Movement-related cortical potentials associated with progressive muscle fatigue in a grasping task

Sex-specific Neural Strategies During Fatiguing Work in Older Adults

BACKGROUND

Historical biases in ergonomics-related studies have been attributed to lack of participant diversity and sensitivity of measurements to capture variability between diverse groups. We posit that a neuroergonomics approach, that is, study of brain-behavior relationships during fatiguing work, allows for unique insights on sex differences in fatigue mechanisms that are not available via traditional "neck down" measurement approaches.

OBJECTIVE

This study examined the supraspinal mechanisms of exercise performance under fatigue and determined if there were any sex differences in these mechanisms.

METHODS

Fifty-nine older adults performed submaximal handgrip contractions until voluntary fatigue. Traditional ergonomics measures, namely, force variability, electromyography (EMG) of arm muscles, and strength and endurance times, and prefrontal and motor cortex hemodynamic responses were recorded.

RESULTS

There were no significant differences observed between older males and females in fatigability outcomes (i.e., endurance times, strength loss, and EMG activity) and brain activation. Effective connectivity from prefrontal to motor areas was significant for both sexes throughout the task, but during fatigue, males had higher interregional connectivity than females.

DISCUSSION

While traditional metrics of fatigue were comparable between the sexes, we observed distinct sex-specific neuromotor strategies (i.e., information flow between frontal-motor regions) that were adopted by older adults to maintain motor performance.

APPLICATION

The findings from this study offer insights into the capabilities and adaptation strategies of older men and women under fatiguing conditions. This knowledge can facilitate in the development of effective and targeted ergonomic strategies that accommodate for the varying physical capacities of diverse worker demographics.

The role of clinical neurophysiology in the definition and assessment of fatigue and fatigability

Though a common symptom, fatigue is difficult to define and investigate, occurs in a wide variety of neurological and systemic disorders, with differing pathological causes. It is also often accompanied by a psychological component. As a symptom of long-term COVID-19 it has gained more attention. In this review, we begin by differentiating fatigue, a perception, from fatigability, quantifiable through biomarkers. Central and peripheral nervous system and muscle disorders associated with these are summarised. We provide a comprehensive and objective framework to help identify potential causes of fatigue and fatigability in a given disease condition. It also considers the effectiveness of neurophysiological tests as objective biomarkers for its assessment. Among these, twitch interpolation, motor cortex stimulation, electroencephalography and magnetencephalography, and readiness potentials will be described for the assessment of central fatigability, and surface and needle electromyography (EMG), single fibre EMG and nerve conduction studies for the assessment of peripheral fatigability. The purpose of this review is to guide clinicians in how to approach fatigue, and fatigability, and to suggest that neurophysiological tests may allow an understanding of their origin and interactions. In this way, their differing types and origins, and hence their possible differing treatments, may also be defined more clearly.

The Effects of Modified Game Schedules on Injury Rates in the National Hockey League (NHL)

Background Due to the COVID-19 pandemic, many professional sports leagues such as the National Hockey League (NHL) made significant changes to their schedules and operating procedures. Changes included a modified 2019-2020 playoff format, the removal of the 2020-2021 preseason, and condensed game schedules. Though these modifications were made in an effort to protect players from COVID-19, they resulted in decreased training time and preparation. The purpose of this study was to assess the impact of these changes on the rate of player injuries in the NHL both after the resumption of the midseason stoppage and during the subsequent seasons. Hypothesis/purpose Changes to the NHL schedule amid the COVID-19 pandemic resulted in a significant increase in player injury rates. Methods NHL injuries were obtained from an NHL injury database for the 2018-2019 through the 2021-2022 seasons. The date of injury, date of return, injury description, player age, and player position were recorded. Injury rates were calculated as the number of total athlete injuries per 1000 game exposures (GEs). The primary outcome was the injury proportion ratio (IPR) when comparing the injury rates of the post-COVID-19 season with baseline seasons. Secondary measures analyzed injuries based on age, anatomic location, month in the season, position, length of injury, season-ending injuries, and recurring injuries. Results A total of 4604 injuries were recorded between 2018 and 2022. The modified 2019-2020 playoffs had significantly higher rates of injury (IPR = 1.84, 95% confidence interval {CI} = 1.36-2.49) with more game exposures per week. The 2020-2021 season had significantly higher rates of overall player injury compared to baseline seasons (IPR = 1.19, 95% CI = 1.09-1.30) and also had a higher rate of season-ending injuries (IPR = 1.71, 95% CI = 1.38-2.11). Most injuries occurred in the first few months of the 2020-2021 season. There was no significant difference in injury rate based on age group and no significant difference in the average length of injury between seasons. Conclusion Increases in injury rates could be due to decreased offseason training between seasons, the elimination of preseason games, and increased game density. Decreasing typical training timelines and eliminating the preseason to rapidly return to normal competition after unexpected events (pandemics, lockdowns, etc.) may pose a risk to player safety in the NHL. These findings should be considered before future schedule changes in professional hockey.

