Cerebellar degeneration affects cortico-cortical connectivity in motor learning networks

Compressed cerebellar functional connectome hierarchy in spinocerebellar ataxia type 3

Spinocerebellar ataxia type 3 (SCA3) is an inherited movement disorder characterized by a progressive decline in motor coordination. Despite the extensive functional connectivity (FC) alterations reported in previous SCA3 studies in the cerebellum and cerebellar-cerebral pathways, the influence of these FC disturbances on the hierarchical organization of cerebellar functional regions remains unclear. Here, we compared 35 SCA3 patients with 48 age- and sex-matched healthy controls using a combination of voxel-based morphometry and resting-state functional magnetic resonance imaging to investigate whether cerebellar hierarchical organization is altered in SCA3. Utilizing connectome gradients, we identified the gradient axis of cerebellar hierarchical organization, spanning sensorimotor to transmodal (task-unfocused) regions. Compared to healthy controls, SCA3 patients showed a compressed hierarchical organization in the cerebellum at both voxel-level (p < .05, TFCE corrected) and network-level (p < .05, FDR corrected). This pattern was observed in both intra-cerebellar and cerebellar-cerebral gradients. We observed that decreased intra-cerebellar gradient scores in bilateral Crus I/II both negatively correlated with SARA scores (left/right Crus I/II: r = -.48/-.50, p = .04/.04, FDR corrected), while increased cerebellar-cerebral gradients scores in the vermis showed a positive correlation with disease duration (r = .48, p = .04, FDR corrected). Control analyses of cerebellar gray matter atrophy revealed that gradient alterations were associated with cerebellar volume loss. Further FC analysis showed increased functional connectivity in both unimodal and transmodal areas, potentially supporting the disrupted cerebellar functional hierarchy uncovered by the gradients. Our findings provide novel evidence regarding alterations in the cerebellar functional hierarchy in SCA3.

Altered functional connectivity in the hippocampal and striatal systems after motor sequence learning consolidation in medial temporal lobe epilepsy individuals

Both the hippocampal and striatal systems participate in motor sequence learning (MSL) in healthy subjects, and the prominent role of the hippocampal system in sleep-related consolidation has been demonstrated. However, some pathological states may change the functional dominance between these two systems in MSL consolidation. To better understand the functional performance within these two systems under the pathological condition of hippocampal impairment, we compared the functional differences after consolidation between patients with left medial temporal lobe epilepsy (LmTLE) and healthy control subjects (HCs). We assessed participants' performance on the finger-tapping task (FTT) during acquisition (on day 1) and after consolidation during sleep (on day 2). All participants underwent an MRI scan (T1 and resting state) before each FTT. We found that the LmTLE group showed performance deficits in offline consolidation compared to the HC group. The LmTLE group exhibited structural changes, such as decreased gray matter volume (GMV) in the left hippocampus and increased GMV in the right putamen (striatum). Our results also revealed that whereas the main effect of consolidation was observed in the hippocampus-related functional connection in the HC group, it was only evident in the striatum-related functional loop in the LmTLE group. Our findings indicated that LmTLE patients may rely more on the striatal system for offline consolidation because of structural impairments in the hippocampus. Additionally, this compensatory mechanism may not fully substitute for the role of the impaired hippocampus itself.NEW & NOTEWORTHY Motor sequence learning (MSL) relies on both the hippocampal and striatal systems, but whether functional performance is altered after MSL consolidation when the hippocampus is impaired remains unknown. Our results indicated that whereas the main effect of consolidation was observed in the hippocampus-related functional connection in the healthy control (HC) group, it was only evident in the striatum-related functional loop in the left medial temporal lobe epilepsy (LmTLE) group.

Inhibitory temporo-parietal effective connectivity is associated with explicit memory performance in older adults

Successful explicit memory encoding is associated with inferior temporal activations and medial parietal deactivations, which are attenuated in aging. Here we used dynamic causal modeling (DCM) of functional magnetic resonance imaging data to elucidate effective connectivity patterns between hippocampus, parahippocampal place area (PPA), and precuneus during encoding of novel visual scenes. In 117 young adults, DCM revealed pronounced activating input from the PPA to the hippocampus and inhibitory connectivity from the PPA to the precuneus during novelty processing, with both being enhanced during successful encoding. This pattern could be replicated in two cohorts (N = 141 and 148) of young and older adults. In both cohorts, older adults selectively exhibited attenuated inhibitory PPA-precuneus connectivity, which correlated negatively with memory performance. Our results provide insight into the network dynamics underlying explicit memory encoding and suggest that age-related differences in memory-related network activity are, at least partly, attributable to altered temporo-parietal neocortical connectivity.

