Motor Adaptation Deficits in Children with Developmental Coordination Disorder and/or Reading Disorder.

Procedural learning has been mainly tested through motor sequence learning tasks in children with neurodevelopmental disorders, especially with isolated Developmental Coordination Disorder (DCD) and Reading Disorder (RD). Studies on motor adaptation are scarcer and more controversial. This study aimed to compare the performance of children with isolated and associated DCD and RD in a graphomotor adaptation task. In total, 23 children with RD, 16 children with DCD, 19 children with DCD-RD, and 21 typically developing (TD) children wrote trigrams both in the conventional (from left to right) and opposite (from right to left) writing directions. The results show that movement speed and accuracy were more impacted by the adaptation condition (opposite writing direction) in children with neurodevelopmental disorders than TD children. Our results also reveal that children with RD have less difficulty adapting their movement than children with DCD. Children with DCD-RD had the most difficulty, and analysis of their performance suggests a cumulative effect of the two neurodevelopmental disorders in motor adaptation.

Dysgraphia Differs Between Children With Developmental Coordination Disorder and/or Reading Disorder.

Handwriting deficits, or dysgraphia, are present in several neurodevelopmental disorders. To investigate whether dysgraphia differs according to the associated disorder, we performed a detailed analysis of handwriting in children with developmental coordination disorders (DCD), reading disorder (RD), or comorbid RD and DCD. Handwriting deficits were investigated at the product (quality of the trace) and the process (movement that generates the trace) levels. Nineteen children with singular RD (among which eight with dysgraphia), 13 children with singular DCD (among which seven with dysgraphia), 16 children with comorbid RD+DCD (among which 11 with dysgraphia), and 20 typically developing children, age 7 to 12, performed the BHK (Brave Handwriting Kinder) test, a standardized assessment of handwriting, on a graphic tablet. Developmental coordination disorders primarily affected handwriting quality, while RD affected slowness and, to a lesser extent, quality. Children with RD, solely or comorbid with DCD, wasted time by lifting and stopping the pen when writing. The comorbidity added to but did not worsen, handwriting difficulties. These results reflect distinct motor impairments and/or strategies in children with DCD or RD. We identified subtypes of dysgraphia and advocated for a fine-grained analysis of the writing process and the assessment of motor and reading skills when studying dysgraphia.

Benefits of a Light-Painting Technique for Learning to Write New Characters: A Proof of Concept With Adults.

Learning to write relies on the effective integration of sensory feedback and a transition from motor control based on written tracings to motor control based on expert writing movements. This study aimed to test whether the photographic technique of light painting (LP) would facilitate this transition. To achieve this, we conducted two experiments using different LP setups. LP involves moving a light source in a dark environment while taking a long-exposure photograph. LP entails both a real-time reduction of product-related visual information and a post-trial addition of process-related visual information. In the first experiment, we conducted a pre-test, training, and post-test in which 16 adults wrote four new characters with the non-dominant hand. During the training sessions, participants stood and wrote in a vertical frame (1 × 1.2 m) two characters in the control condition (with a marker on the vertical support) and two characters in the LP condition (with a flashlight in the air). In the test phases, participants were seated at a table and copied the four characters into a square (4 cm * 4 cm) on a fixed sheet of graphics paper. As in-air writing strongly differs from classical handwriting situations, we performed a second LP experiment. The aim was to implement LP training in a condition closer to writing. Sixteen new participants followed the same protocol but sat at a table and wrote in a horizontal square (20 cm * 20 cm). In both experiments, participants who trained with the LP method wrote faster and with less pressure than those trained in the control condition. We also observed an improvement in spatial accuracy in Experiment 2, whatever the training condition. LP seemed to have led participants to focus on the writing process, probably because it modified the nature and timing of the visual information used for writing. LP may be a promising technique for remediating writing difficulties.

The long-term impact of irradiation on functional connectivity in brain circuits involved in memory processes after pediatric posterior fossa tumor.

