AAVshRNA-mediated PTEN knockdown in adult neurons attenuates activity-dependent immediate early gene induction

Genetic deletion or knockdown of PTEN enables regeneration of CNS axons, enhances sprouting of intact axons after injury, and induces de novo growth of uninjured adult neurons. It is unknown, however how PTEN deletion in mature neurons alters neuronal physiology. As a first step to address this question, we used immunocytochemistry for activity-dependent markers to assess consequences of PTEN knockdown in cortical neurons and granule cells of the dentate gyrus. In adult rats that received unilateral intra-cortical injections of AAV expressing shRNA against PTEN, immunostaining for c-fos under resting conditions (home cage, HC) and after 1 h of exploration of a novel enriched environment (EE) revealed no hot spots of c-fos expression that would suggest abnormal activity. Counts revealed similar numbers of c-fos positive neurons in the area of PTEN deletion vs. homologous areas in the contralateral cortex in the HC and similar induction of c-fos with EE. However, IEG induction in response to high frequency stimulation (HFS) of the cortex was attenuated in areas of PTEN deletion. In rats with AAVshRNA-mediated PTEN deletion in the dentate gyrus, induction of the IEGs c-fos and Arc with HFS of the perforant path was abrogated in areas of PTEN deletion. Immunostaining using phosphospecific antibodies for phospho-S6 (a downstream marker for mTOR activation) and phospho-ERK1/2 revealed abrogation of S6 phosphorylation in PTEN-deleted areas but preserved activation of phosphorylation of ERK1/2. SIGNIFICANCE STATEMENT: Deletion or knockdown of the tumor suppressor gene PTEN enables regenerative growth of adult CNS axons after injury, which is accompanied by enhanced recovery of function. Consequently, PTEN represents a potential target for therapeutic interventions to enhance recovery after CNS injury. Here we show that activity-dependent IEG induction is attenuated in PTEN-depleted neurons. These findings raise the intriguing possibility that functional recovery due to regenerative growth may be limited by the disruption of plasticity-related signaling pathways, and that recovery might be enhanced by restoring PTEN expression after regenerative growth has been achieved.

Mouse corticospinal system comprises different functional neuronal ensembles depending on their hodology

BACKGROUND

Movement performance depends on the synaptic interactions generated by coherent parallel sensorimotor cortical outputs to different downstream targets. The major outputs of the neocortex to subcortical structures are driven by pyramidal tract neurons (PTNs) located in layer 5B. One of the main targets of PTNs is the spinal cord through the corticospinal (CS) system, which is formed by a complex collection of distinct CS circuits. However, little is known about intracortical synaptic interactions that originate CS commands and how different populations of CS neurons are functionally organized. To further understand the functional organization of the CS system, we analyzed the activity of unambiguously identified CS neurons projecting to different zones of the same spinal cord segment using two-photon calcium imaging and retrograde neuronal tracers.

RESULTS

Sensorimotor cortex slices obtained from transgenic mice expressing GCaMP6 funder the Thy1 promoter were used to analyze the spontaneous calcium transients in layer 5 pyramidal neurons. Distinct subgroups of CS neurons projecting to dorsal horn and ventral areas of the same segment show more synchronous activity between them than with other subgroups.

CONCLUSIONS

The results indicate that CS neurons projecting to different spinal cord zones segregated into functional ensembles depending on their hodology, suggesting that a modular organization of CS outputs controls sensorimotor behaviors in a coordinated manner.

Cortical dynamics of sensorimotor information processing associated with balance control in adolescents with and without idiopathic scoliosis

OBJECTIVE

This study aims at examining the cortical dynamics of sensorimotor information processing related to balance control in participants with adolescent idiopathic scoliosis (AIS) and in age-matched controls (CTL).

METHODS

Cortical dynamics during standing balance control were assessed in 13 girls with AIS and 13 age-matched controls using electroencephalography. Time-frequency analysis were used to determine frequency power during ankle proprioception alteration (ankle tendons co-vibration interval) or reintegration of ankle proprioception (post-vibration interval) with or without vision.

RESULTS

Balance control did not differ between groups. In the co-vibration interval, a significant suppression in alpha (8-12 Hz) and beta (13-30 Hz) band power and a significant increase in theta (4-7 Hz) band power were found respectively in the vision and non-vision condition in the AIS group compared to the CTL group. In the post-vibration interval, significant suppressions in beta (13-30 Hz) and gamma (30-50 Hz) band power were observed in the AIS group in the non-vision condition.

