Limb-sequencing deficits after left but not right hemisphere damage

Cognitive neuropsychological and neuroanatomic predictors of naturalistic action performance in left hemisphere stroke: a retrospective analysis

Individuals who have experienced a left hemisphere cerebrovascular accident (LCVA) have been shown to make errors in naturalistic action tasks designed to assess the ability to perform everyday activities such as preparing a cup of coffee. Naturalistic action errors in this population are often attributed to limb apraxia, a common deficit in the representation and performance of object-related actions. However, naturalistic action impairments are also observed in right hemisphere stroke and traumatic brain injury, populations infrequently associated with apraxia, and errors across all these populations are influenced by overall severity. Based on these and other data, an alternative (though not mutually exclusive) account is that naturalistic action errors in LCVA are also a consequence of deficits in general attentional resource availability or allocation. In this study, we conducted a retrospective analysis of data from a large group of 51 individuals with LCVA who had completed a test of naturalistic action, along with a battery of tests assessing praxis, attention allocation and control, reasoning, and language abilities to determine which of these capacities contribute uniquely to naturalistic action impairments. Using a regularized regression method, we found that naturalistic action impairments are predicted by both praxis deficits (hand posture sequencing and gesture recognition), as well as attention allocation and control deficits (orienting and dividing attention), along with language comprehension ability and age. Using support vector regression-lesion symptom mapping (SVR-LSM), we also demonstrated that naturalistic action impairments are associated with lesions to posterior middle temporal gyrus and anterior inferior parietal lobule - regions known to be implicated in praxis; as well the middle frontal gyrus that has been implicated in both praxis and attention allocation and control. Taken together, these findings support the hypothesis that naturalistic action impairments in LCVA are a consequence of apraxia as well as deficits in attention allocation and control.

Laterality in Parkinson's disease: A neuropsychological review

Laterality of motor symptom onset in Parkinson's disease is both well-known and under-appreciated. Treatment of disorders that have asymmetric pathological features, such as stroke and epilepsy, demonstrate the importance of incorporating hemispheric lateralization and specialization into therapy and care planning. These practices could theoretically extend to Parkinson's disease, providing increased diagnostic accuracy and improved treatment outcomes. Additionally, while motor symptoms have generally received the majority of attention, non-motor features (e.g., autonomic dysfunction) also decrease quality of life and are influenced by asymmetrical neurodegeneration. Due to the laterality of cognitive and behavioral processes in the two brain hemispheres, analysis of hemibody side of onset can potentially give insight into expected symptom profile of the patient and allow for increased predictive accuracy of disease progression and outcome, thus opening the door to personalized and improved therapy in treating Parkinson's disease patients. This review discusses motor and non-motor symptoms (namely autonomic, sensory, emotional, and cognitive dysfunction) of Parkinson's disease in respect to hemispheric lateralization from a theoretical perspective in hopes of providing a framework for future research and personalized treatment.

Handedness did not affect motor skill acquisition by the dominant hand or interlimb transfer to the non-dominant hand regardless of task complexity level

Patients undergoing unilateral orthopedic or neurological rehabilitation have different levels of impairments in the right- or left-dominant hand. However, how handedness and the complexity of the motor task affect motor skill acquisition and its interlimb transfer remains unknown. In the present study, participants performed finger key presses on a numeric keypad at 4 levels of sequence complexities with each hand in a randomized order. Furthermore, they also performed motor sequence practice with the dominant hand to determine its effect on accuracy, reaction time, and movement time. The NASA-TLX at the end of each block of both testing and practice was used to confirm participants' mental workload related to sequence complexity. Both right- and left-handed participants performed the motor sequence task with faster RT when using their right hand. Although participants had increasing RT with increasing sequence complexity, this association was unrelated to handedness. Motor sequence practice produced motor skill acquisition and interlimb transfer indicated by a decreased RT, however, these changes were independent of handedness. Higher sequence complexity was still associated with longer RT after the practice, moreover, both right- and left-handed participants' RT increased with the same magnitude with the increase in sequence complexity. Similar behavioral pattern was observed in MT as in RT. Overall, our RT results may indicate left-hemisphere specialization for motor sequencing tasks, however, neuroimaging studies are needed to support these findings. On the other hand, handedness did not affect motor skill acquisition by the dominant hand or interlimb transfer to the non-dominant hand regardless of task complexity level.

Lateralization and Model Transference in a Bilateral Cursor Task

Post-stroke rehabilitation, occupational and physical therapy, and training for use of assistive prosthetics leverages our current understanding of bilateral motor control to better train individuals. In this study, we examine upper limb lateralization and model transference using a bimanual joystick cursor task with orthogonal controls. Two groups of healthy subjects are recruited into a 2-session study spaced seven days apart. One group uses their left and right hands to control cursor position and rotation respectively, while the other uses their right and left hands. The groups switch control methods in the second session, and a rotational perturbation is applied to the positional controls in the latter half of each session. We find agreement with current lateralization theories when comparing robustness to feedforward perturbations in feedback and feedforward measures. We find no evidence of a transferable model after seven days, and evidence that the brain does not synchronize task completion between the hands.

Microstructural integrity of corticospinal and medial lemniscus tracts: insights from diffusion tensor tractography of right-hand amputees

Reductions in sensory and motor activity following unilateral upper limb amputation during adulthood are associated with widespread, activity-dependent reorganization of the gray matter and white matter through the central nervous system. Likewise, in cases of congenital limb absence there is evidence that limited afferent or efferent activity affects the structural integrity of white matter pathways serving the affected side. Evidence that the structural integrity of mature sensory and motor tracts controlling the lost upper limb exhibits similar activity dependence is, however, sparse and inconsistent. Here we used diffusion tensor tractography to test whether amputation of the dominant right hand during adulthood (n = 16) alters the microstructural integrity of the major sensory (medial lemniscus, ML) and motor (corticospinal tract, CST) pathways controlling missing hand function. Consistent with prior findings, healthy control subjects (n = 27) exhibited higher fractional anisotropy (FA), an index of white matter microstructural integrity, within dominant left CST and nondominant right ML. Critically, in contrast to what might be expected if the microstructural organization of these tracts is activity dependent, these asymmetries persisted in amputees. Moreover, we failed to detect any differences in dominant left ML or CST between healthy control subjects and amputees. Our results are consistent with these white matter tracts being robust to changes in activity once mature or that continued use of the residual limb (in a compensatory fashion or with prosthesis) provides stimulation sufficient to maintain tract integrity. NEW & NOTEWORTHY We report that unilateral hand amputation in adults has no significant effects on the structure of major sensory or motor pathways contralateral to the amputation. Our results are consistent with the organization of these white matter tracts being robust to changes in activity once mature or that continued use of the residual limb (with or without a prosthesis) provides stimulation sufficient to maintain tract integrity.

