Pediatric dystonia is a poorly understood disorder characterized by involuntary and repetitive twisting movements often associated with attempts at voluntary movement. Recent studies have suggested that a dysfunction of neuroplasticity and learning may be responsible for some types of focal dystonia in adults. Whether plasticity mechanisms are responsible for childhood generalized dystonia is not known. We propose a series of experiments to determine whether there are motor learning mechanisms in children with cerebral palsy and generalized dystonia. We plan to use a well established motor learning paradigm where the subject interacts with a robotic manipulandum during arm reaching tasks. Learning will be analyzed in children with dystonia and normal controls, and results will be compared to predictions of specific models of computational learning. A retraining paradigm will be developed based on the best-fit model for the subjects. We expect that these experiments may provide new insight into possible therapeutic strategies that leverage brain plasticity and learning mechanisms associated with the voluntary execution of movement.