PURPOSE: Memory is one of the main specific cognitive domains impaired with attention and processing speed after a pediatric brain tumor. This work explored the long-term impact of radiotherapy in children with posterior fossa tumor (PFT) on brain connectivity in neural circuits involved in memory using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS: A total of 20 irradiated and 15 non-irradiated PFT survivors, and 21 healthy controls, prospectively included in the IMPALA study (NCT04324450), performed memory tests assessing episodic, procedural, and working memories and were subjected to an rs-fMRI. We manually contoured main structures involved in memory to explore connectivity at rest in a seed-to-voxel analysis. The groups were compared and differences in connectivity were correlated with behavioral scores and irradiation doses. RESULTS: The performance of all mnesic tasks was lower in PFT survivors with a greater alteration in working and episodic memory in irradiated patients. Irradiated survivors had atypical connectivities in all memory circuits compared to controls and in cortico-caudate and cortico-cerebellar circuits compared to non-irradiated survivors. Non-irradiated survivors had only atypical connectivities in the cortico-cerebellar circuits compared to controls. In irradiated survivors, atypical connectivities in cortico-hippocampal circuits were linked with episodic memory scores and dose of irradiation to the left hippocampus and in cortico-striatal circuits with procedural memory scores and dose of irradiation to the striatum. CONCLUSION: The results of this study highlight that irradiation has a long-term impact on brain connectivity in brain circuits involved in memory after pediatric PFT with a specific radiation-dose effect in supratentorial structures.

Tools and Methods for Diagnosing Developmental Dysgraphia in the Digital Age: A State of the Art.

Handwriting is a complex perceptual motor task that requires years of training and practice before complete mastery. Its acquisition is crucial, since handwriting is the basis, together with reading, of the acquisition of higher-level skills such as spelling, grammar, syntax, and text composition. Despite the correct learning and practice of handwriting, some children never master this skill to a sufficient level. These handwriting deficits, referred to as developmental dysgraphia, can seriously impact the acquisition of other skills and thus the academic success of the child if they are not diagnosed and handled early. In this review, we present a non-exhaustive listing of the tools that are the most reported in the literature for the analysis of handwriting and the diagnosis of dysgraphia. A variety of tools focusing on either the final handwriting product or the handwriting process are described here. On one hand, paper-and-pen tools are widely used throughout the world to assess handwriting quality and/or speed, but no universal gold-standard diagnostic test exists. On the other hand, several very promising computerized tools for the diagnosis of dysgraphia have been developed in the last decade, but some improvements are required before they can be available to clinicians. Based on these observations, we will discuss the pros and cons of the existing tools and the perspectives related to the development of a universal, standardized test of dysgraphia combining both paper-and-pen and computerized approaches and including different graphomotor and writing tasks.

Seeing our hand or a tool during visually-guided actions: Different effects on the somatosensory and visual cortices.

The processing of proprioceptive information in the context of a conflict between visual and somatosensory feedbacks deteriorates motor performance. Previous studies have shown that seeing one's hand increases the weighting assigned to arm somatosensory inputs. In this light, we hypothesized that the sensory conflict, when tracing the contour of a shape with mirror-reversed vision, will be greater for participants who trace with a stylus seen in their hand (Hand group, n = 17) than for participants who trace with the tip of rod without seen their hand (Tool group, n = 15). Based on this hypothesis, we predicted that the tracing performance with mirror vision will be more deteriorated for the Hand group than for the Tool group, and we predicted a greater gating of somatosensory information for the Hand group to reduce the sensory conflict. The participants of both groups followed the outline of a shape in two visual conditions. Direct vision: the participants saw the hand or portion of a light 40 cm rod directly. Mirror Vision: the hand or the rod was seen through a mirror. We measured tracing performance using a digitizing tablet and the cortical activity with electroencephalography. Behavioral analyses revealed that the tracing performance of both groups was similarly impaired by mirror vision. However, contrasting the spectral content of the cortical oscillatory activity between the Mirror and Direct conditions, we observed that tracing with mirror vision resulted in significantly larger alpha (8-12 Hz) and beta (15-25 Hz) powers in the somatosensory cortex for participants of the Hand group. The somatosensory alpha and beta powers did not significantly differ between Mirror and Direct vision conditions for the Tool group. For both groups, tracing with mirror vision altered the activity of the visual cortex: decreased alpha power for the Hand group, decreased alpha and beta power for the Tool group. Overall, these results suggest that seeing the hand enhanced the sensory conflict when tracing with mirror vision and that the increase of alpha and beta powers in the somatosensory cortex served to reduce the weight assigned to somatosensory information. The increased activity of the visual cortex observed for both groups in the mirror vision condition suggests greater visual processing with increased task difficulty. Finally, the fact that the participants of the Tool group did not show better tracing performance than those of the Hand group suggests that tracing deterioration resulted from a sensorimotor conflict (as opposed to a visuo-proprioceptive conflict).