Handedness results from complementary hemispheric dominance, not global hemispheric dominance: evidence from mechanically coupled bilateral movements

Two contrasting views of handedness can be described as 1) complementary dominance, in which each hemisphere is specialized for different aspects of motor control, and 2) global dominance, in which the hemisphere contralateral to the dominant arm is specialized for all aspects of motor control. The present study sought to determine which motor lateralization hypothesis best predicts motor performance during common bilateral task of stabilizing an object (e.g., bread) with one hand while applying forces to the object (e.g., slicing) using the other hand. We designed an experimental equivalent of this task, performed in a virtual environment with the unseen arms supported by frictionless air-sleds. The hands were connected by a spring, and the task was to maintain the position of one hand while moving the other hand to a target. Thus the reaching hand was required to take account of the spring load to make smooth and accurate trajectories, while the stabilizer hand was required to impede the spring load to keep a constant position. Right-handed subjects performed two task sessions (right-hand reach and left-hand stabilize; left-hand reach and right-hand stabilize) with the order of the sessions counterbalanced between groups. Our results indicate a hand by task-component interaction such that the right hand showed straighter reaching performance whereas the left hand showed more stable holding performance. These findings provide support for the complementary dominance hypothesis and suggest that the specializations of each cerebral hemisphere for impedance and dynamic control mechanisms are expressed during bilateral interactive tasks. NEW & NOTEWORTHY We provide evidence for interlimb differences in bilateral coordination of reaching and stabilizing functions, demonstrating an advantage for the dominant and nondominant arms for distinct features of control. These results provide the first evidence for complementary specializations of each limb-hemisphere system for different aspects of control within the context of a complementary bilateral task.

When Non-Dominant Is Better than Dominant: Kinesiotape Modulates Asymmetries in Timed Performance during a Synchronization-Continuation Task

There is a growing consensus regarding the specialization of the non-dominant limb (NDL)/hemisphere system to employ proprioceptive feedback when executing motor actions. In a wide variety of rhythmic tasks the dominant limb (DL) has advantages in speed and timing consistency over the NDL. Recently, we demonstrated that the application of Kinesio^® Tex (KT) tape, an elastic therapeutic device used for treating athletic injuries, improves significantly the timing consistency of isochronous wrist’s flexion-extensions (IWFEs) of the DL. We argued that the augmented precision of IWFEs is determined by a more efficient motor control during movements due to the extra-proprioceptive effect provided by KT. In this study, we tested the effect of KT on timing precision of IWFEs performed with the DL and the NDL, and we evaluated the efficacy of KT to counteract possible timing precision difference between limbs. Young healthy subjects performed with and without KT (NKT) a synchronization-continuation task in which they first entrained IWFEs to paced auditory stimuli (synchronization phase), and subsequently continued to produce motor responses with the same temporal interval in the absence of the auditory stimulus (continuation phase). Two inter-onset intervals (IOIs) of 550-ms and 800-ms, one within and the other beyond the boundaries of the spontaneous motor tempo, were tested. Kinematics was recorded and temporal parameters were extracted and analyzed. Our results show that limb advantages in performing proficiently rhythmic movements are not side-locked but depend also on speed of movement. The application of KT significantly reduces the timing variability of IWFEs performed at 550-ms IOI. KT not only cancels the disadvantages of the NDL but also makes it even more precise than the DL without KT. The superior sensitivity of the NDL to use the extra-sensory information provided by KT is attributed to a greater competence of the NDL/hemisphere system to rely on sensory input. The findings in this study add a new piece of information to the context of motor timing literature. The performance asymmetries here demonstrated as preferred temporal environments could reflect limb differences in the choice of sensorimotor control strategies for the production of human movement.

Reward and punishment enhance motor adaptation in stroke

BACKGROUND AND OBJECTIVE

The effects of motor learning, such as motor adaptation, in stroke rehabilitation are often transient, thus mandating approaches that enhance the amount of learning and retention. Previously, we showed in young individuals that reward and punishment feedback have dissociable effects on motor adaptation, with punishment improving adaptation and reward enhancing retention. If these findings were able to generalise to patients with stroke, they would provide a way to optimise motor learning in these patients. Therefore, we tested this in 45 patients with chronic stroke allocated in three groups.

METHODS

Patients performed reaching movements with their paretic arm with a robotic manipulandum. After training (day 1), day 2 involved adaptation to a novel force field. During the adaptation phase, patients received performance-based feedback according to the group they were allocated: reward, punishment or no feedback (neutral). On day 3, patients readapted to the force field but all groups now received neutral feedback.

RESULTS

All patients adapted, with reward and punishment groups displaying greater adaptation and readaptation than the neutral group, irrespective of demographic, cognitive or functional differences. Remarkably, the reward and punishment groups adapted to similar degree as healthy controls. Finally, the reward group showed greater retention.

CONCLUSIONS

This study provides, for the first time, evidence that reward and punishment can enhance motor adaptation in patients with stroke. Further research on reinforcement-based motor learning regimes is warranted to translate these promising results into clinical practice and improve motor rehabilitation outcomes in patients with stroke.

Bimanual tapping of a syncopated rhythm reveals hemispheric preferences for relative movement frequencies

In bimanual multifrequency tapping, right-handers commonly use the right hand to tap the relatively higher rate and the left hand to tap the relatively lower rate. This could be due to hemispheric specializations for the processing of relative frequencies. An extension of the double-filtering-by-frequency theory to motor control proposes a left hemispheric specialization for the control of relatively high and a right hemispheric specialization for the control of relatively low tapping rates. We investigated timing variability and rhythmic accentuation in right handers tapping mono- and multifrequent bimanual rhythms to test the predictions of the double-filtering-by-frequency theory. Yet, hemispheric specializations for the processing of relative tapping rates could be masked by a left hemispheric dominance for the control of known sequences. Tapping was thus either performed in an overlearned quadruple meter (tap of the slow rhythm on the first auditory beat) or in a syncopated quadruple meter (tap of the slow rhythm on the fourth auditory beat). Independent of syncopation, the right hand outperformed the left hand in timing accuracy for fast tapping. A left hand timing benefit for slow tapping rates as predicted by the double-filtering-by-frequency theory was only found in the syncopated tapping group. This suggests a right hemisphere preference for the control of slow tapping rates when rhythms are not overlearned. Error rates indicate that overlearned rhythms represent hierarchically structured meters that are controlled by a single timer that could potentially reside in the left hemisphere.

Can Eye Fixation During the Grooved Pegboard Test Distinguish Between Planning and Online Correction?

