Frontal and Parietal Contributions to Proprioception and Motor Skill Learning
Phase: NA
Conditions: Basic Science
Sponsor: Indiana University

Frontal and Parietal Contributions to Proprioception and Motor Skill Learning 
NCT05739994 
Study Protocol 
June 1, 2023 

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Frontal and Parietal Contributions to Proprioception and Motor Skill Learning 
                         
 
 
 
 
 
 
Hannah Block, PhD, Associate Professor 
Department of Kinesiology, Program in Neuroscience 
Indiana University Bloomington 
1025 E 7th St, Rm 112, Bloomington, IN 47408 
 
Manasi Wali, MS, PhD Candidate 
Program in Neuroscience and Department of Kinesiology 
Indiana University Bloomington 
1025 E 7th St, Rm 074, Bloomington, IN 47408 
 
 
 
 
 
 
Support Provided by: 
National Institute of Neurological Disorders and Stroke (NINDS) 
 
 

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Study Schema 
1.0 
Background & Rationale 
2.0 
Objective(s) 
3.0 
Outcome Measures 
4.0 
Eligibility Criteria 
4.1 
Inclusion Criteria 
4.2 
Exclusion Criteria 
5.0 
Study Design 
6.0 
Enrollment/Randomization 
7.0 
Study Procedures 
8.0 
Study Calendar 
9.0 
Reportable Events 
10.0 Data Safety Monitoring 
11.0 Study Withdrawal/Discontinuation 
12.0 Statistical Considerations 
13.0 Data Management 
14.0 Privacy/Confidentiality Issues 
15.0 Follow-up and Record Retention 
16.0 References 
 
 

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1.0 
Background & Rationale 
Motor learning is defined as the process that occurs in the brain aimed at developing new 
movements with practice until they can be performed automatically (Schimdt & Wrisberg 2008). 
Motor skill improvement is best noted by a change in the speed-accuracy function, meaning 
execution of motor patterns occurring more accurately at different speed ranges (Kantak et al., 
2017; Reis et al., 2009). Learning motor skills necessitates the interaction of several high-level 
cognitive processes with low-level sensorimotor mechanisms (Krakauer & Mazzoni, 2011). A 
complex neuroanatomical architecture supports the learning and retention of motor skills, which 
includes increased activation in the frontoparietal cortices like dorsolateral prefrontal cortex 
(DLPFC), primary motor cortex, and posterior parietal cortex (PPC), and subcortical structures 
like the cerebellum and basal ganglia, which show increased activation during the later stage of 
short-term motor learning (Floyer-Lea & Matthews, 2005; Halsband & Lange, 2006).  
Motor skill learning involves not only changes in the motor system, but also depends on sensory 
systems. One of the sensory modalities critically important for motor skill is position sense or 
proprioception. It is the ability of an individual to integrate sensory inputs from the muscles and 
joints to determine the positions and movements of body segments in space (Han et al., 2016). 
The proprioceptive information about the hand’s position is taken into consideration by the 
motor system as feedback which is required for smooth and skilled movement execution 
(Bossom, 1974; Jeannerod, 1988). Many studies have shown that an enhancement in 
proprioception results in improvements in motor learning/decline in motor deficits or vice versa, 
although the neural basis of such interactions is unclear. In addition to acting as an interface 
between the sensory and motor cortex, posterior parietal cortex (PPC) is thought to play a role 
in processing higher-level proprioceptive information (Amaral, 2013). Stroke research has 
revealed the critical involvement of PPC, specifically supramarginal gyrus (SMG) in processing 
the sense of position (Findlater et al., 2016). A study by Ben-Shabat et al., 2015, found a key 
role of SMG in proprioception. They suggested that in patients with stroke, decrease in 
proprioception might be associated with decrease in right SMG function which might be due to 
SMG’s role in motor control and spatial processing (Ben-Shabat et al., 2015). However, it is 
unclear how SMG modulates proprioceptive functioning to affect motor skill learning.  
Research has also found an indirect connection between DLPFC and proprioception. Stagg et 
al., (2013) applied anodal tDCS over left DLPFC and found an enhanced functional connectivity 
between sensorimotor cortex and DLPFC. They further suggested that the enhanced activity in 
the DLPFC might be linked to enhanced proprioception. Beck et al., (2019) also found an 
increased activity in the sensorimotor cortex possibly through the fronto-striato-thalamic 
pathways after applying anodal tDCS over DLPFC suggesting that DLPFC might be involved in 
enhancing proprioception in healthy individuals. They proposed that DLPFC can be used as a 
potential target in neurorehabilitation in patients with motor deficits (Beck et al., 2019).  
The sensorimotor network associated with proprioception and motor skill learning is not fully 
understood, and the functional role of activity in high-level areas such as DLPFC and SMG is 
particularly unclear. With greater knowledge of these processes in the healthy brain, it may one 
day be possible to develop rehabilitation strategies that target a patient’s unique mix of sensory 
and motor deficits.  
2.0 
Objective(s) 
The aim of the present study is to test role of activity in SMG and DLPFC in proprioception and 
motor skill learning. A robust way to identify whether a brain region plays a role in a behavior is 
to temporarily modulate its excitability in healthy people using non-invasive brain stimulation 