CONCLUSION

Participants with AIS showed brain oscillations differences compared to CTL in the sensorimotor cortex while controlling their balance in various sensory conditions.

SIGNIFICANCE

Future study using evaluation of cortical dynamics could serve documenting whether rehabilitation programs have an effect on sensorimotor function in AIS.

Changes of functional response in sensorimotor cortex of preterm and full-term infants during the first year: An fNIRS study

BACKGROUND

Motor impairments are frequently associated with preterm birth and interfere in acquisition of essential skills to global development. Using Near Infrared Spectroscopy (NIRS), the study of neural correlates of motor development in early stages of life are feasible in an ecological assessment.

AIMS

To evaluate changes in cortical activity in response to a sensorimotor stimulation in preterm and full-term infants at 6 and 12 months of age.

STUDY DESIGN

A longitudinal study was conducted with 22 infants (12 preterm and 10 full-term). Hemodynamic activity during sensorimotor task (8 blocks of 8 s of vibration applied to infant's right hand) was measured by Functional Near Infrared Spectroscopy (fNIRS). The optical probe consisted of 84 channels positioned according to the international 10-20 system coordinates, covering the frontal (38 channels), parietal (16 channels), temporal (22 channels) and occipital (8 channels) lobes of both hemispheres.

RESULTS

Preterm and full-term infants exhibited differences of location of the activation as well on the hemodynamic response in both the evaluated age groups.

CONCLUSIONS

Group differences in activation of sensorimotor cortex observed in this study demonstrate the potential of fNIRS application for preterm evaluation of motor development in children. Overall, the present work contributes to our understanding of cortical activation of cerebral motor skills spanning early ages in preterm-born children.

Abnormalities in grey matter structure in embouchure dystonia

INTRODUCTION

Embouchure dystonia (ED) is a debilitating movement disorder in professional brass players leading to involuntary muscle contractions/spasms during play. To date, activity changes in sensorimotor cortices during motor tasks and tactile processing, as well as connectivity changes at rest in sensorimotor and auditory brain networks have been described in the disease.

OBJECTIVE

To characterize differences in grey matter volume and asymmetry between brass musicians suffering from ED, healthy brass musicians and healthy nonmusicians.

METHODS

High-resolution structural magnetic resonance imaging was obtained from 24 brass musicians with ED, 23 healthy brass musicians and 24 healthy nonmusicians. Whole-brain voxel-wise morphometry and asymmetry analyses, as well as region-of-interest-based volumetry analysis were performed on the subjects' images and compared between groups. Further, correlations with clinical parameters were investigated.

RESULTS

ED patients showed increased grey matter volume in the primary sensorimotor cortex in relation to both healthy brass players and nonmusicians. Both healthy and diseased musicians showed increased thalamic symmetry in relation to nonmusicians; diseased brass musicians additionally showed increased basal ganglia symmetry compared to nonmusicians. There was an inverse correlation of disease duration with both mean putaminal volume and the extent of basal ganglia asymmetry.

CONCLUSION

This work provides first evidence for structural abnormalities in task-specific orofacial (musician's) dystonia. Somatotopy-related structural primary sensorimotor cortex changes underlying previously observed functional abnormalities underscore the role of maladaptive plasticity in the disease. The study further shows subcortical brain (a)symmetry changes in healthy brass players and hints at a possible role of such changes in focal dystonia.

A newly identified nociresponsive region in the transitional zone (TZ) in rat sensorimotor cortex

The primary somatosensory cortex (S1) comprises a number of functionally distinct regions, reflecting the diversity of somatosensory receptor submodalities innervating the body. In particular, two spatially and functionally distinct nociceptive regions have been described in primate S1 (Vierck et al., 2013; Whitsel et al., 2019). One region is located mostly in Brodmann cytoarchitectonic area 1, where a subset of neurons exhibit functional characteristics associated with myelinated Aδ nociceptors and perception of 1st/sharp, discriminative pain. The second region is located at the transition between S1 and primary motor cortex (M1) in area 3a, where neurons exhibit functional characteristics associated with unmyelinated C nociceptors and perception of 2nd/slow, burning pain. To test the hypothesis that in rats the transitional zone (TZ) - which is a dysgranular region at the transition between M1 and S1 - is the functional equivalent of the nociresponsive region of area 3a in primates, extracellular spike discharge activity was recorded from TZ neurons in rats under general isoflurane anesthesia. Thermonoxious stimuli were applied by lowering the contralateral forepaw or hindpaw into a 48-51 °C heated water bath for 5-10 s. Neurons in TZ were found to be minimally affected by non-noxious somatosensory stimuli, but highly responsive to thermonoxious skin stimuli in a slow temporal summation manner closely resembling that of nociresponsive neurons in primate area 3a. Selective inactivation of TZ by topical lidocaine application suppressed or delayed the nociceptive withdrawal reflex, suggesting that TZ exerts a tonic facilitatory influence over spinal cord neurons producing this reflex. In conclusion, TZ appears to be a rat homolog of the nociresponsive part of monkey area 3a. A possibility is considered that this region might be primarily engaged in autonomic aspects of nociception.