The Grooved Pegboard Test, in its standard use, has well-documented utility. However, a revised methodology needs further study, leading us to investigate whether duration of eye fixation could predict performance on different task conditions of the Grooved Pegboard Test (place and remove pegs) with the preferred and nonpreferred hands. Fifty-two right-handed undergraduate students (33 male and 19 female), with a mean age of 22.22 (±3.57) years, performed the Grooved Pegboard Test. SensoMotoric eye-tracking glasses with a binocular time resolution of 30 Hz were used to measure eye fixation. The videos were recorded in iView software, and data were analyzed using BeGaze software. The number and duration of eye fixations were statistically different with preferred and nonpreferred hands and also differed across tasks. Simple linear regression showed eye fixation duration to predict movement time in the place task (preferred hand: R²= 31%; nonpreferred hand: R²= 41%) and in the remove task (preferred hand: R²= 11%; nonpreferred hand: R²= 25%). Thus, duration of eye fixation during the Grooved Pegboard Test differentially predicted performance with each hand and on preferred and different subtests of this instrument.

Lateralized motor control processes determine asymmetry of interlimb transfer

This experiment tested the hypothesis that interlimb transfer of motor performance depends on recruitment of motor control processes that are specialized to the hemisphere contralateral to the arm that is initially trained. Right-handed participants performed a single-joint task, in which reaches were targeted to 4 different distances. While the speed and accuracy was similar for both hands, the underlying control mechanisms used to vary movement speed with distance were systematically different between the arms: the amplitude of the initial acceleration profiles scaled greater with movement speed for the right-dominant arm, while the duration of the initial acceleration profile scaled greater with movement speed for the left-non-dominant arm. These two processes were previously shown to be differentially disrupted by left and right hemisphere damage, respectively. We now hypothesize that task practice with the right arm might reinforce left-hemisphere mechanisms that vary acceleration amplitude with distance, while practice with the left arm might reinforce right-hemisphere mechanisms that vary acceleration duration with distance. We thus predict that following right arm practice, the left arm should show increased contributions of acceleration amplitude to peak velocities, and following left arm practice, the right arm should show increased contributions of acceleration duration to peak velocities. Our findings support these predictions, indicating that asymmetry in interlimb transfer of motor performance, at least in the task used here, depends on recruitment of lateralized motor control processes.

Driven to Tears or to Joy: Response Dominance and Trait-Based Predictions

The present studies reinvigorate the construct of traitedness from a cognitive perspective. Tendencies toward habit (vs. flexibility) were assessed by examining response dominance performance within choice reaction time tasks. Consistent with the idea that response dominance reflects a tendency toward habitual modes of thought and action, three studies involving 428 undergraduates revealed that trait-outcome and test-retest correlations were higher among individuals higher in response dominance. In Studies 1 and 2, such trait-consistency effects took the form of stronger relations between extraversion and neuroticism, on one hand, and mood states and behavior, on the other. In Study 3, such tendencies took the form of higher test-retest correlations related to daily experiences of mood states, somatic symptoms, and life satisfaction. Together, the studies reveal a consistent effect of response dominance on trait-like consistency and raise some important issues for future studies of the traitedness construct.

Peripheral neuropathy reduces asymmetries in inter-limb transfer in a visuo-motor task

Asymmetry of inter-limb transfer has been associated with the specialization of the dominant and non-dominant motor system. Reductions of asymmetry have been interpreted as behavioural evidence showing a decline of hemispheric lateralization. A previous study showed that ageing did not qualitatively change the inter-limb transfer asymmetry of a visuo-motor task. The current study elaborates on these findings; it examines whether diminished somatosensory information as a result of peripheral neuropathy (PN) adversely affects inter-limb transfer asymmetry. Twenty individuals affected by PN and 20 older controls were recruited and divided equally across two groups. One group trained a visuo-motor task with the right hand while the other group trained it with the left hand. Performance (initial direction error) of the untrained hand before and after training was collected to determine learning effects from inter-limb transfer. Similar to previous studies, the current study showed asymmetric inter-limb transfer in older controls. In contrast, PN showed inter-limb transfer in both directions indicating that PN reduces inter-limb transfer asymmetry. Increased bilateral hemispheric recruitment is suggested to be responsible for this reduced asymmetry which may compensate for deteriorated tactile and/or proprioceptive inputs in PN. Two possible hypotheses are discussed explaining the relationship between declined somatosensory information and increases in bilateral hemispheric recruitment.

The contributions of vision and haptics to reaching and grasping

This review aims to provide a comprehensive outlook on the sensory (visual and haptic) contributions to reaching and grasping. The focus is on studies in developing children, normal, and neuropsychological populations, and in sensory-deprived individuals. Studies have suggested a right-hand/left-hemisphere specialization for visually guided grasping and a left-hand/right-hemisphere specialization for haptically guided object recognition. This poses the interesting possibility that when vision is not available and grasping relies heavily on the haptic system, there is an advantage to use the left hand. We review the evidence for this possibility and dissect the unique contributions of the visual and haptic systems to grasping. We ultimately discuss how the integration of these two sensory modalities shape hand preference.

Preserved motor asymmetry in late adulthood: is measuring chronological age enough?

When comparing motor performance of the dominant and nondominant hands, older adults tend to be less asymmetric compared to young adults. This has suggested decreased motor lateralization and functional compensation within the aging brain. The current study further addressed this question by testing whether motor asymmetry was reduced in a sample of 44 healthy right-handed adults ages 65-89. We hypothesized that the older the age, the less the motor asymmetry, and that 'old old' participants (age 80+) would have less motor asymmetry than 'young old' participants (age 65-79). Using two naturalistic tasks that selectively biased the dominant or nondominant hands, we compared asymmetries in performance (measured as a ratio) across chronological age. Results showed preserved motor asymmetry across ages in both tasks, with no difference in asymmetry ratios in the 'old old' compared to the 'young old.' In the context of previous work, our findings suggest that the aging brain may also be characterized by additional measures besides chronological age.

Handedness in a virtual haptic environment: assessments from kinematic behavior and modeling

This study evaluated hand asymmetries in performance of a dexterous, controlled task under haptic feedback. Participants punctured a virtual membrane with a pushing or pulling movement, using the left or right hand. For pulling movements, the dominant (right) hand exhibited faster average stopping latency and shorter skidding distance. When the kinematic data were fit to a three-phase model previously applied to this task (Klatzky et al., 2013), the right hand exhibited faster force decay attributable to biomechanical factors. Analyses of the aggregated performance measures and model parameters showed that the left and right hands are associated with two different distributions, supporting handedness effects. Furthermore, while the majority of participants expressed right-hand dominance, which was consistent with their self-reported hand preferences, others showed partial or no dominance. This approach could potentially be extended to quantify and differentiate individuals with difficulties in manual behavior due to abnormal motor control (e.g., dyspraxia), progressive deterioration (e.g., Parkinson's syndrome) or improvement (neural regrowth after transplant).

