Neural adaptations in response to long-term balance learning in young and old: Behavioural, structural, functional and neurophysiological differences

Postural control differs between young and elderly and elderly face a higher risk of falls. Thus, balance training is recommended as a countermeasure. However, in addition to deficits in postural control, evidence suggests slower and/or different learning processes in old age. In young subjects, neural plasticity in cortical structures (e.g. M1, SMA) was observed after learning balance tasks for 4 to 6 weeks. Subjects displayed also improved performance not only in the explicitly trained exercises but also in transfer balance tasks. In contrast, neural and behavioral adaptations seem to occur slower and may even involve different brain areas in the elderly. The current study therefore compares long-term learning of balance tasks with respect to behavioural, structural and functional brain adaptations between young and old subjects. Electrophysiological and imaging methods are used to determine adaptations after 2 and 6 months a) at rest (white and grey matter microstructure with quantitative MRI; qMRI), b) during mental simulation of balance tasks (fMRI, TMS) and c) during actual execution of balance tasks (TMS, NIRS). Positive transfer effects on learning and performance of novel postural tasks are tested after the 6 months training.