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Preserved motor skill learning in acute stroke patients

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Abstract

Recovery is dynamic during acute stroke, but whether new motor skills can be acquired with the paretic upper limb (UL) during this recovery period is unknown. Clarifying this unknown is important, because neurorehabilitation largely relies on motor learning. The aim was to investigate whether, during acute stroke, patients achieved motor skill learning and retention with the paretic UL. Over 3 consecutive days (D1–D3), 14 patients practiced with their paretic UL the CIRCUIT, a motor skill learning task with a speed/accuracy trade-off (SAT). A Learning Index (LI) was used to quantify normalised SAT changes in comparison with baseline. Spontaneous motor recovery was quantified by another task without SAT constraint (EASY), by grip force (GF), and the Box and Blocks test (BBT). In patients, CIRCUIT LI improved 98% ± 66.2 (mean ± SD). This improvement was similar to that of young healthy individuals (n = 30) who trained with a slightly different protocol for 3 consecutive days (83.8% ± 58.8%). Generalisation of SAT gains to an untrained circuit was observed in both groups. From D1 to D3, stroke patients improved their performance on EASY, while changes in GF and BBT were heterogeneous. During acute stroke, patients retained SAT gains for a motor skill learned with the paretic UL in a manner similar to that of healthy individuals. These results demonstrate acute stroke patients achieved motor skill learning and retention that exceeded paretic UL improvements explained by spontaneous recovery.

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Acknowledgements

We are grateful to the patients who participated in the project, and to the nursing team of the Stroke Unit for flexibility and assistance. We thank W. Gradkowski for the initial development of the “circuit game” software. We thank the healthy individuals, as well as Dr. Brieuc Vanollande and Dr. Barbara Delgrange who collected this data set. We thank Stéphanie Lefebvre (Ph.D.) and Wojciech Gradkowski for the motor task implementation.

Funding

The work of YV was supported by the following grants: Fonds de la Recherche Scientifique (F.R.S.-FNRS, Nos. F 3/5/5-MCF/ROI/BC-19727 and F 3/5/5-MCF/XH/FC-17514) Post-Doctorate Clinical Master Specialist [SPD] 1.R.506.16 and 1.R.506.18, Fonds Spécial de Recherche (FSR) grant from the Université Catholique de Louvain (UCL) 2016, and Fondation Mont-Godinne 2015–2016. The work of MYD was supported by UCL FSR grant in 2013 and by FRNS-FRIA grants F 3/5/5 2014 and 2016. The work of AR was supported by a grant from the Fondation Mont-Godinne 2015 and by a UCL FSR grant 2016. The work of MB was self-funded.

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  1. Marius Baguma

    Present address: Faculty of Health and Life Sciences, Biomedical Research Institute (BIOMED), UHasselt, Agoralaan Building C, 3590, Diepenbeek, Belgium

Authors and Affiliations

  1. Neurology Department, Stroke Unit/NeuroModulation Unit (NeMU), CHU UCL Namur-Site Godinne, Avenue Docteur G. Thérasse, 5530, Yvoir, Belgium

    Marius Baguma, Maral Yeganeh Doost, Audrey Riga, Patrice Laloux & Yves Vandermeeren

  2. Institute of NeuroScience (IoNS), NEUR Division, UCLouvain, 1200, Brussels, Belgium

    Maral Yeganeh Doost, Audrey Riga, Patrice Laloux & Yves Vandermeeren

  3. Louvain Bionics, UCLouvain, 1348, Louvain-la-Neuve, Belgium

    Maral Yeganeh Doost, Audrey Riga & Yves Vandermeeren

  4. Hôpital Provincial Général de Référence de Bukavu, Department of Internal Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo

    Marius Baguma

  5. Scientific Support Unit (USS), UCLouvain, CHU UCL Namur, Avenue Dr G. Therasse, 5530, Yvoir, Belgium

    Benoît Bihin

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  1. Marius Baguma
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Correspondence to Yves Vandermeeren.

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Ethical standards

All procedures performed in this study were approved by the local Ethics Committee (CHU UCL Namur Mont-Godinne) and were in accordance with the 1964 Helsinki declaration and its later amendments.

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All patients (or the next of kin, on the behalf of the patient) provided a written informed consent prior to participating in the study.

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Baguma, M., Yeganeh Doost, M., Riga, A. et al. Preserved motor skill learning in acute stroke patients. Acta Neurol Belg 120, 365–374 (2020). https://doi.org/10.1007/s13760-020-01304-7

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