From Sensation to Action: Neuroplasticity, Cognitive-Motor Training, and Emerging Biomarkers of Adaptation

Human interaction with the environment depends on the integration of sensory input, cognitive processing, and motor output within dynamic sensorimotor loops. These processes are supported by distributed neural circuits and shaped by learning, memory, and neuroplasticity across the lifespan. This review synthesizes current understanding of the mechanisms underlying sensorimotor integration and highlights how experience-dependent plasticity supports functional recovery and performance optimization in both health and disease. Disruptions such as traumatic brain injury, neurodegenerative disease, and aging may frequently result in combined cognitive and motor impairments. Here, we review non-invasive interventions that leverage neuroplasticity, including physical activity, motor training, and cognitive training, with increasing emphasis on integrated cognitive-motor approaches. Emerging technologies such as virtual reality provide ecologically valid, immersive environments that simultaneously engage perception, cognition, and action, with the potential to enhance training outcomes. However, variability in effectiveness and limited evidence for far transfer remain key challenges. To address these limitations, we highlight the integration of immersive training with objective biological measures. In particular, proton nuclear magnetic resonance (¹H NMR)-based metabolomics offers a promising, non-invasive approach to identify biomarkers of neuroplastic adaptation. The integration of robust biomarker tools may facilitate the development and assessment of effective precision cognitive-motor interventions to optimize rehabilitation approaches and help build resilience in vulnerable individuals.