Cortical beta oscillations are associated with motor performance following visuomotor learning

People vary in their capacity to learn and retain new motor skills. Although the relationship between neuronal oscillations in the beta frequency range (15-30 Hz) and motor behaviour is well established, the electrophysiological mechanisms underlying individual differences in motor learning are incompletely understood. Here, we investigated the degree to which measures of resting and movement-related beta power from sensorimotor cortex account for inter-individual differences in motor learning behaviour in the young and elderly. Twenty young (18-30 years) and twenty elderly (62-77 years) healthy adults were trained on a novel wrist flexion/extension tracking task and subsequently retested at two different time points (45-60 min and 24 h after initial training). Scalp EEG was recorded during a separate simple motor task before each training and retest session. Although short-term motor learning was comparable between young and elderly individuals, there was considerable variability within groups with subsequent analysis aiming to find the predictors of this variability. As expected, performance during the training phase was the best predictor of performance at later time points. However, regression analysis revealed that movement-related beta activity significantly explained additional variance in individual performance levels 45-60 min, but not 24 h after initial training. In the context of disease, these findings suggest that measurements of beta-band activity may offer novel targets for therapeutic interventions designed to promote rehabilitative outcomes.

Atypical somatosensory-motor cortical response during vowel vocalization in spasmodic dysphonia

OBJECTIVE

Spasmodic dysphonia (SD) is a debilitating voice/speech disorder without an effective cure. To obtain a better understanding of the underlying cortical neural mechanism of the disease we analyzed electroencephalographic (EEG) signals of people with SD during voice production.

METHOD

Ten SD individuals and 10 healthy volunteers produced 50 vowel vocalization epochs of 2500 ms duration. Two EEG features were derived: (1) event-related change in spectral power during vocalization relative to rest, (2) inter-regional spectral coherence.

RESULTS

During early vocalization (500-1000 ms) the SD group showed significantly larger alpha band spectral power over the left motor cortex. During late vocalization (1000-2500 ms) SD patients showed a significantly larger gamma band coherence between left somatosensory and premotor cortical areas.

CONCLUSIONS

Two atypical patterns of cortical activity characterize the pathophysiology of spasmodic dysphonia during voice production: (1) a reduced movement-related desynchronization of motor cortical networks, (2) an excessively large synchronization between left somatosensory and premotor cortical areas.

SIGNIFICANCE

The pathophysiology of SD is characterized by an abnormally high synchronous activity within and across cortical neural networks involved in voice production that is mainly lateralized in the left hemisphere.

Use of imperceptible wrist vibration to modulate sensorimotor cortical activity

Peripheral sensory stimulation has been used as a method to stimulate the sensorimotor cortex, with applications in neurorehabilitation. To improve delivery modality and usability, a new stimulation method has been developed in which imperceptible random-frequency vibration is applied to the wrist concurrently during hand activity. The objective of this study was to investigate effects of this new sensory stimulation on the sensorimotor cortex. Healthy adults were studied. In a transcranial magnetic stimulation (TMS) study, resting motor threshold, short-interval intracortical inhibition, and intracortical facilitation for the abductor pollicis brevis muscle were compared between vibration on vs. off, while subjects were at rest. In an electroencephalogram (EEG) study, alpha and beta power during rest and event-related desynchronization (ERD) for hand grip were compared between vibration on vs. off. Results showed that vibration decreased EEG power and decreased TMS short-interval intracortical inhibition (i.e., disinhibition) compared with no vibration at rest. Grip-related ERD was also greater during vibration, compared to no vibration. In conclusion, subthreshold random-frequency wrist vibration affected the release of intracortical inhibition and both resting and grip-related sensorimotor cortical activity. Such effects may have implications in rehabilitation.

Interplay between hypoactivity, muscle properties and motor command: How to escape the vicious deconditioning circle?