Writing letters in two graphic systems: Behavioral and neural correlates in Latin-Arabic biscripters.

Biscriptuality is the ability to read and write using two scripts. Despite the increasing number of biscripters, this phenomenon remains poorly understood. Here, we focused on investigating graphomotor processing in French-Arabic biscripters. We chose the French and Arabic alphabets because they have comparable visuospatial complexity and linguistic features, but differ dramatically in their graphomotor characteristics. In a first experiment we describe the graphomotor features of the two alphabets and showed that while Arabic and Latin letters are produced with the same velocity and fluency, Arabic letters require more pen lifts, contain more right-to-left strokes and clockwise curves, and take longer to write than Latin letters. These results suggest that Arabic and Latin letters are produced via different motor patterns. In a second experiment we used functional magnetic resonance imaging to ask whether writing the two scripts relies upon partially distinct or fully overlapping neural networks, and whether the elements of the previously described handwriting network are recruited to the same extent by the two scripts. We found that both scripts engaged the so-called "writing network", but that within the network, Arabic letters recruited the left superior parietal lobule (SPL) and the left primary motor cortex (M1) more strongly than Latin letters. Both regions have previously been identified as holding scale-invariant representations of letter trajectories. Arabic and Latin letters also activated distinct regions that do not belong to the writing network. Complementary analyses indicate that the differences observed between scripts at the neural level could be driven by the specific graphomotor features of each script. Overall, our results indicate that particular features of the practiced scripts can lead to different motor organization at both the behavioral and brain levels in biscripters.

Impact of a pediatric posterior fossa tumor and its treatments on motor procedural learning.

INTRODUCTION: Posterior fossa tumor (PFT) survivors have difficulty learning new skills. Procedural memory is a skill learning system that allows, through training, the automatization of procedures and progressive improvement of performance. It underlies most of the motor procedures in everyday life that we perform automatically, such as riding a bike or writing. Motor procedural memory is divided into two components: motor sequence learning involving mainly cortico-striatal networks, and motor adaptation involving mainly cortico-cerebellar networks. The aim of this work was to explore the impact of a tumor and its treatment during childhood on procedural learning hypothesizing that sequence learning would be impaired in PFT survivors who have been treated with radiotherapy, whereas motor adaptation would be impaired in all PFT survivors. METHOD: 22 irradiated survivors of PFT, 17 non-irradiated survivors and 21 healthy controls from the IMPALA study (NCT04324450) performed a motor sequence learning task and a motor adaptation task. Doses received by striatal and cerebellar structures were reported from the initial dosimetry plans. RESULTS: Sequence learning was preserved in both tumor groups, but at the individual level 7/22 irradiated, and 4/17 non-irradiated participants failed to learn the motor sequence. Motor adaptation was impaired in both tumor groups, predominantly in the irradiated group. CONCLUSION: This study sheds new light on the long-term impact of PFT treatments in childhood on a rarely-studied part of memory, which is perceptual-motor procedural learning. Our results suggest that the cerebellum and striatum could be considered as organs at risk with regard to procedural learning.

Does modifying visual feedback facilitate learning to write new pseudoletters?

Learning to write relies on the efficient integration of visual and proprioceptive feedback, with a transition from a control, based on the visual inspection of the written trace at the beginning of the learning process to a more predictive control, based mainly on handwriting movement, in proficient writers. The aim of this study was to test the effect of a partial deletion of the written trace, as well as the effect of supplementary visual information, on handwriting kinematics in a learning task. Twenty-four adults learned to write six new pseudoletters using their non-dominant hand on a touch screen digital tablet. Three pseudoletters were trained with modified visual feedback conditions and the other three, in the control condition, i.e. without any visual modification. Results revealed that, in the short-term, the pseudoletters learned with modified visual feedback were traced faster and more fluently than those learned in the control condition, without spatial accuracy reduction. This method seems to be efficient in adults, which is a prerequisite before testing a method with children.

Effects of biscriptuality on graphomotor coordination dynamics.