Effects of motor fatigue on cortical activation level and functional connectivity during upper limb resistance training

This study aimed to clarify the effects of motor fatigue on cortical activation levels and functional connectivity during upper limb resistance training using functional near-infrared spectroscopy (fNIRS). Ten healthy college students participated in a high intensity upper limb resistance training and fNIRS was used to measure the changes of oxyhemoglobin concentration changes (HbO) in bilateral sensorimotor cortex (SMC), premotor cortex (PMC), supplementary motor area (SMA), and dorsolateral prefrontal cortex (DLPFC). The integral value (IV) of blood oxygen signal was calculated as an indicator of cortical activation level and the whole brain correlation analysis was used to calculate cortical functional connectivity. The results showed that as motor fatigue deepened, the activation levels of bilateral DLPFC and PMC in early stage were significantly higher than those in later stage (P<0.05), and the functional connectivity strength of the motor related cortex areas between the hemispheres was significantly reduced, which was manifested by the functional connectivity strength of LSMC-RSMC and LPMC-RSMC showed a significant decrease in middle stage compared with that in early stage (P<0.05) and that the functional connectivity strength of LPMC-RSMC and RSMC-SMA showed a significant decrease in later stage compared with that in early stage (P<0.05). In each stage, the motor related cortex areas maintained high activation levels and the cerebral cortex showed extensive functional connectivity.Clinical Relevance- The clinical relevance of this study is to deepen the understanding of the neural processes related to upper limb resistance training based on motor fatigue, and provide a clinical basis for optimizing resistance training strategies related to motor dysfunction patients with altered brain function under fatigue.

Modeling Brain Functional Connectivity Patterns during an Isometric Arm Force Exertion Task at Different Levels of Perceived Exertion: A Graph Theoretical Approach

The perception of physical exertion is the cognitive sensation of work demands associated with voluntary muscular actions. Measurements of exerted force are crucial for avoiding the risk of overexertion and understanding human physical capability. For this purpose, various physiological measures have been used; however, the state-of-the-art in-force exertion evaluation lacks assessments of underlying neurophysiological signals. The current study applied a graph theoretical approach to investigate the topological changes in the functional brain network induced by predefined force exertion levels for twelve female participants during an isometric arm task and rated their perceived physical comfort levels. The functional connectivity under predefined force exertion levels was assessed using the coherence method for 84 anatomical brain regions of interest at the electroencephalogram (EEG) source level. Then, graph measures were calculated to quantify the network topology for two frequency bands. The results showed that high-level force exertions are associated with brain networks characterized by more significant clustering coefficients (6%), greater modularity (5%), higher global efficiency (9%), and less distance synchronization (25%) under alpha coherence. This study on the neurophysiological basis of physical exertions with various force levels suggests that brain regions communicate and cooperate higher when muscle force exertions increase to meet the demands of physically challenging tasks.

EEG-Based Spectral Analysis Showing Brainwave Changes Related to Modulating Progressive Fatigue During a Prolonged Intermittent Motor Task

Repeatedly performing a submaximal motor task for a prolonged period of time leads to muscle fatigue comprising a central and peripheral component, which demands a gradually increasing effort. However, the brain contribution to the enhancement of effort to cope with progressing fatigue lacks a complete understanding. The intermittent motor tasks (IMTs) closely resemble many activities of daily living (ADL), thus remaining physiologically relevant to study fatigue. The scope of this study is therefore to investigate the EEG-based brain activation patterns in healthy subjects performing IMT until self-perceived exhaustion. Fourteen participants (median age 51.5 years; age range 26−72 years; 6 males) repeated elbow flexion contractions at 40% maximum voluntary contraction by following visual cues displayed on an oscilloscope screen until subjective exhaustion. Each contraction lasted ≈5 s with a 2-s rest between trials. The force, EEG, and surface EMG (from elbow joint muscles) data were simultaneously collected. After preprocessing, we selected a subset of trials at the beginning, middle, and end of the study session representing brain activities germane to mild, moderate, and severe fatigue conditions, respectively, to compare and contrast the changes in the EEG time-frequency (TF) characteristics across the conditions. The outcome of channel- and source-level TF analyses reveals that the theta, alpha, and beta power spectral densities vary in proportion to fatigue levels in cortical motor areas. We observed a statistically significant change in the band-specific spectral power in relation to the graded fatigue from both the steady- and post-contraction EEG data. The findings would enhance our understanding on the etiology and physiology of voluntary motor-action-related fatigue and provide pointers to counteract the perception of muscle weakness and lack of motor endurance associated with ADL. The study outcome would help rationalize why certain patients experience exacerbated fatigue while carrying out mundane tasks, evaluate how clinical conditions such as neurological disorders and cancer treatment alter neural mechanisms underlying fatigue in future studies, and develop therapeutic strategies for restoring the patients' ability to participate in ADL by mitigating the central and muscle fatigue.

Perceived Barriers to Blood Flow Restriction Training

Blood flow restriction (BFR) training is increasing in popularity in the fitness and rehabilitation settings due to its role in optimizing muscle mass and strength as well as cardiovascular capacity, function, and a host of other benefits. However, despite the interest in this area of research, there are likely some perceived barriers that practitioners must overcome to effectively implement this modality into practice. These barriers include determining BFR training pressures, access to appropriate BFR training technologies for relevant demographics based on the current evidence, a comprehensive and systematic approach to medical screening for safe practice and strategies to mitigate excessive perceptual demands of BFR training to foster long-term compliance. This manuscript attempts to discuss each of these barriers and provides evidence-based strategies and direction to guide clinical practice and future research.

Physical or Cognitive Exertion Does Not Influence Cortical Movement Preparation for Rapid Arm Movements

The contribution of central factors to movement preparation (e.g., the contingent negative variation [CNV]) and the influence of fatigue on such factors are still unclear, even though executive cognitive functions are regarded as key elements in motor control. Therefore, this study examined CNV amplitude with electroencephalography in 22 healthy humans during a rapid arm movement task prior to and following three experimental conditions: (a) a no exertion/control condition, (b) a physical exertion, and (c) a cognitive exertion. CNV amplitude was affected neither by a single bout of physical/cognitive exertion nor by the control condition. Furthermore, no time-on-task effects of the rapid arm movement task on the CNV were found. Exertion did not affect cortical movement preparation, which is in contrast to previous findings regarding time-on-task effects of exertion on CNV. Based on the current findings, the rapid arm movement task is deemed suitable to measure cortical movement preparation, without being affected by learning effects and physical/cognitive exertion.