Activity-dependent processes addressing the central nervous system (CNS) and musculoskeletal structures are critical for maintaining motor performance. Chronic reduction in activity, whether due to a sedentary lifestyle or extended bed rest, results in impaired performance in motor tasks and thus decreased quality of life. In the first part of this paper, we give a narrative review of the effects of hypoactivity on the neuromuscular system and behavioral outcomes. Motor impairments arise from a combination of factors including altered muscle properties, impaired afferent input, and plastic changes in neural structure and function throughout the nervous system. There is a reciprocal interplay between the CNS and muscle properties, and these sensorimotor loops are essential for controlling posture and movement. As a result, patients under hypoactivity experience a self-perpetuating cycle, in with sedentarity leading to decreased motor activity and thus a progressive worsening of a situation, and finally deconditioning. Various rehabilitation strategies have been studied to slow down or reverse muscle alteration and altered motor performance. In the second part of the paper, we review representative protocols directed toward the muscle, the sensory input and/or the cerebral cortex. Improving an understanding of the loss of motor function under conditions of disuse (such as extended bed rest) as well as identifying means to slow this decline may lead to therapeutic strategies to preserve quality of life for a range of individuals. The most efficient strategies seem multifactorial, using a combination of approaches targeting different levels of the neuromuscular system.

Repeated Vowel Production Affects Features of Neural Activity in Sensorimotor Cortex

The sensorimotor cortex is responsible for the generation of movements and interest in the ability to use this area for decoding speech by brain–computer interfaces has increased recently. Speech decoding is challenging however, since the relationship between neural activity and motor actions is not completely understood. Non-linearity between neural activity and movement has been found for instance for simple finger movements. Despite equal motor output, neural activity amplitudes are affected by preceding movements and the time between movements. It is unknown if neural activity is also affected by preceding motor actions during speech. We addressed this issue, using electrocorticographic high frequency band (HFB; 75–135 Hz) power changes in the sensorimotor cortex during discrete vowel generation. Three subjects with temporarily implanted electrode grids produced the /i/ vowel at repetition rates of 1, 1.33 and 1.66 Hz. For every repetition, the HFB power amplitude was determined. During the first utterance, most electrodes showed a large HFB power peak, which decreased for subsequent utterances. This result could not be explained by differences in performance. With increasing duration between utterances, more electrodes showed an equal response to all repetitions, suggesting that the duration between vowel productions influences the effect of previous productions on sensorimotor cortex activity. Our findings correspond with previous studies for finger movements and bear relevance for the development of brain-computer interfaces that employ speech decoding based on brain signals, in that past utterances will need to be taken into account for these systems to work accurately.

Optimization of sampling rate and smoothing improves classification of high frequency power in electrocorticographic brain signals

Objective

High-frequency band (HFB) activity, measured using implanted sensors over the cortex, is increasingly considered as a feature for the study of brain function and the design of neural-implants, such as Brain-Computer Interfaces (BCIs). One common way of extracting these power signals is using a wavelet dictionary, which involves the selection of different temporal sampling and temporal smoothing parameters, such that the resulting HFB signal best represents the temporal features of the neuronal event of interest. Typically, the use of neuro-electrical signals for closed-loop BCI control requires a certain level of signal downsampling and smoothing in order to remove uncorrelated noise, optimize performance and provide fast feedback. However, a fixed setting of the sampling and smoothing parameters may lead to a suboptimal representation of the underlying neural responses and poor BCI control. This problem can be resolved with a systematic assessment of parameter settings.

Approach

With classification of HFB power responses as performance measure, different combinations of temporal sampling and temporal smoothing values were applied to data from sensory and motor tasks recorded with high-density and standard clinical electrocorticography (ECoG) grids in 12 epilepsy patients.

Main results

The results suggest that HFB ECoG responses are best performed with high sampling and subsequent smoothing. For the paradigms used in this study, optimal temporal sampling ranged from 29 Hz to 50 Hz. Regarding optimal smoothing, values were similar between tasks (0.1-0.9 s), except for executed complex hand gestures, for which two optimal possible smoothing windows were found (0.4-0.6 s and 0.9-2.7 s).

Significance

The range of optimal values indicates that parameter optimization depends on the functional paradigm and may be subject-specific. Our results advocate a methodical assessment of parameter settings for optimal decodability of ECoG signals.

