Alzheimer's desease and implicit motor learning – MAAMI

Experiments exploring abilities to represent an action in MCI patients through mental rotation tasks and assess the capacity of postural anticipation. Two experimental groups were formed: a group of elderly people without cognitive impairment and a group of seniors at the MCI stage of Alzheimer's disease. Also an experiment involves implicit learning of rising from floor with an exercise of puzzle which refers to order a motor sequence.
Technologically development of a demonstrator for the development of interactive applications and virtual immersion «games« on digital tablet that will be tested in clinical trials.

Results are in progress:
- Scientifically through the state of the art and experimentation about the knowledge of implicit learning by observation, immersion and empathy in AD patients and the effects of coupling-music movement
- At the technological and industrial level with the design and development of systems used in the home and in institutions,
- Clinically and ethics in terms of feasibility, conditions of use and therapeutic validity.

The project has prevention targets in consequences of Alzheimer's disease and understanding of the linkages that exist among patients with AD, between observation and execution of movement and more generally compensatory mechanisms (implicit mechanisms and link movement / music). It aims to develop tools that will be adapted to the needs of this population to allow effective stimulation of cognitive and motor functions, as close to the activities of daily life.

-Bourrelier J., Kubicki A. , Crognier L., Mourey F. La capacité à simuler des actions évaluée à travers un paradigme implicite de rotation mentale : impact des troubles cognitifs légers dans le cadre de la maladie d’Alzheimer. 2e congrès européen de stimulation cognitive STIMCO. Toulouse, septembre 2014.

-Ferreri, L., Bigand, E., Perrey, S., Muthalib, M., Bugaiska, A. (2014): “Music enhances memory performances in young and older adults by modulating prefrontal cortex activity: an fNIRS study”, 9th FENS (Federation of European Neuroscience Societies) Forum, Milan, Italy 5-9 July 2014.

Alzheimer’s disease (AD) is a progressive illness characterized by a degeneration of neuronal tissue manifesting itself as problems with cerebral functions. Although deficits in memory which are the focus of research efforts are the most salient characteristics of the disease other symptoms could affect the daily activities of the patient before these important changes in memory. Alterations in motor capacities constitute one of these possibilities. The repercussions of AD on motor capacities however remain poorly understood. The project MAAMI (AD and implicit motor learning) belongs to the group of non-medication therapies (National Health Agencies). Such therapies aim to fight against the dependence, confinement and resulting isolation of AD patients (measure 7 of the Alzheimer’s program, axe 2-3 of the Tecsan call).
The aim of the project MAAMI at the theoretical level is to better comprehend the effects of perception-action coupling on the maintenance of the motor capacities in patients suffering from AD (light to moderately effected). At the technical level we aim to reinforce their remaining cognitive and motor capacities with the use of virtual reality interactive games. The adaptation of user interfaces should facilitate their reception to programmes developed for use in the hospitals (outpatient) and at their homes. We will pay attention especially in the clinical approach to avoid the possibility of creating a feeling of failure in the patients.
Attaining these objectives will require us to take into consideration the most recent results coming from the field of integrative neuroscience. These recent advances have not been exploited for use in the fields of cognition and motor activity. This is particularly true of our understanding that common neuronal systems underlie perception and action. The project MAAMI is in continuum with a preceding ANR Tecsan project (2006-2010). The aim of the preceding Tecsan was to develop new methods to help with motor rehabilitation by exploiting the coupling between perception and action execution. In the current project we wish to identify problems with the executive functions of AD patients because of their repercussions for daily life. We seek to develop visual and musical interactive interfaces that solicit systems involved with carrying out and memorising movement sequences. Since implicit memory (perceptive representations) and procedural memory (automatic motor capacities) could be less effected at the early and moderate stages of the disease, we could think of re-activating the physiological substrates responsible for action by perception action coupling hence allowing the development of compensatory mechanisms linked to cerebral plasticity. The originality in the project MAMI will be to consider movement, music and their synchronisation as therapeutic agents. The combination of motor re-education and of musical sequences should favour an improvement in functional capacities and more generally the quality of life.
Finally MAAMI has as an objective the prevention of the consequences of AD, of understanding the coupling that exists between observation and movement and more globally of uncovering compensatory activities (implicit mechanisms connecting music and movement)). The project aims to develop tools adapted to the needs of this population allowing the efficient stimulation of cognitive and motor functions especially in the outpatient care facilities.
This project was previously submitted in 2011 and has been modified based on the recommendations of the reviewers. We emphasize here the connections of this project with the previously funded SIMACTION project. We extend the previous project to the development of a tool targeted for individual use as well as for use in medical rehabilitation institutions. We have reorganized the tasks and sub tasks that were outlined in the previous submission and shortened the duration of the project to 6 months.