title: Impaired motor learning by a pursuit rotor test reduces functional outcomes during rehabilitation of poststroke ataxia.
abstract: BACKGROUND
  Motor learning is essential to gain skills with neurorehabilitation.
  
  
  OBJECTIVE
  To investigate whether capacity for motor learning affects rehabilitation outcome and its relevant brain activation in ataxic patients with stroke.
  
  
  METHODS
  Twelve patients presenting with ataxia admitted for inpatient rehabilitation 2 to 3 months after infratentorial stroke and 6 control subjects performed 8 repetitions of 30-second pursuit rotor (PR) task. Cortical oxygenated hemoglobin (oxyHb) signals were measured using functional near-infrared spectroscopy.
  
  
  RESULTS
  Both patients and controls learned the PR skill, although the gains in PR performance were significantly lower in patients. In patients, the less learning significantly correlated with smaller rehabilitation gains assessed by the Functional Independence Measure. The Fugl-Meyer score for coordination and balance did not change. Center of task-related increase of cortical oxyHb signals shifted from the presupplementary motor area (preSMA) to the supplementary motor area (SMA) with task repetitions in controls but not in patients. Accordingly, serial changes of ratio of oxyHb increase in the preSMA to SMA (preSMA/SMA ratio) were significantly different between the groups. In patients and controls, gains in PR performance and changes of the preSMA/SMA ratio correlated.
  
  
  CONCLUSIONS
  Impaired motor sequence learning by the PR task was correlated with reduced rehabilitation gains for ataxic patients with stroke.
authors.affiliation: Neurorehabilitation Research Institute, Morinomiya Hospital, Osaka, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Hatakenaka
authors.forename: Ichiro
authors.initials: I
authors.lastname: Miyai
authors.forename: Masahito
authors.initials: M
authors.lastname: Mihara
authors.forename: Hajime
authors.initials: H
authors.lastname: Yagura
authors.forename: Noriaki
authors.initials: N
authors.lastname: Hattori
mesh_terms: D000704:Analysis of Variance; D001259:Ataxia / Q000209:etiology / Q000473:pathology / Q000534:rehabilitation*; D001921:Brain / Q000378:metabolism / Q000473:pathology; D001931:Brain Mapping; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007858:Learning / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology*; D009788:Occupational Therapy / Q000379:methods; D010108:Oxyhemoglobins / Q000378:metabolism; D020127:Recovery of Function / Q000502:physiology*; D019265:Spectroscopy, Near-Infrared; D020521:Stroke / Q000150:complications; D016896:Treatment Outcome
chemical_list: D010108:Oxyhemoglobins