Referred cramping phantom hand pain elicited in the face and eliminated by peripheral nerve block

Phantom limb pain is a restricting condition for a substantial number of amputees with quite different characteristics of pain. Here, we report on a forearm amputee with constant phantom pain in the hand, in whom we could regularly elicit the rare phenomenon of referred cramping phantom pain by touching the face. To clarify the underlying mechanisms, we followed the cramp during the course of an axillary blockade of the brachial plexus. During the blockade, both phantom pain and the referred cramp were abolished, while a referred sensation of "being touched at the phantom" persisted. Furthermore, to identify the cortical substrate, we elicited the cramp during functional magnetic imaging. Imaging revealed that referred cramping phantom limb pain was associated with brain activation of the hand representation in the primary sensorimotor cortex. The results support the hypothesis that referred cramping phantom limb pain in this case is associated with a substantial brain activation in the hand area of the deafferented sensorimotor cortex. However, this alone is not sufficient to elicit referred cramping phantom limb pain. Peripheral inputs, both, from the arm nerves affected by the amputation and from the skin in the face at which the referred cramp is evoked, are a precondition for referred cramping phantom limb pain to occur, at least in this case.

Face sensorimotor cortex undergoes neuroplastic changes in a rat model of trigeminal neuropathic pain

Trigeminal nerve injury can result in neuropathic pain behavior and alterations in motor function, but it is unclear if such injury produces neuroplastic alterations in face sensorimotor cortex that could contribute to the alterations in motor function. Therefore, this study aimed to determine if trigeminal nerve injury in a rat neuropathic pain model induces neuroplastic changes in jaw and tongue motor representations in face sensorimotor cortex in association with facial nociceptive behavior. Right infraorbital nerve transection was performed in adult male Sprague-Dawley rats; sham-operated rats served as controls. Nociceptive behavior was assessed by testing facial mechanical sensitivity pre-operatively and post-operatively (1-28 days). Intracortical microstimulation was also applied post-operatively in a series of microelectrode penetrations to map jaw and tongue motor representations in the face sensorimotor cortex by analyzing anterior digastric and genioglossus electromyographic activities evoked by microstimulation at histologically verified sites in face primary somatosensory cortex (face-SI) as well as face primary motor cortex (face-MI). Compared to sham, infraorbital nerve injury induced a significant (2-way repeated-measures analysis of variance, P < 0.001) bilateral decrease in facial mechanical threshold that lasted up to 28 days post-operatively. Nerve injury also induced a significant bilateral decrease compared to sham (P < 0.05) in the number of anterior digastric and/or genioglossus sites in face-MI and in face-SI. These findings indicate that trigeminal nerve injury induces neuroplastic alterations in jaw and tongue motor representations in face sensorimotor cortex that are associated with facial nociceptive behavior and that may contribute to sensorimotor changes following trigeminal nerve injury.

The rat corticospinal system is functionally and anatomically segregated

The descending corticospinal (CS) projection has been considered a key element for motor control, which results from direct and indirect modulation of spinal cord pre-motor interneurons in the intermediate gray matter of the spinal cord, which, in turn, influences motoneurons in the ventral horn. The CS tract (CST) is also involved in a selective and complex modulation of sensory information in the dorsal horn. However, little is known about the spinal network engaged by the CST and the organization of CS projections that may encode different cortical outputs to the spinal cord. This study addresses the issue of whether the CS system exerts parallel control on different spinal networks, which together participate in sensorimotor integration. Here, we show that in the adult rat, two different and partially intermingled CS neurons in the sensorimotor cortex activate, with different time latencies, distinct spinal cord neurons located in the dorsal horn and intermediate zone of the same segment. The fact that different populations of CS neurons project in a segregated manner suggests that CST is composed of subsystems controlling different spinal cord circuits that modulate motor outputs and sensory inputs in a coordinated manner.

