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@ARTICLE{Nackaerts:843731,
      author       = {Nackaerts, Evelien and Michely, Jochen and Heremans, Elke
                      and Swinnen, Stephan P. and Smits-Engelsman, Bouwien C. M.
                      and Vandenberghe, Wim and Grefkes, Christian and Nieuwboer,
                      Alice},
      title        = {{T}raining for {M}icrographia {A}lters {N}eural
                      {C}onnectivity in {P}arkinson's {D}isease},
      journal      = {Frontiers in neuroscience},
      volume       = {12},
      issn         = {1662-453X},
      address      = {Lausanne},
      publisher    = {Frontiers Research Foundation},
      reportid     = {FZJ-2018-01283},
      pages        = {3},
      year         = {2018},
      abstract     = {Despite recent advances in clarifying the neural networks
                      underlying rehabilitation in Parkinson's disease (PD), the
                      impact of prolonged motor learning interventions on brain
                      connectivity in people with PD is currently unknown.
                      Therefore, the objective of this study was to compare
                      cortical network changes after 6 weeks of visually cued
                      handwriting training (= experimental) with a placebo
                      intervention to address micrographia, a common problem in
                      PD. Twenty seven early Parkinson's patients on dopaminergic
                      medication performed a pre-writing task in both the presence
                      and absence of visual cues during behavioral tests and
                      during fMRI. Subsequently, patients were randomized to the
                      experimental (N = 13) or placebo intervention (N = 14) both
                      lasting 6 weeks, after which they underwent the same testing
                      procedure. We used dynamic causal modeling to compare the
                      neural network dynamics in both groups before and after
                      training. Most importantly, intensive writing training
                      propagated connectivity via the left hemispheric visuomotor
                      stream to an increased coupling with the supplementary motor
                      area, not witnessed in the placebo group. Training enhanced
                      communication in the left visuomotor integration system in
                      line with the learned visually steered training. Notably,
                      this pattern was apparent irrespective of the presence of
                      cues, suggesting transfer from cued to uncued handwriting.
                      We conclude that in early PD intensive motor skill learning,
                      which led to clinical improvement, alters cortical network
                      functioning. We showed for the first time in a
                      placebo-controlled design that it remains possible to
                      enhance the drive to the supplementary motor area through
                      motor learning.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {572 - (Dys-)function and Plasticity (POF3-572)},
      pid          = {G:(DE-HGF)POF3-572},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29403348},
      UT           = {WOS:000422995500002},
      doi          = {10.3389/fnins.2018.00003},
      url          = {https://juser.fz-juelich.de/record/843731},
}