# Mechanisms and Rehabilitation of Cerebellar Ataxia

> **NIH NIH R01** · HUGO W. MOSER RES INST KENNEDY KRIEGER · 2020 · $427,048

## Abstract

Cerebellar damage impairs movement coordination and adaptive motor learning abilities, making actions like
reaching inaccurate and very difficult to control. There are currently no medications that systematically improve
cerebellar movement incoordination or `ataxia', making rehabilitation therapy the main treatment option. Yet,
people with ataxia are notoriously difficult to treat with physical therapy, likely due to the fact that they are
limited in their ability to learn new movement patterns. The studies proposed here address this challenge
through the development of a staged, individualized approach to understanding if distinct interventions will be
helpful to different people. We will use mathematical modeling of patient-specific movement deficits, alternative
learning mechanisms, and robotic control of reaching to test whether we can systematically reduce arm ataxia.
In Aim 1, we will determine if reinforcement based motor learning can be used as an alternative strategy in
people with cerebellar damage. Our preliminary data show that reinforcement based motor learning is much
more effective than adaptive motor learning for reaching movements in people with ataxia. We will test whether
this can be used to change complex elements of 3D reaching that are more clinically meaningful for people
with ataxia. In Aim 2, we will test whether long-term reinforcement-based training can reduce ataxia and
improve 3D reaching performance. Here we will test whether people who show learning via reinforcement on a
single day in Aim 1. We will determine if they benefit more from a 2-week course of virtual reality-based
reinforcement reach training compared to 2 weeks of standard reaching practice. We will study how training
transfers to natural reaching movements (i.e. those outside of the virtual reality environment) and clinical rating
scales of arm ataxia and function. In Aim 3, we will develop compensatory robotic assistance for people with
ataxia based on individualized models of cerebellar function. This is essential for individuals with the most
severe ataxia and learning problems who do not learn at all in Aim 1. In sum, this proposal provides a scientific
framework for determining an individual's motor learning potential for rehabilitation versus the need for
intelligent compensatory robotic assistance. Our overarching goal is to provide a foundation for devising and
choosing new rehabilitation strategies.

## Key facts

- **NIH application ID:** 9900035
- **Project number:** 5R01HD040289-17
- **Recipient organization:** HUGO W. MOSER RES INST KENNEDY KRIEGER
- **Principal Investigator:** Amy J. Bastian
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $427,048
- **Award type:** 5
- **Project period:** 2002-03-22 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9900035

## Citation

> US National Institutes of Health, RePORTER application 9900035, Mechanisms and Rehabilitation of Cerebellar Ataxia (5R01HD040289-17). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/9900035. Licensed CC0.

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