Movement-related beta oscillations show high intra-individual reliability

Oscillatory activity in the beta frequency range (15-30Hz) recorded from human sensorimotor cortex is of increasing interest as a putative biomarker of motor system function and dysfunction. Despite its increasing use in basic and clinical research, surprisingly little is known about the test-retest reliability of spectral power and peak frequency measures of beta oscillatory signals from sensorimotor cortex. Establishing that these beta measures are stable over time in healthy populations is a necessary precursor to their use in the clinic. Here, we used scalp electroencephalography (EEG) to evaluate intra-individual reliability of beta-band oscillations over six sessions, focusing on changes in beta activity during movement (Movement-Related Beta Desynchronization, MRBD) and after movement termination (Post-Movement Beta Rebound, PMBR). Subjects performed visually-cued unimanual wrist flexion and extension. We assessed Intraclass Correlation Coefficients (ICC) and between-session correlations for spectral power and peak frequency measures of movement-related and resting beta activity. Movement-related and resting beta power from both sensorimotor cortices was highly reliable across sessions. Resting beta power yielded highest reliability (average ICC=0.903), followed by MRBD (average ICC=0.886) and PMBR (average ICC=0.663). Notably, peak frequency measures yielded lower ICC values compared to the assessment of spectral power, particularly for movement-related beta activity (ICC=0.386-0.402). Our data highlight that power measures of movement-related beta oscillations are highly reliable, while corresponding peak frequency measures show greater intra-individual variability across sessions. Importantly, our finding that beta power estimates show high intra-individual reliability over time serves to validate the notion that these measures reflect meaningful individual differences that can be utilised in basic research and clinical studies.

Disrupted mitochondrial genes and inflammation following stroke

AIMS

Determine the subacute time course of mitochondria disruption, cell death, and inflammation in a rat model of unilateral motor cortical ischemic stroke.

MAIN METHODS

Rats received unilateral ischemia of the motor cortex and were tested on behavioral tasks to determine impairments. Animals were euthanized at 24h, 72h and 144h and mRNA expression of key mitochondria proteins and indicators of inflammation, apoptosis and potential regenerative processes in ipsilesion cortex and striatum, using RT-qPCR. Mitochondrial proteins were examined at 144h using immunoblot analysis.

KEY FINDINGS

Rats with stroke induced-behavioral deficits had sustained, 144h post-lesion, decreases in mitochondrial-encoded electron transport chain proteins NADH dehydrogenase subunit-1 and cytochrome c oxidase subunit-1 (mRNA and protein) and mitochondrial DNA content in perilesion motor and sensory cortex. Uncoupling-protein-2 gene expression, but not superoxide dismutase-2, remained elevated in ipsilateral cortex and striatum at this time. Cortical inflammatory cytokine, interleukin-6, was increased early and was followed by increased macrophage marker F4/80 after stroke. Cleaved caspase-3 activation was elevated in cortex and growth associated protein-43 was elevated in the cortex and striatum six days post-lesion.

SIGNIFICANCE

We identified a relationship between three disrupted pathways, (1) sustained loss of mitochondrial proteins and mitochondrial DNA copy number in the cortex linked to decreased mitochondrial gene transcription; (2) early inflammatory response mediated by interleukin- 6 followed by macrophages; (3) apoptosis in conjunction with the activation of regenerative pathways. The stroke-induced spatial and temporal profiles lay the foundation to target pharmacological therapeutics to these three pathways.

Brain-machine interfaces for rehabilitation of poststroke hemiplegia

Noninvasive brain-machine interfaces (BMIs) are typically associated with neuroprosthetic applications or communication aids developed to assist in daily life after loss of motor function, eg, in severe paralysis. However, BMI technology has recently been found to be a powerful tool to promote neural plasticity facilitating motor recovery after brain damage, eg, due to stroke or trauma. In such BMI paradigms, motor cortical output and input are simultaneously activated, for instance by translating motor cortical activity associated with the attempt to move the paralyzed fingers into actual exoskeleton-driven finger movements, resulting in contingent visual and somatosensory feedback. Here, we describe the rationale and basic principles underlying such BMI motor rehabilitation paradigms and review recent studies that provide new insights into BMI-related neural plasticity and reorganization. Current challenges in clinical implementation and the broader use of BMI technology in stroke neurorehabilitation are discussed.

Rodent spinal cord injury models for studies of axon regeneration

For over a century, axon regeneration has been considered the Holy Grail for spinal cord injury (SCI) repair. Although there are other factors that could contribute to improving function, restoring the long motor and sensory tracts that are interrupted by SCI has the greatest potential for actually reversing paralysis, restoring the brain's control of autonomic functions mediated by sympathetic and parasympathetic circuits of the spinal cord and restoring sensation. Accordingly and in keeping with the overall theme of this special issue, this review focuses narrowly on rodent SCI models for studies of axon regeneration.