Neuroergonomics Applications of Electroencephalography in Physical Activities: A Systematic Review

Recent years have seen increased interest in neuroergonomics, which investigates the brain activities of people engaged in diverse physical and cognitive activities at work and in everyday life. The present work extends upon prior assessments of the state of this art. However, here we narrow our focus specifically to studies that use electroencephalography (EEG) to measure brain activity, correlates, and effects during physical activity. The review uses systematically selected, openly published works derived from a guided search through peer-reviewed journals and conference proceedings. Identified studies were then categorized by the type of physical activity and evaluated considering methodological and chronological aspects via statistical and content-based analyses. From the identified works (n = 110), a specific number (n = 38) focused on less mobile muscular activities, while an additional group (n = 22) featured both physical and cognitive tasks. The remainder (n = 50) investigated various physical exercises and sporting activities and thus were here identified as a miscellaneous grouping. Most of the physical activities were isometric exertions, moving parts of upper and lower limbs, or walking and cycling. These primary categories were sub-categorized based on movement patterns, the use of the event-related potentials (ERP) technique, the use of recording methods along with EEG and considering mental effects. Further information on subjects' gender, EEG recording devices, data processing, and artifact correction methods and citations was extracted. Due to the heterogeneous nature of the findings from various studies, statistical analyses were not performed. These were thus included in a descriptive fashion. Finally, contemporary research gaps were pointed out, and future research prospects to address those gaps were discussed.

Evaluation of vibrant muscles over the shoulder region among workers of the hand screen printing industry

This study focuses on evaluation of the muscle activities associated with shoulder pain among workers of the hand screen printing (HSP) industry. Activities of three major muscles which showed higher muscle activity for a HSP job were observed for fatigue using surface electromyography (SEMG). The anatomical sites were chosen on the basis of a statistical survey and a visual inspection conducted before the experiment. Activities of the deltoid, teres major and infraspinatus were recorded using SEMG and the nature of muscle activities was studied for about 50 m of cloth printing. Data collected were processed using LabVIEW 2014 and the activities were analyzed using statistical tests and regression analyses. The results showed an increased risk of shoulder disorders with an increase in working time. Some of the risks which might cause disorders were predicted from the results; inspection and possible mitigations were suggested.

Effects of Parkinson disease and antiparkinson medication on central adaptations to repetitive grasping

Cortical activity during motor task performance is attenuated in individuals with Parkinson disease (PD) relative to age-matched adults without PD, and this activity is enhanced with antiparkinson medication. It remains unclear, however, whether the relative change in cortical activity over the duration of the task, i.e., central adaptation, is affected individuals with PD, and if so, whether medication corrects for any unique behaviors. Movement-related cortical potentials (MRCPs) were recorded from scalp electrode sites Cz and C1 during 150 repetitive handgrip contractions at 70% of maximal voluntary contraction, in individuals with PD (n = 10) both ON and OFF of their PD medication, and neurologically normal age- and sex-matched controls (n = 10). Repetitions were divided into two Blocks (Block 1 and 2: repetitions 1-60 and 91-150, respectively), and the composite MRCP slopes were calculated during periods representing movement initiation (-2 s to movement onset) and execution (movement onset to 1 s). No significant interactions were noted for either comparison (PD OFF vs. control; PD OFF vs. PD ON), irrespective of electrode site (Cz or C1) or movement period (initiation or execution). Despite similar MRCP slopes and task performance, PD OFF endorsed greater perceived exertion during task performance than controls. In the present study, we observed attenuated task-related cortical activity among individuals with PD OFF relative to controls, but a similar relative adaptive response to a fatiguing task. Additionally, although antiparkinson medication enhanced cortical activity (PD OFF vs. PD ON), central adaptation was similar.

Role of multisensory stimuli in vigilance enhancement- a single trial event related potential study

Development of interventions to prevent vigilance decrement has important applications in sensitive areas like transportation and defence. The objective of this work is to use multisensory (visual and haptic) stimuli for cognitive enhancement during mundane tasks. Two different epoch intervals representing sensory perception and motor response were analysed using minimum variance distortionless response (MVDR) based single trial ERP estimation to understand the performance dependency on both factors. Bereitschaftspotential (BP) latency L3 (r=0.6 in phase 1 (visual) and r=0.71 in phase 2 (visual and haptic)) was significantly correlated with reaction time as compared to that of sensory ERP latency L2 (r=0.1 in both phase 1 and phase 2). This implies that low performance in monotonous tasks is predominantly dependent on the prolonged neural interaction with the muscles to initiate movement. Further, negative relationship was found between the ERP latencies related to sensory perception and Bereitschaftspotential (BP) and occurrence of epochs when multisensory cues are provided. This means that vigilance decrement is reduced with the help of multisensory stimulus presentation in prolonged monotonous tasks.

