Objectives: Although motor adaptation is a highly relevant process for both everyday life as well as rehabilitation many details of this process are still unresolved. To evaluate the contribution of primary motor (M1), parietal and cerebellar areas to motor adaptation processes transcranial direct current stimulation (tDCS) has been applied. We hypothesized that anodal stimulation of the cerebellum and the M1 improves the learning process in mirror drawing, a task involving fine grained and spatially well-organized hand movements. Methods: High definition tDCS (HD-tDCS) allows a focal stimulation to modulate brain processes. In a single-session double-blind study, we compared the effects of different anodal stimulation procedures. The groups received stimulation either at the cerebellum (CER), at right parietal (PAR), or at left M1, and a SHAM group was included. Participants (n=83) had to complete several mirror drawing tasks before, during, and after stimulation. They were instructed to re-trace a line in the shape of a pentagonal star as fast and accurate as possible. Tracing time (seconds) and accuracy (deviation in mm) have been evaluated. Results: The results indicated that cerebellar HD-tDCS can facilitate motor adaptation in a single session. The stimulation at M1 showed only a tendency to increase motor adaptation and these effects were visible only during the first part of the stimulation. Stimulating the right parietal area, relevant for visuospatial processing did not lead to increased performance. Conclusions: Our results suggest that motor adaptation relies to a great extent on cerebellar functions and HD-tDCS can speed up this process. (JINS, 2016, 22, 928–936)

The cerebellum is part of a neural circuit involved in procedural motor learning. We examined how congenital cerebellar malformations affect mirror drawing performance, a procedural learning task that involves learning to trace the outline of a star while looking at the reflection of the star in a mirror. Participants were 88 children with spina bifida myelomeningocele, a neural tube defect that results in lesions of the spinal cord, dysmorphology of the cerebellum, and requires shunt treatment for hydrocephalus, and 35 typically developing controls. Participants completed 10 trials in the morning and 10 trials following a 3-hr delay. Although children with spina bifida myelomeningocele were initially slower at tracing and made more errors than controls, all participants improved their performance of the task, as demonstrated by increased speed and accuracy across trials. Moreover, degree of cerebellar dysmorphology was not correlated with level of performance, rate of acquisition, or retention of mirror drawing. The results suggest that congenital cerebellar dysmorphology in spina bifida does not impair motor skill learning as measured by acquisition and retention of the mirror drawing task. (JINS, 2004, 10, 877–887.)