Evolution of cerebral cortico-cortical communication during visuomotor adaptation to a cognitive-motor executive challenge

Cortical dynamics were examined during a cognitive-motor adaptation task that required inhibition of a familiar motor plan. EEG coherence between the motor planning (Fz) and left hemispheric region was progressively reduced over trials (low-beta, high-beta, gamma bands) along with faster, straighter reaching movements during both planning and execution. The major reduction in coherence (delta, low/high-theta, low/high-alpha bands) between Fz and the left prefrontal region during both movement planning and execution suggests gradual disengagement of frontal executive following its initial role in the suppression of established visuomotor maps. Also, change in the directionality of phase lags (delta, high-alpha, high-beta, gamma bands) reflects a progressive shift from feedback to feedforward motor control. The reduction of cortico-cortical communication, particularly in the frontal region, and the strategic feedback/feedforward mode shift translated as higher quality motor performance. This study extends our understanding of the role of frontal executive beyond purely cognitive tasks to cognitive-motor tasks.

Effector-independent brain activity during motor imagery of the upper and lower limbs: an fMRI study

We utilized functional magnetic resonance imaging (fMRI) to evaluate the common brain region of motor imagery for the right and left upper and lower limbs. The subjects were instructed to repeatedly imagined extension and flexion of the right or left hands/ankles. Brain regions, which included the supplemental motor area (SMA), premotor cortex and parietal cortex, were activated during motor imagery. Conjunction analysis revealed that the left SMA and inferior frontal gyrus (IFG)/ventral premotor cortex (vPM) were commonly activated with motor imagery of the right hand, left hand, right foot, and left foot. This result suggests that these brain regions are activated during motor imagery in an effector independent manner.

Age-specific activation of cerebral areas in motor imagery--a fMRI study

INTRODUCTION

The objectives of this study were to study the age-specific activation patterns of cerebral areas during motor execution (ME) and motor imaging (MI) of the upper extremities and to discuss the age-related neural mechanisms associated with ME or MI.

METHODS

The functional magnetic resonance imaging technique was used to monitor the pattern and intensity of brain activation during the ME and MI of the upper extremities in 20 elderly (>50 years) and 19 young healthy subjects (<25 years).

RESULTS

No major differences were identified regarding the activated brain areas during ME or MI between the two groups; however, a minor difference was noted. The intensity of the activated brain area during ME was stronger in the older group than in the younger group, while the results with MI were the opposite. The posterior central gyrus and supplementary motor area during MI were more active in the younger group than in the older group. The putamen, lingual, and so on demonstrated stronger activation during dominant hand MI in the older group.

CONCLUSION

The results of this study revealed that the brain structure was altered and that neuronal activity was attenuated with age, and the cerebral cortex and subcortical tissues were found to be over-activated to achieve the same level of ME and MI, indicating that the activating effects of the left hemisphere enhanced with age, whereas the inhibitory effects declined during ME, and activation of the right hemisphere became more difficult during MI.

The ipsilesional upper limb can be affected following stroke

OBJECTIVE

Neurological dysfunction commonly occurs in the upper limb contralateral to the hemisphere of the brain in which stroke occurs; however, the impact of stroke on function of the ipsilesional upper limb is not well understood. This study aims to systematically review the literature relating to the function of the ipsilesional upper limb following stroke and answer the following research question: Is the ipsilesional upper limb affected by stroke?

DATA SOURCE

A systematic review was carried out in Medline, Embase, and PubMed.

REVIEW METHODS

All studies investigating the ipsilesional upper limb following stroke were included and analysed for important characteristics. Outcomes were extracted and summarised. Results. This review captured 27 articles that met the inclusion criteria. All studies provided evidence that the ipsilesional upper limb can be affected following stroke.

CONCLUSION

These findings demonstrate that clinicians should consider ipsilesional upper limb deficits in rehabilitation and address this reduced functional capacity. Furthermore, the ipsilesional upper limb should not be used as a "control" measure of recovery for the contralateral upper limb.

Rethinking motor lateralization: specialized but complementary mechanisms for motor control of each arm

Motor lateralization in humans has primarily been characterized as “handedness”, resulting in the view that one arm-hemisphere system is specialized for all aspects of movement while the other is simply a weaker analogue. We have proposed an alternative view that motor lateralization reflects proficiency of each arm for complementary functions that arises from a specialization of each hemisphere for distinct movement control mechanisms. However, before this idea of hemispheric specialization can be accepted, it is necessary to precisely identify these distinct, lateralized mechanisms. Here we show in right-handers that dominant arm movements rely on predictive mechanisms that anticipate and account for the dynamic properties of the arm, while the non-dominant arm optimizes positional stability by specifying impedance around equilibrium positions. In a targeted-reaching paradigm, we covertly and occasionally shifted the hand starting location either orthogonal to or collinear with a particular direction of movement. On trials on which the start positions were shifted orthogonally, we did not notice any strong interlimb differences. However, on trials on which start positions were shifted orthogonally, the dominant arm largely maintained the direction and straightness of its trajectory, while the non-dominant arm deviated towards the previously learned goal position, consistent with the hypothesized control specialization of each arm-hemisphere system. These results bring together two competing theories about mechanisms of movement control, and suggest that they coexist in the brain in different hemispheres. These findings also question the traditional view of handedness, because specialized mechanisms for each arm-hemisphere system were identified within a group of right-handers. It is likely that such hemispheric specialization emerged to accommodate increasing motor complexity during evolution.

Cognitive alterations in motor imagery process after left hemispheric ischemic stroke

BACKGROUND

Motor imagery training is a promising rehabilitation strategy for stroke patients. However, few studies had focused on the neural mechanisms in time course of its cognitive process. This study investigated the cognitive alterations after left hemispheric ischemic stroke during motor imagery task.

METHODOLOGY/PRINCIPAL FINDINGS

Eleven patients with ischemic stroke in left hemisphere and eleven age-matched control subjects participated in mental rotation task (MRT) of hand pictures. Behavior performance, event-related potential (ERP) and event-related (de)synchronization (ERD/ERS) in beta band were analyzed to investigate the cortical activation. We found that: (1) The response time increased with orientation angles in both groups, called "angle effect", however, stoke patients' responses were impaired with significantly longer response time and lower accuracy rate; (2) In early visual perceptual cognitive process, stroke patients showed hypo-activations in frontal and central brain areas in aspects of both P200 and ERD; (3) During mental rotation process, P300 amplitude in control subjects decreased while angle increased, called "amplitude modulation effect", which was not observed in stroke patients. Spatially, patients showed significant lateralization of P300 with activation only in contralesional (right) parietal cortex while control subjects showed P300 in both parietal lobes. Stroke patients also showed an overall cortical hypo-activation of ERD during this sub-stage; (4) In the response sub-stage, control subjects showed higher ERD values with more activated cortical areas particularly in the right hemisphere while angle increased, named "angle effect", which was not observed in stroke patients. In addition, stroke patients showed significant lower ERD for affected hand (right) response than that for unaffected hand.