Biscriptuality is the ability to write in two different writing systems. The aim of this study was to examine the effects of biscriptuality on graphomotor coordination dynamics in right-handed adults. Thirty-four French monoscriptuals and 34 French-Arabic biscriptual participants traced series of loops in two writing directions and in two directions of rotation. We found that biscriptuals displayed a general advantage over monoscriptuals in terms of tracing frequency, while both groups displayed a preference for the left-to-right direction. These results provide novel evidence on the effects of writing direction and type of expertise on graphomotor performance by showing that biscriptuality could be an asset. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The determinants of saccade targeting strategy in neurodevelopmental disorders: The influence of suboptimal reading experience.

Whether eye-movements deficits are causal in reading disorders (RD) or rather a consequence of linguistic processing difficulty experienced by disabled readers has been extensively debated.Since RD are frequently comorbid with the Neurofibromatosis type1 (NF1), children with NF1 were used as a comparison group for children with dyslexia in this study.Eye movements were recorded while 21 dyslexic, 20 NF1, and 20 typically developing children performed an oculomotor lateralized bisection task. In this experiment, we manipulated the type of stimulus - discrete (words and strings of hashes) versus continuous (solid lines) - and the visual field where the stimulus was displayed (left vs right). The results showed that (1) only proficient readers (TD and NF1 without RD) showed fully developed oculomotor mechanisms for efficient reading, with a clear preferred viewing location located to the left of the word's centre in both visual fields, and fine-tuned saccade targeting guided by the between-character space information and (2) NF1 poor readers mirrored the dyslexic eye movement behaviour, with less accuracy and more variability in saccadic programming, no sensitivity to the discreteness of the stimuli, particularly in the left visual field. We concluded that disruption to oculomotor behaviour reflectsthe fact that many of the processes involved in reading are not yet automatized for children with RD, independently of NF1. This suggests that the differences in saccade targeting strategy between children with and without RD would be secondary consequences of their reduced reading experience.

Visual-processing deficits in children with neurofibromatosis type 1: A clinical marker of reading difficulties.

Today's estimates indicate that nearly 50% of children with Neurofibromatosis type 1 (NF1) suffer from reading disabilities, with a high impact on their academic achievement. In addition to the well-documented importance of phonological skills in reading acquisition and neurodevelopmental disorders, visual-attention processes also appear as important factors in learning to read. The present study aimed at assessing the role of visual-processing dysfunction in the high prevalence of reading disabilities in NF1 children and providing a useful tool for clinician in the early detection of reading impairment in this neurogenetic disorder. Forty-two children with NF1 and 42 typically developing children (TD) participated in the study. All were right-handed and did not present intellectual disability or attention deficit hyperactivity disorder. Visual-attention processes were assessed with the Developmental Eye Movement (DEM) test, together with the NF1 children's reading level. NF1 children with and without reading disabilities were then compared. The results showed that visual-processing deficits were highly present among the NF1 children included in our study. Furthermore, poor readers with NF1 presented an increased risk of visual-processing deficits compared to peers. This finding supports the role of visual-processing deficits in the reading difficulties encountered in nearly half of children with NF1. Finally, in NF1 children without intellectual or attention disability, visual-processing deficits emerge as one of the clinical markers of reading disabilities. The study holds important clinical implications both for the identification, by providing a useful screening tool, and the management of reading disabilities in NF1 children.

A prospective behavioral and imaging study exploring the impact on long-term memory of radiotherapy delivered for a brain tumor in childhood and adolescence.

BACKGROUND: Posterior fossa tumors represent two thirds of brain tumors in children. Although progress in treatment has improved survival rates over the past few years, long-term memory impairments in survivors are frequent and have an impact on academic achievement. The hippocampi, cerebellum and cerebellar-cortical networks play a role in several memory systems. They are affected not only by the location of the tumor itself and its surgical removal, but also by the supratentorial effects of complementary treatments, particularly radiotherapy. The IMPALA study will investigate the impact of irradiation doses on brain structures involved in memory, especially the hippocampi and cerebellum. METHODS/DESIGN: In this single-center prospective behavioral and neuro-imaging study, 90 participants will be enrolled in three groups. The first two groups will include patients who underwent surgery for a posterior fossa brain tumor in childhood, who are considered to be cured, and who completed treatment at least 5 years earlier, either with radiotherapy (aggressive brain tumor; Group 1) or without (low-grade brain tumor; Group 2). Group 3 will include control participants matched with Group 1 for age, sex, and handedness. All participants will perform an extensive battery of neuropsychological tests, including an assessment of the main memory systems, and undergo multimodal 3 T MRI. The irradiation dose to the different brain structures involved in memory will be collected from the initial radiotherapy dosimetry. DISCUSSION: This study will provide long-term neuropsychological data about four different memory systems (working memory, episodic memory, semantic memory, and procedural memory) and the cognitive functions (attention, language, executive functions) that can interfere with them, in order to better characterize memory deficits among the survivors of brain tumors. We will investigate the correlations between neuropsychological and neuroimaging data on the structural (3DT1), microstructural (DTI), functional (rs-fMRI), vascular (ASL) and metabolic (spectroscopy) impact of the tumor and irradiation dose. This study will thus inform the setting of dose constraints to spare regions linked to the development of cognitive and memory functions. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04324450, registered March 27, 2020, updated January 25th, 2021. Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/NCT04324450.

