Motor sequence learning in patients with ideomotor apraxia: Effects of long-term training

Neuropsychologia, vol. 159, pp. 107921

Abstract

Recent studies show that limb apraxia is a quite frequent, yet often underdiagnosed, higher motor impairment following stroke. Because it adversely affects every-day life and personal independence, successful rehabilitation of apraxia is essential for personal well-being. Nevertheless, evidence of long-term efficacy of training schemes and generalization to untrained actions is still scarce. One possible reason for the tendency of this neurological disorder to persist may be a deficit in planning, conceptualisation and storage of complex motor acts. This pilot study aims at investigating explicit motor learning in apractic stroke patients. In particular, we addressed the ability of apractic patients to learn and to retain new explicit sequential finger movements across 10 training sessions over a 3-week interval. Nine stroke patients with ideomotor apraxia in its chronic stage participated in a multi-session training regimen and were included in data analyses. Patients performed an explicit finger sequence learning task (MSLT - motor sequence learning task), which is a well-established paradigm to investigate motor learning and memory processes. Patients improved task performance in terms of speed and accuracy across sessions. Specifically, they showed a noticeable reduction in the mean time needed to perform a correct sequence and the number of erroneous sequences. We found also a trend for improved performance at the Goldenberg apraxia test protocol: "imitation of meaningless hand and finger gestures" relative to when assessed before the MSLT training. Patients with ideomotor apraxia demonstrated the ability to acquire and maintain a novel sequence of movements; and, this training was associated with hints towards improvement of apraxia symptoms.

Authors 12

1. Sarah Willms Aachen Department of Neurology, Medical Faculty Division for Clinical and Cognitive Sciences

   RWTH Aachen University

   Affiliation as printed

   Division for Clinical and Cognitive Sciences, Department of Neurology, Medical Faculty, RWTH Aachen University, Germany

2. Miriam Abel Aachen Department of Neurology, Medical Faculty Division for Clinical and Cognitive Sciences

   RWTH Aachen University

   Affiliation as printed

   Division for Clinical and Cognitive Sciences, Department of Neurology, Medical Faculty, RWTH Aachen University, Germany

3. Avi Karni

   University of Haifa

   Affiliation as printed

   Department of Neurobiology, University of Haifa, Israel

4. Carmit Gal

   University of Haifa

   Affiliation as printed

   Department of Neurobiology, University of Haifa, Israel

5. Julien Doyon

   McGill University

   Affiliation as printed

   McConnell Brain Imaging Centre, McGill University, Montreal, Canada

6. Bradley R. King

   KU Leuven · University of Utah

   Affiliation as printed

   Department of Health and Kinesiology, University of Utah, USA; Department of Movement Sciences, KU Leuven, Belgium

   Department of Health and Kinesiology, University of Utah, USA

   Department of Movement Sciences, KU Leuven, Belgium

7. Joseph Claßen

   Leipzig University

   Affiliation as printed

   Department of Neurology, University of Leipzig, Germany

8. Jost‐Julian Rumpf

   Leipzig University

   Affiliation as printed

   Department of Neurology, University of Leipzig, Germany

9. Giovanni Buccino

   IRCCS Ospedale San Raffaele · Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele · Vita-Salute San Raffaele University

   Affiliation as printed

   Division of Neuroscience, IRCCS San Raffaele and Vita Salute San Raffaele University, Milano, Italy

10. Antonello Pellicano Aachen Department of Neurology, Medical Faculty Division for Clinical and Cognitive Sciences

    RWTH Aachen University

    Affiliation as printed

    Division for Clinical and Cognitive Sciences, Department of Neurology, Medical Faculty, RWTH Aachen University, Germany

11. Juliane Klann Aachen Department of Neurology, Medical Faculty Division for Clinical and Cognitive Sciences

    RWTH Aachen University · SRH University of Applied Sciences Heidelberg

    Affiliation as printed

    Division for Clinical and Cognitive Sciences, Department of Neurology, Medical Faculty, RWTH Aachen University, Germany; SRH University of Applied Health Sciences, Campus Heidelberg, Germany

    Division for Clinical and Cognitive Sciences, Department of Neurology, Medical Faculty, RWTH Aachen University, Germany

    SRH University of Applied Health Sciences, Campus Heidelberg, Germany

12. Ferdinand Binkofski corresponding Aachen Department of Neurology, Medical Faculty Division for Clinical and Cognitive Sciences

    RWTH Aachen University · Forschungszentrum Jülich

    Affiliation as printed

    Division for Clinical and Cognitive Sciences, Department of Neurology, Medical Faculty, RWTH Aachen University, Germany; Institute for Medicine and Neuroscience (INM-4), Research Center Jülich GmbH, Germany. Electronic address: fbinofski@ukaachen.de

    Division for Clinical and Cognitive Sciences, Department of Neurology, Medical Faculty, RWTH Aachen University, Germany

    Institute for Medicine and Neuroscience (INM-4), Research Center Jülich GmbH, Germany