CONCLUSIONS/SIGNIFICANCE

Cortical activation was altered differently in each cognitive sub-stage of motor imagery after left hemispheric ischemic stroke. These results will help to understand the underlying neural mechanisms of mental rotation following stroke and may shed light on rehabilitation based on motor imagery training.

Tool use without a tool: kinematic characteristics of pantomiming as compared to actual use and the effect of brain damage

Movement goals and task mechanics differ substantially between actual tool use and corresponding pantomimes. In addition, apraxia seems to be more severe during pantomime than during actual tool use. Comparisons of these two modes of action execution using quantitative methods of movement analyses are rare. In the present study, repetitive scooping movements with a ladle from a bowl into a plate were recorded and movement kinematics was analyzed. Brain-damaged patients using their ipsilesional hand and healthy control subjects were tested in three conditions: pantomime, demonstration with the tool only, and actual use in the normal context. Analysis of the hand trajectories during the transport component revealed clear differences between the tasks, such as slower actual use and moderate deficits in patients with left brain damage (LBD). LBD patients were particularly impaired in the scooping component: LBD patients with apraxia exhibited reduced hand rotation at the bowl and the plate. The deficit was most obvious during pantomime but actual use was also affected, and reduced hand rotation was consistent across conditions as indicated by strong pair-wise correlations between task conditions. In healthy control subjects, correlations between movement parameters were most evident between the pantomime and demonstration conditions but weak in correlation pairs involving actual use. From these findings and published neuroimaging evidence, we conclude that for a specific tool-use action, common motor schemas are activated but are adjusted and modified according to the actual task constraints and demands. An apraxic LBD individual can show a deficit across all three action conditions, but the severity can differ substantially between conditions.

Inter-limb Coupling in Coordinated Bimanual Movement: Attention and Asymmetries

Inter-limb coupling, a phenomenon whereby each of the upper limbs tends to take on characteristics of the intended movement of the other, represents a limitation on the ability to perform asymmetrical bimanual movements. Two experiments each employing 16 dextral and 16 sinistral normal subjects are reported. In the first experiment evidence of inter-limb coupling was observed during a continuous bimanual rotary task. This coupling appeared to be asymmetrical, with the nonpreferred hand contributing more to coupling than the preferred hand, especially in dextrals. In the second experiment asymmetries in inter-limb coupling were found to be modified by the conscious direction of attention to one or other hand. This suggests that the often reported strong inter-limb asymmetry associated with dextrality, and the weaker assymetry associated with sinistrality, may be partly due to an underlying inter-limb attentional asymmetry in the former, and a relative lack of attentional asymmetry in the latter.

Shared neural resources between left and right interlimb coordination skills: the neural substrate of abstract motor representations

Functional magnetic resonance imaging was used to reveal the shared neural resources between movements performed with effectors of the left versus right body side. Prior to scanning, subjects extensively practiced a complex coordination pattern involving cyclical motions of the ipsilateral hand and foot according to a 90 degrees out-of-phase coordination mode. Brain activity associated with this (nonpreferred) coordination pattern was contrasted with pre-existing isodirectional (preferred) coordination to extract the learning-related brain networks. To identify the principal candidates for effector-independent movement encoding, the conjunction of training-related activity for left and right limb coordination was determined. A dominantly left-lateralized parietal-to-(pre)motor activation network was identified, with activation in inferior and superior parietal cortex extending into intraparietal sulcus and activation in the premotor areas, including inferior frontal gyrus (pars opercularis). Similar areas were previously identified during observation of complex coordination skills by expert performers. These parietal-premotor areas are principal candidates for abstract (effector-independent) movement encoding, promoting motor equivalence, and they form the highest level in the action representation hierarchy.

Dissociation of initial trajectory and final position errors during visuomotor adaptation following unilateral stroke

Previous studies have demonstrated that following stroke, motor impairment can occur ipsilateral to the lesion. Such impairments have provided insight into the contributions of each hemisphere to movement control, showing that left and right hemisphere damage produce different effects on movement: Left hemisphere damage produces deficits in specifying features of movement trajectory, while right hemisphere damage produces deficits in achieving an accurate and stable final position. We now propose that left and right hemisphere damage should also produce different deficits in the adaptation of trajectory and position. To test this idea, we examined adaptation to visuomotor rotations in the ipsilesional arms of hemiparetic stroke patients with left (LHD) and right hemisphere damage (RHD). We found that LHD interfered with adaptation of initial direction, but not with the ability to adapt the final position of the limb. In contrast, RHD interfered with online corrections to the final position during the course of adaptation. These findings support our hypothesis that the control of trajectory and steady-state position may be lateralized to the left and right hemispheres, respectively.

Hemispheric specialization and functional impact of ipsilesional deficits in movement coordination and accuracy

Previous studies have demonstrated that following unilateral stroke, motor impairment occurs both contralateral, as well as ipsilateral, to the lesion. Although ipsilesional impairments can be functionally limiting, they can also provide important insight into the role of the ipsilateral hemisphere in controlling movement and the lateralization of specific motor control mechanisms, given that unilateral arm movements are thought to recruit processes in each hemisphere. The purpose of this study was to examine whether left and right hemisphere damage following stroke produces different ipsilesional deficits, and whether our dynamic dominance model of motor lateralization can predict such deficits. Specifically, the dynamic dominance model attributes control of multijoint dynamics to the left hemisphere, and control of steady-state position to the right hemisphere. Chronic stroke patients with either left or right hemisphere damage (LHD or RHD) used their ipsilesional arm, and the control subjects used either their left or right arm (LHC or RHC), to perform targeted reaching movements in different directions within the workspace ipsilateral to their reaching arm. We found that the LHD group showed deficits in controlling the arm's trajectory due to impaired multijoint coordination, but no deficits in achieving accurate final positions. In contrast, the RHD group showed deficits in final position accuracy but not in the ability to coordinate multiple joints during movement, thereby providing additional evidence for the hemisphere-specific nature of motor deficits. Furthermore, while both the LHD and RHD groups were functionally impaired to the same degree on the Jebsen Hand Function Test (JHFT), our results suggest that the underlying mechanisms for such impairment may be hemisphere-dependent.