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(Cohen et al., 1997; Reis et al., 2008). This is commonly done in research with a short 
sequence of low-intensity transcranial magnetic stimulation (TMS), also known as repetitive 
TMS (rTMS). A small, temporary reduction in cortical excitability can be achieved through 
continuous theta burst stimulation (cTBS), a low intensity patterned form of rTMS that is 
delivered over 40 seconds, with excitability effects lasting up to an hour (Huang et al., 2005). 
rTMS is used clinically to treat conditions such as depression and is considered very low risk 
provided the generally accepted screening criteria are met. In the research setting, this 
technique is widely used not only in healthy adults (as in this study) but also in children and 
people with concussion, stroke, Parkinson's disease, and more (Rossi et al. 2021).                                          
In separate groups of subjects, we will use a 40-second sequence of rTMS called continuous 
theta burst stimulation (cTBS) over SMG, DLPFC, or sham (control), before the subject performs 
tasks known to involve proprioception and either a short or longer sequence of motor skill 
learning (a maze tracing task). If cTBS over SMG or DLPFC has an impact on task performance 
for that group (in comparison to the sham, or control group), it suggests activity in that brain 
region is important for the affected aspect of task performance.    
This project has two objectives:  
• 
Objective 1. To explore the role of DLPFC and SMG in proprioception.  
• 
Objective 2. To assess the role of DLPFC and SMG on motor skill learning and 
proprioceptive changes at two different time scales.  
 
Because cTBS is intended to be disruptive, it is possible that the sham group will have the best 
performance in one or more outcome measures. It is also possible that some aspects of 
performance will be better in the SMG or DLPFC group due to complexities of the neural networks 
supporting these behaviors. However, it is not the goal of the study to determine which 
intervention yields the “best” task performance, it is simply to determine the details of how the 
DLPFC and SMG groups differ from each other and from the sham group. 
 
 
3.0 
Outcome Measures/Endpoints 
Outcome measures will be assessed during the 
main (experimental) session, which takes place 
on a single day. Proprioceptive outcome 
measures will be assessed 3 times, and motor 
outcome measures 4 times, on this day (Fig. 1). 
Outcome Measure 1: Proprioception. This will be 
quantified from a psychometric function, based 
on a sequence of trials in which the participant 
estimates their hand position. From the 
psychometric function we will extract 
proprioceptive bias (50% point) and sensitivity 
(distance between 25% and 75% points on the 
function).  
Outcome Measure 2: Motor skill. This will be 
quantified from the speed-accuracy function, based on the person’s in-track accuracy when 
tracing the maze at three different speeds. Shifts in the speed accuracy function (better 
accuracy at any of the movement speeds) indicates motor skill learning. 
Fig. 1. Session design of the main (experimental) 
session, which takes place on a single day. 
Proprioception and motor skill will be assessed at 
multiple time points. 

