Jonathan Tsay¹, Cristina Rossi², Hannah Block³, Chris Miall⁴

¹University of California Berkeley, ²Johns Hopkins University, ³Indiana University Bloomington, ⁴University of Birmingham

A visuo-centric perspective on motor learning is appealing. Not only does it fit with a zeitgeist which holds vision as a “dominant” sense, but it also matches our intuition of how we view task success: In day-to-day life, we frequently interact with visual objects, whether it be picking up a glass of water or moving the computer mouse over a desired icon. When a perturbation is introduced, we try to re-establish conditions such that the visual feedback is once again reinforcing. However, this visuo-centric perspective neglects evidence regarding the role of proprioception in motor control and learning: For instance, deafferented individuals struggle to generate specific patterns of muscle contractions in a feedforward manner. Moreover, neurologically healthy and congenitally blind individuals can adapt to a force-field perturbation without the aid of vision, presumably relying solely on proprioceptive input. This panel will present an alternative to the visuo-centric framework, arguing that proprioception may play an indispensable role in motor learning. We will show behavioral, theoretical/computational, neurophysiological and case-study results addressing both basic and clinical questions related to proprioception: Jonathan Tsay will present a new mechanistic understanding of implicit adaptation, a process that is elicited to minimize a proprioceptive error, the distance between the perceived hand position and its intended goal. He will use this proprioceptive re-alignment model (PReMo) to re-examine many phenomena that have previously been interpreted in terms of learning from visual errors, as well as offer novel accounts for unexplained phenomena. Cristina Rossi will present new findings that characterize the multiple learning mechanisms involved in locomotor adaptation, and their relationship to perceptual changes. A common mechanism may result in motor aftereffects and perceptual aftereffects, whereas another mechanism allows the locomotor system to flexible scale its adaptive response to different task demands (i.e., speed ratios on a split belt treadmill). Hannah Block will present new results that strengthen the behavioral and neural link between visuo-proprioceptive recalibration and motor planning. She will also show how these perceptual changes are not only difficult for people to consciously detect but are also robustly retained even after participants are permitted to view their actual hand. Chris Miall will present data from deafferented participants, showing how intact proprioception is critical to allowing an implicit representation of actions, and how without it, actions are governed explicitly, with consequent loss of adaptive sensorimotor responses. We will conclude with a 20-min discussion about the role of proprioception in sensorimotor learning. Prof. Denise Henriques will join the panel to help catalyze a stimulating discussion.

We are capable of a nearly endless repertoire of movements: we can walk, run, skip, reach, grab, kick, throw, dance, and more.  The ease with which most of us perform these movements conceals the fact that motor control is one of the most complex tasks the brain performs.  How can we make sense of this vast complexity?  To do so, scientists always seek simpler systems as a starting point toward full understanding.  A brain-computer interface offers one such simplification.  A brain-computer interface, or BCI, directly connects the brain to the external world, bypassing damaged biological pathways.  It replaces the impaired parts of the nervous system with hardware and software that translates a user‘s internal motor commands into action.  A BCI can provide new insights into the natural processes of motor planning, control, and learning.  In turn, the better we understand natural motor control, the better BCI systems will be.   My research addresses both sides of this relationship.  First, I use BCIs to address basic science questions about how we execute movements and learn new motor skills.  How does the brain learn to make skilled movements?  How do neural dynamics drive skilled movements?  Then, I apply what we have learned about the brain to develop BCI algorithms to improve clinical BCIs.  How can BCIs generalize between diverse skilled movements?