Movement-Related Cortical Potential Amplitude Reduction after Cycling Exercise Relates to the Extent of Neuromuscular Fatigue

Exercise-induced fatigue affects the motor control and the ability to generate a given force or power. Surface electroencephalography allows researchers to investigate movement-related cortical potentials (MRCP), which reflect preparatory brain activity 1.5 s before movement onset. Although the MRCP amplitude appears to increase after repetitive single-joint contractions, the effects of large-muscle group dynamic exercise on such pre-motor potential remain to be described. Sixteen volunteers exercised 30 min at 60% of the maximal aerobic power on a cycle ergometer, followed by a 10-km all-out time trial. Before and after each of these tasks, knee extensor neuromuscular function was investigated using maximal voluntary contractions (MVC) combined with electrical stimulations of the femoral nerve. MRCP was recorded during 60 knee extensions after each neuromuscular sequence. The exercise resulted in a significant decrease in the knee extensor MVC force after the 30-min exercise (−10 ± 8%) and the time trial (−21 ± 9%). The voluntary activation level (VAL; −6 ± 8 and −12 ± 10%), peak twitch (Pt; −21 ± 16 and −32 ± 17%), and paired stimuli (P100 Hz; −7 ± 11 and −12 ± 13%) were also significantly reduced after the 30-min exercise and the time trial. The first exercise was followed by a decrease in the MRCP, mainly above the mean activity measured at electrodes FC1-FC2, whereas the reduction observed after the time trial was related to the FC1-FC2 and C2 electrodes. After both exercises, the reduction in the late MRCP component above FC1-FC2 was significantly correlated with the reduction in P100 Hz (r = 0.61), and the reduction in the same component above C2 was significantly correlated with the reduction in VAL (r = 0.64). In conclusion, large-muscle group exercise induced a reduction in pre-motor potential, which was related to muscle alterations and resulted in the inability to produce a maximal voluntary contraction.

Frontier studies on fatigue, autonomic nerve dysfunction, and sleep-rhythm disorder

Fatigue is defined as a condition or phenomenon of decreased ability and efficiency of mental and/or physical activities, caused by excessive mental or physical activities, diseases, or syndromes. It is often accompanied by a peculiar sense of discomfort, a desire to rest, and reduced motivation, referred to as fatigue sensation. Acute fatigue is a normal condition or phenomenon that disappears after a period of rest; in contrast, chronic fatigue, lasting at least 6 months, does not disappear after ordinary rest. Chronic fatigue impairs activities and contributes to various medical conditions, such as cardiovascular disease, epileptic seizures, and death. In addition, many people complain of chronic fatigue. For example, in Japan, more than one third of the general adult population complains of chronic fatigue. It would thus be of great value to clarify the mechanisms underlying chronic fatigue and to develop efficient treatment methods to overcome it. Here, we review data primarily from behavioral, electrophysiological, and neuroimaging experiments related to neural dysfunction as well as autonomic nervous system, sleep, and circadian rhythm disorders in fatigue. These data provide new perspectives on the mechanisms underlying chronic fatigue and on overcoming it.

Neural mechanisms of mental fatigue

Fatigue is defined as a decline in the ability and efficiency of mental and/or physical activities that is caused by excessive mental and/or physical activities. Fatigue can be classified as physical or mental. Mental fatigue manifests as potentially impaired cognitive function and is one of the most significant causes of accidents in modern society. Recently, it has been shown that the neural mechanisms of mental fatigue related to cognitive task performance are more complex than previously thought and that mental fatigue is not caused only by impaired activity in task-related brain regions. There is accumulating evidence supporting the existence of mental facilitation and inhibition systems. These systems are involved in the neural mechanisms of mental fatigue, modulating the activity of task-related brain regions to regulate cognitive task performance. In this review, we propose a new conceptual model: the dual regulation system of mental fatigue. This model contributes to our understanding of the neural mechanisms of mental fatigue and the regulatory mechanisms of cognitive task performance in the presence of mental fatigue.

Movement-related cortical potentials during muscle fatigue induced by upper limb submaximal isometric contractions

The aim of this study was to examine the central neurophysiological mechanisms during fatigue induced by submaximal isometric contractions. A total of 23 individuals participated in the study and were assigned to fatigue and nonfatigue groups. Handgrip force, root mean square (RMS) of surface electromyography (sEMG) signal and movement-related cortical potentials during self-paced submaximal handgrip isometric contractions were assessed for each participant. The experimental data showed significant decreases in both maximal voluntary contraction [-24.3%; F(3, 42)=19.62, P<0.001, ηp=0.48] and RMS [-30.1%; F(3, 42)=19.01, P<0.001, ηp=0.57] during maximal voluntary contractions and a significant increase [F(3, 42)=14.27, P<0.001, ηp=0.50] in the average RMS of sEMG over four blocks in the fatigue group. There was no significant difference in the readiness potential between the fatigue and the nonfatigue groups at early stages, and at late stages, significant differences were observed only at the Fp1 and FC1 sites. Motor potential amplitudes were significantly higher in the fatigue group than in the nonfatigue group irrespective of block or electrode positions. Positive waveforms were observed in the prefrontal cortex in states without muscle fatigue, whereas a negative waveform pattern was observed with muscle fatigue. Significant within-subject correlations were observed between motor potential at the C1 site and RMS of sEMG (r=-0.439, P=0.02, ηp=0.11). Neurophysiological evidence indicates that cortical activity increases in the prefrontal cortex, primary motor cortex and supplementary motor cortex with muscle fatigue. Muscle fatigue appears to have considerable effects on the components of movement-related cortical potentials during movement execution, whereas the readiness potential before movement is sensitive to cognitive demands during prolonged exercise. Our results provide additional evidence for a link between central motor command during movement execution and motor unit recruitment.

Neural effect of mental fatigue on physical fatigue: a magnetoencephalography study

We sought to clarify the neural effect of mental fatigue on physical fatigue using magnetoencephalography (MEG) and classical conditioning techniques. Eleven right-handed volunteers participated in this study. On the first day, participants performed fatigue-inducing maximum handgrip trials for 10 min; metronome sounds were started 5 min after the beginning of the trials. We used metronome sounds as conditioned stimuli and maximum handgrip trials as unconditioned stimuli to cause physical fatigue. On the next day, MEG recordings during the imagery of maximum grips of the right hand guided by the metronome sounds were performed for 10 min just before (control session) and after (mental fatigue session) a 30-min fatigue-inducing mental task session. In the right anterior cingulate cortex (Brodmann's area 23), the alpha-band event-related synchronization of the mental fatigue session relative to the control session within the time window of 500–600 ms after the onset of handgrip cue sounds was identified. We demonstrated that mental fatigue suppresses activities in the right anterior cingulate cortex during physical fatigue.