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4.0 
Eligibility Criteria 
4.1 
Inclusion Criteria 
• 
Between the ages of 18-45 years old. Aging has been shown to affect the morphology 
of sensory and motor nerves, conduction velocities of nerves, and number of motor 
neurons in the spinal cord; to avoid these confounding factors we will only examine 
younger-to middle-aged adults. 
• 
Right-handed. There are differences in cortical function and corticospinal projections 
such that testing the right arm of a right-handed individual is not necessarily equivalent 
to testing the left arm of a left-handed individual. To eliminate this confound, we will 
only test right-handed individuals.  
• 
Covid has been found to have neurological effects in some people, but mostly the 
effects on sensorimotor control and neurophysiology are unknown. We will only include 
individuals who report being free of Covid symptoms in week preceding testing. 
 
4.2 
Exclusion Criteria  
• 
Any past or present history of neurological disorders, heart or respiratory disease, 
hypertension, brain injury, spinal cord surgery, or metal implants in the head. 
• 
Orthopedic or pain conditions. 
• 
Pregnant or think they might be pregnant. 
• 
Lack of normal vision or corrected-to-normal vision with contacts or glasses. 
• 
Subjects will also be excluded if they currently suffer from frequent severe headaches, 
glaucoma, heart or respiratory disease, hypertension, psychiatric conditions, or learning 
or attention conditions.  
• 
They will also be excluded for current or past: visual, hearing, or balance impairments; 
stroke, seizure/epilepsy (including family history), or severe head trauma; fainting; or 
diabetes.  
• 
Subjects will be excluded for metal implants in the head other than titanium; cochlear 
implants; implanted neurostimulator; cardiac pacemaker; intracardiac lines; or a 
medication infusion device.  
• 
Because TMS does not penetrate deeply into the head, we cannot test subjects whose 
hair does not permit contact between the TMS coil and the scalp. We will therefore 
exclude subjects with dreadlocks, weaves, or hair extensions.  
• 
To protect the data from extraneous peripheral influences, we will also exclude subjects 
who have had serious injury to the bones, joints, or muscles of either hand or arm, and 
have not fully recovered. For the purpose of this study, "fully recovered" means they no 
longer notice any pain, weakness, or loss of sensation in the injured area, and have no 
mobility limitations. 
• 
Taking medications or drugs that are known to affect cortical excitability and possibly 
seizure risk in an rTMS study. These medications/drugs are (Rossi et al., 2009): 
imipramine, amitriptyline, doxepine, nortriptyline, maprotiline, chlorpromazine, 
clozapine, foscarnet, ganciclovir, ritonavir, amphetamines, cocaine, (MDMA, ecstasy), 
phencyclidine (PCP, angel’s dust), ketamine, gamma-hydroxybutyrate (GHB), 
theophylline, mianserin, fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram, 
reboxetine, venlafaxine, duloxetine, bupropion, mirtazapine, fluphenazine, pimozide, 
haloperidol, olanzapine, quetiapine, aripiprazole, ziprasidone, risperidone, chloroquine, 
mefloquine, imipenem, penicillin, ampicillin, cephalosporins, metronidazole, isoniazid, 

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levofloxacin, cyclosporin, chlorambucil, vincristine, methotrexate, cytosine arabinoside, 
BCNU, lithium, anticholinergics, antihistamines, sympathomimetics.  
• 
Claustrophobic, or are unable to remain still for long periods of time; or use an intra-
uterine device (IUD) who’s MR compatibility has not been established. 
• 
 People who have a BMI over 30 will be excluded as it may be uncomfortable or 
impossible to lay in the MRI scanner. 
• 
Potential subjects will be invited to reschedule if they would otherwise be eligible 
(according to the initial screening), but the day of testing have drunk more than 3 units 
of alcohol or taken other recreational drugs in the 24 hour period prior to testing; have 
had more than 3 cups of coffee in the last hour; are sleep deprived (<4 hours sleep the 
previous night); or have participated in another brain stimulation experiment the same 
day.  
• 
In addition, we will invite subjects to reschedule if they have any of the common Covid 
symptoms within the last week.  
• 
After giving their consent, participants may be excluded during or after the 
familiarization session if they are unable to perform the reaching task or follow 
instructions, or if their TMS stimulation parameters cannot be reliably determined by 
the experimenter, or if TMS is not well tolerated. 
5.0 
Study Design 
 
