Sensorimotor Impairment, Stroke
Conditions
Keywords
procedural learning, maladaptive plasticity
Brief summary
After a stroke, plasticity occurs in the brain from microscopic to network level with positive but also negative consequences for functional recovery. Why post-stroke plasticity takes a beneficial or a maladaptive direction is still incompletely understood. Because the biological mechanisms underlying sensorimotor learning parallel those observed during recovery, learning mechanisms could be potential modifiers of post-stroke neuroplasticity and have a discrete mal-/adaptive impact on the recovery of sensorimotor function. This project seeks to further the understanding of the link between brain circuits that control the integration of new information during procedural learning in the injured brain and those circuits that are involved in adaptive plastic changes during recovery of sensorimotor function post-stroke. The project's methodological approach will allow the characterization of procedural learning-related neural network dynamics based on functional magnetic resonance imaging (MRI) in human volunteers with and without neurologically impairment post-stroke. Through multivariate integration of behavioral and biological descriptors of sensorimotor recovery, the project will investigate the association between motor learning-related network dynamics and descriptors of recovery.
Interventions
BEHAVIORALVisuomotor learning task
Participants undergo functional magnetic resonance imaging during the performance of the visuomotor learning task. The visuomotor learning task involves holding a device in the hand that measures the strength of the grip when squeezing the 'gripper'.
Sponsors
National Institute of General Medical Sciences (NIGMS)
Medical University of South Carolina
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
For all participants: * adult volunteers (age ≥18 years) * right-hand dominance as defined by the Edinburgh Handedness Inventory Stroke-specific inclusion criteria: * ischemic or hemorrhagic lesion * subcortical or cortical tissue involvement * chronic phase (\>6 months) after their index lesion * voluntary whole-hand grip force (MRC, Medical Research Council scale for muscle force ≥2) * repeated release (standardized as a reduction of 50% of maximum voluntary contraction measured with a dynamometer)
Exclusion criteria
For all participants: * Presence of any MRI risk factors * substance use disorder * psychotic disorders Stroke-group specific
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Learning Rate as Indexed by Change in the Precision of Visuomotor Grip Force Adjustment (i.e., Reduction of Precision Error in Force Adjustment) | Pre Learning Session and Post Learning Session (approximately 90 minutes) | Isometric whole-hand grip force is captured continuously with grip-force transducers (at 1000Hz) and adjusted relative to the individual maximum voluntary contraction. Precision of force adjustment is based on the recorded muscle force monitored during task performance and defined as the actual force exerted by the participant relative to the target force (measurement unit: precision in %), with positive values indicating over- and negative values indicating undershoot. Learning rate from before to after learning will be defined as the difference in precision between before as compared to after one single learning session. Precision error was calculated as the percentage deviation of the actual grip force from the target force, averaged across trials before and after the learning task. A reduction in force error indexes a behavioral advantage of force adjustment over time and is thus interpreted as learning. |
| Change in Blood-oxygen-level-dependent (BOLD) Signal Derived Multi-voxel Brain Activation | Pre Learning Session and Post Learning Session (approximately 90 minutes) | Learning-related BOLD-signal-derived brain activation relative to motor performance. |
Countries
United States
Participant flow
Recruitment details
Recruitment period 09/01/2022 - 03/30/2024
Participants by arm
| Arm | Count |
|---|---|
| stroke group Visuomotor learning task: Participants undergo functional magnetic resonance imaging during the performance of the visuomotor learning task. The visuomotor learning task involves holding a device in the hand that measures the strength of the grip when squeezing the 'gripper'. | 25 |
| control group Visuomotor learning task: Participants undergo functional magnetic resonance imaging during the performance of the visuomotor learning task. The visuomotor learning task involves holding a device in the hand that measures the strength of the grip when squeezing the 'gripper'. | 15 |
| Total | 40 |
Baseline characteristics
| Characteristic | control group | Total | stroke group |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 7 Participants | 16 Participants | 9 Participants |
| Age, Categorical Between 18 and 65 years | 8 Participants | 24 Participants | 16 Participants |
| Age, Continuous | 60 years | 59.5 years | 59 years |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 13 Participants | 26 Participants | 13 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 2 Participants | 14 Participants | 12 Participants |
| Region of Enrollment United States | 15 Participants | 40 Participants | 25 Participants |
| Sex: Female, Male Female | 8 Participants | 19 Participants | 11 Participants |
| Sex: Female, Male Male | 7 Participants | 21 Participants | 14 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 25 | 0 / 15 |
| other Total, other adverse events | 0 / 25 | 1 / 15 |
| serious Total, serious adverse events | 0 / 25 | 0 / 15 |
Outcome results
Primary
Change in Blood-oxygen-level-dependent (BOLD) Signal Derived Multi-voxel Brain Activation
Learning-related BOLD-signal-derived brain activation relative to motor performance.
Time frame: Pre Learning Session and Post Learning Session (approximately 90 minutes)
Population: One stroke group participant was excluded because of poor data quality (excessive movement inside the MRI). One control group participant excluded due to incidental findings.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| stroke group | Change in Blood-oxygen-level-dependent (BOLD) Signal Derived Multi-voxel Brain Activation | 2.6 percentage of BOLD signal change |
| control group | Change in Blood-oxygen-level-dependent (BOLD) Signal Derived Multi-voxel Brain Activation | 3.25 percentage of BOLD signal change |
Primary
Learning Rate as Indexed by Change in the Precision of Visuomotor Grip Force Adjustment (i.e., Reduction of Precision Error in Force Adjustment)
Isometric whole-hand grip force is captured continuously with grip-force transducers (at 1000Hz) and adjusted relative to the individual maximum voluntary contraction. Precision of force adjustment is based on the recorded muscle force monitored during task performance and defined as the actual force exerted by the participant relative to the target force (measurement unit: precision in %), with positive values indicating over- and negative values indicating undershoot. Learning rate from before to after learning will be defined as the difference in precision between before as compared to after one single learning session. Precision error was calculated as the percentage deviation of the actual grip force from the target force, averaged across trials before and after the learning task. A reduction in force error indexes a behavioral advantage of force adjustment over time and is thus interpreted as learning.
Time frame: Pre Learning Session and Post Learning Session (approximately 90 minutes)
Population: One stroke group participant was excluded because of poor data quality (excessive movement inside the MRI). One control group participant excluded due to incidental findings.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| stroke group | Learning Rate as Indexed by Change in the Precision of Visuomotor Grip Force Adjustment (i.e., Reduction of Precision Error in Force Adjustment) | -1.48 Percentage deviation from target force |
| control group | Learning Rate as Indexed by Change in the Precision of Visuomotor Grip Force Adjustment (i.e., Reduction of Precision Error in Force Adjustment) | 0.303 Percentage deviation from target force |