Hemisphere Specific Impairments in Reach-to-Grasp Control After Stroke: Effects of Object Size

Background and objective. The authors investigated hemispheric specialization for the visuomotor transformation of grasp preshaping and the coordination between transport and grasp in individuals poststroke. Based on a bilateral model, the authors hypothesized that after unilateral stroke there would be hemisphere-specific deficits revealed by the ipsilesional limb. Methods. Right or left stroke and age- and limb-matched nondisabled participants performed rapid reach-to-grasp of 3 sized objects. The authors quantified grasp preshaping as the correlation between initial aperture velocity and peak aperture, and peak aperture and object diameter. A cross correlation analysis using transport velocity and aperture size was performed to quantify transport-grasp coordination. All statistical tests for hemisphere-specific deficits involved comparisons between each stroke group and the matched nondisabled group. Results. Overall, the right stroke group, but not left stroke group, demonstrated prolonged movement time. For grasp preshaping there was a higher correlation between initial aperture velocity and peak aperture for the right stroke group and a lower correlation between peak aperture and object diameter for the left stroke group. For transport-grasp coordination the correlation between transport velocity and aperture size was higher for the left stroke group and lower for the right stroke group, which also demonstrated a higher standard deviation of time lag. Conclusions. After left stroke, there was deficient scaling of grasp preshaping and stronger transport-grasp coordination. In contrast, after right stroke, grasp preshaping began earlier and transport-grasp coordination was weaker. Together, these hemisphere-specific deficits suggest a left hemisphere specialization for the visuomotor transformation of grasp preshaping and a right hemisphere specialization for transport-grasp coordination.

Evidence for anticipatory motor control within a cerebello-diencephalic-parietal network

The posterior parietal cortex and the cerebellum are assumed to contribute to anticipatory motor control. Thus, it is reasonable that these areas act as a functional unit. To identify a neural signature of anticipatory motor control, 11 healthy volunteers performed a bimanual finger-tapping task with respect to isochronous (i.e., regular) and randomized (i.e., irregular) auditory pacing. Neuromagnetic activity was recorded using a 122-channel whole-head neuromagnetometer. Functional interaction between spatially distributed brain areas was determined by measures of tap-related phase synchronization. Assuming that (i) the cerebellum predicts sensory events by an internal model and (ii) the PPC maintains this prediction, we hypothesized that functional interaction between both structures varies depending on the predictability of the pacing signal. During isochronous pacing, functional connectivity within a cerebello-diencephalic-parietal network before tap onset was evident, suggesting anticipatory motor control. During randomized pacing, however, functional connectivity after tap onset was increased within a parietal-cerebellar loop, suggesting mismatch detection and update of the internal model. Data of the present study imply that anticipatory motor control is implemented in a network-like manner. Our data agree well with the hypothesis that functional connectivity in a cerebello-diencephalic-parietal loop might be crucial for anticipatory motor control, whereas parietal-cerebellar interaction might be critical for feedback processing.

Hemispheric asymmetry of frequency-dependent suppression in the ipsilateral primary motor cortex during finger movement: a functional magnetic resonance imaging study

Electrophysiological studies have suggested that the activity of the primary motor cortex (M1) during ipsilateral hand movement reflects both the ipsilateral innervation and the transcallosal inhibitory control from its counterpart in the opposite hemisphere, and that their asymmetry might cause hand dominancy. To examine the asymmetry of the involvement of the ipsilateral motor cortex during a unimanual motor task under frequency stress, we conducted block-design functional magnetic resonance imaging with 22 normal right-handed subjects. The task involved visually cued unimanual opponent finger movement at various rates. The contralateral M1 showed symmetric frequency-dependent activation. The ipsilateral M1 showed task-related deactivation at low frequencies without laterality. As the frequency of the left-hand movement increased, the left M1 showed a gradual decrease in the deactivation. This data suggests a frequency-dependent increased involvement of the left M1 in ipsilateral hand control. By contrast, the right M1 showed more prominent deactivation as the frequency of the right-hand movement increased. This suggests that there is an increased transcallosal inhibition from the left M1 to the right M1, which overwhelms the right M1 activation during ipsilateral hand movement. These results demonstrate the dominance of the left M1 in both ipsilateral innervation and transcallosal inhibition in right-handed individuals.

Exploration of computational methods for classification of movement intention during human voluntary movement from single trial EEG

OBJECTIVE

To explore effective combinations of computational methods for the prediction of movement intention preceding the production of self-paced right and left hand movements from single trial scalp electroencephalogram (EEG).

METHODS

Twelve naïve subjects performed self-paced movements consisting of three key strokes with either hand. EEG was recorded from 128 channels. The exploration was performed offline on single trial EEG data. We proposed that a successful computational procedure for classification would consist of spatial filtering, temporal filtering, feature selection, and pattern classification. A systematic investigation was performed with combinations of spatial filtering using principal component analysis (PCA), independent component analysis (ICA), common spatial patterns analysis (CSP), and surface Laplacian derivation (SLD); temporal filtering using power spectral density estimation (PSD) and discrete wavelet transform (DWT); pattern classification using linear Mahalanobis distance classifier (LMD), quadratic Mahalanobis distance classifier (QMD), Bayesian classifier (BSC), multi-layer perceptron neural network (MLP), probabilistic neural network (PNN), and support vector machine (SVM). A robust multivariate feature selection strategy using a genetic algorithm was employed.

RESULTS

The combinations of spatial filtering using ICA and SLD, temporal filtering using PSD and DWT, and classification methods using LMD, QMD, BSC and SVM provided higher performance than those of other combinations. Utilizing one of the better combinations of ICA, PSD and SVM, the discrimination accuracy was as high as 75%. Further feature analysis showed that beta band EEG activity of the channels over right sensorimotor cortex was most appropriate for discrimination of right and left hand movement intention.

CONCLUSIONS

Effective combinations of computational methods provide possible classification of human movement intention from single trial EEG. Such a method could be the basis for a potential brain-computer interface based on human natural movement, which might reduce the requirement of long-term training.

SIGNIFICANCE

Effective combinations of computational methods can classify human movement intention from single trial EEG with reasonable accuracy.

Evidence for a distributed hierarchy of action representation in the brain

Complex human behavior is organized around temporally distal outcomes. Behavioral studies based on tasks such as normal prehension, multi-step object use and imitation establish the existence of relative hierarchies of motor control. The retrieval errors in apraxia also support the notion of a hierarchical model for representing action in the brain. In this review, three functional brain imaging studies of action observation using the method of repetition suppression are used to identify a putative neural architecture that supports action understanding at the level of kinematics, object centered goals and ultimately, motor outcomes. These results, based on observation, may match a similar functional-anatomic hierarchy for action planning and execution. If this is true, then the findings support a functional-anatomic model that is distributed across a set of interconnected brain areas that are differentially recruited for different aspects of goal-oriented behavior, rather than a homogeneous mirror neuron system for organizing and understanding all behavior.