 
                
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Potential subjects 
respond to flyers
Electronic screening
Eligible
Familiarization Session: 
In person screening, Consent form, 
Handedness questionnaire, TMS tolerance 
check, Behavioral task practice
Ineligible
Random group 
assignment
No MRI or MRI  
Main Session: 
Screening, Proprioceptive assesment 1, Motor 
assessment 1, cTBS, Proprioceptive assessment 2, Motor 
assessment 2, Motor skill training (short), Motor 
assessment 3, Motor skill training (long), Proprioceptive 
assesment 3, Motor assesment 4
Ineligible

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6.0 
Enrollment/Randomization  
Potential subjects will initiate contact with the research staff in response to the recruitment 
flyers. The subject will be given information about what the experiment entails and will be 
asked questions to make sure they meet the inclusion/exclusion criteria. If they are interested 
in participating and meet the inclusion/exclusion criteria, then they will be scheduled for their 
first session (familiarization session) which will take place in the Sensorimotor Neurophysiology 
Laboratory, 1025 E. 7th St., PH 079, Bloomington IN, 47405.  
At the familiarization session, before any experimental procedures occur, a research team 
member will explain the procedures in more detail and go through the consent form with the 
subject. The subject will then have the opportunity to ask any questions and read the informed 
consent before signing. After the familiarization session, if the subject was not bothered by 
TMS and wants to continue, random group assignment will occur, following a block 
randomization table. There will be 3 groups that differ in cTBS intervention and amount of 
motor skill practice. Subjects will have a 67% chance of receiving cTBS, and a 33% chance of 
receiving sham cTBS (details below). 
7.0 
Study Procedures 
All procedures are conducted for research purposes only. The study will be comprised of 
a familiarization session, an anatomical MRI brain scan session (except for those 
assigned to a sham group) and one experimental session. Subjects will be offered the 
option to combine their familiarization session and MRI scan or MRI scan and 
experimental session in the same day for a total of 2 lab visits or on separate days for a 
total of 3 lab visits. (Table 1). All study procedures will take place in the Sensorimotor 
Neurophysiology Lab, SPH 079 and the MRI scan will take place in the Imaging Research 
Facility in the Psychology building. 
 
Table 1. Study structure. TMS = transcranial magnetic stimulation, cTBS = continuous theta burst stimulation, MRI 
= Magnetic Resonance Imaging. TMS is applied over motor cortex. cTBS is applied over DLPFC or SMG. 
Session 
Procedures 
Proceed to next session if… 
Familiarization 
TMS, motor skill task, proprioception 
assessment 
Subject comfortable with TMS, can follow 
task instructions, and wants to continue 
MRI anatomical 
scan  
Anatomical scan of the brain – 
dependent on group assignment  
Subject wants to continue 
Main 
Session  
TMS, cTBS, proprioception and motor 
skill assessments, motor skill practice. 
End of experiment 
 
The familiarization session involves transcranial magnetic stimulation (TMS) over the 
motor cortex, a motor skill task that involves a series of tracing movements with the right 
arm, and a position sense task that involves a series of judgements about the location of 
their right-hand position. First, subjects will fill out a TMS screening form. Upon 
confirming eligibility, subjects will sit in a comfortable chair while a non-invasive brain 
stimulation device (the TMS coil) is held over their head. We will deliver brief magnetic 
stimuli over the motor cortex that evoke a small twitch in their hand muscles. Subjects 
will wear a pair of goggles that enable accurate positioning of the TMS coil relative to the 