Jasmine Mirdamadi¹, Sue Peters², Sam Stuart³, Rachael Seidler⁴

¹Emory University, ²Western University, ³Northumbria University, ⁴University of Florida

Postural control involves hierarchical coordination of sensorimotor circuits mediated through automatic, subcortical mechanisms and top-down cortical mechanisms. Cortical involvement in balance and gait has traditionally been inferred indirectly, through degradation in performance during a cognitive task. Direct measures of brain activity during balance and mobility using electroencephalography (EEG) and functional near infrared spectroscopy (fNIRS) offer mechanistic insight into declines in function that are needed to predict fall risk, detect declines in function before a fall, and develop targeted interventions. Greater cortical activity may compensate for declines in automatic postural control. However, whether greater brain activity is compensatory or dysfunctional remains unclear due to a large emphasis on a single brain region (e.g., prefrontal cortex), the same task difficulty, or same environmental context. We will discuss recent advancements in brain activity during balance and mobility, highlighting individual, group, and task-dependent changes and their associations with function in health, aging, and neurological impairment. Jasmine Mirdamadi will discuss EEG activity evoked by standing balance perturbations as a function of task difficulty and an individual’s balance ability. She will then translate this work to whole-body motion perception to provide a mechanistic framework for how cortical sensory integration needed for perception may contribute to balance function. Sue Peters will discuss cortical activity involved in planning of limb coordination for step initiation and walking and how cortical activity changes with attention and rehabilitation interventions in people with and without stroke. Sam Stuart will discuss the use of mobile brain/body imaging, through separate and combined fNIRS and EEG devices, to monitor brain activity response to cueing interventions (i.e., visual, auditory, tactile cues) for walking impairment in Parkinson’s disease (PD). He will also describe brain activity changes with pharmaceutical intervention and complex mobility tasks (i.e., turning). Lessons from the field will be provided on using combined mobile imaging and inertial sensor technology in clinical populations. Main discussion points include: which aspects of cortical activity distinguish individual differences in balance and mobility function? Is altered cortical activity compensatory or dysfunctional? How can cortical activity inform mechanisms of interventions or guide precision medicine? Are we ready for a multimodal neuroimaging approach?

Manual force encoding in the motor cortex of macaques and humans

Elizaveta Okorokova¹, Anton Sobinov¹, John Downey¹, Ashley van Driesche¹, Qinpu He¹, Charles Greenspon¹, Nicholas Hatsopoulos¹, Sliman Bensmaia¹

¹University of Chicago

Motor cortex isolates skill-specific dynamics to implement context-specific feedback control

Eric Trautmann¹, Najja Marshall², Hannah Chen¹, Francisco Sacadura¹, Elom Amematsro¹, Elijah Aliyari¹, Daniel Wolpert¹, Michael Shadlen¹, Mark Churchland¹

¹Columbia University, ²Stanford University

Nonlinear manifolds underlie neural population activity during behaviour

Catia Fortunato¹, Jorge Bennasar-Vázquez¹, Junchol Park², Lee Miller³, Joshua Dudman², Matthew Perich⁴, Juan Gallego⁵

¹Bioengineering Department, ²Janelia Research Campus, ³Feinberg School of Medicine Northwestern, ⁴Icahn School of Medicine at Mount Sinai, ⁵Imperial College London

Effector-specific sensorimotor transformations in dorsolateral prefrontal cortex during a head-unrestrained reach task

Veronica Nacher¹, Parisa Abedi-Khoozani¹, Vishal Bharmauria¹, Harbandhan Arora¹, Xiaogang Yan¹, Saihong Sun¹, Hongying Wang¹, John Crawford¹

¹York University

Reformatting of the Representation of Action from Neocortex to Striatum

Junchol Park¹, Catia Fortunato², Juan Gallego²

¹Howard Hughes Medical Institute, ²Imperial College London

Somatosensory and motor cortex both causally contribute to speech motor learning

Matthias Franken¹, Timothy Manning¹, Alexandra Williams¹, David Ostry¹

¹McGill University

Where is the target of our movement?

