substantial differences were apparent. At retention, healthy control participants demonstrated increased blood oxygenation level dependent (BOLD) response in left dorsal premotor cortex (PMd; BA 6) but decreased BOLD response left dorsolateral prefrontal cortex (DLPFC; BA 9) during repeated sequence tracking. In contrast, at retention individuals with stroke did not show this reduction in DLPFC during repeated tracking. Instead implicit sequence-specific motor learning and general improvements in motor control were associated with increased BOLD response in the left middle frontal gyrus BA 8, regardless of sequence type after stroke. These data emphasize the potential importance of a prefrontal-based attentional network for implicit motor learning after stroke. This study is the first to highlight the importance of the prefrontal cortex for implicit sequence-specific motor learning after stroke. Hum Brain Mapp, 2011. © 2010 Wiley-Liss, Inc.

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