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head (Brainsight Neuronavigation system) and have stick-on sensors on their hand to 
measure their muscle activity upon stimulation. This will take approximately 20 minutes.  
For the motor skill task and the position sense task, they will sit in a comfortable chair 
and view the task display in a mirror while grasping a robotic manipulandum handle 
(BKIN) in their right hand (Fig. 2). During the motor skill task, they will guide a cursor 
representing hand position through the displayed maze. The hand feedback will be given 
using a visual cursor (10 mm diameter white circle). This design is similar to Mirdamadi 
and Block (2020) with six straight line segments connected in abrupt corners (Fig. 2, left). 
Subjects will move the cursor into a red square at the start of the trial. The square will 
turn green after 1s, and the maze track will appear with another green square at the end 
it. The participants will be instructed to reach the second target at the end of the track by 
moving the white cursor within the track as accurately as possible. The trial ends when 
the cursor enters the second target at the end of the maze. Feedback will be given about 
their movement time (too fast, too slow, good speed) and accuracy with points. The 
desired speed range will change during the speed-accuracy tradeoff assessment. The 
maze will be performed over three movement times (MT) ranges to assess the speed-
accuracy tradeoff in three blocks of trials (MT 1:-600 – 850 ms; MT 2: 850 – 1100 ms; MT 
3: 1100 – 1400 ms). 10 trials will be performed in each MT range and the block order will 
be randomized. The maze tracing will be standardized meaning the same maze will be 
used for all the trials between subjects.  
During the position sense task, the participant’s hand will be passively moved by the 
robotic manipulandum to two different positions. Participants will be asked to report 
whether the second position is closer to their body than the first position. An adaptive 
staircase algorithm is used to determine the test positions with a 0.5 cm step size. There 
will be 82 trials in total each time and the test will be standardized across participants.  
The motor skill and position sense assessments will take approximately 30 minutes. If 
subjects are comfortable with all procedures and can follow task instructions, they will be 
assigned to a group. This group assignment will decide whether they need an anatomical 
brain scan.  
 

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The MRI scan of the brain, if needed, will 
involve a 20-minute visit to the IU Imaging 
Research Facility (IRF) at 1101 E 10th St, 
Bloomington IN (PY 159). The participant will 
complete a safety screening questionnaire. 
Then they will be asked to lay in the scanner 
bed and remain still for the scan, which takes 6 
minutes.  
The main session will take about two hours. The 
subjects’ MRI scans will be uploaded in the 
Brainsight neuronavigation system in the lab 
(Rogue Research), which will be used for 
accurate positioning of the TMS coil for cTBS 
delivery. MRI-guided TMS is widely used in the 
field for targeting brain structures outside of 
primary motor cortex with TMS (Caulfield et al.,2022; Nieminen et al., 2022). The main 
session includes all the same elements as the familiarization session (TMS, proprioceptive 
assessment, motor skill task), plus cTBS. After the first motor skill assessment and 
proprioception assessment (Fig. 1), we will deliver single pulses of magnetic stimuli over 
the motor cortex and determine the resting motor threshold (RMT) as the lowest TMS 
intensity that elicits a muscle twitch of at least 50 microvolts at least 10 times out of 20 
(Rossini et al., 2015). We will then deliver cTBS in the standard pattern (600 pulses over 
40 seconds, at an intensity of 70% of RMT). For non-sham groups the coil will be 
positioned over DLPFC or SMG, as determined by the Brainsight neuronavigation system. 
For sham groups, the coil will be tilted 90 degrees so the magnetic field is not directed 
into the head; they hear the clicking noises but no current is induced in the brain (Rossi et 
al., 2009). Then, subjects will perform second pair of assessment tasks. This will be 
followed by practice of the maze tracing task for about 20 minutes, with a motor skill 
assessment partway through. Practice of the maze task will occur at a single MT range 
(MT 2). The session will conclude with the third pair of assessment tasks.  
8.0 
Study Calendar 
 
Familiarization 
Session 
MRI session if 
needed 
Main Session 
First visit 
Second visit 
Second or third visit 
STUDY PROCEDURES 
 
 
 
In person screen, Consent and 
Handedness questionnaire 
X 
 
 
TMS tolerance check 
X 
 
 
Practice Behavioral tasks 
X 
 
 
Random group assignment 
X 
 
 
In person Screening 
 
X 
X 
cTBS 
 
 
X 
Position sense assessment task 
 
 
X 
Motor skill assessment task 
 
 
X 
Figure 2. Setup for behavioral procedures. 
Participant 
holds 
handle 
of 
robotic
manipulandum with right hand and makes 
arm movements to targets presented in 
visual display (motor skill task) or judges
where handle is moved in relation to a
target (position sense task). 