Jeroen Smeets¹, Cristina de la Malla², Eli Brenner¹

¹Vrije Universiteit Amsterdam, ²Universitat de Barcelona

Predicting full-body proprioceptive cortical anatomy and neural coding with topographic autoencoders

Max Grogan¹, Kyle Blum², Lee Miller², Aldo Faisal¹

¹Imperial College London, ²Northwestern University

Biomimetic stimuli from a vestibular prosthesis improve postural control in a nonhuman primate

Olivia Leavitt¹, Kathleen Cullen¹

¹Johns Hopkins University

Characterization of head orientation and heading during everyday activity: Implications for modeling

Christian Sinnott¹, Peter Hausamann², Paul MacNeilage¹

¹University of Nevada – Reno, ²KINEXON

Ocular eccentricity affects subjective visual vertical perception in health and disease

Catherine Agathos¹, Anca Velisar¹, Natela Shanidze¹

¹Smith-Kettlewell Eye Research Institute

Perception of time-varying envelopes begins at the single-neuron level in central vestibular pathways: implications for perception and motor control

Isabelle Mackrous¹, Jerôme Carriot¹, Kathleen Cullen², Maurice Chacron¹

¹McGill University, ²Johns Hopkins

Humans optimize energy and time for point-to-point walking movements

Elizabeth Carlisle¹, Arthur Kuo¹

¹University of Calgary

Deep brain stimulation frequency affects evoked potential delay, amplitude, and frequency components

Jessica Vidmark¹, Estefania Hernandez-Martin², Terence Sanger¹

¹University of California, Irvine, ²University of La Laguna

Konstantina Kilteni¹, David Schneider², Avner Wallach³, Kathleen Cullen⁴, Konstantina Kilteni¹

¹Karolinska Institutet, ²New York University, ³Columbia University, ⁴John Hopkins University

Distinguishing the sensations that are produced by our own movements (reafference) from those produced by external causes (exafference) is a fundamental problem for our nervous system and a prerequisite for our survival. Compare how dramatically different our responses are (a) to the footsteps we hear, when these are not due to our walking (auditory reafference) but due to a stranger following us (auditory exafference); (b) to our vestibular input, when this is not generated by our head motion (vestibular reafference) but because we accidentally fall on the floor (vestibular exafference); and (c) to the touch we feel on our cheek, when this is not due to our hand (somatosensory reafference) but due to an insect crawling on our face (somatosensory exafference). To solve this problem and guide our behavior appropriately, the nervous system uses information about the organisms’ own movements to predict the reafferent sensory signals. The prediction can then be canceled from the incoming sensations, thus amplifying the difference between self-generated and external sensations. This panel will raise questions on the similarities and differences in this cancelation mechanism across four different species (mice, electric fish, monkeys, humans) and four different modalities (auditory, electrosensory, vestibular, somatosensory), as well as its functional advantages in motor control. In mice, David Schneider will show that auditory responses to self-generated sounds are suppressed relative to sounds that are unexpectedly shifted in frequency. He will argue that this frequency-specific suppression in the auditory cortex arises from a stable, learned, and specific movement-based prediction that is implemented over short time scales with within-movement temporal specificity. Avner Wallach will show that the responses of the electrosensory lobe output neurons in freely swimming electric fish selectively encode external stimuli. He will argue that the cerebellum-like circuitry of the electrosensory lobe learns and stores multiple motor-based predictions specific to different sensory contexts. Kathleen Cullen will show how vestibular reafference is canceled in primates by a cerebellum-based mechanism, when there is a precise match between the actual and expected proprioceptive feedback. She will argue that this cerebellum-based mechanism displays rapid updating whenever a new sensorimotor relationship is established. Konstantina Kilteni will show that the responses of the human somatosensory cortices to self-generated touch are attenuated compared to externally generated touch, or self-generated touch that is shifted in time, and that the functional corticocerebellar connectivity is related to this attenuated perceived intensity of the somatosensory reafference. She will argue that somatosensory attenuation depends on an internal model between the specific action and its temporally precise feedback.

