Complex tools and motor-to-mechanical transformations

Object-oriented hand dexterity and grasping abilities, from the animal quarters to the neurosurgical OR: a systematic review of the underlying neural correlates in non-human, human primate and recent findings in awake brain surgery

Introduction

The sensorimotor integrations subserving object-oriented manipulative actions have been extensively investigated in non-human primates via direct approaches, as intracortical micro-stimulation (ICMS), cytoarchitectonic analysis and anatomical tracers. However, the understanding of the mechanisms underlying complex motor behaviors is yet to be fully integrated in brain mapping paradigms and the consistency of these findings with intraoperative data obtained during awake neurosurgical procedures for brain tumor removal is still largely unexplored. Accordingly, there is a paucity of systematic studies reviewing the cross-species analogies in neural activities during object-oriented hand motor tasks in primates and investigating the concordance with intraoperative findings during brain mapping. The current systematic review was designed to summarize the cortical and subcortical neural correlates of object-oriented fine hand actions, as revealed by fMRI and PET studies, in non-human and human primates and how those were translated into neurosurgical studies testing dexterous hand-movements during intraoperative brain mapping.

Methods

A systematic literature review was conducted following the PRISMA guidelines. PubMed, EMBASE and Web of Science databases were searched. Original articles were included if they: (1) investigated cortical activation sites on fMRI and/or PET during grasping task; (2) included humans or non-human primates. A second query was designed on the databases above to collect studies reporting motor, hand manipulation and dexterity tasks for intraoperative brain mapping in patients undergoing awake brain surgery for any condition. Due to the heterogeneity in neurosurgical applications, a qualitative synthesis was deemed more appropriate.

Results

We provided an updated overview of the current state of the art in translational neuroscience about the extended frontoparietal grasping-praxis network with a specific focus on the comparative functioning in non-human primates, healthy humans and how the latter knowledge has been implemented in the neurosurgical operating room during brain tumor resection.

Discussion

The anatomical and functional correlates we reviewed confirmed the evolutionary continuum from monkeys to humans, allowing a cautious but practical adoption of such evidence in intraoperative brain mapping protocols. Integrating the previous results in the surgical practice helps preserve complex motor abilities, prevent long-term disability and poor quality of life and allow the maximal safe resection of intrinsic brain tumors.

The functional organization of skilled actions in the adextral and atypical brain

When planning functional grasps of tools, right-handed individuals (dextrals) show mostly left-lateralized neural activity in the praxis representation network (PRN), regardless of the used hand. Here we studied whether or not similar cerebral asymmetries are evident in non-righthanded individuals (adextrals). Sixty two participants, 28 righthanders and 34 non-righthanders (21 lefthanders, 13 mixedhanders), planned functional grasps of tools vs. grasps of control objects, and subsequently performed their pantomimed executions, in an event-related functional magnetic resonance imaging (fMRI) project. Both hands were tested, separately in two different sessions, counterbalanced across participants. After accounting for non-functional components of the prospective grasp, planning functional grasps of tools was associated with greater engagement of the same, left-hemisphere occipito-temporal, parietal and frontal areas of PRN, regardless of hand and handedness. Only when the analyses involved signal changes referenced to resting baseline intervals, differences between adextrals and dextrals emerged. Whereas in the left hemisphere the neural activity was equivalent in both groups (except for the occipito-temporo-parietal junction), its increases in the right occipito-temporal cortex, medial intraparietal sulcus (area MIP), the supramarginal gyrus (area PFt/PF), and middle frontal gyrus (area p9-46v) were significantly greater in adextrals. The inverse contrast was empty. Notably, when individuals with atypical and typical hemispheric phenotypes were directly compared, planning functional (vs. control) grasps invoked, instead, significant clusters located nearly exclusively in the left hemisphere of the typical phenotype. Previous studies interpret similar right-sided vs. left-sided increases in neural activity for skilled actions as handedness dependent, i.e., located in the hemisphere dominant for manual skills. Yet, none of the effects observed here can be purely handedness dependent because there were mixed-handed individuals among adextrals, and numerous mixed-handed and left-handed individuals possess the typical phenotype. Thus, our results clearly show that hand dominance has limited power in driving the cerebral organization of motor cognitive functions.

Physical Education with Eduball Stimulates Non-Native Language Learning in Primary School Students

Although the neuronal mechanisms of action and cognition are related, the division of intellectual and physical lessons is standard in schools. This is surprising, because numerous studies show that integrating physical education (PE) with teaching content stimulates critical skills. For example, several experiments indicate that Eduball-based PE (i.e., lessons in a sports hall during which students play team mini-games with educational balls with printed letters, numbers, and other signs) develops mathematical and language competencies. At the same time, the Eduball method does not slow down learners’ physical development. However, we have little knowledge about the effects of such techniques on non-native language learning. Consequently, the absence of incorporating core academic subjects into PE in dual-language schools or during foreign language education is exceptionally high. Here, we replicated the Eduball experiment, but with the goal of testing this method for non-native language learning. Thus, the intervention occurred in a dual-language primary school and we evaluated second language (L2) learning. As before, we used the technique of parallel groups (experimental and control); in both groups, there were three 45-min PE classes per week. In the experimental class, two of them were held using Eduball. After a half-year experiment, children from the experimental group (one second-grade, N = 14) improved their non-native language skills significantly more than their peers from the control group (one second-grade, N = 12). These findings demonstrate that Eduball-type intervention stimulates non-native language learning in children. Hence, our report suggests that specific body training forms can support L2 learning.

Action goals and the praxis network: an fMRI study

The praxis representation network (PRN) of the left cerebral hemisphere is typically linked to the control of functional interactions with familiar tools. Surprisingly, little is known about the PRN engagement in planning and execution of tool-directed actions motivated by non-functional but purposeful action goals. Here we used functional neuroimaging to perform both univariate and multi-voxel pattern analyses (MVPA) in 20 right-handed participants who planned and later executed, with their dominant and non-dominant hands, disparate grasps of tools for different goals, including: (1) planning simple vs. demanding functional grasps of conveniently vs. inconveniently oriented tools with an intention to immediately use them, (2) planning simple—but non-functional—grasps of inconveniently oriented tools with a goal to pass them to a different person, (3) planning reaching movements directed at such tools with an intention to move/push them with the back of the hand, and (4) pantomimed execution of the earlier planned tasks. While PRN contributed to the studied interactions with tools, the engagement of its critical nodes, and/or complementary right hemisphere processing, was differently modulated by task type. E.g., planning non-functional/structural grasp-to-pass movements of inconveniently oriented tools, regardless of the hand, invoked the left parietal and prefrontal nodes significantly more than simple, non-demanding functional grasps. MVPA corroborated decoding capabilities of critical PRN areas and some of their right hemisphere counterparts. Our findings shed new lights on how performance of disparate action goals influences the extraction of object affordances, and how or to what extent it modulates the neural activity within the parieto-frontal brain networks.