Neural mechanisms underlying chronic fatigue

Fatigue is defined as a condition or phenomenon of declined ability and efficiency of mental and/or physical activities, caused by excessive mental or physical activities, diseases, or syndromes. Acute fatigue is a normal condition that disappears after a period of rest; in contrast, chronic fatigue does not disappear after an ordinary rest. Chronic fatigue impairs daily activities and contributes to various medical conditions and death. In addition, many people complain of chronic fatigue. It would thus be of great value to clarify the mechanisms underlying chronic fatigue and to develop efficient treatment methods to overcome it. Here, we review data primarily from behavioral, neurophysiological, and neuroimaging experiments related to the neural mechanisms underlying chronic fatigue. We propose that repetitive and prolonged overwork and/or stress cause neural damage of a facilitation system, as well as central sensitization and classical conditioning of an inhibition system. We also propose a new treatment strategy for chronic fatigue on the basis of its underlying neural mechanisms.

Regulatory mechanism of performance in chronic cognitive fatigue

Chronic cognitive fatigue is characterized by a sensation of long-lasting fatigue that impairs cognitive functions. Facilitation and inhibition systems in the central nervous system play primary roles in determining the output to the peripheral system, that is, performance. Sensory input from the peripheral system to the central nervous system activates the inhibition system to limit performance, whereas motivational input activates the facilitation system to enhance performance. The dysfunction of the facilitation system and central sensitization and classical conditioning of the inhibition system play important roles in the pathophysiology of chronic cognitive fatigue. Because the dorsolateral prefrontal cortex receives input from both the facilitation and inhibition systems to determine performance, metabolic, functional, and structural impairments of the dorsolateral prefrontal cortex induced by repetitive and prolonged overwork, stress, and stress responses contribute to the impaired functioning and cognitive performance that occur in people with chronic cognitive fatigue. This hypothesis of the regulatory mechanism of performance provides a new perspective on the neural mechanisms underlying chronic cognitive fatigue.

Neuroergonomics: a review of applications to physical and cognitive work

Neuroergonomics is an emerging science that is defined as the study of the human brain in relation to performance at work and in everyday settings. This paper provides a critical review of the neuroergonomic approach to evaluating physical and cognitive work, particularly in mobile settings. Neuroergonomics research employing mobile and immobile brain imaging techniques are discussed in the following areas of physical and cognitive work: (1) physical work parameters; (2) physical fatigue; (3) vigilance and mental fatigue; (4) training and neuroadaptive systems; and (5) assessment of concurrent physical and cognitive work. Finally, the integration of brain and body measurements in investigating workload and fatigue, in the context of mobile brain/body imaging ("MoBI"), is discussed.

The neurophysiology of central and peripheral fatigue during sub-maximal lower limb isometric contractions

Fatigue has been defined as an exercise-induced decline in force generation capacity because of changes at both the peripheral and central levels. Movement is preceded and accompanied by brain activities related to the preparation and execution of movement (movement related cortical potentials, MRCP), which have been correlated with the perception of effort (RPE). We combined force measurements, surface electromyography (sEMG), peripheral electrical stimulation (maximal twitch, MT) and MRCP analysis to further our understanding of the neural correlates of peripheral and central changes during a fatiguing task involving the lower limbs. Eighteen healthy volunteers performed 4 blocks of isometric knee extensions at 40% of the maximal voluntary contraction (MVC) for a total of 240 2-s contractions. At the baseline and after each block, we measured RPE, MT and MVC. We simultaneously recorded the force of the knee extensor muscles, root mean square (RMS) of the sEMG of the vastus lateralis muscle, and electroencephalography (EEG) from 64 channels. The MRCPs were extracted from the EEG recordings and averaged in the early (Block 1-2) and late (Block 3-4) blocks. Two cohorts were obtained by cluster analysis based on the RPE (i.e., perception of effort) and MT (i.e., peripheral fatigue). We observed a significant decline in both the MVC (-13%) and RMS (-25%) of the sEMG signal over the course of the task; thus, muscle fatigue had occurred in all of the participants regardless of the cohort. The MRCP amplitude was larger in the fatigued than the non-fatigued MT cohort in the supplementary and premotor areas, whereas the MRCP amplitude was larger in the fatigued than the non-fatigued RPE cohort in the aforementioned areas, and also in the primary motor and prefrontal cortices (PFC). The increase in the positive activity of the PFC, along with the perception of effort, represents a novel result, suggesting that it is modulated more by the perception of effort than peripheral fatigue.

Transient shifts in frontal and parietal circuits scale with enhanced visual feedback and changes in force variability and error

When subjects perform a learned motor task with increased visual gain, error and variability are reduced. Neuroimaging studies have identified a corresponding increase in activity in parietal cortex, premotor cortex, primary motor cortex, and extrastriate visual cortex. Much less is understood about the neural processes that underlie the immediate transition from low to high visual gain within a trial. This study used 128-channel electroencephalography to measure cortical activity during a visually guided precision grip task, in which the gain of the visual display was changed during the task. Force variability during the transition from low to high visual gain was characterized by an inverted U-shape, whereas force error decreased from low to high gain. Source analysis identified cortical activity in the same structures previously identified using functional magnetic resonance imaging. Source analysis also identified a time-varying shift in the strongest source activity. Superior regions of the motor and parietal cortex had stronger source activity from 300 to 600 ms after the transition, whereas inferior regions of the extrastriate visual cortex had stronger source activity from 500 to 700 ms after the transition. Force variability and electrical activity were linearly related, with a positive relation in the parietal cortex and a negative relation in the frontal cortex. Force error was nonlinearly related to electrical activity in the parietal cortex and frontal cortex by a quadratic function. This is the first evidence that force variability and force error are systematically related to a time-varying shift in cortical activity in frontal and parietal cortex in response to enhanced visual gain.