Predictability as Control Priority in a Functional Task: Computational Research with Clinical Applications

Rashida Nayeem¹, Salah Bazzi¹, Mohsen Sadeghi¹, Reza Sharif Razavian¹, Dagmar Sternad¹

¹Northeastern University

A distributed circuit for regulating feedback control policy

Jonathan Michaels¹, Mehrdad Kashefi¹, Olivier Codol¹, Rhonda Kersten¹, J. Andrew Pruszynski¹

¹Western University

Behaviorally relevant, but not any salient events, inhibit rapid hand movements

Clara Kuper¹, Martin Rolfs²

¹Humboldt Universität zu Berlin, Berlin School of Mind and Brain, ²Humboldt Universität zu Berlin, Berlin School of Mind and Brain, Bernstein Center for Computational

Emergence of habitual control in a novel motor skill over multiple days of practice

Christopher Yang¹, Noah Cowan¹, Adrian Haith¹

¹Johns Hopkins University

A sensory race between oculomotor control areas for coordinating motor timing

Antimo Buonocore¹, Ziad Hafed¹

¹University of Tuebingen

Express reaching responses are preserved in Parkinsons Disease and insensitive to levodopa treatment

Rebecca Kozak¹, Maggie Prenger¹, Madeline Gilchrist¹, Kathryne Van Hedger¹, Mimma Anello¹, Penny MacDonald¹, Brian Corneil¹

¹Western University

Vikram Chib¹, Court Hull², Amanda Therrien³, Mati Joshua⁴

¹Johns Hopkins University, ²Duke University, ³Moss Rehabilitation Research Institute, ⁴The Hebrew University of Jerusalem

Motor performance is motivated by the rewards and costs at stake. Historically the basal ganglia have been implicated in the representation of motivational factors that drive motor performance; however recent studies have also identified motivational signals in cerebellum, suggesting an interaction between cerebellum and basal ganglia to generate motivated motor behavior. In this session we will present recent evidence for the roles of basal ganglia and cerebellum in motivated performance, across human and animal models. We will discuss the similarities and differences between cerebellar and striatal signals and why these seemingly disparate brain regions might encode affective information. First, Vikram Chib will present data that examine how fatigue influences motivational state, making human participants less willing to engage in effortful exertion. Using fMRI data, he will describe how signals related to motor cortical state in premotor cortex influence computations of effort value in the basal ganglia, decreasing motivation and willingness to exert. Vikram’s data will provide an account of how the basal ganglia incorporates information about bodily state to motivate motor performance. Second, Amanda Therrien will present a series of studies that examine state estimation and its relationship with reward learning in individuals with cerebellar degeneration. Estimations of body state are hypothesized to depend on computations within the cerebellum. Cerebellar damage in humans significantly impairs state estimation, which in turn impairs motor control and learning. Amanda will show that estimations of body state are incorporated in the processing of reinforcement and reward information, and that the cerebellum mediates this function. Third, Court Hull will present data testing how signals in the cerebellum might convey reward predictions in order to guide motor learning. Using a combination of calcium imaging and electrophysiology in awake behaving mice, he is testing whether cerebellar climbing fibers obey the requirements of reward prediction error, how behavioral context affects these signals, and how these signals might act to shape cerebellar output. Court’s data will address the mechanisms of reward signaling in the cerebellum, and how they compare with what is known for basal ganglia circuits. Finally, Mati Joshua will present studies that recorded neural data from eye-movement areas in the basal ganglia and cerebellum of monkeys, while manipulating eye-movement parameters and reward. Recent findings of reward signals in the cerebellum challenge the view that the cerebellum performs error-based learning, whereas the basal ganglia are involved in reward-based learning. While cerebellar reward signals demonstrate some resemblance to those in the basal ganglia, a direct comparison has been lacking. Mati’s data will provide a direct comparison between reward and eye-movement signals in the cerebellum and the basal ganglia.

Join us to learn more about the society, the financial position, incoming board members and more!

Beyond remapping: how is cortical information content altered following hand loss?