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9.0 
Reportable Events 
Outcome and Adverse Event Data including: seizure induction (rare), syncope 
(epiphenomenon); transient headache, neck pain, toothache, paresthesia, hearing 
changes; lightheadedness; and nausea (Rossi et al., 2009). 
Expected adverse events that will be reported in annual reviews: 
1. 
Slight discomfort lasting less than a second on the scalp near the TMS coil. 
2. 
Twitching of the face and jaw due to the magnetic pulse, which may be 
unpleasant but usually not painful. 
3. 
Transient headache, neck pain, toothache, paresthesia, hearing changes. 
4. 
Lightheadedness or nausea 
Exceptional adverse events that will be reported immediately: 
1. 
Seizure. The appearance of a seizure during application of TMS with stimulation 
parameters regarded as safe cannot be excluded, therefore we defined 
appearance of a seizure as an exceptional adverse event. 
2. 
Syncope. 
All exceptional adverse events will be reported to the IRB immediately by the PI. Subjects 
will be excluded for seizure induction and syncope. However, the subject will make the 
decision for continuation for the other transient discomforts. 
In addition to the IRB’s minimal requirements, we will report adverse events including: date, 
time, description of the adverse event, and treatment or handling of the event. We will also 
provide a summary of cumulative adverse events annually. 
10.0 Data Safety Monitoring 
The PI will be responsible for data and safety monitoring. The study team will meet at least 
monthly to discuss any difficulties with carrying out the experimental protocol and to review the 
data. Dr. Block will always be available in person or by phone when data collections are 
occurring. Notes recording the date of each meeting and the results of the safety review will be 
kept in the Block lab's Teams channel for this project. 
11.0 Study Withdrawal/Discontinuation 
The participant will contact the study personnel by phone or e- mail and inform us that he or 
she is withdrawing. There are no risks to participant by withdrawing early. If an exceptional 
adverse event occurs, we will withdraw the subject immediately. For minor, expected adverse 
events, withdrawal will be discussed with the subject. We would also withdraw the subject if 
they are unable to follow the instructions for the motor skill task or position sense task. If a 
subject meets exclusion criteria temporarily on their familiarization session and/or first 
experimental session (e.g., did not get more than 4 hours of sleep the night before, drank too 
much coffee, etc), we will simply reschedule the session. However, if they temporarily meet the 
exclusion criteria on their second experimental session, they will be excluded. If the subject 
develops a medical condition such that they no longer pass the TMS screening questionnaire 
and the situation is not temporary, we will withdraw the subject. Participants may also be 
excluded if we are unable to make the TMS measurements. This happens on rare occasions 
 
Familiarization 
Session 
MRI session if 
needed 
Main Session 
First visit 
Second visit 
Second or third visit 
Motor skill practice 
 