Cortical Activity during a Highly-Trained Resistance Exercise Movement Emphasizing Force, Power or Volume

Cortical activity is thought to reflect the biomechanical properties of movement (e.g., force or velocity of movement), but fatigue and movement familiarity are important factors that require additional consideration in electrophysiological research. The purpose of this within-group quantitative electroencephalogram (EEG) investigation was to examine changes in cortical activity amplitude and location during four resistance exercise movement protocols emphasizing rate (PWR), magnitude (FOR), or volume (VOL) of force production, while accounting for movement familiarity and fatigue. EEG signals were recorded during each complete repetition and were then grouped by functional region, processed to eliminate artifacts, and averaged to compare overall differences in the magnitude and location of cortical activity between protocols over the course of six sets. Biomechanical, biochemical, and exertional data were collected to contextualize electrophysiological data. The most fatiguing protocols were accompanied by the greatest increases in cortical activity. Furthermore, despite non-incremental loading and lower force levels, VOL displayed the largest increases in cortical activity over time and greatest motor and sensory activity overall. Our findings suggest that cortical activity is strongly related to aspects of fatigue during a high intensity resistance exercise movement.

Spatiotemporal dynamics of brain activity during the transition from visually guided to memory-guided force control

It is well established that the prefrontal cortex is involved during memory-guided tasks whereas visually guided tasks are controlled in part by a frontal-parietal network. However, the nature of the transition from visually guided to memory-guided force control is not as well established. As such, this study examines the spatiotemporal pattern of brain activity that occurs during the transition from visually guided to memory-guided force control. We measured 128-channel scalp electroencephalography (EEG) in healthy individuals while they performed a grip force task. After visual feedback was removed, the first significant change in event-related activity occurred in the left central region by 300 ms, followed by changes in prefrontal cortex by 400 ms. Low-resolution electromagnetic tomography (LORETA) was used to localize the strongest activity to the left ventral premotor cortex and ventral prefrontal cortex. A second experiment altered visual feedback gain but did not require memory. In contrast to memory-guided force control, altering visual feedback gain did not lead to early changes in the left central and midline prefrontal regions. Decreasing the spatial amplitude of visual feedback did lead to changes in the midline central region by 300 ms, followed by changes in occipital activity by 400 ms. The findings show that subjects rely on sensorimotor memory processes involving left ventral premotor cortex and ventral prefrontal cortex after the immediate transition from visually guided to memory-guided force control.

Recovery patterns in electroencephalographic global field power during maximal isometric force production

In previous work, cortical activity decreased with fatigue following novel movements or small muscle group actions. These muscle actions, however, do not appear related to the cortical activity seen with biologically relevant and highly trained movement patterns (i.e., ingrained patterns). The cortical recovery response to ingrained patterns-and how it differs with altered load, speed, or volume - is unknown. The purpose of this balanced, within-group study was to investigate differences in cortical activity 24 hours after physically distinct variations of a highly trained squat exercise (n = 7, minimum 4 years resistance training experience). Four resistance protocols were chosen: rate of force development (PWR, 6 × 3 squat jumps at 30% of 1 repetition maximum [1RM]); magnitude of force development (FOR, 6 × 3 squat at 95% of 1RM); volume of force development (VOL, 6 × 10 squat at 80% of their 1RM); and control (CTRL, 6 sets unracking an empty bar). Twenty-four hours later, subjects performed a peak isometric squat while electroencephalographic and biochemical markers of exertion and fatigue were obtained. Global field power detected the quantity of activity superficial to motor regions. Waveforms of activity throughout the isometric squats were obtained and grand averages calculated to produce quantitative depictions of cortical activity. Significance was P ≤ 0.05. Peak isometric squat force was not statistically different 24 hours postexercise (Force [N]: PWR: 2828.79 ± 461.17; FOR: 2887.64 ± 453.09; VOL: 2910.17 ± 625.81; CTRL 2768.53 ± 374.85). Subjects produced similar and characteristic cortical activity patterns during isometric squats despite varying indices of fatigue. Differences were observed based upon the use or nonuse of aerobic endurance exercise in their training program. Patterns of activity in data seem to have emerged based on differences in training preference. Global Field Power (uV) during the isometric squat for PWR was 26.98 ± 14.64; FOR 24.06 ± 19.05; VOL 23.05 ± 13.37; and CTRL 15.78 ± 8.11. Previous research suggests that cortical activity decreases with physical activity; however, despite substantial endocrine, perceptual, and biomechanical differences between protocols, cortical activity was not decreased below control during the performance of a maximal isometric squat 24 hours after various exercise protocols.

Central adaptations to repetitive grasping in healthy aging

Augmented cortical activity during repetitive grasping mitigates repetition-related decrease in cortical efficiency in young adults. It is unclear if similar processes occur with healthy aging. We recorded movement-related cortical potentials (MRCP) during 150 repetitive handgrip contractions at 70% of maximal voluntary contraction (MVC) in healthy young (n = 10) and old (n = 10) adults. Repetitions were grouped into two Blocks (Block 1 and 2: repetitions 1-60 and 91-150, respectively) and analyzed separately to assess the effects of aging and block. EMG of the flexor digitorum superficialis and handgrip force were also recorded. No changes in EMG or MVC were observed across blocks for either group. Significant interactions (P < 0.05) were observed for MRCPs recorded from mesial (FCz, Cz, CPz) and motor (C1, C3, Cz) electrode sites, with younger adults demonstrating significant increases in MRCP amplitude. Focal MRCP activity in response to repetitive grasping resulted in minimal changes (i.e. Block 1 versus Block 2) in older adults. Central adaptive processes change across the lifespan, showing increasingly less focal activation in older adults during repetitive grasping. Our findings are consistent with previous paradigms demonstrating more diffuse cortical activation during motor tasks in older adults.