Visuomotor Adaptation Deficits in Patients with Essential Tremor

Essential tremor (ET) is a progressive movement disorder whose pathophysiology is not fully understood. Current evidence supports the view that the cerebellum is critically involved in the genesis of the tremor in ET. However, it is still unknown whether cerebellar dysfunction affects not only the control of current movements but also the prediction of future movements through dynamic adaptation toward a changed environment. Here, we tested the capacity of 28 patients with ET to adapt in a visuomotor adaptation task known to depend on intact cerebellar function. We found specific impairments in that task compared to age-matched healthy controls. Adaptation to the visual perturbation was disrupted in ET patients, while de-adaptation, the phase after abrupt removal of the perturbation, developed similarly to control subjects. Baseline tremor-independent motor performance was as well similar to healthy controls, indicating that adaptation deficits in ET patients were not rooted in an inability to perform goal-directed movements. There was no association between clinical severity scores of ET and early visuomotor adaptation abilities. These results provide further evidence that the cerebellum is dysfunctional in ET.

What neurological diseases tell us about procedural perceptual-motor learning? A systematic review of the literature

INTRODUCTION

Procedural perceptual-motor learning of sequences (PPMLS) provides perceptual-motor skills in many activities of daily living. Based on behavioral and neuroimaging results, theoretical models of PPMLS postulate that the cortico-striatal loop, the cortico-cerebellar loop and the hippocampus are specifically involved in the early stage of PPMLS while the cortico-striatal loop would be specifically involved in the late stage of PPMLS. Hence, current models predict that the early stage of PPMLS should be impaired in Parkinson's disease (PD: lesion of the cortico-striatal loop), in cerebellar disease (CD: lesion of the cortico-cerebellar loop) and in Alzheimer's disease (AD: lesion of the hippocampus), whereas the late stage of PPMLS should be specifically impaired in PD.

OBJECTIVE

The aim of the study is (1) to draw a complete picture of experimental results on PPMLS in PD, CD and AD (2) to understand heterogeneity of results as regard to participant and task characteristics.

METHOD

This review is based on the guideline proposed by the PRISMA statement.

RESULTS

Our review reveals (1) that the experimental results clarify the theoretical models and (2) that the impairment of PPMLS depends on both the personal characteristics of the participants and the characteristics of the task to-be-learnt rather than on the disease itself.

CONCLUSION

Our results highlight that these characteristics should be more carefully considered to understand the heterogeneity of results across studies on PPMLS and the effects of rehabilitation programs.

Relationship between neurological and cerebellar soft signs, and implicit motor learning in schizophrenia and bipolar disorder

BACKGROUND

Schizophrenia (SZ) and bipolar disorder (BD) patients share deficits in motor functions in the form of neurological (NSS) and cerebellar soft signs (CSS), and implicit motor learning disturbances. Here, we use cluster analysis method to assess (1) the relationship between those abnormalities in SZ and BD and (2) the differences between those groups.

METHODS

33 SZ patients, 33 BD patients as well as 31 healthy controls (HC) took part in the study. We assessed CSS with the International Cooperative Ataxia Rating Scale (ICARS) and NSS with the Neurological Evaluation Scale (NES). Implicit motor learning was evaluated with the Serial Reaction Time Task (SRTT). Participants were divided into clusters (Ward's method) based on the mean response time and mean error rate in SRTT. The difference in ICARS and NES scores, and SRTT variables between clusters were evaluated. We have measured associations between SRTT parameters and both ICARS and NES total scores and subscores.

