Abstract

Recovery of skilled movement after stroke is assumed to depend on motor learning. However, the capacity for motor learning and factors that influence motor learning after stroke have received little attention. In this study, we first compared motor skill acquisition and retention between well-recovered stroke patients and age- and performance-matched healthy controls. We then tested whether beta oscillations (15–30 Hz) from sensorimotor cortices contribute to predicting training-related motor performance. Eighteen well-recovered chronic stroke survivors (mean age 64 ± 8 years, range: 50–74 years) and 20 age- and sex-matched healthy controls were trained on a continuous tracking task and subsequently retested after initial training (45–60 min and 24 h later). Scalp electroencephalography was recorded during the performance of a simple motor task before each training and retest session. Stroke patients demonstrated capacity for motor skill learning, but it was diminished compared to age- and performance-matched healthy controls. Furthermore, although the properties of beta oscillations prior to training were comparable between stroke patients and healthy controls, stroke patients did show less change in beta measures with motor learning. Lastly, although beta oscillations did not help to predict motor performance immediately after training, contralateral (ipsilesional) sensorimotor cortex post-movement beta rebound measured after training helped predict future motor performance, 24 h after training. This finding suggests that neurophysiological measures such as beta oscillations can help predict response to motor training in chronic stroke patients and may offer novel targets for therapeutic interventions.

Highlights

  • Stroke is a leading cause of adult disability, with lasting motor impairment being a common post-stroke outcome (Feigin et al, 2014)

  • We were able to confirm that the capacity for motor skill learning is preserved in chronic stroke patients, but the rate of learning was diminished compared to healthy controls even when the task is of equal difficulty for everyone

  • We were able to show that one aspect of cortical oscillatory behaviour in stroke patients, immediate posttraining post-movement beta rebound (PMBR) from contralateral sensorimotor cortex, contributed significantly to predicting motor performance 24 hours after training

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Summary

Introduction

Stroke is a leading cause of adult disability, with lasting motor impairment being a common post-stroke outcome (Feigin et al, 2014). Whilst there is currently no evidence that stroke survivors lose their capacity for motor skill acquisition (Hardwick et al, 2017), there are considerable inter-individual differences in response to rehabilitative training, making predictions about recovery challenging (Stinear, 2010). The reasons for this clinical phenomenon are unclear. The potential for plasticity in the post-stroke brain is important as it could facilitate or hinder recovery of function. Understanding how to take advantage of post-stroke alterations in cortical inhibition and excitation to promote recovery is an important clinical and scientific goal

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