Overpressure on fingertips prevents state estimation of the pen grip force and movement accuracy.

We tested the hypothesis that the inability to move a pen accurately in a graphic task is partly due to a decrease of afferent somatosensory information resulting from overpressure on the tactile receptors of the fingers holding the pen. To disentangle the depressed somatosensory origin from an altered motor command, we compared a condition in which the participant actively produces pressure on the pen (active grip) with a condition in which pressure is passively applied (passive grip, no grip-related motor command). We expected that the response of the somatosensory cortex to electric stimulation of the wrist's tactile nerve (i.e., SEP) would be greater in the natural pen grip (baseline condition) than in the two overpressure conditions (actively or passively induced). Fifteen adults were required to trace a geometrical shape in the three grip conditions. The SEP amplitude was not significantly different between the baseline and both overpressure conditions. However, behavioral results showed that drawing accuracy is impaired when the pressure on the pen is increased (passively or actively). Cortical source analyses revealed that the activity of the superior parietal areas (SPL) increased in both overpressure conditions. Our findings suggest that the SPL is critical for sensorimotor integration, by maintaining an internal representation of pen holding. These cortical changes might witness the impaired updating of the finger-pen interaction force for such drawing actions under visual guidance.

Musical sonification improves motor control in Parkinson's disease: a proof of concept with handwriting.

A growing number of studies postulate the use of music to improve motor control in patients with Parkinson's disease (PD). The effects of music are greatly variable from one individual to the other and do not always reach the expected benefits. This study aimed to optimize the use of music in the management of movement disorders inherent to PD in a handwriting task. We developed and tested musical sonification (MS), a method that transforms in real-time kinematic variables into music. Twelve patients with PD, on medication, and 12 healthy controls were recruited in a pretest/training/posttest design experiment. Three training sessions were compared, for which participants were asked to produce graphomotor exercises: one session with music (unrelated to handwriting), one with MS (controlled by handwriting), and one in silence. Results showed that the performance in training was better under MS than under silence or background music, for both groups. After training, the benefits of MS were still present for both groups, with a higher effect for PD patients than for control group. Our results provide a proof of concept to consider MS as a relevant auditory guidance strategy for movement rehabilitation in patients with PD.

Developmental coordination disorder and dysgraphia: signs and symptoms, diagnosis, and rehabilitation.

Developmental coordination disorder (DCD) is a common and well-recognized neurodevelopmental disorder affecting approximately 5 in every 100 individuals worldwide. It has long been included in standard national and international classifications of disorders (especially the Diagnostic and Statistical Manual of Mental Disorders). Children and adults with DCD may come to medical or paramedical attention because of poor motor skills, poor motor coordination, and/or impaired procedural learning affecting activities of daily living. Studies show DCD persistence of 30-70% in adulthood for individuals who were diagnosed with DCD as children, with direct consequences in the academic realm and even beyond. In particular, individuals with DCD are at increased risk of impaired handwriting skills. Medium-term and long-term prognosis depends on the timing of the diagnosis, (possible) comorbid disorders (and their diagnosis), the variability of signs and symptoms (number and intensity), and the nature and frequency of the interventions individuals receive. We therefore chose to investigate the signs and symptoms, diagnosis, and rehabilitation of both DCD and developmental dysgraphia, which continues to receive far too little attention in its own right from researchers and clinicians.

Digitalized spiral drawing in Parkinson's disease: A tool for evaluating beyond the written trace.