RESULTS

Cluster analysis based on the SRTT parameters allowed to extract three clusters. Those were characterized by the increasing disruption of motor functioning (psychomotor retardation, the severity of NSS and CSS) regardless of the diagnosis. Cluster 1 covered almost all of HC and was characterized by faster reaction times and small number of errors. BD and SZ patients represented in cluster 1, although fully functional in performing the SRTT, showed higher rates of NSS and CSS. Patients with BD and SZ were set apart in clusters 2 and 3 in a similar proportion. Cluster 2 presented significantly slower reaction times but with the comparable number of errors to cluster 1. Cluster 3 consisted of participants with normal or decreased reaction time and significantly increased number of errors. None of the clusters were predominantly composed of the patients representing one psychiatric diagnosis.

CONCLUSIONS

To our best knowledge, we are presenting the first data indicating the relationship between implicit motor learning and NSS and CSS in SZ and BD patients' groups. Lack of clusters predominantly represented by patients with the diagnosis of SZ or BD may refer to the model of schizophrenia-bipolar disorder boundary, pointing out the similarities between those two disorders.

Motor training-related brain reorganization in patients with cerebellar degeneration

Cerebellar degeneration progressively impairs motor function. Recent research showed that cerebellar patients can improve motor performance with practice, but the optimal feedback type (visual, proprioceptive, verbal) for such learning and the underlying neuroplastic changes are unknown. Here, patients with cerebellar degeneration (N = 40) and age‐ and sex‐matched healthy controls (N = 40) practiced single‐joint, goal‐directed forearm movements for 5 days. Cerebellar patients improved performance during visuomotor practice, but a training focusing on either proprioceptive feedback, or explicit verbal feedback and instruction did not show additional benefits. Voxel‐based morphometry revealed that after training gray matter volume (GMV) was increased prominently in the visual association cortices of controls, whereas cerebellar patients exhibited GMV increase predominantly in premotor cortex. The premotor cortex as a recipient of cerebellar efferents appears to be an important hub in compensatory remodeling following damage of the cerebro‐cerebellar motor system.

Role of Cortico-ponto-cerebellar Tract from Supplementary Motor Area in Ataxic Hemiparesis of Supratentorial Stroke Patients

Cortical lesions of the supplementary motor area (SMA) are important in balance control and postural recovery in stroke patients, while the role of subcortical lesions of the SMA has not been studied. This study aimed to investigate the subcortical projections of the SMA and its relationship with ataxia in supratentorial stroke patients. Thirty-three patients with hemiparesis were divided into 3 groups (severe ataxia, n = 9; mild to moderate ataxia, n = 13; no ataxia, n = 11). Ataxia severity was assessed using the Scale for Ataxia Rating Assessment. Diffusion tensor imaging analysis used the fractional anisotropy (FA) values and tract volume as parameters of white matter tract degeneration. The FA values of regions related to ataxia were analyzed, that is the SMA, posterior limb of the internal capsule, basal ganglia, superior cerebellar peduncle, middle cerebellar peduncle, inferior cerebellar peduncle, and cerebellum. Tract volumes of the corticostriatal tract and cortico-ponto-cerebellar (CPC) tract originating from the SMA were evaluated. There were significant differences among the 3 groups in FA values of the subcortical regions of the CPC tract. Furthermore, the volume of the CPC tract originating from the SMA showed significant negative correlation with ataxia severity. There was no correlation between ataxia and corticostriatal tract volume. Therefore, we found that subcortical lesions of the CPC tract originating from the SMA could contribute to ataxia severity in stroke patients with ataxic hemiparesis.

Effects of Anodal Cerebellar Transcranial Direct Current Stimulation on Movements in Patients with Cerebellar Ataxias: A Systematic Review

Cerebellar transcranial direct current stimulation (cerebellar tDCS) is a promising therapy for cerebellar ataxias and has attracted increasing attention from researchers and clinicians. A timely systematic review focusing on randomized sham-controlled trials and repeated measures studies is warranted. This study was to systematically review existing evidence regarding effects of anodal cerebellar tDCS on movements in patients with cerebellar ataxias. The searched databases included Web of Science, MEDLINE, PsycINFO, CINAHL, EMBASE, Cochrane Library, and EBSCOhost. Methodological quality of the selected studies was assessed using the Physiotherapy Evidence Database scale. Five studies with 86 patients were identified. Among these, four studies showed positive effects of anodal cerebellar tDCS. Specifically, anodal cerebellar tDCS decreased disease severity and improved finger dexterity and quality of life in patients, but showed incongruent effects on gait control and balance, which may be due to heterogeneity of research participants and choices of measures. The protocols of anodal cerebellar tDCS that improved movements in patients commonly placed the anode over the whole cerebellum and provided ten 2-mA 20-min stimulation sessions. The results may show preliminary evidence that anodal cerebellar tDCS is beneficial to reducing disease severity and improving finger dexterity and quality of life in patients, which lays the groundwork for future studies further examining responses in the cerebello-thalamo-cortical pathway. An increase in sample size, the use of homogeneous patient groups, exploration of the optimal stimulation protocol, and investigation of detailed neural mechanisms are clearly needed in future studies.

