Cerebellar damage disrupts movement coordination. Actions ranging from walking to reaching become inaccurate and difficult to control, resulting in poor functional movements. Therapeutic approaches for cerebellar motor disorders, or 'ataxia,'rely heavily on rehabilitation since there are no medications that systematically improve movement coordination. Rehabilitation is limited by the fact that cerebellar damage dramatically disrupts motor learning (i.e. the ability to learn movements through trial-and-error practice). Recently, we discovered that people with cerebellar damage can show motor learning, but only when the errors driving learning are small and gradual. It is also known that non-invasive stimulation of the brain can improve motor learning in healthy subjects. In this project, we will work to understand whether use of gradual learning strategies and non-invasive brain stimulation can improve learning of movement coordination of people with cerebellar damage. We will study both reaching and walking movements.
In aim 1, we will test whether (a) the learning benefit associated with gradual learning is due to the small error size or due to the subject's lack of explicit awareness of error;(b) whether we can use gradual learning to teach people with cerebellar damage to correct their specific reaching deficits, and (c) whether gradual learning benefits extend to walking, which would imply a general brain mechanism for this type of learning.
In aim 2 we will use transcranial magnetic stimulation (TMS) to test whether gradual motor learning is more associated with increased excitability in primary motor cortex, whereas learning from large and abrupt errors is more associated with increased excitability in the cerebellum.
In aim 3, we will determine whether non-invasive, transcranial direct current stimulation (tDCS) of different brain regions can augment motor learning in people with cerebellar damage. In sum, an increased understanding of the mechanisms of motor learning could lead to important changes in rehabilitation treatments for people with ataxia from cerebellar damage. Our overarching goal is to provide a scientific foundation for devising new rehabilitation strategies.

Public Health Relevance

Cerebellar damage causes poor movement control and an ability to learn to improve movement. We will work to understand whether use of gradual learning strategies and non-invasive brain stimulation can improve motor learning and thus, coordination of people with cerebellar damage. If true, these approaches could be translated into novel and effective rehabilitation strategies.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD040289-11
Application #
8208006
Study Section
Motor Function, Speech and Rehabilitation Study Section (MFSR)
Program Officer
Nitkin, Ralph M
Project Start
2001-04-01
Project End
2016-03-31
Budget Start
2012-04-01
Budget End
2013-03-31
Support Year
11
Fiscal Year
2012
Total Cost
$379,459
Indirect Cost
$106,385
Name
Hugo W. Moser Research Institute Kennedy Krieger
Department
Type
DUNS #
155342439
City
Baltimore
State
MD
Country
United States
Zip Code
21205
Bhanpuri, Nasir H; Okamura, Allison M; Bastian, Amy J (2014) Predicting and correcting ataxia using a model of cerebellar function. Brain 137:1931-44
Ilg, W; Bastian, A J; Boesch, S et al. (2014) Consensus paper: management of degenerative cerebellar disorders. Cerebellum 13:248-68
Keller, Jennifer L; Bastian, Amy J (2014) A home balance exercise program improves walking in people with cerebellar ataxia. Neurorehabil Neural Repair 28:770-8
Musselman, Kristin E; Stoyanov, Cristina T; Marasigan, Rhul et al. (2014) Prevalence of ataxia in children: a systematic review. Neurology 82:80-9
Kurtzer, Isaac; Trautman, Paxson; Rasquinha, Russell J et al. (2013) Cerebellar damage diminishes long-latency responses to multijoint perturbations. J Neurophysiol 109:2228-41
Hoyer, Erik H; Bastian, Amy J (2013) The effects of task demands on bimanual skill acquisition. Exp Brain Res 226:193-208
Cantarero, Gabriela; Tang, Byron; O'Malley, Rebecca et al. (2013) Motor learning interference is proportional to occlusion of LTP-like plasticity. J Neurosci 33:4634-41
Gibo, Tricia L; Criscimagna-Hemminger, Sarah E; Okamura, Allison M et al. (2013) Cerebellar motor learning: are environment dynamics more important than error size? J Neurophysiol 110:322-33
Block, Hannah; Bastian, Amy; Celnik, Pablo (2013) Virtual lesion of angular gyrus disrupts the relationship between visuoproprioceptive weighting and realignment. J Cogn Neurosci 25:636-48
Charles, Steven K; Okamura, Allison M; Bastian, Amy J (2013) Does a basic deficit in force control underlie cerebellar ataxia? J Neurophysiol 109:1107-16

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