Reward enhances motor adaptation learning in acute stroke patients

Abstract

AbstractThe majority of motor recovery occurs within the first weeks after stroke and has been hypothesized to rely on similar mechanisms as motor learning. However, it remains unknown whether acute stroke patients are capable of error-based motor adaptation learning and, if so, whether such learning may be enhanced by reinforcement feedback. Here, we show for the first time that acute stroke patients exhibit successful error-based motor adaptation with their paretic hand by replicating well-known phenomena such as savings and retention of adaptation learning. Notably, reward and punishment feedback exerted dissociative modulatory effects on motor adaptation. Contrary to findings in healthy subjects and chronic stroke patients, punishment did not enhance learning rates during early adaptation but led to poorer performance than reward. Most importantly, reward feedback enhanced both initial learning and retention, emphasizing the potential of reward and discouraging punishment feedback in early neurorehabilitation after stroke.