Evidence for cerebellar motor functional reorganization in brain tumor patients: An fMRI study

Functional reorganization of the motor system following brain damage has been studied extensively in stroke patients, in which not only the cerebrum but also the cerebellum (Cbll) undergoes substantial reorganization. However, the role of Cbll in motor functional reorganization in brain tumor patients remains poorly investigated. Because brain damages in brain tumor patients occur much more slowly than in stroke patients, the neural mechanisms for motor functional reorganization might differ between these two disease conditions. This functional magnetic resonance imaging (fMRI) study investigated whether Cbll constitutes the neural substrates for motor functional reorganization in eighteen supratentorial brain tumor patients who exhibited no clinical signs of paresis. The patients and normal volunteers underwent a unilateral hand movement task. In the patients, the locus of primary sensory motor (SM1) activation during contralesional hand movement was significantly displaced by the tumor, suggesting functional compromise and/or reorganization in the central sulcus region. In addition, their contralesional Cbll activation during contralesional hand movement was substantially increased as compared to normal controls. The finding represents the first conclusive evidence that Cbll is involved in the motor-related functional reorganization in patients with brain tumor.

Graph-theoretical analysis of resting-state fMRI in pediatric obsessive-compulsive disorder

BACKGROUND

fMRI graph theory reveals resting-state brain networks, but has never been used in pediatric OCD.

METHODS

Whole-brain resting-state fMRI was acquired at 3T from 21 children with OCD and 20 age-matched healthy controls. BOLD connectivity was analyzed yielding global and local graph-theory metrics across 100 child-based functional nodes. We also compared local metrics between groups in frontopolar, supplementary motor, and sensorimotor cortices, regions implicated in recent neuroimaging and/or brain stimulation treatment studies in OCD.

RESULTS

As in adults, the global metric small-worldness was significantly (P<0.05) lower in patients than controls, by 13.5% (%mean difference=100%X(OCD mean - control mean)/control mean). This suggests less efficient information transfer in patients. In addition, modularity was lower in OCD (15.1%, P<0.01), suggesting less granular - or differently organized - functional brain parcellation. Higher clustering coefficients (23.9-32.4%, P<0.05) were observed in patients in frontopolar, supplementary motor, sensorimotor, and cortices with lower betweenness centrality (-63.6%, P<0.01) at one frontopolar site. These findings are consistent with more locally intensive connectivity or less interaction with other brain regions at these sites.

LIMITATIONS

Relatively large node size; relatively small sample size, comorbidities in some patients.

CONCLUSIONS

Pediatric OCD patients demonstrate aberrant global and local resting-state network connectivity topologies compared to healthy children. Local results accord with recent views of OCD as a disorder with sensorimotor component.

Implied functional crossed cerebello-cerebral diaschisis and interhemispheric compensation during hand grasping more than 20 years after unilateral cerebellar injury in early childhood

BACKGROUND

Crossed cerebello-cerebral diaschisis (CCCD) conventionally refers to decreased resting cerebral activity caused by injury to the contralateral cerebellum. We investigated whether functional activation of a contralesional cerebral cortical region controlling a specific task is reduced during task performance in a patient with a unilateral cerebellar lesion. We also examined functional compensation by the corresponding ipsilesional cerebral cortex. It was hypothesized that dysfunction of the primary sensorimotor cortex (SM1) contralateral to the cerebellar lesion would be detected together with a compensatory increase in neural activity of the ipsilesional SM1. To test these possibilities, we conducted non-invasive functional neuroimaging techniques for bilateral SM1 during hand grasping, a task known to activate predominantly the SM1 contralateral to the grasping hand. Activity in SM1 during hand grasping was measured electrophysiologically by magnetoencephalography and hemodynamically by near-infrared spectroscopy in an adult with mild right hemiataxia associated with a large injury of the right cerebellum due to resection of a tumor in early childhood.

RESULTS

During left hand grasping, increased neural activity was detected predominantly in the right SM1, the typical developmental pattern. In contrast, neural activity increased in the bilateral SM1 with slight right-side dominance during right (ataxic) hand grasping.

CONCLUSIONS

This study reported a case that implied functional CCCD and compensatory neural activity in the SM1 during performance of a simple hand motor task in an adult with unilateral cerebellar injury and mild hemiataxia 24 years prior to the study without rehabilitative interventions. This suggests that unilateral cerebellar injuries in early childhood may result in persistent functional abnormalities in the cerebrum into adulthood. Therapeutic treatments that target functional CCCD and interhemispheric compensation might be effective for treating ataxia due to unilateral cerebellar damage.

Laterality judgments in people with low back pain--A cross-sectional observational and test-retest reliability study

BACKGROUND

Disruption of cortical representation, or body schema, has been indicated as a factor in the persistence and recurrence of low back pain (LBP). This has been observed through impaired laterality judgment ability and it has been suggested that this ability is affected in a spatial rather than anatomical manner.