A review of combined TMS-EEG studies to characterize lasting effects of repetitive TMS and assess their usefulness in cognitive and clinical neuroscience

Transcranial magnetic stimulation (TMS) has developed into a powerful tool for studying human brain physiology and brain-behavior relations. When applied in sessions of repeated stimulation, TMS can lead to changes in neuronal activity/excitability that outlast the stimulation itself. Such aftereffects are at the heart of the offline TMS protocols in cognitive neuroscience and neurotherapeutics. However, whether these aftereffects are of applied interest critically depends on their magnitude and duration, which should fall within an experimentally or clinically useful range without increasing risks and adverse effects. In this short review, we survey combined TMS-EEG studies to characterize the TMS-aftereffects as revealed by EEG to contribute to the characterization of the most effective and promising repetitive TMS-parameters. With one session of conventional repetitive TMS (of fixed pulse frequency), aftereffects were consistently comparable in magnitude to EEG-changes reported after learning or with fatigue, and were short-lived (<70 min). The few studies using recently developed protocols (such as theta burst stimulation) suggest comparable effect-size but longer effect-durations. Based on the reviewed data, it is expected that TMS-efficacy can be further promoted by repeating TMS-sessions, by using EEG-gated TMS to tailor TMS to current neuronal state, or by other, non-conventional TMS-protocols. Newly emerging developments in offline TMS research for cognitive neuroscience and neurotherapeutics are outlined.

Neural basis of postural instability identified by VTC and EEG

In this study, we investigated the neural basis of virtual time to contact (VTC) and the hypothesis that VTC provides predictive information for future postural instability. A novel approach to differentiate stable pre-falling and transition-to-instability stages within a single postural trial while a subject was performing a challenging single leg stance with eyes closed was developed. Specifically, we utilized wavelet transform and stage segmentation algorithms using VTC time series data set as an input. The VTC time series was time-locked with multichannel (n = 64) EEG signals to examine its underlying neural substrates. To identify the focal sources of neural substrates of VTC, a two-step approach was designed combining the independent component analysis (ICA) and low-resolution tomography (LORETA) of multichannel EEG. There were two major findings: (1) a significant increase of VTC minimal values (along with enhanced variability of VTC) was observed during the transition-to-instability stage with progression to ultimate loss of balance and falling; and (2) this VTC dynamics was associated with pronounced modulation of EEG predominantly within theta, alpha and gamma frequency bands. The sources of this EEG modulation were identified at the cingulate cortex (ACC) and the junction of precuneus and parietal lobe, as well as at the occipital cortex. The findings support the hypothesis that the systematic increase of minimal values of VTC concomitant with modulation of EEG signals at the frontal-central and parietal-occipital areas serve collectively to predict the future instability in posture.

Effects of motor fatigue on human brain activity, an fMRI study

The main purpose of this study was to investigate effects of motor fatigue on brain activation in humans, using fMRI. First, we assessed brain activation that correlated with muscle activity during brief contractions at different force levels (force modulation). Second, a similar analysis was done for sustained contractions inducing motor fatigue. Third, we studied changes in brain activation due to motor fatigue over time. And fourth, we investigated cross-over effects of fatigue by comparing brain activation before and after the fatiguing condition during simple and high-order motor tasks (reaction time tasks). Several motor areas in the brain showed increased activity with increased muscle activity, both during force modulation and motor fatigue. Interestingly, the cerebellum showed a smaller increase in activation, during compensatory activation due to fatigue, while additional activation was found in the pre-supplementary motor area and in a frontal area. During motor fatigue, there was a decrease in force production, an increase in force variability, and an increase in muscle activity. Brain areas comparable with the aforementioned areas also showed stronger activation over time. After fatigue, reaction time task performance remained the same (compared to before fatigue), while increased activation in orbitofrontal areas was found. Furthermore, there was a reduction in subjects' maximal voluntary contraction force, accompanied by a decrease in activation of the supplementary motor area (SMA). These results suggest that especially the activity in the SMA and frontal areas is affected by motor fatigue.

Fatigue and functional performance of human biceps muscle following concentric or eccentric contractions

A long-lasting fatigue was measured in human biceps muscle, following 40 maximal isokinetic concentric or eccentric contractions of the forearm, as the response to single-shock stimuli every minute for 4 h. This protocol allowed new observations on the early time course of long-lasting fatigue. Concentric contractions induced a novel progressive decline to 30.2% (SE 7.8, n = 7) of control at 23 min with complete recovery by 120 min. Eccentric contractions lead initially to a smaller force reduction of similar time course followed by a slower decline to 40.0% (SE 5.1, n = 7) control at 120 min with recovery less than half complete at 4 h. A 50-Hz test stimuli overcame both fatigues, identifying low-frequency fatigue. EMG recordings from the biceps muscle showed moderate (<20%) changes during the fatigue. A visual-tracking task showed no decrement in performance at the time of maximal fatigue of the single-shock response. Because the eccentric contractions have a similar activation, a larger force, but much smaller metabolic usage than concentric contractions, it is concluded that the initial decline is related to the effects of metabolites, whereas the slower phase after eccentric contractions is associated with higher mechanical stress.