Dollyane Muret¹, Maria Kromm¹, Arabella Bouzigues¹, Vijay Kolli², Tamar Makin¹

¹UCL, ²Queen Mary’s Hospital

The Effect of Tactile Augmentation on Force Field Adaptation

Chen Avraham¹, Ilana Nisky¹

¹Ben-Gurion University of the Negev

Effects of task-irrelevant visual feedback on motor adaptation in a bimanual redundant motor task

Toshiki Kobayashi¹, Daichi Nozaki¹

¹The University of Tokyo

Distinct functional architectures for implicit and explicit motor learning from reinforcement signals

Andrew Byun¹, Maurice Smith¹

¹Harvard John A. Paulson School of Engineering and Applied Sciences

Blocking cerebellar signals increases internal noise and impairs motor adaptation

Yifat Prut¹, Sharon Israeli¹, Firas Mawase², Jonathan Kadmon¹

¹The Hebrew University, ²The Technion Israel Institute of Technology

Probing the foundations of motor learning for physical Human-AI collaboration

Ali Shafti¹, William Dudley¹, Aldo Faisal²

¹Imperial College London, ²Imperial College London & University of Bayreuth

High-performance kinematic decoding and neural-state estimation that leverages general properties of motor-cortex population geometry

Sean Perkins¹, Karen Schroeder¹, John Cunningham¹, Qi Wang¹, Mark Churchland¹

¹Columbia University

Influence of implicit and explicit feedback response to a visual error on visuomotor learning response

Yuto Makino¹, Keisyu Inoue¹, Toshiki Kobayashi¹, Daichi Nozaki¹

¹The University of Tokyo

Visual feedback at object grasp supports digit position flexibility and efficient anticipatory force control

Joshua Bland¹, Marco Davare², Michelle Marneweck¹

¹University of Oregon, ²King’s College London

Express Visuomotor Responses in Hip Abductor Muscles: Evidence for an Intricate Relationship Between Fast Stepping and Postural Control

Lucas Billen¹, Brian Corneil², Vivian Weerdesteyn¹

¹Donders Institute, Radboud University Medical Center, ²Western University

Sensory tuning in neuronal movement commands

Ziad Hafed¹, Amarender Bogadhi², Matthias Baumann¹, Anna Denninger¹

¹Centre for Integrative Neuroscience, ²Boehringer Ingelheim Pharma GmbH & Co. KG

Nociception impedes grasping recovery in the spinal cord injured rat

John Walker¹, Taegyo Kim¹, Simon Giszter¹, Megan Detloff¹

¹Drexel University College of Medicine

An intention-based strategy for grasping prosthesis

Andres Agudelo-Toro¹, Jonathan Michaels², Wei-An Sheng³, Hansjörg Scherberger⁴

¹German Primate Center, ²Western University, ³Institut des Sciences Cognitives Marc Jeannerod, ⁴University of Göttingen

Hasty sensorimotor decisions rely on an overlap of broad and selective changes in motor activity

Gerard Derosiere¹, David Thura², Paul Cisek³, Julie Duque¹

¹Catholic University of Louvain, ²Lyon Neuroscience Research Center, ³University of Montreal

Cerebellar function for recalibrating visual space, motor space and internal movement predictions

Jana Masselink¹, Alexis Cheviet², Denis Pélisson², Markus Lappe¹

¹University of Muenster, ²University Claude Bernard Lyon 1

Get out and experience Dublin!  Further information regarding organized walking tours will be available shortly.

