Investigation into motor learning to develop novel rehabilitation therapies

1Zsigmond Tamas Kincses, 2Andrea Antal, 2Walter Paulus, 3Rose Bosnell, 3Valentia Tomassini, 3Charlotte Stagg, 3Paul M. Matthews, 3Heidi Johansen-Berg, 3Christian Beckmann, 1Laszlo Vecsei

1Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
2Department of Neurophysiology, Georg-Augus University, Göttingen, Germany
3FMRIB, Department of Clinical Neurology, John Radcliffe Hospital, University of Oxford, Oxford, UK

Adaptive reorganisation during recovery after brain injury shares common mechanisms with those processes for learning in healthy brain. These processes include plastic changes at the molecular, cellular, regional and at network level. In our studies we showed in an MR spectroscopy study that GABA neurotransmission is modulated during motor learning. With a model-free fMRI approach we identified the functional networks that are related to different aspects of skill acquisition. In a consecutive study we mapped the white-matter structural networks that contribute to such learning. Similarly, in stroke patients white matter microstructure can have a predictive value of the successfulness of rehabilitation.

In a next set of investigations we modulated the cortical excitability to improve visuo-motor learning by transcranial direct current stimulation (tDCS). The polarity sensitive modulation of cortical neurotransmitters that share common features with those seen during motor learning were identified by MR spectroscopy. Functional MRI investigations showed that besides the local effect of external electrical stimulation a whole network of areas change activity during tDCS.

These results mark out the pathway to a new set of studies identifying a more effective rehabilitation approaches.