Separating coordinative and executive dysfunction in cerebellar patients during motor skill acquisition

Abstract

ObjectivePatients with cerebellar stroke are impaired in motor skill acquisition and cognitive/executive performance. The aim was to test whether skill acquisition in cerebellar patients is influenced by executive demands such as the intermittent exercise of a conflicting motor task. MethodsPatients with cerebellar stroke and healthy controls were tested in two serial reaction time experiments. In Experiment 1, participants performed practice runs (always same sequence) and interference runs (new sequence for each run) in a strictly alternating fashion. In Experiment 2, participants rested between successive practice runs; the duration of rests was adapted to the duration of interference runs in the other experiment. Participants of Experiment 1 were also tested for cognitive–executive functions (Wisconsin Card Sort, Word Fluency, Trail Making, Digit Span backwards). Results(1) Patients in Experiment 1, although always slower than controls, acquired motor skills in the first run before interference but in contrast to controls failed to improve their performance in subsequent runs. (2) Patients in Experiment 2 improved their performance consistently over several runs. (3) Patients of Experiment 1 were worse than controls in several cognitive–executive functions; however, these deficits did not correlate with the degree of interference in motor skill acquisition. InterpretationSimple movement coordination and higher order context-related movement organisation are separate cerebellar functions. In cerebellar patients, impaired movement coordination is associated with generally slower reaction times whereas organisational deficits are associated with a specific impairment to change between motor sets. Motor-executive functions responsible for the latter impairment might be independent from cognitive–executive functions.