Regional cerebral blood flow changes in human brain related to ipsilateral and contralateral complex hand movements--a PET study

Observing an expert's action swapped with an observer's face increases corticospinal excitability during combined action observation and motor imagery

This study aimed to examine whether observing an expert's action swapped with an observer's face increases corticospinal excitability during combined action observation and motor imagery (AOMI). Twelve young males performed motor imagery of motor tasks with different difficulties while observing the actions of an expert performer and an expert performer with a swapped face. Motor tasks included bilateral wrist dorsiflexion (EASY) and unilateral two-ball rotating motions (DIFF). During the AOMI of EASY and DIFF, single-pulse transcranial magnetic stimulation was delivered to the left primary motor cortex, and motor-evoked potentials (MEPs) were obtained from the extensor carpi ulnaris and first dorsal interosseous muscles of the right upper limb, respectively. Visual analogue scale (VAS) assessed the subjective similarity of the expert performer with the swapped face in the EASY and DIFF to the participants themselves. The MEP amplitude in DIFF was larger in the observation of the expert performer with the swapped face than that of the expert performer (P = 0.012); however, the corresponding difference was not observed in EASY (P = 1.000). The relative change in the MEP amplitude from observing the action of the expert performer to that of the expert performer with the swapped face was positively correlated with VAS only in DIFF (r = 0.644, P = 0.024). These results indicate that observing the action of an expert performer with the observer's face enhances corticospinal excitability during AOMI, depending on the task difficulty and subjective similarity between the expert performer being observed and the observer.

Effects of repetitive practice of motor tasks on somatosensory gating

Introduction

During voluntary muscle contraction, the amplitude of the somatosensory evoked potential (SEP) is reduced by inhibiting sensory information from a peripheral nerve supplying the contracted muscle. This phenomenon is called “gating.” We reported that participants with good motor skills indicated strong suppression of somatosensory information. The present study investigated the effects of motor performance improvement following repetitive practice on the SEP amplitude.

Methods

The ball rotation task (BR task) was practiced by 15 healthy participants repetitively. SEPs were recorded before (pre) and after (post) repetitive practice.

Results

The BR task performance was significantly improved and the required muscle activation to perform the task was significantly reduced after the repetitive practice. The degree of gating was not significant between pre and post- for the SEP amplitude. A significant correlation was found between changes in SEP amplitude from pre to post and performance improvement.

Discussion

After repetitive practice, the degree of gating did not change, but the performance of the BR task improved, and the muscle activity required for the BR task decreased. These results suggest that repetitive practice does not change the degree of gating but changes the mechanism of gating. Furthermore, they indicate that suppression of the somatosensory area may play a role in improving task performance.

Impacts of simplifying articulation movements imagery to speech imagery BCI performance

Objective.Speech imagery (SI) can be used as a reliable, natural, and user-friendly activation task for the development of brain-computer interface (BCI), which empowers individuals with severe disabilities to interact with their environment. The functional near-infrared spectroscopy (fNIRS) is advanced as one of the most suitable brain imaging methods for developing BCI systems owing to its advantages of being non-invasive, portable, insensitive to motion artifacts, and having relatively high spatial resolution.Approach.To improve the classification performance of SI BCI based on fNIRS, a novel paradigm was developed in this work by simplifying the articulation movements in SI to make the articulation movement differences clearer between different words imagery tasks. A SI BCI was proposed to directly answer questions by covertly rehearsing the word '' or '' ('yes' or 'no' in English), and an unconstrained rest task also was contained in this BCI. The articulation movements of SI were simplified by retaining only the movements of the jaw and lips of vowels in Chinese Pinyin for words '' and ''.Main results.Compared with conventional speech imagery, simplifying the articulation movements in SI could generate more different brain activities among different tasks, which led to more differentiable temporal features and significantly higher classification performance. The average 3-class classification accuracies of the proposed paradigm across all 20 participants reached 69.6% and 60.2% which were about 10.8% and 5.6% significantly higher than those of the conventional SI paradigm operated in the 0-10 s and 0-2.5 s time windows, respectively.Significance.These results suggested that simplifying the articulation movements in SI is promising for improving the classification performance of intuitive BCIs based on speech imagery.