Unique behavioral strategies in visuomotor learning: Hope for the non-learner

The existence of individual differences in motor learning capability is well known but the behaviors or strategies that contribute to this variability have been vastly understudied. What performance characteristics distinguish an expert level performer from individuals who experience little to no success, those labeled non-learners? We designed a rule-based visuomotor task which requires identification (discovery) and then exploitation of specific explicit and implicit task components that requires a specific movement pattern, the task rule, for goal achievement. When participants first attempt the task, they are informed about the goal, but are naïve to the task rule. Therefore, the purpose of this experiment is to determine how acquisition of both implicit and explicit task components, the inherent elements of the task rule, reveals differing strategies associated with performance and task success. We test the hypothesis that an examination of performance will reveal sub-groups with varying levels of success. Further, for each subgroup, we expect to find a unique relationship between visual Time-in-Target feedback (a measure of success) and subsequent updating of each task component. Out of 32 non-disabled adults, we identified three distinct sub-groups: (Low Performer/Non-Learner (LP, N = 9), Moderate Performer (MP, N = 12) and High Performer (HP, N = 11)). A quantitative analysis of behavioral patterns reveals three findings: First, the LP sub-group demonstrated significantly lower task success which was associated with difficulty identifying the explicit component of the task. Second, the HP sub-group acquired the two task components in parallel over practice. Third, when both explicit and implicit component performance is plotted across sub-groups, a task component continuum emerges that seamlessly progresses from low to moderate to high performer groups. An exploratory analysis reveals that self-reported level of prior lifetime accumulation of video game and physical activity experience is a significant predictor of individual task performance (R² = 0.50). In summary, what appears to be a key distinction between varying levels of human rule-based motor learning is the process by which feedback is used to update performance of inherent elements of the task rule. Evidence of a performance continuum and limited prior experience suggests that Low Performer/Non-Learners are generally inexperienced with these kinds of tasks, although the role of genetics and other innate learning capabilities in visuomotor learning is still largely unknown. These findings provoke new research directions toward probing the differential performance strategies associated with expertise and the development of interventions aimed to convert non-learners into learners.

PONT: A Protocol for Online Neuropsychological Testing

A major challenge for neuropsychological research arises from the fact that we are dealing with a limited resource: the patients. Not only is it difficult to identify and recruit these individuals, but their ability to participate in research projects can be limited by their medical condition. As such, sample sizes are small, and considerable time (e.g., 2 years) is required to complete a study. To address limitations inherent to laboratory-based neuropsychological research, we developed a protocol for online neuropsychological testing (PONT). We describe the implementation of PONT and provide the required information and materials for recruiting participants, conducting remote neurological evaluations, and testing patients in an automated, self-administered manner. The protocol can be easily tailored to target a broad range of patient groups, especially those who can be contacted via support groups or multisite collaborations. To highlight the operation of PONT and describe some of the unique challenges that arise in online neuropsychological research, we summarize our experience using PONT in a research program involving individuals with Parkinson's disease and spinocerebellar ataxia. In a 10-month period, by contacting 646 support group coordinators, we were able to assemble a participant pool with over 100 patients in each group from across the United States. Moreover, we completed six experiments (n > 300) exploring their performance on a range of tasks examining motor and cognitive abilities. The efficiency of PONT in terms of data collection, combined with the convenience it offers the participants, promises a new approach that can increase the impact of neuropsychological research.