David Xing¹, Ilka Diester², Ann Kennedy¹, Jesse Marshall³, David Xing¹

¹Northwestern University, ²University of Freiburg, ³Harvard University

Our nervous system is capable of generating an amazingly rich variety of movements across a diverse set of contexts and environments. Yet, traditionally, the motor system has been studied using constrained paradigms that involve highly stereotyped and overtrained movements. While such approaches are important for the controlled study of individual aspects of motor control, they are unable to capture the underlying neural principles governing naturalistic movements, and are insufficient for determining whether these principles generalize across the full behavioral repertoire of the animal. For example, research has revealed that aspects of motor control may be heterogenous across different movement modalities. Fast optogenetic inactivation of motor cortex revealed different muscle response latencies between reaching and locomotion. How does cortical influence on downstream muscles vary across a wider variety of movements? New paradigms that facilitate motor system study across multiple behaviors in unconstrained animals are necessary to address these questions. One reason for the lack of such studies is due to the historical challenge of obtaining electrophysiological and behavioral data from unrestrained animals. However, recent advances in computer vision, large-scale electrophysiology, and wireless data transfer have enabled the development of novel freely-moving paradigms. In this panel, we will present and discuss recent technical developments in video-based kinematic tracking and the resultant freely-behaving experiments enabled by these advances. We will present the findings of four lines of research, revealing novel principles underlying the neural control of unconstrained, naturalistic movements. First, David Xing will present on the development of a novel freely-climbing paradigm in mice with simultaneous large-scale neural and EMG recordings. Animals in this paradigm perform a variety of motor actions such as dexterous climbing and locomotion, as well as grooming, eating and leaping. Next, Ilka Diester will introduce a virtual head-fixation approach based on 3D motion tracking combined with a model which removes the influence of undesired body movements on neuronal activity. She will report how this strategy allows the analysis of defined behaviors, unveiling an unexpectedly large fraction of neurons in the rat motor cortex tuned to paw movements, which was previously masked by body posture tuning. Next, Ann Kennedy will present findings indicating preserved covariance patterns among monkey M1 neurons across a range of unconstrained behaviors in a large telemetry cage requiring limb coordination and body posture changes. Finally, Jesse Marshall will discuss recent advances in 3D behavioral measurement tools, and how they facilitate quantitative comparisons between the neural codes underlying natural and learned behaviors.

Postural and volitional signals occupy separate neural dimensions in motor cortex

Patrick Marino¹, Lindsay Bahureksa², Carmen Fisac², Emily Oby¹, Asma Motiwala², Erinn Grigsby¹, Adam Smoulder², Alan Degenhart³, Wilsaan Joiner⁴, Steven Chase⁵, Byron Yu², Aaron Batista¹

¹University of Pittsburgh, ²Carnegie Mellon University, ³Starfish Neuroscience, ⁴University of California, Davis, ⁵Carnegie Mellon University

Vestibular reflexes in neck muscles contribute to stabilizing the head across the range of dynamic motion experienced during everyday life

Robyn Mildren¹, Omid Zobeiri¹, Kathleen Cullen¹

¹Johns Hopkins University

Resting-state functional connectivity predicts postural deficits following spaceflight

Heather McGregor¹, Nichole Beltran², Yiri De Dios², Jacob Bloomberg³, Scott Wood⁴, Ajitkumar Mulavara², Roy Riascos⁵, Patricia Reuter-Lorenz⁶, Rachael Seidler¹

¹University of Florida, ²KBR, ³NASA Johnson Space Center, retired, ⁴NASA Johnson Space Center, ⁵University of Texas Health Science Center at Houston, ⁶University of Michigan

Basal ganglia-spinal cord pathway that commands locomotor asymmetries

Jared Cregg¹, Simrandeep Kaur Sidhu¹, Ilary Allodi¹, Roberto Leiras¹, Ole Kiehn¹

¹University of Copenhagen

Data-driven gait signatures reveal individual-specific differences in gait dynamics post-stroke

Taniel Winner¹, Trisha Kesar², Lena Ting¹, Gordon Berman³

¹Georgia Institute of Technology and Emory University, ²Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, ³Department of Biology, Emory University

Movement is governed by rotational dynamics in spinal motor networks

Rune Berg¹

¹University of Copenhagen

Andreea Bostan², David Robbe³, Roxanne Lofredi¹, Wolf-Julian Neumann¹, Robert Turner²

