Table_1_Can Daytime Napping Assist the Process of Skills Acquisition After Stroke?.DOCX

Acquisition and reacquisition of skills is a main pillar of functional recovery after stroke. Nighttime sleep has a positive influence on motor learning in healthy individuals, whereas the effect of daytime sleep on neuro-rehabilitative training and relearning of the trained skills is often neglected. The aim of this study was to investigate the relationship between daytime sleep (napping) and the ability to learn a new visuomotor task in chronic stroke patients. The main hypothesis was that sleep enhances motor memory consolidation after training resulting in better motor performance after a period of daytime sleep. Thirty stroke survivors completed the study. They were randomized to one of three different conditions (i) wakeful resting, (ii) short nap (10–20 min), or (iii) long nap (50–80 min). All individuals trained the task with the contralesional, stroke-impaired hand, behavioral evaluation was performed after the break time (wake, nap), and 24 h later. Patients demonstrated a significant task-related behavioral improvement throughout the training. In contrast to the main hypothesis, there was no evidence for sleep-dependent motor consolidation early after the initial, diurnal break, or after an additional full night of sleep. In a secondary analysis, the performance changes of stroke survivors were compared with those of a group of healthy older adults who performed the identical task within the same experimental setup with their non-dominant hand. Performance levels were comparable between both cohorts at all time points. Stroke-related difficulties in motor control did not impact on the degree of performance improvement through training and daytime sleep did not impact on the behavioral gains in the two groups. In summary, the current study indicates that one-time daytime sleep after motor training does not influence behavioral gains.

技能的获取与再习得是脑卒中后功能康复的核心支柱。夜间睡眠对健康个体的运动学习具有积极作用，然而日间睡眠对神经康复训练及已掌握技能再学习的影响却常被忽略。本研究旨在探讨日间睡眠（午睡）与慢性脑卒中患者学习新型视觉运动任务的能力之间的关联。本研究的核心假说为：训练后睡眠可促进运动记忆巩固，进而使受试者在日间睡眠后获得更优异的运动表现。本研究共纳入30名脑卒中幸存者，将其随机分配至三种实验条件之一：(i) 清醒静息组，(ii) 短午睡组（10~20分钟），(iii) 长午睡组（50~80分钟）。所有受试者均使用卒中受损侧手完成任务训练，并在休息时段（清醒静息、午睡）结束后及24小时后开展行为学评估。受试者在整个训练过程中，任务相关的行为表现均出现显著提升。与核心假说相悖的是，无论是在初始日间休息后，还是在额外经过一整夜睡眠后，均未发现睡眠依赖的运动记忆巩固相关证据。在二次分析中，我们将脑卒中幸存者的表现变化与一组健康老年受试者进行了对比——后者在相同实验框架下使用非利手完成了完全相同的任务。两个队列在所有时间点的表现水平均无显著差异。卒中相关的运动控制障碍并未对训练带来的表现提升程度产生影响，日间睡眠也未对两组的行为学获益产生任何作用。综上，本研究表明，运动训练后的单次日间睡眠并不会对行为学获益产生影响。