Using Diffusion Tensor Imaging to Identify the White Matter Correlates of Motor Skill Learning and Visuospatial Processes in Older Adults

Repetitive practice of functional movement patterns during motor rehabilitation are known to drive learning (or relearning) of novel motor skills, but the learning process is highly variable between individuals such that responsiveness to task-specific training is often patient-specific. A number of neuroimaging and neurophysiological methods have been proposed to better predict a patient’s responsiveness to a given type or dose of motor therapy. However, these methods are often time- and resource-intensive, and yield results that are not readily interpretable by clinicians. In contrast, standardized visuospatial tests may offer a more feasible solution. The work presented in this dissertation demonstrate that a clinical paper-and-pencil test of visuospatial function may improve predictive models of motor skill learning in older adults and individuals with stroke pathology. To further our understanding of the neuroanatomical correlates underlying this behavioral relationship, I collected diffusion-weighted magnetic resonance images from 19 nondemented older adults to determine if diffusion characteristics of white matter tracts explain shared variance in delayed visuospatial memory test scores and motor skill learning. Consistent with previous work, results indicated that the structural integrity of regions with the bilateral anterior thalamic radiations, corticospinal tracts, and superior longitudinal fasciculi are related to delayed visuospatial memory performance and one-week skill retention. Overall, results of this dissertation suggest that incorporating a clinical paper-and-pencil test of delayed visuospatial memory may prognose motor rehabilitation outcomes and support that personalized variables should be considered in standards of care. Moreover, regions within specific white matter tracts may underlie this behavioral relationship and future work should investigate these regions as potential targets for therapeutic intervention.