Implicit sequence learning processes after unilateral stroke

Implicit learning is durable over time, robust under psychological stress and shows specificity of transfer; characteristics that may be beneficial in stroke rehabilitation. The purpose of this study was to investigate implicit sequence learning processes in unilateral stroke using an extended number of trial blocks in a serial reaction time task (SRTT). Previous research, using a SRTT, has produced equivocal results that may be associated with the small number of trial blocks used. Seven adults, at least one year after stroke, and eight controls performed 54 blocks of a modified SRTT over two weeks. Participants responded with a finger key press during acquisition and retention and with a whole arm movement during transfer. Response times in milliseconds were used to measure learning. The stroke group performed more slowly than the controls during all experimental phases. Response times for both groups decreased with practice of the repeating sequence, increased with introduction of a random sequence, and decreased when reintroduced to the repeating sequence of the SRTT. Both groups demonstrated delayed retention of knowledge of the sequence over a two-week period and exhibited specificity of transfer. These data suggest that with extended practice people with unilateral stroke are able to learn implicitly.

Targeted Aiming Movements Are Compromised in Nonaffected Limb of Persons With Stroke

Background. Research has shown that movement impairments following stroke are typically associated with the limb contralateral to the side of the stroke. Prior studies identified ipsilateral motor declines across a variety of tasks. Objective. Two experiments were conducted to better understand the ipsilateral contributions to organization and execution of proximal upper extremity multisegment aiming movements in persons with right-hemispheric stroke. Methods. Participants performed reciprocal aiming (Experiment 1) and 2-segment aiming movements (Experiment 2) on a digitizing tablet. In both experiments, target size and/or target orientation were manipulated to examine the influence of accuracy constraints on the planning and organization of movements. Results. Kinematic measures, submovement analysis, and harmonicity measures were included in this study. Declines in organization and execution of multisegment movements were found to contribute to performance decrements and slowing in stroke patients. Furthermore, stroke patients were unable to efficiently plan multisegment movements as one functional unit, resulting in discrete movements. Conclusions . Results suggest the importance of considering ipsilateral contributions to the control and organization of targeted aiming movements as well as implications for rehabilitation and recovery.

Task-dependent asymmetries in the utilization of proprioceptive feedback for goal-directed movement

Whereas the majority of studies regarding upper limb asymmetries in motor performance have focused on preferred arm dominance for producing motor output, studies exploring the role of sensory feedback have suggested that the preferred and non-preferred arms are specialized for different aspects of movement. A recent study by Goble et al. (2006) found evidence of a non-preferred left arm (and presumably right hemisphere) proprioceptive dominance for a target matching task that required subjects to both memorize and transfer across hemispheres proprioceptive target information. This paradigm contrasted previous studies of proprioceptive matching asymmetry that explored only memory-based matching and produced equivocal results. The purpose of the present study, therefore, was to examine task-dependent asymmetries in proprioceptive matching performance, including differences related to active versus passive presentation of the matching target. It was found that the non-preferred left arm of right handers matched target elbow angles more accurately than the preferred arm, but only in the matching condition that required both memory and interhemispheric transfer. Task-dependent asymmetries were not affected by the mode of target presentation and assessment of matching kinematics revealed differences in strategy for both the speed and smoothness of targeted movements. Taken together, these results suggest that the non-preferred arm/hemisphere system is specialized for the processing of movement-related proprioceptive feedback.

Ipsilateral motor activation during unimanual and bimanual motor tasks

OBJECTIVE

To test for the presence and possible asymmetry of ipsilateral motor activation during unimanual and bimanual motor tasks.

METHODS

Twelve right-handed healthy subjects underwent motor evoked potential (MEP) measurement of one hand (target-hand) while the other hand (task-hand) performed different motor tasks. The target-hand was either at rest (first experiment) or performed a Perdue PegBoard task (second experiment). The task-hand was either at rest, performed a simultaneous pegboard task, or rotated a coin (second experiment).

RESULTS

In the first experiment, the motor task resulted in significant increase in MEP area in the target-hand, regardless which hand was the task-hand, with a greater increase when the left hand was the task-hand. In the second experiment, ipsilateral motor activation was not present for either hand, however, when the right hand was the task-hand, performance of continuous coin rotation by the right hand resulted in a significant decrease in the MEP area of the left hand.

CONCLUSIONS

Hemispheric asymmetry and task-dependence of ipsilateral motor cortex activation supports the postulate that motor activity may start bilaterally with subsequent interhemispheric inhibition. Furthermore, in right-handers, the left motor cortex is either more active in ipsilateral hand movements or exerts more effective inhibitory control over the right motor cortex than vice versa.

SIGNIFICANCE

We suggest that hemispheric asymmetry in ipsilateral motor control is a factor in determining motor dominance in right-handed individuals.

Ideomotor Apraxia And Functional Ability

The impact of ideomotor apraxia (IMA) on functional ability has been a relatively neglected topic in research. This has been due to the continued focus on performance on gesture imitation and pantomime of tool-use, together with widespread acceptance of anecdotal evidence that IMA has no effect when directly manipulating objects. An increasing number of studies have shown that IMA does in fact result in increased clumsiness when handling objects and may contribute to disability in everyday life. However the effect seems relatively mild compared to the stark abnormalities on gesture imitation and pantomime. The conventional explanation for this is that the cues provided by naturalistic contexts improve retrieval of action representations, but an alternative account concerns task-specific cognitive demands. Performance on simple prehensile tasks can be successfully guided by physical affordances whereas motor tasks may be failed if they require the support of memory or problem solving ability. A central deficit in IMA may be impaired postural representation causing inability to solve the problem of how to manipulate objects where neither affordance nor memory can dictate action. However, this account still fails to explain fully the patterns of error seen on complex naturalistic tasks such as dressing. Future research needs to further our understanding of how IMA maps on to disability, which will have implications for theory building and for therapeutic intervention.

Dimensional complexity of neuromagnetic activity reduced during finger movement of greater difficulty

OBJECTIVE

We investigated the variation in dimensionality (D2) of neuromagnetic activity over the primary sensorimotor cortex (SM1) in healthy adults performing motor tasks of different difficulty.

METHODS

Magnetoencephalography (MEG) was used to record neuromagnetic activity during self-paced, brisk unimanual finger extension at a rate of 1 and 2 Hz using the index finger of the dominant and non-dominant hands in 16 healthy subjects. Motor task difficulty was rated by the relative difference in time measurement between 1 and 2 Hz finger movements of both hands. The relative difference in dimensionality of SM1 activity was calculated by subtracting the D2 value in 2 Hz movement from that in 1 Hz one within subjects.

RESULTS

Simple regression analyses show a significantly negative relationship between the relative dimensional complexity and the relative motor task difficulty in the contralateral SM1 for the left- (p<0.05), but not the right- (p=0.447) hand movement.

CONCLUSIONS

The present data suggest that a motor task of greater difficulty may engender a reduction of simultaneously active quasi-independent neuronal generators in the contralateral SM1 underpinned by stronger neuronal connectivity of a relatively low dimensionality.

SIGNIFICANCE

The decrease in dimensional complexity of MEG activity associated with a motor task of greater difficulty gives new insights to motor control strategy.

Asymmetry of interhemispheric interaction in left-handed subjects

In right-handed subjects the execution of a simple finger-tapping task is associated with an asymmetry of interhemispheric interaction, probably suggesting that the dominant left hemisphere inhibits the right one. The present study investigated the left-handed subjects in order to elucidate whether this asymmetry is related to handedness. Nineteen healthy subjects performed unimanual left, right, and bimanual auditorily paced finger-tapping tasks while neuromagnetic activity was recorded with a 122-channel whole-head neuromagnetometer (MEG). Simultaneously, we recorded activity of the first dorsal interosseus (FDI) muscle of both hands. By using the analysis tool dynamic imaging of coherent sources (DICS), oscillatory activity at alpha as well as at beta frequency within the primary sensorimotor (S1/M1) and premotor (PMC) cortex was localized. As expected, we observed oscillatory coupling between S1/M1 and PMC contralateral to the moving hand. Furthermore, coupling between left PMC and bilateral S1/M1 occurred in each movement condition, suggesting that the left PMC modulates neural activity in bilateral primary sensorimotor cortices independent of the moving hand. Coupling between bilateral S1/M1 occurred more frequently and significantly stronger during the right hand condition. This result demonstrates the same interhemispheric coupling pattern as in right-handed subjects, suggesting that the asymmetry of this interaction is not due to hand dominance. A specialization of the left premotor cortex either for superior motor control per se or for the execution of sequential tasks might account for these results.

Complex Motor Function in Humans: Validating and Extending the Postulates of Alexandr R. Luria

OBJECTIVE

We used functional brain imaging to reevaluate Luria's postulates and to elaborate the neural circuitry underlying performance of complex motor tasks.

BACKGROUND

The anatomic organization and physiologic functioning of the normal human motor system have great significance for understanding motor dysfunction and remediation in neurology. Working with victims of penetrating head injuries, noted Russian neuropsychologist Aleksandr R. Luria designed several tests of fine motor control to understand their difficulties with complex voluntary movements. This led to his postulates that such function involves the premotor cortices and their interaction with the parietal lobe.

METHOD

Six healthy young adults performed the hand imitation, fist-scissors-gun, and piano key tasks during blood oxygen level-dependent functional magnetic resonance imaging at 3 T.

RESULTS

All 3 tasks revealed activation of both premotor and parietal cortices. Furthermore, while hand Imitation relied more on the ventral premotor area and right parietal lobe, fist-scissors-gun and piano key relied more on the supplementary motor cortex.

CONCLUSIONS

We postulate that differences in task-dependent activations across these tasks relate to degrees of sequential movement, pacing, and imitation. These results uphold Luria's original hypotheses, and extend that work by providing a further characterization of the motor areas involved in complex motor behaviors.

Suppression of the non-dominant motor cortex during bimanual symmetric finger movement: A functional magnetic resonance imaging study

Patterns of bimanual coordination in which homologous muscles are simultaneously active are more stable than those in which homologous muscles are engaged in an alternating fashion. This may be attributable to the stronger involvement of the dominant motor cortex in ipsilateral hand movements via interaction with the non-dominant motor system, known as neural crosstalk. We used functional magnetic resonance imaging to investigate the neural representation of the interhemispheric interaction during bimanual mirror movements. Thirteen right-handed subjects completed four conditions: sequential finger tapping using the right and left index and middle fingers, bimanual mirror and parallel finger tapping. Auditory cues (3 Hz) were used to keep the tapping frequency constant. Task-related activation in the right primary motor cortex was significantly less prominent during mirror than unimanual left-handed movements. This was mirror- and non-dominant side-specific; parallel movements did not cause such a reduction, and the left primary motor cortex showed no such differential activation across the unimanual right, bimanual mirror, and bimanual parallel conditions. Reducing the contralateral innervation of the left hand may increase the fraction of the force command to the left hand coming from the left primary motor cortex, enhancing the neural crosstalk.

Spatial and kinematic features of apraxic movement depend on the mode of execution

Knowledge about the dependency of apraxic movements on the mode of execution may enhance the understanding of apraxia and of the cerebral representation of actions. We examined a common tool-use action in nine patients with left hemisphere damage and apraxia. Arm movements during the use of a handsaw were measured and tested in three different modes of execution: pantomime, pantomime with a bar shaped like the handle of the saw, and actual sawing. Analysis concentrated on spatial and kinematic features of the wrist trajectories during these repetitive movements. In healthy control subjects, both pantomime conditions differed from actual use mainly by larger amplitudes during miming. Apraxic patients executed large proportions of their pantomiming movements in an incorrect direction away from the appropriate anteroposterior direction, while other movement features were normal. The availability of the handle-like bar did not improve performance. During actual use, movement direction was constraint by mechanical demands. In this condition patients moved with moderately decreased velocity. However, this deficit was not related to the errors in movement direction characteristic of pantomiming. These data suggest that pantomiming and actual execution of an action are dictated by different external requirements and constraints, pantomiming serves to convey information, while actual use has to obey the mechanical demands of the task. Due to these differences, spatial and kinematic movement features in healthy subjects vary between the modes of execution, movements are differently vulnerable to apraxia, and deficits in patients may dissociate.

Tapping, grasping and aiming in ideomotor apraxia

Very few studies have investigated sensorimotor control in apraxia using tasks that differ in movement complexity. Nevertheless, there is some evidence to suggest that spontaneous behaviour, although relatively preserved, can be rather clumsy or awkward, and that patients with ideomotor apraxia may have subtle kinematic abnormalities in movements made in the laboratory. It remains unclear whether patients with ideomotor apraxia perform normally on movements such as visually guided aiming, that may not depend on higher-order, more cognitive, processes and that are relatively unguided by overlearned contexts. In this study, three different sensorimotor tasks were given to the same sample of patients with quantified apraxic disturbance. Finger tapping, goal-directed grasping and aiming with and without visual feedback were examined in these patients. A clear dissociation was found between grossly impaired gesture imitation and intact motor programming of goal-directed movements with visual feedback. Apraxic patients were, however, impaired on aiming movements without visual feedback, suggesting that apraxia is associated with an increased reliance on integration of online visual information with feedforward/feedback somatosensory and motor signals. Furthermore, patients were impaired on single finger tapping which was a surprisingly good predictor of apraxia severity.