Motor Sequence Learning Deficits in Idiopathic Parkinson's Disease Are Associated With Increased Substantia Nigra Activity

Previous studies have shown that persons with Parkinson’s disease (pwPD) share specific deficits in learning new sequential movements, but the neural substrates of this impairment remain unclear. In addition, the degree to which striatal dopaminergic denervation in PD affects the cortico-striato-thalamo-cerebellar motor learning network remains unknown. We aimed to answer these questions using fMRI in 16 pwPD and 16 healthy age-matched control subjects while they performed an implicit motor sequence learning task. While learning was absent in both pwPD and controls assessed with reaction time differences between sequential and random trials, larger error-rates during the latter suggest that at least some of the complex sequence was encoded. Moreover, we found that while healthy controls could improve general task performance indexed by decreased reaction times across both sequence and random blocks, pwPD could not, suggesting disease-specific deficits in learning of stimulus-response associations. Using fMRI, we found that this effect in pwPD was correlated with decreased activity in the hippocampus over time. Importantly, activity in the substantia nigra (SN) and adjacent bilateral midbrain was specifically increased during sequence learning in pwPD compared to healthy controls, and significantly correlated with sequence-specific learning deficits. As increased SN activity was also associated (on trend) with higher doses of dopaminergic medication as well as disease duration, the results suggest that learning deficits in PD are associated with disease progression, indexing an increased drive to recruit dopaminergic neurons in the SN, however, unsuccessfully. Finally, there were no differences between pwPD and controls in task modulation of the cortico-striato-thalamo-cerebellar network. However, a restricted nigral-striatal model showed that negative modulation of SN to putamen connection was larger in pwPD compared to controls during random trials, while no differences between the groups were found during sequence learning. We speculate that learning-specific SN recruitment leads to a relative increase in SN- > putamen connectivity, which returns to a pathological reduced state when no learning takes place.

Neurostructural changes and declining sensorimotor function due to cerebellar cortical degeneration

Neurodegeneration of the cerebellum progresses over years and primarily affects cerebellar cortex. It leads to a progressive loss of control and coordination of gait, posture, speech, fine motor, and oculomotor function. Yet, little is known how the cerebro-cerebellar network compensates for the loss in cerebellar cortical neurons. To address this knowledge gap, we examined 30 people with cerebellar cortical degeneration and a group of 30 healthy controls. We assessed visuomotor performance during a forearm-pointing task to 10°, 25°, and 50° targets. In addition, using MRI imaging, we determined neurodegenerative-induced changes in gray matter volume (GMV) in the cerebro-cerebellar network and correlated them to markers of motor performance. The main results are as follows: first, the relative joint position error (RJPE) during pointing was significantly greater in the ataxia group for all targets confirming the expected motor control deficit. Second, in the ataxia group, GMV was significantly reduced in cerebellar cortex but increased in the deep cerebellar nuclei. Motor error (RJPE) correlated negatively with decreased cerebellar GMV but positively with increased GMV in supplementary motor area (SMA) and premotor cortex. GMV of the deep cerebellar nuclei did not correlate significantly with markers of motor performance. We discuss whether the GMV changes in the cerebellar output nuclei and the extracerebellar efferent targets in secondary motor cortex can be understood as a central compensatory response to the neurodegeneration of the cerebellar cortex.NEW & NOTEWORTHY Neurodegeneration of the cerebellum progresses over years and primarily affects cerebellar cortex. It leads to a progressive loss of control and coordination of movement. We here show that the neurodegenerative process not only leads to cells loss in cerebellar cortex but also induces neurostructural changes in the form of increased gray matter in the efferent targets of the cerebellar cortex, namely, the cerebellar output nuclei, the SMA, and premotor cortex.

The Ties That Bind: Aberrant Plasticity and Networks Dysfunction in Movement Disorders-Implications for Rehabilitation

Background: Movement disorders encompass various conditions affecting the nervous system. The pathological processes underlying movement disorders lead to aberrant synaptic plastic changes, which in turn alter the functioning of large-scale brain networks. Therefore, clinical phenomenology does not only entail motor symptoms but also cognitive and motivational disturbances. The result is the disruption of motor learning and motor behavior. Due to this complexity, the responsiveness to standard therapies could be disappointing. Specific forms of rehabilitation entailing goal-based practice, aerobic training, and the use of noninvasive brain stimulation techniques could "restore" neuroplasticity at motor-cognitive circuitries, leading to clinical gains. This is probably associated with modulations occurring at both molecular (synaptic) and circuitry levels (networks). Several gaps remain in our understanding of the relationships among plasticity and neural networks and how neurorehabilitation could promote clinical gains is still unclear. Purposes: In this review, we outline first the networks involved in motor learning and behavior and analyze which mechanisms link the pathological synaptic plastic changes with these networks' disruption in movement disorders. Therefore, we provide theoretical and practical bases to be applied for treatment in rehabilitation.

