Learning in Stroke

After a stroke, plasticity occurs in the brain from microscopic to network level with positive but also negative consequences for functional recovery. Why post-stroke plasticity takes a beneficial or a maladaptive direction is still incompletely understood. Because the biological mechanisms underlying sensorimotor learning parallel those observed during recovery, learning mechanisms could be potential modifiers of post-stroke neuroplasticity and have a discrete mal-/adaptive impact on the recovery of sensorimotor function. This project seeks to further the understanding of the link between brain circuits that control the integration of new information during procedural learning in the injured brain and those circuits that are involved in adaptive plastic changes during recovery of sensorimotor function post-stroke. The project's methodological approach will allow the characterization of procedural learning-related neural network dynamics based on functional magnetic resonance imaging (MRI) in human volunteers with and without neurologically impairment post-stroke. Through multivariate integration of behavioral and biological descriptors of sensorimotor recovery, the project will investigate the association between motor learning-related network dynamics and descriptors of recovery.

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Key information

Conditions

Stroke Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Nervous System Diseases Sensorimotor Impairment Vascular Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Medical University of South Carolina

Charleston, South Carolina, 29425, United States

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

For all participants:

adult volunteers (age ≥18 years)
right-hand dominance as defined by the Edinburgh Handedness Inventory

Stroke-specific inclusion criteria:

ischemic or hemorrhagic lesion
subcortical or cortical tissue involvement
chronic phase (>6 months) after their index lesion
voluntary whole-hand grip force (MRC, Medical Research Council scale for muscle force ≥2)
repeated release (standardized as a reduction of 50% of maximum voluntary contraction measured with a dynamometer)

Exclusion criteria

For all participants:

Presence of any MRI risk factors
substance use disorder
psychotic disorders

Stroke-group specific exclusion criteria:

Primary intracerebral hematoma
subarachnoid hemorrhage
bi-hemispheric or cerebellar strokes
other concomitant neurological disorders affecting upper extremity motor function
documented history of dementia before or after stroke
severe aphasia, particularly of receptive nature (NIHSS Language subsection ≥2), affecting their ability to understand the purpose of the study and give informed consent
uncontrolled hypertension despite treatment
intake of tricyclic anti-depressants or neuroleptic medication.

Treatment and study plan

Visuomotor learning task

Behavioral

Participants undergo functional magnetic resonance imaging during the performance of the visuomotor learning task. The visuomotor learning task involves holding a device in the hand that measures the strength of the grip when squeezing the 'gripper'.

Primary outcomes

Learning Rate as Indexed by Change in the Precision of Visuomotor Grip Force Adjustment (i.e., Reduction of Precision Error in Force Adjustment)

Time frame: Pre Learning Session and Post Learning Session (approximately 90 minutes)

Isometric whole-hand grip force is captured continuously with grip-force transducers (at 1000Hz) and adjusted relative to the individual maximum voluntary contraction.

Precision of force adjustment is based on the recorded muscle force monitored during task performance and defined as the actual force exerted by the participant relative to the target force (measurement unit: precision in %), with positive values indicating over- and negative values indicating undershoot. Learning rate from before to after learning will be defined as the difference in precision between before as compared to after one single learning session. Precision error was calculated as the percentage deviation of the actual grip force from the target force, averaged across trials before and after the learning task. A reduction in force error indexes a behavioral advantage of force adjustment over time and is thus interpreted as learning.
Change in Blood-oxygen-level-dependent (BOLD) Signal Derived Multi-voxel Brain Activation

Time frame: Pre Learning Session and Post Learning Session (approximately 90 minutes)

Learning-related BOLD-signal-derived brain activation relative to motor performance.

Sponsors and collaborators

Lead sponsor

Medical University of South Carolina

Other

Collaborators

National Institute of General Medical Sciences (NIGMS)

Registry information

Official study title

Neural Circuitries of Motor Learning as a Target to Modulate Sensorimotor Recovery After Stroke

Important dates

Study start: 2022
Primary completion: 2024
Study completion: 2025
First posted: Aug 23, 2022
Registry last updated: Oct 20, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed