The effect of postcentral cortical lesions on motor responses to sudden upper limb displacements in monkeys

Long Latency Reflexes in Clinical Neurology: A Systematic Review

BACKGROUND

Long latency reflexes (LLRs) are impaired in a wide array of clinical conditions. We aimed to illustrate the clinical applications and recent advances of LLR in various neurological disorders from a systematic review of published literature.

METHODS

We reviewed the literature using appropriately chosen MeSH terms on the database platforms of MEDLINE, Web of Sciences, and Google Scholar for all the articles from 1st January 1975 to 2nd February 2021 using the search terms "long loop reflex", "long latency reflex" and "C-reflex". The included articles were analyzed and reported using synthesis without meta-analysis (SWiM) guidelines.

RESULTS

Based on our selection criteria, 40 articles were selected for the systematic review. The various diseases included parkinsonian syndromes (11 studies, 217 patients), Huntington's disease (10 studies, 209 patients), myoclonus of varied etiologies (13 studies, 127 patients) including progressive myoclonic epilepsy (5 studies, 63 patients) and multiple sclerosis (6 studies, 200 patients). Patients with parkinsonian syndromes showed large amplitude LLR II response. Enlarged LLR II was also found in myoclonus of various etiologies. LLR II response was delayed or absent in Huntington's disease. Delayed LLR II response was present in multiple sclerosis. Among the other diseases, LLR response varied according to the location of cerebellar lesions while the results were equivocal in patients with essential tremor.

CONCLUSIONS

Abnormal LLR is observed in many neurological disorders. However, larger systematic studies are required in many neurological disorders in order to establish its role in diagnosis and management.

Alterations in Cerebellar Functional Connectivity Are Correlated With Decreased Psychomotor Vigilance Following Total Sleep Deprivation

Previous studies have reported significant changes in functional connectivity among various brain networks following sleep restriction. The cerebellum plays an important role in information processing for motor control and provides this information to higher-order networks. However, little is known regarding how sleep deprivation influences functional connectivity between the cerebellum and the cerebral cortex in humans. The present study aimed to investigate the changes in cerebellar functional connectivity induced by sleep deprivation, and their relationship with psychomotor vigilance. A total of 52 healthy men underwent resting-state functional magnetic resonance imaging before and after 36 h of total sleep deprivation. Functional connectivity was evaluated using region of interest (ROI)-to-ROI analyses, using 26 cerebellar ROIs as seed regions. Psychomotor vigilance was assessed using the psychomotor vigilance test (PVT). Decreased functional connectivity was observed between cerebellar seed regions and the bilateral postcentral, left inferior frontal, left superior medial frontal, and right middle temporal gyri. In contrast, increased functional connectivity was observed between the cerebellum and the bilateral caudate. Furthermore, decrease in functional connectivity between the cerebellum and the postcentral gyrus was negatively correlated with increase in PVT reaction times, while increase in functional connectivity between the cerebellum and the bilateral caudate was positively correlated with increase in PVT reaction times. These results imply that altered cerebellar functional connectivity is associated with impairment in psychomotor vigilance induced by sleep deprivation.

Somatosensory system integrity explains differences in treatment response after stroke

OBJECTIVE

To test the hypothesis that, in the context of robotic therapy designed to enhance proprioceptive feedback via a Hebbian model, integrity of both somatosensory and motor systems would be important in understanding interparticipant differences in treatment-related motor gains.

METHODS

In 30 patients with chronic stroke, behavioral performance, neural injury, and neural function were quantified for somatosensory and motor systems. Patients then received a 3-week robot-based therapy targeting finger movements with enhanced proprioceptive feedback.

RESULTS

Hand function improved after treatment (Box and Blocks score increase of 2.8 blocks, p = 0.001) but with substantial variability: 9 patients showed improvement exceeding the minimal clinically important difference (6 blocks), while 8 patients (all of whom had >2-SD greater proprioception deficit compared to 25 healthy controls) showed no improvement. In terms of baseline behavioral assessments, a somatosensory measure (finger proprioception assessed robotically) best predicted treatment gains, outperforming all measures of motor behavior. When the neural basis underlying variability in treatment response was examined, somatosensory-related variables were again the strongest predictors. A multivariate model combining total sensory system injury and sensorimotor cortical connectivity (between ipsilesional primary motor and secondary somatosensory cortices) explained 56% of variance in treatment-induced hand functional gains (p = 0.002).

CONCLUSIONS

Measures related to the somatosensory network best explained interparticipant differences in treatment-related hand function gains. These results underscore the importance of baseline somatosensory integrity for improving hand function after stroke and provide insights useful for individualizing rehabilitation therapy.

CLINICALTRIALSGOV IDENTIFIER

NCT02048826.

The stretch reflex and the contributions of C David Marsden

The stretch reflex or myotatic reflex refers to the contraction of a muscle in response to its passive stretching by increasing its contractility as long as the stretch is within physiological limits. For ages, it was thought that the stretch reflex was of short latency and it was synonymous with the tendon reflex, subserving the same spinal reflex arc. However, disparities in the status of the two reflexes in certain clinical situations led Marsden and his collaborators to carry out a series of experiments that helped to establish that the two reflexes had different pathways. That the two reflexes are dissociated has been proved by the fact that the stretch reflex and the tendon reflex, elicited by stimulation of the same muscle, have different latencies, that of the stretch reflex being considerably longer. They hypothesized that the stretch reflex had a transcortical course before it reached the spinal motor neurons for final firing. Additionally, the phenomenon of stimulus-sensitive cortical myoclonus lent further evidence to the presence of the transcortical loop where the EEG correlate preceded the EMG discharge. This concept has been worked out by later neurologists in great detail, and the general consensus is that indeed, the stretch reflex is endowed with a conspicuous transcortical component.

Neuromuscular control in landing from supra-maximal dropping height

The present study utilized high-impact supra-maximal landings to examine the influence of the pre-impact force level on the post-impact electromyographic (EMG) activity and, in particular, on the short latency EMG reflex (SLR) component. Unilateral-leg landings were performed in a sitting position on a sledge apparatus after release from high, but individually constant dropping height. A lower limb guiding device fixed to the front of the sledge seat allowed the subjects to sustain a given pre-set force level up to impact. This force level was either freely chosen or set at 20, 35, and 50% of maximal isometric plantarflexion force. EMG activity was recorded from eight major lower limb muscles. It was expected that the increase in the pre-impact force level would require the intervention of a protective neural strategy during the post-impact phase that would attenuate the SLR amplitude. The ultrasonography recordings confirmed that the soleus fascicles were stretched to induce SLR. The main finding was the similarity across all tested conditions of the impact peak force and post-impact EMG activity, including the SLR response. Both observations are mostly attributed to the similar EMG levels and close force levels reached toward impact. The instruction to maintain a given pre-set force level was indeed overruled when getting close to impact. It is suggested that, in the present supra-maximal landing condition, a protective central neural strategy did occur that took into account the pre-set force level to secure similar impact loads.

Differential modulation of spinal and corticospinal excitability during drop jumps

Previously it was shown that spinal excitability during hopping and drop jumping is high in the initial phase of ground contact when the muscle is stretched but decreases toward takeoff. To further understand motor control of stretch-shortening cycle, this study aimed to compare modulation of spinal and corticospinal excitability at distinct phases following ground contact in drop jump. Motor-evoked potentials (MEPs) induced by transcranial magnetic stimulation (TMS) and H-reflexes were elicited at the time of the short (SLR)-, medium (MLR)-, and long (LLR, LLR(2))-latency responses of the soleus muscle (SOL) after jumps from 31 cm height. MEPs and H-reflexes were expressed relative to the background electromyographic (EMG) activity. H-reflexes were highly facilitated at SLR (172%) and then progressively decreased (MLR = 133%; LLR = 123%; LLR(2) = 110%). TMS showed no effect at SLR, MLR, and LLR, whereas MEPs were significantly facilitated at the LLR(2) (122%; P = 0.003). Background EMG was highest at LLR and lowest at LLR(2). Strong H-reflex facilitation at the beginning of the stance phase indicated significant contribution of Iotaa-afferent input to the alpha-motoneurons during this phase that then progressively declined toward takeoff. Conversely, corticospinal excitability was exclusively increased at the phase of push off (LLR(2), approximately 120 ms). It is argued that corticomotoneurons increased their excitability at LLR(2). At LLR ( approximately 90 ms), Iotaa-afferent transmission as well as corticospinal excitability was low, whereas background EMG was high. Therefore it is speculated that other sources, presumably subcortical in origin, contributed to the EMG activity at LLR in drop jumps.

Middle-finger reflex

A new reflex is described: middle-finger extensor reflex elicited by percussion of tendon insertion of musculus extensor digitorum communis in forearm. Following percussion using a reflex hammer, two EMG responses from the belly of the muscle were recorded: a short latency monosynaptic reflex with a latency of 31.4 +/- 1.5 ms (M1), and a long-latency middle-finger reflex with a mean latency of 64.8 +/- 6.31 ms (M2), the former being a monosynaptic extensor reflex, and the latter belonging to a spino-cortico-spinal reflex circuitry. It was suggested that the middle-finger extensor reflex elicited by radial nerve afferents and efferents (C7-C8) would be of clinical and theoretical importance.

Interlimb transfer of load compensation during rapid elbow joint movements

Previous research has shown that training of a novel task can improve subsequent performance in the opposite arm owing to anticipation of the previously learned task conditions. Interestingly, we recently reported preliminary evidence that such transfer might also include modulation of feedback-mediated responses. We now test interlimb transfer of load compensation responses, measured through kinematic and EMG recordings during rapid 20 degrees elbow flexion movements. Two subject groups, LR and RL, each comprising six right-handed subjects, first performed using either the left (LR) or right (RL) arm, followed by opposite arm performance. After 30 trials of consistent performance, five random trials within a background of 50 trials were loaded with a 2-kg mass prior to the "go" signal. We compared load compensation responses for naive performance with those following opposite arm exposure. Under naive conditions, the resulting load compensation responses began about 50 ms following movement onset, and were substantially more effective for the nondominant arm. Opposite arm exposure substantially improved the accuracy of only dominant arm responses. This, however, did not occur through changes in the short latency components of the load compensation response. Instead, changes in muscle activities, associated with interlimb transfer, began some 150 ms following movement onset. We expect that these changes represent transfer in the "volitional" component of the load compensation response. Because the shorter latency response was unaffected by opposite arm exposure, modulation of this component likely requires prior experience with limb specific effectors.

The effects of muscle history on short latency stretch reflex response of soleus muscle

The purpose of the present study was to investigate the combined effects of muscle history, activation and stretching velocity on short latency stretch response (SLR). Stretches (70, 120 and 200 deg s-1) were elicited to both passive and active (10-25% MVC) triceps surae muscle with constant (ISO), lengthened (LEN) or shortened (SHO) muscle length. Under the passive SHO pre-condition both SLR amplitude and reflex torque (RT) decreased where as latency increased compared with the passive ISO pre-condition. Such observations were absent in active trials. Stretches applied to a lengthening passive muscle (LEN) resulted in smaller SLR amplitude and RT compared with passive ISO. In active muscle the stretch response increased with stretching velocity in ISO and SHO. However, in LEN there was large interindividual variability and no velocity dependent increase in SLR amplitude was observed. Smaller amplitude and longer latency of passive SLR in SHO could result from increased slack in the intrafusal fibres, which may be compensated by fusimotor activation during the active condition. The mechanism behind the smaller amplitude in passive LEN and the lack of velocity dependence in active LEN may be related to changes in motoneuron pool excitability or changes in the spindle sensitivity to stretch.

Investigating human motor control by transcranial magnetic stimulation

In this review we discuss the contribution of transcranial magnetic stimulation (TMS) to the understanding of human motor control. Compound motor-evoked potentials (MEPs) may provide valuable information about corticospinal transmission, especially in patients with neurological disorders, but generally do not allow conclusions regarding the details of corticospinal function to be made. Techniques such as poststimulus time histograms (PSTHs) of the discharge of single, voluntarily activated motor units and conditioning of H reflexes provide a more optimal way of evaluating transmission in specific excitatory and inhibitory pathways. Through application of such techniques, several important issues have been clarified. TMS has provided the first real evidence that direct monosynaptic connections from the motor cortex to spinal motoneurons exist in man, and it has been revealed that the distribution of these projections roughly follows the same proximal-distal gradient as in other primates. However, pronounced differences also exist. In particular, the tibialis anterior muscle appears to receive as significant a monosynaptic corticospinal drive as muscles in the hand. The reason for this may be the importance of this muscle in controlling the foot trajectory in the swing phase of walking. Conditioning of H reflexes by TMS has provided evidence of changes in cortical excitability prior to and during various movements. These experiments have generally confirmed information obtained from chronic recording of the activity of corticospinal cells in primates, but information about the corticospinal contribution to movements for which information from other primates is sparse or lacking has also been obtained. One example is walking, where TMS experiments have revealed that the corticospinal tract makes an important contribution to the ongoing EMG activity during treadmill walking. TMS experiments have also documented the convergence of descending corticospinal projections and peripheral afferents on spinal interneurons. Current investigations of the functional significance of this convergence also rely on TMS experiments. The general conclusion from this review is that TMS is a powerful technique in the analysis of motor control, but that care is necessary when interpreting the data. Combining TMS with other techniques such as PSTH and H reflex testing amplifies greatly the power of the technique.

NMDA-dependent and NMDA-independent neural processes in the bicucculline-disinhibited motor cortex of the cat during the acquisition and reproduction of a conditioned paw-on-support placing reflex

Neuron activity was recorded in the motor area of the cat cortex during acquisition of an operant conditioned reflex consisting of placing the forepaw on a support in conditions of local disinhibition by spontaneous diffusion of the GABA(A) receptor blocker bicucculline from the recording micropipette. The conditioned signal was electrical stimulation of the parietal cortex with a train of 3-5 impulses. Addition of 2-amino-5-phosphopentanoic acid (APV), an NMDA glutamate receptor blocker, led to disappearance of the secondary excitatory components (in the poststimulus interval 30-120 msec) from neuronal responses in the disinhibited cortex both to the "indifferent" (before training) and the conditioned stimulation of the parietal cortex, while excitatory reactions associated with elevation and placing of the paw on the support showed no significant change in the presence of APV. Acquisition of the operant conditioned reflex was accompanied by an increase in the amplitude (p < 0.006) and duration (p < 0.00002) of secondary responses and decreases in their latent periods (p < 0.00002). In some cases--in fixed conditioned reflexes--secondary responses to conditioned stimulation in the disinhibited cortex were transformed into trains of epileptiform discharges. The hypothesis that changes in neuronal reactions in the disinhibited cortex during learning are based on increases in the efficiency of horizontal (collateral) connections between pyramidal neurons in layers II and III of the cortex is discussed.

[The appearance manner of C-response in healthy individuals]

The existence of long-latency responses following M and H waves in the complex muscular action potential elicited by stimulation of peripheral nerves was reported by Upton et al. This electrical potential, called the C-response, is applied to examinations in central nervous system diseases. However, the pathway and details on fundamental types of waveforms have not yet been clarified. The main purpose of this study is to classify the waveforms of the C-response, based on the analysis of waveforms. To investigate the type of C-responses, we developed a modified superimposing method. We also investigated the types in different age groups. Fifty-seven healthy individuals (30 males and 27 females) aged between 20 and 73 (average age: 43.1 years old) were enrolled as subjects. All subjects were instructed to oppose the thumb against the little finger of their dominant hands so that the abductor pollicis brevis was in voluntary isometric contraction; subsequently, electrical stimuli were repeatedly applied to the median nerve at the wrist. The stimuli had a strength of 110% of the threshold value of the M wave. The electrical potential was recorded with surface electrodes placed on the muscle belly of the abductor pollicis brevis. In each measurement, 200 waveforms were averaged. A Neuropack 8 (Nihon Kohden, Co., Ltd.) was used for recording and analysis of electromyograms. Measured negative peak latencies (ms) were divided by the subjects' heights (m) to obtaining the corrected latencies per unit height. The time axis of a waveform was also corrected with each height, and shifted so that the latency of the negative peak of the H wave was observed at the same position (modified superimposing method). Then, the position where the negative peak of the C-response appeared most frequently was examined. We clarified that C-responses have three types. C-responses have two major negative peaks basically, C1 and C2 (the latency of C1 is shorter than that of C2). Type 1 has only C2; Type 2 has C1 and C2; Type 3 has both C1 and C2 but the latency of C2 is shorter than that of Type 2. Type 1 was observed in 37 cases (64.9%), Type 2 in 15 cases (26.3%), and Type 3 in 5 cases (8.8%). The incidence of each C-response type depended on the age of the subjects, Type 1 was observed frequently in young subjects, and Types 2 and 3 were observed more frequently as the age of the subjects increased.

Evidence for transcortical reflex pathways in the lower limb of man

The existence of transcortical reflex pathways in the control of distal arm and hand muscles in man is now widely accepted. Much more controversy exists regarding a possible contribution of such reflexes to the control of leg muscles. It is often assumed that transcortical reflex pathways play no, or only a minor, role in the control of leg muscles. Transcortical reflex pathways according to this view are reserved for the control of the distal upper limb and are seen in close relation to the evolution of the primate hand. Here we review data, which provide evidence that transcortical reflexes do exist for lower limb muscles and may play a significant role in the control of at least some of these muscles. This evidence is based on animal research, recent experiments combining transcranial magnetic stimulation with peripheral electrical and mechanical stimulation in healthy subjects and neurological patients. We propose that afferent activity from muscle and skin may play a role in the regulation of bipedal gait through transcortical pathways.

Air-puff-induced facilitation of motor cortical excitability studied in patients with discrete brain lesions

Air-puff stimulation applied to a fingertip is known to exert a location-specific facilitatory effect on the size of the motor evoked potentials elicited in hand muscles by transcranial magnetic stimulation. In order to clarify its nature and the pathway responsible for its generation, we studied 27 patients with discrete lesions in the brain (16, 9 and 2 patients with lesions in the cerebral cortex, thalamus and brainstem, respectively). Facilitation was absent in patients with lesions affecting the primary sensorimotor area, whereas it was preserved in patients with cortical lesions that spared this area. Facilitation was abolished with thalamic lesions that totally destroyed the nucleus ventralis posterolateralis (VPL), but was preserved with lesions that at least partly spared it. Lesions of the spinothalamic tract did not impair facilitation. The size of the N20-P25 component of the somatosensory evoked potential showed a mild correlation with the amount of facilitation. The facilitation is mainly mediated by sensory inputs that ascend the dorsal column and reach the cortex through VPL. These are fed into the primary motor area via the primary sensory area, especially its anterior portion, corresponding to Brodmann areas 3 and 1 (possibly also area 2), without involving other cortical regions. The spinothalamic tract and direct thalamic inputs into the motor cortex do not contribute much to this effect. Some patients could generate voluntary movements despite the absence of the facilitatory effect. The present method will enable us to investigate in humans the function of one of the somatotopically organized sensory feedback input pathways into the motor cortex, and will be useful in monitoring ongoing finger movements during object manipulation.

Functional roles of the proprioceptive system in the control of goal-directed movement

This article explored functional roles of the proprioceptive system during the control of goal-directed movements. Proprioceptive information contributes to the control of movement through both reflex and central connections. Spinal and transcortical reflex loops establish a servomechanism which provides automatic corrections of unexpected changes in muscle length and allows compensation for undesirable irregularities in the mechanical properties of muscles by modulating limb stiffness at the subconscious level. Central connections provide the control system with information about peripheral states which is used in voluntary components of movement control. Before the initiation of movement, proprioceptive information about initial limb orientation becomes a basis for the programming of motor commands. During a movement, proprioceptive input about velocities and angular displacements of a limb is used to regulate movement by triggering planned sequences of muscle activation and modulating motor commands. After movement, feedback produced by responses is compared with previously stored information, verifying the quality of the movement. Considering potential roles of the reflex and central connections, the proprioceptive system seems to constitute an important aspect of motor control mechanisms, providing the control system with efficiency and flexibility in the regulation of goal-directed movements.

Effects on muscle activity from microstimuli applied to somatosensory and motor cortex during voluntary movement in the monkey

It is well known that electrical stimulation of primary somatosensory cortex (SI) evokes movements that resemble those evoked from primary motor cortex. These findings have led to the concept that SI may possess motor capabilities paralleling those of motor cortex and speculation that SI could function as a robust relay mediating motor responses from central and peripheral inputs. The purpose of this study was to rigorously examine the motor output capabilities of SI areas with the use of the techniques of spike- and stimulus-triggered averaging of electromyographic (EMG) activity in awake monkeys. Unit recordings were obtained from primary motor cortex and SI areas 3a, 3b, 1, and 2 in three rhesus monkeys. Spike-triggered averaging was used to assess the output linkage between individual cells and motoneurons of the recorded muscles. Cells in motor cortex producing postspike facilitation (PSpF) in spike-triggered averages of rectified EMG activity were designated corticomotoneuronal (CM) cells. Motor output efficacy was also assessed by applying stimuli through the microelectrode and computing stimulus-triggered averages of rectified EMG activity. One hundred seventy-one sites in motor cortex and 68 sites in SI were characterized functionally and tested for motor output effects on muscle activity. The incidence, character, and magnitude of motor output effects from SI areas were in sharp contrast to effects from CM cell sites in primary motor cortex. Of 68 SI cells tested with spike-triggered averaging, only one area 3a cell produced significant PSpF in spike-triggered averages of EMG activity. In comparison, 20 of 171 (12%) motor cortex cells tested produced significant postspike effects. Single-pulse intracortical microstimulation produced effects at all CM cell sites in motor cortex but at only 14% of SI sites. The large fraction of SI effects that was inhibitory represented yet another marked difference between CM cell sites in motor cortex and SI sites (25% vs 93%). The fact that motor output effects from SI were frequently absent or very weak and predominantly inhibitory emphasizes the differing motor capabilities of SI compared with primary motor cortex.

Afferent mechanism of cortical myoclonus studied by proprioception-related SEPs

Proprioception-related somatosensory evoked potentials (SEPs) to passive flexion movement of the middle finger at proximal interphalangeal joint were recorded in 7 patients with myoclonus of cortical origin who demonstrated enlarged electrical SEPs (giant SEPs). In 3 out of the 7 patients, the proprioception-related SEPs were also enlarged. The remaining 4 patients showed giant electrical SEPs without enhancement of proprioception-related SEPs. Long loop electromyographic response was recorded during the resting condition in all of the 3 patients with enlarged proprioception-related SEPs. We have previously reported that proprioception-related SEPs are mainly generated by muscle afferent inputs, though electrical SEPs are thought to reflect mostly cutaneous inputs with some contribution from muscle afferents. Therefore, it is concluded that hyperexcitability of the sensorimotor cortex in cortical myoclonus is modality-specific. Cortical excitability is exaggerated to both cutaneous and deep receptor inputs in some patients, but only to cutaneous input in others.

Information processing within the motor cortex. I. Responses of morphologically identified motor cortical cells to stimulation of the somatosensory cortex

Inputs from the somatosensory cortex to the motor cortex have been proposed to function in learning of motor skills. In an attempt to analyze how these somatosensory inputs were processed in the motor cortex, neurons in the superficial layer of the cat motor cortex were classified into three groups on the basis of synaptic responses elicited by intracortical microstimulation (ICMS) of area 2. ICMS was delivered through seven electrodes implanted in area 2. When ICMS through one of the seven sites produced a response that was greater than 50% of the response produced by stimulating the seven sites at a time, the site was called a "dominant" site. Type I cells were those that had a dominant stimulation site and showed a constant response latency when examined by a double shock test. Type II cells were those that had a dominant site but displayed a variable latency. Type III cells had no dominant site and showed a variable latency. Latency of type I responses was 1.2-2.6 milliseconds, which was much shorter than that of type II and type III responses. Seventy-nine neurons in layers II/III of the motor cortex, which responded to ICMS in area 2, were stained by intracellular injection of biocytin. From the presence of an apical dendrite and rich spines on the dendrites, 23 type I, 21 type II, and 15 type III cells were classified as pyramidal cells. Type II pyramidal cells were located more superficially than type I and type III pyramidal cells. On the basis of the absence or sparseness of dendritic spines, three type I and four type II cells in layers II/III were classified as nonpyramidal cells. These cells consisted of five small multipolar cells in layer II and a large multipolar cell and a small bitufted cell in layer III. The remaining 11 cells were not classified because of insufficient staining. Since type I and type II cells are considered to represent monosynaptic and polysynaptic responses to stimulation of area 2, respectively, information flow from type I cells to more superficially located type II cells is presumed in layers II/III of the motor cortex. Type III responses suggest the presence of a convergent flow of impulses inside of and/or between areas 2 and 4.

The effect of fasciculus cuneatus lesions on finger positioning and long-latency reflexes in monkeys

Previous studies have reported abnormalities in fine hand and finger movements following interruption of the fasciculus cuneatus (FC) in primates. We report here that many of these deficits could be caused by an inability to actively regulate the position of the finger. Three macaques were trained to maintain the index finger in one position against constant or changing loads. Periodically, torque pulses were used to elicit reflexes in finger muscles. Following unilateral FC lesions, the monkeys failed to adjust finger position during the trials, and the normal M2 long-latency response was absent in the finger muscles. Performance on the task was impaired only in monkeys with complete lesions that included the deep ventral portion of the FC. These results suggest that afferent fibers in the FC regulate finger position, and do so partly through reflexive mechanisms. When the FC is interrupted, the inability to control finger position disturbs fine motor activities.

Transcranial cortical stimulation. Late excitability changes in the soleus and anterior tibial motoneurone pools

The effect of conditioning magnetic transcranial cortical stimulation (TCCS) on the excitability levels of the soleus and anterior tibial motoneurone pools was studied by Hmax/2 technique 40-400 msec after the stimulus. The target muscles were relaxed throughout the tests. Two periods of facilitation (the first at 80-100 msec and the second at 180-200 msec) were found. They shared approximately the same latencies as the late responses (S100 and S > 150) that we have previously recorded following TCCS. A period of inhibition that started at 150 msec was also recorded. A period of facilitation could also be noted when the conditioning stimulus was applied either over the deltoid muscle or when the click that accompanied the magnetic pulse was used. This suggests that brain-stem areas related to those of the startle reaction play an important role for the appearance of the facilitatory changes. The necessary input probably comes from both peripheral and cortical sources.

The influence of the shape of mechanical stimuli on muscle stretch reflexes and SEP

Stretching of human thenar muscle was carried out using mechanical stimuli of different amplitudes and velocities in 50 normal subjects. Amplitudes of early M1 and late M2 reflex responses as well as cortical evoked potentials were recorded. M1 and M2 increased with a larger mechanical stimulus. Steeper mechanical stimuli generated larger M1 amplitudes, whereas M2 remained unaffected. Amplitudes of early cortical evoked potentials increased with increase of both rise-time and amplitude of muscle stretch. The shape of the mechanical stimulus is critical for the resulting reflex response. The different behaviours of M1 and M2 with increasing stimulus velocity are in favour of their different origins. Our results support a participation of slowly conducting muscle spindle afferents in the generation of the late M2 response in distal human hand muscles.

The basis and functional role of the late EMG activity in human forearm muscles following wrist displacement

The present paper examines the hypothesis that the long latency EMG activity produced by muscle stretch is the result of long loop reflex pathways involved in the control of limb stiffness. We recorded the cerebral responses and late EMG activity in agonist and antagonist muscles following sudden stretch of the wrist extensor muscles under 4 experimental conditions in 11 subjects. In each experiment subjects held their right wrist extended isometrically against a constant force of 2.3 N and a trial was begun with a step increase in the force from 2.3 N to 18.4 N, to stretch the extensor muscle. In the first and second experiments the force change occurred unpredictably and subjects had to either oppose the perturbation (Unpredictable Oppose) or relax the forearm muscles once the increase in force was detected (Unpredictable Let-Go). In the third and fourth experiments the force change occurred predictably when subjects pressed a thumb switch with the left hand to cause it. As before, subjects were instructed to either oppose the perturbation (Predictable Oppose) or relax the forearm muscles (Predictable Let-Go). Responses were recorded from the flexor and extensor carpi radialis muscles and from the scalp. When the perturbing force occurred unpredictably, early latency EMG activity (the MI response) was seen in the stretched extensor muscle, and longer latency EMG activity was seen simultaneously in both extensor and flexor muscles. When the force change occurred predictably the late EMG activity was considerably attenuated, especially in the Predictable Let-Go condition. Cerebral responses similarly depended upon the predictability of the perturbation.(ABSTRACT TRUNCATED AT 250 WORDS)

Evidence that a long latency stretch reflex in humans is transcortical

1. The hypothesis that the long latency reflex response to muscle stretch in humans uses a transcortical pathway was tested by looking for convergence onto cortical neurones in eleven normal subjects. 2. Postsynaptic events in single flexor pollicis longus (FPL) motoneurones were derived from changes in the firing probability of individual FPL motor units. 3. Extension of the terminal phalynx of the thumb resulted in both short latency and long latency facilitations of individual FPL motoneurones. These were not reproduced by electrical stimulation of afferents in the terminal phalynx. Magnetic stimulation over the contralateral motor cortex produced strong, short latency facilitation of FPL motoneurones. 4. When the facilitation produced by stimulation over the cortex was superimposed on the long latency facilitation produced by extension of the thumb, the facilitation produced by both stimuli was greater than the sum of the individual facilitations produced by either stimulus given alone. This was not the case when the superimposition occurred on the short latency response to stretch. 5. We conclude that afferent systems excited by the stretch of FPL converge onto cortical neurones which are known to facilitate motoneurones. Thus the cortex is likely to contribute to the long latency stretch reflex in humans.

Differential activation of motor units in the wrist extensor muscles during the tonic vibration reflex in man

1. Single motor unit activity was recorded in the extensor carpi radialis longus and extensor carpi radialis brevis muscles of five healthy human subjects, using metal microelectrodes. 2. Motor units were characterized on the basis of their twitch contraction times and their force recruitment thresholds during voluntary imposed-ramp contractions. 3. The discharge patterns of forty-three motor units were studied during tonic vibration reflex elicited by prolonged (150 s) trains of vibration (30 Hz) applied to the distal tendons of the muscles. The temporal relationships between the individual small tendon taps of the vibratory stimulus and the motor unit impulses were analysed on dot raster displays and post-stimulus time histograms. 4. After tendon taps, the impulses of motor units with long twitch contraction times (mean +/- S.D., 47.2 +/- 10.7 ms) and low recruitment thresholds (0.88 +/- 0.6 N) formed a single narrow peak (P1) with a latency (22.7 +/- 1.4 ms) which was comparable to that of the tendon jerk in the extensor carpi radialis muscles. These motor units were named 'P1 units'. On the other hand, the response of motor units with shorter twitch contraction times (31.1 +/- 3.3 ms) and higher recruitment thresholds (3.21 +/- 1.3 N) showed two peaks: a short latency (23.4 +/- 1.3 ms) P1 peak similar to the previous one and a P2 peak occurring 9.4 +/- 1.2 ms later. These motor units were named 'P1-P2 units'. 5. When the reflex contraction increased slowly, the P1 peaks of 'P1-P2 units' were clearly predominant at the beginning of the contraction, during the rising phase of the motor unit discharge frequency, while the P2 peaks became predominant when the units had reached their maximal discharge frequency. 6. Increasing the tendon vibration frequency (35, 55, 75, 95 Hz) did not modify the 'P1 unit' discharge pattern. Due to interference between vibration period and peak latencies, increasing the vibration frequency caused the P1 and P2 peaks of 'P1-P2 units' to overlap. 7. Superficial cutaneous stimulation of the dorsal side of the forearm during tendon vibration noticeably decreased the P1 peaks in both types of motor units. In the P2 peaks it could result in either a decrease or an increase but the average effect was a slight increase. 8. When applied 10 s before tendon vibration, cutaneous stimulation considerably suppressed the tonic vibration reflex.(ABSTRACT TRUNCATED AT 400 WORDS)

Non-invasive evaluation of central motor tract excitability changes following peripheral nerve stimulation in healthy humans

The interval between muscle stretch and the onset of the long latency electromyographic responses (LLRs) has been theoretically fragmented into an afferent time (AT), taken at the peak of wave N20 of somatosensory evoked potentials and an efferent time (ET), calculated by means of magnetic transcranial stimulation (TCS), the two being separated by a cortical interval (CI). If this were the case, the afferent input should progressively 'energize' the sensorimotor cortex during the CI and change the excitability of cortico-spinal tracts. To investigate this, motor evoked potentials (MEPs) from thumb flexor muscles were recorded, whilst a conditioning stimulation of median or ulnar nerve randomly preceded (10-48 msec intervals) magnetic brain TCS. Nerve stimulation was adjusted to motor threshold and amplitudes of conditioned and test MEPs at different nerve-TCS interstimulus intervals were evaluated. Conditioned MEPs were significantly attenuated with nerve-TCS intervals between 16 and 20 msec for elbow and 20 and 22 msec for wrist stimulation. This was followed by MEP potentiation with nerve-TCS intervals corresponding to the sum of AT + CI (mean 23.2 msec, range 21.7-24.8). The onset latency of facilitated conditioned MEPs was about 1 msec briefer than that of test MEPs, but invariably longer than the latency of MEPs facilitated by a voluntary contraction. This protocol did not demonstrate amplitude facilitation of the segmental H reflex, corroborating the idea that the facilitated part of the conditioning nerve-TCS curve receives a transcortical loop contribution.

Changes in electromyographic responses to muscle stretch, related to the programming of movement parameters

Three experiments are reported that used the advance information paradigm which consists of providing subjects with either no or partial information about an upcoming movement. Subjects moved handles to control the vertical displacements of CRT beams, to point to eight targets. The illumination of different combinations of these targets prior to movement execution provided advance information about which hand, movement direction, or movement extent would be required. Reaction time (RT), integrated EMG activity in the forearm extensor and flexor muscles, and M1, M2, and M3 components of the stretch reflex responses triggered in these muscles were analysed as a function of the precued movement parameter. Compared to the no-information condition, RT decreased in all precue conditions; however, the reduction was greater when direction than when hand was precued, and greater when hand than extent was precued. The EMG activity of forearm muscles increased during the preparatory period in all precue conditions, but generally did not differ among them. An overall facilitation of the stretch reflex components was observed in all precue conditions. This facilitation: (1) was greater for flexor than extensor muscles, (2) was similar regardless of the degree of extent precued, (3) differed for the M2 and M3 components depending on whether the responding hand precued was ipsilateral or contralateral. When the precued movement direction was considered, similar changes in the M3 component were found in extensor and flexor muscles. M3 was facilitated when the muscle was precued as an agonist and was inhibited when it was precued as an antagonist. Collectively these data provide support for a motor programming conception of movement organization.

Observations on the motor control of brief teeth clenching in man

Without artificial feedback control, maximum voluntary isometric contractions were performed for about 1 s by six subjects. Randomly selected surface electromyograms of the anterior temporalis and masseter muscles suggested that, in some cases, the motor control of the entire isometric contraction might have been preprogrammed through the phenomenon of anticipation. In the majority of cases, the control of the initial contraction phase might have been preprogrammed, followed by a phase of servo-controlled motor activity. As a functional basis for the servo-control of isometric force generation, it was suggested that compartmentalized 'extrafusal and intrafusal motor units' were recruited and decruited in an orderly manner, and periods of alpha-motor inhibition were interpreted as signs of switching from one control scheme to another, possibly via a transcortical loop.

Functional role of the sensory cortex in learning motor skills in cats

The functional role of corticocortical input projecting to the motor cortex in learning motor skills was investigated by training 3 cats with and without the projection area. After unilateral removal of areas 1, 2, 2 praeinsularis and a part of 5, the cat was placed in a box and trained to pick up a small piece of food from a beaker in front of the box. Since the beaker and the edge of the box had a space in between, the cat had to develop a new motor skill to being the food back to the box across the space. This skill consisted of combined supination and flexion of the paw to hold the food over the gap. In all 3 cats, the training period necessary for acquisition of the motor skill for the forelimb contralateral to the lesioned brain was significantly longer than the period necessary for the forelimb ipsilateral to the lesioned cortex. Ablation of the remaining projection area after completion of the training did not impair the learned motor skill. The results suggest that the input from the lesioned area to the motor cortex participates in learning motor skills.

Response of human muscle spindle afferents to abrupt load perturbations

Response patterns of single muscle spindle primary afferents to abrupt load perturbations inflicted upon the contracting finger flexors were investigated in awake human subjects using the technique of microneurography. Units showed a transient high-frequency discharge in the rising phase of the stretch. No repeated burst activity attributable to irregularities of the stretch velocity or to mechanical oscillations of the muscle could be detected.

Role of the human fusimotor system in a motor adaptation task

1. Single-unit activity was recorded with the microneurographic technique from the radial nerve of attending human subjects. During active finger movements, impulses in spindle afferents from the extensor digitorum muscle were analysed along with joint movements, size of imposed load and EMG activity of the receptor-bearing muscle. 2. In a simple motor adaptation task the subjects were requested to perform ramp-and-hold movements of prescribed amplitudes and velocities at a single metacarpo-phalangeal joint. A test run consisted of a series of movement cycles when the flexor muscle was continuously loaded with a constant torque, immediately followed by cycles when this load was abruptly decreased during the flexion movement, producing a fast stretch of the receptor-bearing muscle. The subjects' task was to strive for movements of constant velocity and particularly to minimize the effect of the disturbance. In order to allow prediction on the basis of immediately preceding cycles, the disturbance was always injected at the same angular position in a number of successive cycles. 3. Motor adaptation was manifested as a successive decrease of the perturbation amplitude, usually associated with the development of a continuous and growing EMG activity in the parent muscle and a growing reflex response of long latency (60 ms). Short-latency reflexes were not seen. 4. The main mechanism accounting for the improved performance was a co-contraction of the agonist-antagonist muscle pair during voluntary movements, producing an increased muscular stiffness. The reflex did not contribute to the motor adaptation because it was not fast enough to curtail the perturbation. 5. The development and the growth of the reflex were not due to a growing fusimotor drive during adaptation, because spindle discharge actually decreased when the reflex increased. The size of spindle response was related to the amplitude of perturbation rather than to the amplitude of the reflex. These findings suggest that reflex modifications were due to central excitability changes which paralleled the muscle contraction. 6. Spindle firing rate during active movements was generally higher in disturbed cycles compared to undisturbed cycles, indicating a higher fusimotor drive. Since muscle contraction was present mainly in the former, this finding may simply represent a case of fusimotor activation along with skeletomotor activation. No indication of an independence between the two was found. 7. The findings lend no support for the view that the size of the stretch reflex in a behavioural task is adjusted by selective changes of the fusimotor drive.

Organization and synaptic relationships of the projection from the primary sensory to the primary motor cortex in the cat

It is known from previous studies that fibers originating from cells in area 2 of the cat primary somatosensory cortex project topographically to area 4 of the motor cortex and that they terminate preferentially in the caudal region of the cruciate sulcus. We examined this pathway to determine more precisely the distribution pattern of fibers and the laminar arrangement of axon terminals in the motor cortex. The recently developed technique of PHA-L staining enabled us to label anterogradely the axons that form this projection. Iontophoretic injections of PHA-L were made into the rostral bank of the ansate sulcus (area 2). After 7 days the cats were perfused and the tissue was processed immunohistochemically to stain the PHA-L filled fibers. Light microscopic examination revealed that a small cluster of cells in the sensory cortex gave rise to multiple foci of labeled axons in area 4. The labeled fibers formed columnlike arrays, which were located for the most part in the posterior bank of the cruciate sulcus and were separated by irregular intervals of cortex devoid of labeled fibers. Clusters of labeled fibers were also found in the anterior region of the cruciate sulcus in some of the animals. The dimensions of the labeled areas and the small number of cells that gave rise to each group of fibers suggested that axonal branches of cells within the injection site formed the multiple foci. Variations in the immunohistochemical staining enabled us to study the laminar distribution of sensory cortex axon terminals with the electron microscope. Whereas some PHA-L labeled terminals were found in the deep cortical layers, the majority (82%) were spread throughout layers I-III. Differences in the laminar distribution of sensory cortex afferents that formed axodendritic or axospinous synapses were noted. Synapses formed with dendritic shafts were relatively sparse (28%) and were confined to the superficial layers. Some of the more numerous axospinous synapses, which accounted for 72% of identified synapses, were found in layers V and VI, although most were in layers I-III. The distribution pattern of terminals showed little variation between columns in different areas of the motor cortex, including that in the anterior cruciate region. The pattern of termination of the sensory to motor cortex projection is discussed in relation to the physiological characteristics of this pathway.

Importance of the projection from the sensory to the motor cortex for recovery of motor function following partial thalamic lesion in the monkey

Motor deficits produced by thalamic lesions were studied using adult cynomolgus monkeys. Lesioned areas included n. ventralis anterior (VA), ventralis lateralis (VL), n. ventralis posterolateralis pars oralis (VPLo), pars caudalis (VPLc) n. subthalamus (STN) and n. centrum medianum (CM). When the lesion included VA, VL and VPLo, there was a cerebellar syndrome, i.e., ataxia and dysmetria. When the lesion included VPLo and VPLc, the animal was paralyzed. When the lesion included VPLo and rostral part of VPLc, there was loss of orientation in hand movement and clumsiness of finger manipulation. These motor deficits gradually disappeared within 1-2 weeks and the function recovered near to normal except for when VPLo and VPLc were totally destroyed. After recovery of motor function, the somatic sensory cortex (areas 1, 2, 3b) ipsilateral to the thalamic lesion was removed. Removal of the sensory cortex resulted in abolition of the recovered function, but when the border area between VPLo and VPLc was intact, the function recovered again. On the other hand, when the thalamic lesion included this border area, succeeding cortical lesion permanently abolished the recovered function or the reappeared function was substantially worse than that before the cortical lesion. Neuronal mechanisms subserving these differences are discussed and it is concluded that when direct sensory input to the motor cortex was interrupted by lesion of the border area between VPLo and VPLc, the lost function was compensated by reorganization of the projection from the sensory cortex to the motor cortex.

Transient responses to load perturbations of the forearm in a monkey with a chronic lesion in the internal capsule

Small electrolytic lesions were produced in the internal capsule of a monkey. The changes in muscle tone were quantified by studying the EMG responses of elbow muscles and the mechanical responses of the forearm to pseudo-random torque perturbations applied to the elbow joint. Immediately following the lesion, the EMG responses of both biceps and triceps muscles were depressed. Subsequently, biceps responses recovered and became eventually greater than in the control. Triceps responses, instead, remained low throughout the follow-up period (3 months). The mechanical behavior of the forearm was characterized in terms of the dynamic relationship between the applied torque perturbations and the resulting changes in elbow angle. After the lesion, the damping of the elbow responses decreased relative to the control. Possible mechanisms for the observed changes in the EMG and mechanical behavior are discussed.

Long-latency reflex activity in squirrel monkeys with occlusion of the middle cerebral artery

The primate middle cerebral artery (MCA) preparation has been studied as an animal model of human spasticity resulting from stroke. MCA occlusion in 3 squirrel monkeys was accomplished through a transorbital approach and animals were evaluated by 'clinical' examinations and studies of EMG responses to torque motor imposed joint displacement. Animals were transiently hemiparetic but not spastic postoperatively, although all were found to have a large infarct in MCA territory on post-mortem examination. The electromyographic (EMG) response of biceps in normal animals to torque motor imposed elbow extension consisted of both early (M1) and late (M2) components (Tatton et al. 1975). These components were unchanged following MCA occlusion. The EMG response to metacarpophalangeal joint extension in finger flexors or normal animals consisted solely of a long-latency (M2) component (Lenz et al. 1983a). Following MCA occlusion the M2 component in this muscle was decreased or absent, but a short-latency (M1) component appeared.

'Long-latency' responses occurring with startle in the conscious monkey

A monkey was noted to have an intermittent startle response to tendon tapping and vibration of proximal arm muscles. The latency of the first phase of this response, averaging 34 ms in triceps (and of average duration 49 ms), was similar to that described for the long-latency reflex response to muscle stretch in the same muscles. Unrecognised startle responses could explain some of the reported differences in long-latency reflexes in proximal and distal muscles.

Long-latency stretch reflexes of the human elbow extensors during voluntary relaxation: differences between agonistic muscles

Reflex electromyographic (EMG) responses of elbow extensor muscles to unexpected elbow flexion were recorded in the absence of initial tonic activity from subjects instructed not to resist the stretch. The monosynaptic component M1 was present only in the anconeus muscle and only for high accelerations. The acceleration value at which the long-latency components M2 and M3 appeared was lower for anconeus than for triceps brachii. Increases in peak acceleration of stretch resulted in decreases in M2 and M3 latencies and increases in M2 and M3 magnitudes in both muscles. However, M2 and M3 latencies for anconeus were shorter than those of triceps brachii, except at high acceleration values. Furthermore, the magnitude of M2 and M3 components of anconeus activity increased faster for low accelerations than for high accelerations, whereas those of triceps brachii increased in proportion to the acceleration. These differences between anconeus and triceps brachii were similar to those described earlier for voluntary movements. It is suggested that the motoneurons of all elbow extensor muscles may be recruited as a single motoneuron pool following Henneman's size principle, irrespective of whether the activity is voluntary or reflex in origin.

Response synergies over a single leg when it is perturbed during the complex rhythmic movement of pedalling

Previous studies report that perturbing the posture of humans evokes specific patterns of muscular synergies in the legs. This study investigated the pattern of muscular responses of a whole limb when it was rapidly perturbed in the phase of extending during stationary pedalling. Subjects were instructed to resist. Accordingly, we anticipated increased extensor activity at knee and ankle to overcome the perturbation. This did not occur in the initial responses, appearing at latencies of 85-132 ms (mean = 104 ms). In contrast, there was facilitation in tibialis anterior, and the knee extensors vastus medialis and rectus femoris, together with profound inhibition of the ankle extensors soleus and lateral gastrocnemius. The anticipated extensor response across the limb appeared in the subsequent pattern of electromyogram (EMG) activity, with latencies ranging from 121 to 195 ms (mean = 168 ms), together with a large increase in propulsive force on the pedal. The difference in EMG patterns and latencies between initial and subsequent synergies was used to separate the responses into an earlier 'prevolitional' and a later 'volitional' component.

Modulation of slow and fast elbow extensor EMG tonic activity by stretch reflexes in man

Reflex EMG responses to sudden passive flexion of the elbow were recorded from anconeus and triceps brachii in 5 human volunteers. While the subjects were required not to resist the flexion movement, they were required to maintain an extension torque of 3.5 or 7.0 Nm prior to its onset. Under these isotonic conditions, the latency and amplitude of the reflex activities from anconeus and triceps brachii did not differ significantly, in contrast to the findings of Le Bozec (1986) in actively relaxed subjects. The myotatic/postmyotatic EMG amplitude ratio did not provide a further quantitative way to distinguish between these muscles. The absence of a difference between the reflex activities of a slow (anconeus) and a fast (triceps brachii) muscle is interpreted as resulting from a strong drive of spindle activity on the whole extensor motoneuron pool, which outweights the differences in recruitment due to the differing relative amounts of type I and type II fibres in the two muscles. Differences like those described between finger and calf muscles by other authors are thought to be due to the relative degree of corticalization of these muscles. All short and long latency responses of the muscles increased in magnitude and decreased in latency with increasing background EMG activity as well as with increasing initial length. The position and tonic activity dependency of these responses is explained in terms of alpha-gamma coactivation.

Dominance of the short-latency component in perturbation induced electromyographic responses of long-trained monkeys

The effects of prolonged training of adult monkeys subjected to random, brief perturbations of alternating elbow flexions and extensions were studied over a period of four years. The training was intensive at first, for about one year, and then irregular, with long pauses, during the following three years. As a consequence of the prolonged training with the brief perturbations, the M2 component of the electromyographic (EMG) response of the biceps and triceps muscles became gradually smaller, and finally disappeared. The M1 component, on the other hand, progressively increased in amplitude and continued to do so after the loss of the M2, until it finally dominated the EMG response. The training had similar effects on the response of the biceps muscle to longer perturbations, but, only under certain conditions, did it affect the triceps muscle response. All changes occurred at earlier stages of the training in the flexor than in the extensor muscle. These observations demonstrate a long-term functional plasticity of the sensorimotor system of adult animals and suggest a growing role for fast segmental mechanisms in the reaction to external disturbances as motor learning progresses. Changes at various levels of the stretch reflex system could underlie the enlargement of the M1 component, while the lack of the M2 component should, at least partially, reflect a reduced cortical effect on alpha-motoneurones and/or changes in spinal systems processing afferent information.

Short and long latency reflex responses elicited by electrical and mechanical stimulation in human hand muscle

The relationship between electrically and mechanically induced reflex responses in the rectified, averaged surface electromyogram of the first interosseus dorsalis muscle was examined in 18 healthy human subjects. Both methods evoked identifiable short and long latency reflex responses. The onset latencies for short latency reflexes with electrical and mechanical stimulations were 30.6 ms (+/- 2.2 ms) and 28.9 ms (+/- 2.2 ms) and for long latency reflexes 50.0 ms (+/- 2.8 ms) and 51.2 ms (+/- 5.2 ms), respectively. The correlation of the onset latencies of the reflexes revealed significant correspondence between the electrical and mechanical methods implying at least partly mutual mechanisms.

Effect of disuse of hand for recovery of motor function following dorsal column section in the monkey

A question of whether use or disuse of the hand affects the recovery of motor function following dorsal column (DC) section was examined in monkeys. The hand was immobilized by a cast for 16 and 18 days after the section. When the cast was removed, the motor deficit was severer than that observed immediately after the DC section in control animals clearly indicating that the usage of the hand was necessary for the recovery. However, the impairment was not permanent. The hand skill started improving following the removal of the cast and reached the same level as the control although it took longer than for control animals. Neuronal mechanisms for the recovery are discussed in relation to the formation of new synapses.