The Cerebellum and Implicit Sequencing: Evidence from Cerebellar Ataxia

The cerebellum recognizes sequences from prior experiences and uses this information to generate internal models that predict future outcomes in a feedforward manner [Front Hum Neurosci 8: 475, 2014; Cortex 47: 137-44, 2011; Cerebellum 7: 611-5, 2008; J Neurosci 26: 9107-16, 2006]. This process has been well documented in the motor domain, but the cerebellum's role in cognitive sequencing, within the context of implicit versus explicit processes, is not well characterized. In this study, we tested individuals with cerebellar ataxia and healthy controls to clarify the role of the cerebellum sequencing using variations on implicit versus explicit and motor versus cognitive demands across five experiments. Converging results across these studies suggest that cerebellar feedforward mechanisms may be necessary for sequencing in the implicit domain only. In the ataxia group, rhythmic tapping, rate of motor learning, and implicit sequence learning were impaired. However, for cognitive sequencing that could be accomplished using explicit strategies, the cerebellar group performed normally, as though they shifted to extra-cerebellar mechanisms to compensate. For example, when cognitive and motor functions relied on cerebellar function simultaneously, the ataxia group's motor function was unaffected, in contrast to that of controls whose motor performance declined as a function of cognitive load. These findings indicated that the cerebellum is not critical for all forms of sequencing per se. Instead, it plays a fundamental role for sequencing within the implicit domain, whether functions are motor or cognitive. Moreover, individuals with cerebellar ataxia are generally able to compensate for cognitive sequencing when explicit strategies are available in order to preserve resources for motor function.

Beneficial effects of cerebellar tDCS on motor learning are associated with altered putamen-cerebellar connectivity: A simultaneous tDCS-fMRI study

Non-invasive transcranial stimulation of cerebellum and primary motor cortex (M1) has been shown to enhance motor learning. However, the mechanisms by which stimulation improves learning remain largely unknown. Here, we sought to shed light on the neural correlates of transcranial direct current stimulation (tDCS) during motor learning by simultaneously recording functional magnetic resonance imaging (fMRI). We found that right cerebellar tDCS, but not left M1 tDCS, led to enhanced sequence learning in the serial reaction time task. Performance was also improved following cerebellar tDCS compared to sham in a sequence production task, reflecting superior training effects persisting into the post-training period. These behavioral effects were accompanied by increased learning-specific activity in right M1, left cerebellum lobule VI, left inferior frontal gyrus and right inferior parietal lobule during cerebellar tDCS compared to sham. Despite the lack of group-level changes comparing left M1 tDCS to sham, activity increase in right M1, supplementary motor area, and bilateral middle frontal cortex, under M1 tDCS, was associated with better sequence performance. This suggests that lack of group effects in M1 tDCS relate to inter-individual variability in learning-related activation patterns. We further investigated how tDCS modulates effective connectivity in the cortico-striato-cerebellar learning network. Using dynamic causal modelling, we found altered connectivity patterns during both M1 and cerebellar tDCS when compared to sham. Specifically, during cerebellar tDCS, negative modulation of a connection from putamen to cerebellum was decreased for sequence learning only, effectively leading to decreased inhibition of the cerebellum. These results show specific effects of cerebellar tDCS on functional activity and connectivity in the motor learning network and may facilitate the optimization of motor rehabilitation involving cerebellar non-invasive stimulation.