 
X 

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when we can't identify a good motor hotspot to deliver the stimuli. In any case, we would pay 
any withdrawn participant for the amount of time they have spent participating. 
12.0 Statistical Considerations 
Based on a prior study performed in the lab with a similar paradigm using cTBS (Mirdamadi & 
Block, 2021), we predict an effect size f of at least 0.14 to detect a significant interaction in the 
planned mixed measures ANOVA between stimulation type (DLPFC, SMG, sham), motor training 
duration (short, long) and timepoint on the proprioception function and motor skill function. 
Power analysis indicates we need 24 subjects in each group to have 0.8 power to detect this 
effect (alpha 0.05). 
13.0 Statistical Data Management 
Primary data will be collected via direct data capture from measurement instrument and stored 
electronically in the lab’s Teams storage. The storage location will be backed up automatically 
every day.  
14.0 Privacy/Confidentiality Issues 
No one will be in the room with the subject except the investigator(s) when the consent process 
begins. The experimenter will review each section of the ICS with the subject in person, in the 
lab, at the beginning of the first session. The risk of loss of confidentiality will be minimized by 
storing identifying information only in two places, both secured to the best of our ability: (1) 
Printed identifying information consists of the signed consent form and in-person screening 
forms. Both will be kept in the subject's folder in a locked file cabinet in our lab (PH 079), which 
is also locked when we're not in there. (2) Electronic identifying information exists in a 
password-protected spreadsheet of subject names and contact information, with the numerical 
code that will be associated with the experimental data. The spreadsheet is kept on a secure 
network drive on the IU Teams server, accessible only to the investigators. If subjects respond 
to the initial screening questions over e-mail, we will delete this e-mail after determining 
eligibility. The text of the initial screening e-mail tells the subject we are happy to ask the 
screening questions by phone, so they know they have the option of not writing personal 
information in an e-mail. All the information we ask in the initial screening is replicated on the 
in-person screening form, which subjects fill out when they come to the lab, and this form is 
used to officially determine eligibility, so there is no need to retain the initial e-mail. To protect 
the subject's confidentiality, we will only e-mail the subject from an IU e-mail account (ending 
in indiana.edu or iu.edu). There will be no other electronic or paper identifying information, as 
all experimental data we collect (through software or a paper data sheet during the experiment) 
will only have the numerical code assigned to the subject. 
Individual data will be associated with a numerical code rather than the subject’s name or 
birthdate. Printed data (forms) will be stored in the subject’s folder in the Laboratory in a 
locked file cabinet in a locked room. Electronic data will be stored on a secure drive on the SPH 
server. An electronic document containing the numerical codes with identifiable subject 
information such as name and contact information will be password protected and kept on a 
secure drive on the SPH server, accessible only by the investigators. Data analysis and 
publication will not include any identifying information. 
15.0 Follow-up and Record Retention 

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This study will take up to 3 years. We will retain paper and electronic data for 3 years after the 
study is completed and then destroy them: paper documents will be shredded, and electronic 
data will be deleted and overwritten. 
16.0 References 
Amaral, D. (2014). The Functional Organization of Perception and Movement. In Principles of Neural Science, Fifth 
Edition (Vol. 1–Book, Section). McGraw-Hill Education. 
accessbiomedicalscience.mhmedical.com/content.aspx?aid=1101678786 
Beck, E. N., Narayanan, S. S., McDermott, R., & Witney, A. G. (2019). CAN TRANSCRANIAL DIRECT CURRENT 
STIMULATION OVER THE DORSOLATERAL PREFRONTAL CORTEX ENHANCE PROPRIOCEPTION? [Preprint]. 
Neuroscience. https://doi.org/10.1101/539510 
Ben-Shabat, E., Matyas, T. A., Pell, G. S., Brodtmann, A., & Carey, L. M. (2015). The Right Supramarginal Gyrus Is 
Important for Proprioception in Healthy and Stroke-Affected Participants: A Functional MRI Study. Frontiers in 
Neurology, 6. https://doi.org/10.3389/fneur.2015.00248 
Bossom, J. (1974). Movement without proprioception. Brain Research, 45, 285-296. 
Caulfield, K. A., Fleischmann, H. H., Cox, C. E., Wolf, J. P., George, M. S., & McTeague, L. M. (2022). 
Neuronavigation maximizes accuracy and precision in TMS positioning: Evidence from 11,230 distance, angle, 
and electric field modeling measurements. Brain Stimulation: Basic, Translational, and Clinical Research in 
Neuromodulation, 15(5), 1192–1205. https://doi.org/10.1016/j.brs.2022.08.013 
Cohen, L. G., Celnik, P., Pascual-Leone, A., Corwell, B., Faiz, L., Dambrosia, J., Honda, M., Sadato, N., Gerloff, C., 
Catala´, M. D., & Hallett, M. (1997). Functional relevance of cross-modal plasticity in blind humans. Nature, 
389(6647), 180–183. https://doi.org/10.1038/38278 
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