Bereitschaftspotential and movement-related potentials: Origin, significance, and application in disorders of human movement

The existence of a slow negative wave, the Bereitschaftspotential ("BP"), preceding voluntary movement by 1 second or more was first reported more than 40 years ago. There appears to be considerable interindividual differences, but there is general agreement that the initial negativity actually consists of two distinct phases. Uncertainty remains about many other properties and features of the response, including nomenclature, which makes the existing literature difficult to synthesize. The duration of the premovement negativity raises questions about how and when voluntary movement is initiated. Premovement negativities can also be seen before (predictably) externally paced movement, and these have similarities to the BP. Although lateralized generators exist, it is likely that the majority of the early component of the BP (BP1 or early BP), arises from the anterior supplementary motor area (SMA) and more rostral pre-SMA. The late phase of the BP (BP2 or late BP) is probably generated by activity in both the SMA proper and the contralateral motor cortex. Changes in the BP occur in several movement disorders, notably Parkinson's disease, in which the pattern is consistent with a failure of pre-SMA activation. The presence (or absence) of a clear preceding negativity can also have diagnostic importance for certain movement disorders.

Central adaptations during repetitive contractions assessed by the readiness potential

Physiological fatigue, a loss of maximal force producing capacity, may originate both from changes at the peripheral and at the central level. The readiness potential (RP) provides a measure to study adaptations to physiological fatigue at the motor cortex. We have studied the RP in the course of repetitive contractions at a high force level. Fourteen female healthy subjects made repetitive force grip contractions at 70% of their maximal voluntary contraction (MVC) for 30 min. Contractions were self-paced and inter-squeeze interval was about 7 s. During the repetitive contractions, the area under the curve of the RP almost doubled at electrode Cz and increased fourfold at electrodes C3' and C4'. The onset of negativity moved forward from 1.5 to 1.9 s before force onset at Cz and from 1.0 to 1.6 s and 1.7 s before force onset at C3' and C4', respectively. EMG amplitude and median frequency did not change significantly and MVC after the fatiguing exercise was 93% of MVC before, indicating relatively little physiological fatigue. The increase of the RP during the repetitive contractions is clearly in excess of the almost absent signs of peripheral fatigue. Because the increase of the RP does not lead to an increased force production, we propose that it is a central adaptation counteracting the decrease of cortical efficiency during repetitive contractions.

An Experimental Study to Investigate the Effects of a Motion Tracking Electromagnetic Sensor During EEG Data Acquisition

A power spectral analysis study was conducted to investigate the effects of using an electromagnetic motion tracking sensor on an electroencephalogram (EEG) recording system. The results showed that the sensors do not generate any consistent frequency component(s) in the power spectrum of the EEG in the frequencies of interest (0.1-55 Hz).

Electrophysiological evidence for cortical plasticity with movement repetition

The role of movement repetition and practice has been extensively studied as an aspect of motor skill learning but has rarely been investigated in its own right. As practice is considered a prerequisite for motor learning we expected that even the repetitive execution of a simple movement would rapidly induce changes in neural activations without changing performance. We used 64-channel event-related potential mapping to investigate these effects of movement repetition on corresponding brain activity in humans. Ten healthy right-handed young adults performed a power grip task under visual force control to ensure constant behaviour during the experimental session. The session consisted of two parts intersected by a break. For analysis each part was subdivided into two runs to control for potential attention or fatigue effects, which would be expected to disappear during the break. Microstate analysis revealed that distinct topographies and source configurations during movement preparation, movement execution and feedback integration are responsive to repetition. The observed patterns of changes differed for the three microstates, suggesting that different, repetition-sensitive neural mechanisms are involved. Moreover, this study clearly confirms that movement repetition, in the absence of skill learning, is capable of inducing changes in neural networks.

Movement related potentials in acutely induced weakness and stroke

Weakness is a common symptom of neurological illness, and recovery may occur via restorative or compensatory mechanisms. Functional imaging studies have shown varied patterns of activity in motor areas following recovery from stroke. Movement related potentials (MRP) reflect the activity in primary and non-primary motor areas. We recorded MRPs in association with index finger abduction in six normal volunteers before and after induced weakness of a hand muscle and in six stroke patients with subcortical lesions and weakness affecting the arm. In both groups of subjects the greatest change was observed in the motor potential component of the MRP. On average, the motor potential had its greatest amplitude and duration at the time of the greatest weakness and became smaller with recovery. In artificially-induced weakness, the MRP had an earlier onset latency (P=0.042) and a greater early BP component (P=0.05) for the weakened finger. For the stroke subjects overall, the peak and NS' amplitudes were largest for the initial study and declined thereafter. Similar but smaller changes were present for movements of the clinically unaffected side. The increased motor potential is therefore consistent with increased activity in the motor cortex, and this may occur as compensation for weakness in both normals and after stroke.

Movement-related cortical potentials in myotonic dystrophy

OBJECTIVE

To investigate a possible deficit of the voluntary movement mechanism within the central nervous system (CNS) in patients with myotonic dystrophy (MyD).

METHODS

Movement-related cortical potentials preceding voluntary extension of the right middle and index fingers were studied in 9 patients with MyD and compared with those in 11 age-matched healthy subjects and 9 age-matched patients with other neuromuscular disorders (NMDs).

RESULTS

The amplitudes of Bereitschaftspotential was smaller in MyD patients than in age-matched controls and age-matched patients with other NMDs although there was no statistically significant difference. The amplitude of negative slope was significantly smaller in MyD patients than in age-matched controls and age-matched patients with other NMDs. Clinical findings such as age, disease duration, degree of motor impairment and cognitive function had no effect on the individual electrophysiological parameters.

CONCLUSIONS

The present results suggest that subclinical abnormalities exist in CNS function associated with motor preparation and execution, which is independent of muscle weakness.