Implicit learning of symmetry of human movement and gray matter density: Evidence against pure domain general and pure domain specific theories of implicit learning

Theories of the neural basis of implicit learning postulated that specific regions were responsible for specific structures (e.g., supra-finite state) regardless of domain (e.g., vision, movement); others assumed that implicit learning was the adaptation that occurred within neural regions dealing with each domain. We explored whether people could implicitly learn to detect symmetry in biological motion, and if so, based on voxel-based morphometry (VBM), whether the learning was associated with language-related regions involved with supra-finite state grammars (such as symmetry) or motor-related regions. To explore the relevance of motor-related regions, we investigated brain structural changes in athletes compared with non-athletes and the advantage of athletes in implicit learning of action symmetry. Further, we examined whether motor imagery ability could account for the role of motor-related regions in this learning. Participants passively observed and memorized a number of biological motion sequences instantiating a symmetry rule and then judged new sequences as grammatical or not. Behaviorally, the implicit acquisition of symmetry could extend to process biological motion. Athletes showed superior classification accuracy and kinesthetic imagery ability, and gave more familiarity attributions. VBM results showed that athletes exhibited greater gray matter density in the right cerebellum, as well as the left lingual gyrus, the left precuneus, the left calcarine gyrus, and the right thalamus. Correlation analysis showed that the cerebellar gray matter density was positively associated with classification accuracy, which was mediated by kinesthetic imagery ability. Moreover, gray matter density of the left inferior frontal cortex was also positively associated with classification accuracy, indicating the involvement of regions related to symmetry learning across domains. The study provides initial evidence that implicit learning involves both adaptation within brain regions responsible for the specific domain as well as brain regions processing the same structure across domains, at least in a case of supra-finite state grammars.

Do the Dento-Thalamic Connections of Genetic Absence Epilepsy Rats from Strasbourg Differ from Those of Control Wistar Rats?

The thalamo-cortical circuit is important in the genesis of absence epilepsy. This circuit can be influenced by connecting pathways from various parts of central nervous system. The aim of the present study is to define the dento-thalamic connections in Wistar animals and compare the results with genetic absence epilepsy rats from Strasbourg (GAERS) using the biotinylated dextran amine (BDA) tracer. We injected BDA into the dentate nucleus of 13 (n = 6 Wistar and n = 7 GAERS) animals. The dento-thalamic connections in the Wistar animals were denser and were connected to a wider range of thalamic nuclei compared with GAERS. The dentate nucleus was bilaterally connected to the central (central medial [CM], paracentral [PC]), ventral (ventral medial [VM], ventral lateral [VL], and ventral posterior lateral [VPL]), and posterior (Po) thalamic nuclei in Wistar animals. The majority of these connections were dense contralaterally and scarce ipsilaterally. Contralateral connections were present with the parafascicular (PF), ventral posterior medial, ventral anterior (VA), and central lateral (CL) thalamic nuclei in Wistar animals. Whereas in GAERS, bilateral connections were observed with the VL and CM. Contralateral connections were present with the PC, VM, VA, and PF thalamic nuclei in GAERS. The CL, VPL, and Po thalamic nucleus connections were not observed in GAERS. The present study showed weak/deficit dento-thalamic connections in GAERS compared with control Wistar animals. The scarce information flow from the dentate nucleus to thalamus in GAERS may have a deficient modulatory role on the thalamus and thus may affect modulation of the thalamo-cortical circuit.

New Horizons in Early Dementia Diagnosis: Can Cerebellar Stimulation Untangle the Knot?

Differentiating Mild Cognitive Impairment (MCI) from dementia and estimating the risk of MCI-to-dementia conversion (MDC) are challenging tasks. Thus, objective tools are mandatory to get early diagnosis and prognosis. About that, there is a growing interest on the role of cerebellum-cerebrum connectivity (CCC). The aim of this study was to differentiate patients with an early diagnosis of dementia and MCI depending on the effects of a transcranial magnetic stimulation protocol (intermittent theta-burst stimulation -iTBS) delivered on the cerebellum able to modify cortico-cortical connectivity. Indeed, the risk of MDC is related to the response to iTBS, being higher in non-responder individuals. All patients with MCI, but eight (labelled as MCI-), showed preserved iTBS aftereffect. Contrariwise, none of the patients with dementia showed iTBS aftereffects. None of the patients showed EEG aftereffects following a sham TBS protocol. Five among the MCI- patients converted to dementia at 6-month follow-up. Our data suggest that cerebellar stimulation by means of iTBS may support the differential diagnosis between MCI and dementia and potentially identify the individuals with MCI who may be at risk of MDC. These findings may help clinicians to adopt a better prevention/follow-up strategy in such patients.