¹Charité – Universitätsmedizin Berlin, ²University of Pittsburgh, ³Inserm Aix-Marseille University

What are the functions of the basal ganglia? Thirty years ago, the answer to this question seemed to be within reach, but lasting efforts in search for a unifying framework were of no avail. Indeed, behavioral correlates of basal ganglia activity seem as diverse as the ever-increasing complexity of their anatomical and molecular circuit characteristics. The basal ganglia network is uniquely positioned at the center of the motor network to integrate widespread cortical and subcortical information and, under the influence of dopamine, distribute the result of these computations to a similarly diverse array of cortical and subcortical outputs. Whatever the function of the basal ganglia, it is likely embedded in the ability of this web of long-range synaptic connections to shape motor control and learning across the brain. Conversely, the power of these network level connections can be observed in the synchronous oscillations across cortex, basal ganglia and thalamus that are pathologically exaggerated in basal ganglia- based movement disorders. The present panel reviews recent advances in pathway-specific functional anatomy and physiological mechanisms of basal ganglia dependent motor control. It aims to integrate findings from rodent, non-human primate and human clinical research spanning a variety of research methods including transsynaptic tracing, behavoiur, invasive electrophysiology, neuroimaging and computational modelling. While these methods are diverse, the studies presented all focus on structural and functional basal ganglia networks for motor learning and kinematic control. Research highlights include the overlap of basal ganglia and cerebellar circuits in non-human primates with neuromodulation induced changes in human trial to trial motor improvement, an interrogation of potential roles of the dorsal striatum in motor learning, effort and cost signalling and dopamine dependent vigor signals reflected in temporal dynamics in human basal ganglia beta and gamma band activity. The findings presented here serve as case studies to challenge the resilience of influential basal ganglia theories such as the vigorous tutor paradigm, habit formation, reward prediction error signals and energy cost discounting. Our studies suggest that basal ganglia computations result in synaptic modulation of distributed motor networks for motor plan invigoration and consolidation. Importantly, input and output feedback loops may prevail at each stage of the circuit from pre- and primary motor cortex, thalamus and cerebellum. Beta and gamma band oscillatory synchronization may reflect a physiological mechanism for communication in these distributed neural populations, through dopamine-dependent changes in excitability and vulnerability for synaptic potentiation. In summary, our panel highlights the importance of circuit-level computations for understanding basal ganglia function and discusses the translational implications for DBS in basal ganglia disorders.

The technology to collect Balance and Gait Digital Health Outcomes are Ready for Clinical Trials. However, wearable, inertial sensors provide a myriad of potential measures during prescribed tasks and even more measures during passive monitoring in daily life. Studies have shown that both balance and gait are controlled by several relatively independent neural control systems (domains) that can be affected differently by each neurological disease and by each intervention. Clinical validity includes discovery of which, particular domain is affected by a specific cohort.  Evidence to support the use of a particular balance or gait measure as an outcome for a clinical trial includes determining the extent to which measures show: Verification of accuracy, Sensitivity/Specificity, Reliability, Face Validity, Related to Patient-Reported Outcomes and/or Fall Risk, Responsive to Progression, Related to Physiological Biomarkers, Responsive to Change (Effect Size). No one measure will be the best in all categories of evidence so we recommend developing a composite score including several, independent measures using Multiple Criteria Decision Analysis (MCDA). MCDA is a systematic approach to determining the best outcome. Experts weigh the relative importance of all available evidence and the weighted sum of evidence is used to determine the most useful outcome.  Examples of evidence supporting balance and gait outcomes for Parkinson’s disease, Cerebellar ataxia, Multiple Sclerosis, and other neurological disorders will be discussed. Benefits and challenges of measuring gait passively in daily life compared to prescribed test in the laboratory or clinic will also be discussed.

Following the Distinguished Career Award presentation and talk, join us for a drink to celebrate NCM 2022!