One of the current scientific challenges is to propose novel tools and tasks designed to identify new motor biomarkers in Parkinson's disease (PD). Among these, a focus has placed on drawing tasks. Independently from clinical ratings, this study aimed to evaluate the pen movement and holding in digitalized spiral drawing in individuals with PD without and with medical treatment and in healthy controls. A three-step data-driven analysis was conducted. First, the effects of spatial and temporal constraints on several variables were determined. Second, the relationship between handedness and dominance of PD symptoms was investigated for the most relevant variables. Finally, a third analysis was conducted to assess the occurrence of changes associated with PD. The first analysis revealed that the number of velocity peaks and pen altitude variations were the most relevant variables in spiral drawing for evaluating the effect of the disease and medication. The second analysis revealed that the effect of medication was present for the movement fluency only, when spirals with spatial constraints were produced at a spontaneous speed by the hand on the side of dominant PD signs. Finally, the third analysis showed that the effect of medication was greater at the beginning of drawing than at the end. Digitalized spiral drawing makes it possible to observe precisely when the kinematic changes related to the disease occur during the task. Such a simple and quick task might be of great relevance to contribute to the diagnosis and follow-up of PD.

The optimal viewing position effect in printed versus cursive words: Evidence of a reading cost for the cursive font.

Two eye-movement experiments were conducted to examine the effects of font type on the recognition of words presented in central vision, using a variable-viewing-position technique. Two main questions were addressed: (1) Is the optimal viewing position (OVP) for word recognition modulated by font type? (2) Is the cursive font more appropriate than the printed font in word recognition in children who exclusively write using a cursive script? In order to disentangle the role of perceptual difficulty associated with the cursive font and the impact of writing habits, we tested French adults (Experiment 1) and second-grade French children, the latter having exclusively learned to write in cursive (Experiment 2). Results revealed that the printed font is more appropriate than the cursive for recognizing words in both adults and children: adults were slightly less accurate in cursive than in printed stimuli recognition and children were slower to identify cursive stimuli than printed stimuli. Eye-movement measures also revealed that the OVP curves were flattened in cursive font in both adults and children. We concluded that the perceptual difficulty of the cursive font degrades word recognition by impacting the OVP stability.

Motor control of handwriting in the developing brain: A review.

This review focuses on the acquisition of writing motor aspects in adults, and in 5-to 12-year-old children without learning disabilities. We first describe the behavioural aspects of adult writing and dominant models based on the notion of motor programs. We show that handwriting acquisition is characterized by the transition from reactive movements programmed stroke-by-stroke in younger children, to an automatic control of the whole trajectory when the motor programs are memorized at about 10 years old. Then, we describe the neural correlates of adult writing, and the changes that could occur with learning during childhood. The acquisition of a new skill is characterized by the involvement of a network more restricted in space and where neural specificity is increased in key regions. The cerebellum and the left dorsal premotor cortex are of fundamental importance in motor learning, and could be at the core of the acquisition of handwriting.

On the Auditory-Proprioception Substitution Hypothesis: Movement Sonification in Two Deafferented Subjects Learning to Write New Characters.

The aim of this study was to evaluate the compensatory effects of real-time auditory feedback on two proprioceptively deafferented subjects. The real-time auditory feedback was based on a movement sonification approach, consisting of translating some movement variables into synthetic sounds to make them audible. The two deafferented subjects and 16 age-matched control participants were asked to learn four new characters. The characters were learned under two different conditions, one without sonification and one with sonification, respecting a within-subject protocol. The results revealed that characters learned with sonification were reproduced more quickly and more fluently than characters learned without and that the effects of sonification were larger in deafferented than in control subjects. Secondly, whereas control subjects were able to learn the characters without sounds the deafferented subjects were able to learn them only when they were trained with sonification. Thirdly, although the improvement was still present in controls, the performance of deafferented subjects came back to the pre-test level 2 h after the training with sounds. Finally, the two deafferented subjects performed differently from each other, highlighting the importance of studying at least two subjects to better understand the loss of proprioception and its impact on motor control and learning. To conclude, movement sonification may compensate for a lack of proprioception, supporting the auditory-proprioception substitution hypothesis. However, sonification would act as a "sensory prosthesis" helping deafferented subjects to better feel their movements, without permanently modifying their motor performance once the prosthesis is removed. Potential clinical applications for motor rehabilitation are numerous: people with a limb prosthesis, with a stroke, or with some peripheral nerve injury may potentially be interested.