OBJECTIVES

We compared laterality judgment performance of foot and trunk movements between people with LBP with or without leg pain and healthy controls, and investigated associations between test performance and pain. We also assessed the test-retest reliability of the Recognise Online™ software when used in a clinical and a home setting.

DESIGN

Cross-sectional observational and test-retest study.

METHODS

Thirty individuals with LBP and 30 healthy controls performed judgment tests of foot and trunk laterality once supervised in a clinic and twice at home.

RESULTS

No statistically significant group differences were found. LBP intensity was negatively related to trunk laterality accuracy (p = 0.019). Intraclass correlation values ranged from 0.51 to 0.91. Reaction time improved significantly between test occasions while accuracy did not.

CONCLUSIONS

Laterality judgments were not impaired in subjects with LBP compared to controls. Further research may clarify the relationship between pain mechanisms in LBP and laterality judgment ability. Reliability values were mostly acceptable, with wide and low confidence intervals, suggesting test-retest reliability for Recognise Online™ could be questioned in this trial. A significant learning effect was observed which should be considered in clinical and research application of the test.

Convergence of flexor reflex and corticospinal inputs on tibialis anterior network in humans

OBJECTIVE

Integration between descending and ascending inputs at supraspinal and spinal levels is a key characteristic of neural control of movement. In this study, we characterized convergence of the flexor reflex and corticospinal inputs on the tibialis anterior (TA) network in healthy human subjects. Specifically, we characterized the modulation profiles of the spinal TA flexor reflex following subthreshold and suprathreshold transcranial magnetic stimulation (TMS). We also characterized the modulation profiles of the TA motor evoked potentials (MEPs) following medial arch foot stimulation at sensory and above reflex threshold.

METHODS

TA flexor reflexes were evoked following stimulation of the medial arch of the foot with a 30 ms pulse train at innocuous intensities. TA MEPs were evoked following TMS of the leg motor cortex area.

RESULTS

TMS at 0.7 and at 1.2 MEP resting threshold increased the TA flexor reflex when TMS was delivered 40-100 ms after foot stimulation, and decreased the TA flexor reflex when TMS was delivered 25-110 ms before foot stimulation. Foot stimulation at sensory and above flexor reflex threshold induced a similar time-dependent modulation in resting TA MEPs, that were facilitated when foot stimulation was delivered 40-100 ms before TMS. The flexor reflex and MEPs recorded from the medial hamstring muscle were modulated in a similar manner to that observed for the TA flexor reflex and MEP.

CONCLUSION

Cutaneomuscular afferents from the distal foot can increase the output of the leg motor cortex area. Descending motor volleys that directly or indirectly depolarize flexor motoneurons increase the output of the spinal FRA interneuronal network. The parallel facilitation of flexor MEPs and flexor reflexes is likely cortical in origin.

SIGNIFICANCE

Afferent mediated facilitation of corticospinal excitability can be utilized to strengthen motor cortex output in neurological disorders.

Corticokinematic coherence mainly reflects movement-induced proprioceptive feedback

Corticokinematic coherence (CKC) reflects coupling between magnetoencephalographic (MEG) signals and hand kinematics, mainly occurring at hand movement frequency (F0) and its first harmonic (F1). Since CKC can be obtained for both active and passive movements, it has been suggested to mainly reflect proprioceptive feedback to the primary sensorimotor (SM1) cortex. However, the directionality of the brain-kinematics coupling has not been previously assessed and was thus quantified in the present study by means of renormalized partial directed coherence (rPDC). MEG data were obtained from 15 subjects who performed right index-finger movements and whose finger was, in another session, passively moved, with or without tactile input. Four additional subjects underwent the same task with slowly varying movement pace, spanning the 1-5 Hz frequency range. The coupling between SM1 activity recorded with MEG and finger kinematics was assessed with coherence and rPDC. In all conditions, the afferent rPDC spectrum, which resembled the coherence spectrum, displayed higher values than the efferent rPDC spectrum. The afferent rPDC was 37% higher when tactile input was present, and it was at highest at F1 of the passive conditions; the efferent rPDC level did not differ between conditions. The apparent latency for the afferent input, estimated within the framework of the rPDC analysis, was 50-100 ms. The higher directional coupling between hand kinematics and SM1 activity in afferent than efferent direction strongly supports the view that CKC mainly reflects movement-related somatosensory proprioceptive afferent input to the contralateral SM1 cortex.