The relationships between motor behavior and sensory gating in the ball rotation task

During voluntary muscle contraction, sensory information induced by electrostimulation of the nerves supplying the contracting muscle is inhibited and the amplitude of the corresponding somatosensory evoked potential (SEP) decreases. This phenomenon is called "gating." The reduction of the SEP amplitude is reportedly significantly larger when task performance is high. However, the relationship between dexterous movement skills and gating remains unclear. In this study, we investigated through a ball rotation (BR) task how dexterous movement skills affect the SEP amplitudes. Thirty healthy subjects performed the BR task comprising the rotation of two wooden balls as quickly as possible. We estimated the median number of ball rotations for each participant and classified the participants into two (fast and slow) groups based on the results. Moreover, we recorded SEPs, while the subjects performed BR tasks or rested. SEP amplitude reduction (P45) was significantly larger in the fast than in the slow group. We also observed that the P45 amplitude during the BR task was attenuated even more so in the case of the participants with better dexterous movement skills. Our results suggest that the participants with better dexterous movement skills might display stronger somatosensory information suppression because of increasing the motor cortex activity and the afferent input during the BR task.

Engagement of the contralateral limb can enhance the facilitation of motor output by loud acoustic stimuli

When intense sound is presented during light muscle contraction, inhibition of the corticomotoneuronal pathway is observed. During action preparation, this effect is reversed, with sound resulting in excitation of the corticomotoneuronal pathway. We investigated how combined maintenance of a muscle contraction during preparation for a ballistic action impacts the magnitude of the facilitation of motor output by a loud acoustic stimulus (LAS) - a phenomenon known as the StartReact effect. Participants executed ballistic wrist flexion movements and a LAS was presented simultaneously with the imperative signal in a subset of trials. We examined whether the force level or muscle used to maintain a contraction during preparation for the ballistic response impacted reaction time and/or the force of movements triggered by the LAS. These contractions were sustained either ipsilaterally or contralaterally to the ballistic response. The magnitude of facilitation by the LAS was greatest when low force flexion contractions were maintained in the limb contralateral to the ballistic response during preparation. There was little change in facilitation when contractions recruited the contralateral extensor muscle, or when they were sustained in the same limb that executed the ballistic response. We conclude that a larger network of neurons which may be engaged by a contralateral sustained contraction prior to initiation may be recruited by the LAS, further contributing to the motor output of the response. These findings may be particularly applicable in stroke rehabilitation where engagement of the contralesional side may increase the benefits of a LAS to the functional recovery of movement.

Repetitive training of contralateral limb through reconsolidation strengthens motor skills

Consolidated memories become transiently labile after memory reactivation, allowing update through reconsolidation. Although previous reports have indicated that the effects of post-reactivation training depend on the type of practice, it is unclear whether post-reactivation motor skill training of one limb can enhance the performance of the opposite limb. The present study aimed to investigate whether post-reactivation training (performing an isometric pinch force task) under two different training conditions using the left limb would enhance motor skills of the right limb through reconsolidation. Motor skills were measured in 38 healthy right-handed young adults during three sessions (S): S1 (right-hand training), S2 (memory reactivation and left-hand training 6 h after S1), and S3 (right-hand motor skill test 24 h after S1). Participants were assigned to one of three groups according to the task performed during S2: untrained controls (no training), left-hand training (constant force conditions), or left-hand training (variable force conditions). Left-hand training after memory reactivation during S2 significantly enhanced the motor skills of the right hand. Notably, constant training conditions significantly increased performance compared to the control group. These findings suggest that post-reactivation training in one limb effectively enhances motor skills in the opposite limb, and the effects depend on the training strategy, which has important implications for motor rehabilitation.

Importance of the Primary Motor Cortex in Development of Human Hand/Finger Dexterity

Hand/finger dexterity is well-developed in humans, and the primary motor cortex (M1) is believed to play a particularly important role in it. Here, we show that efficient recruitment of the contralateral M1 and neuronal inhibition of the ipsilateral M1 identified by simple hand motor and proprioceptive tasks are related to hand/finger dexterity and its ontogenetic development. We recruited healthy, right-handed children (n = 21, aged 8–11 years) and adults (n = 23, aged 20–26 years) and measured their brain activity using functional magnetic resonance imaging during active and passive right-hand extension–flexion tasks. We calculated individual active control-related activity (active–passive) to evaluate efficient brain activity recruitment and individual task-related deactivation (neuronal inhibition) during both tasks. Outside the scanner, participants performed 2 right-hand dexterous motor tasks, and we calculated the hand/finger dexterity index (HDI) based on their individual performance. Participants with a higher HDI exhibited less active control-related activity in the contralateral M1 defined by the active and passive tasks, independent of age. Only children with a higher HDI exhibited greater ipsilateral M1 deactivation identified by these tasks. The results imply that hand/finger dexterity can be predicted by recruitment and inhibition styles of the M1 during simple hand sensory–motor tasks.

Hemodynamic Signal Changes During Motor Imagery Task Performance Are Associated With the Degree of Motor Task Learning

Purpose

This study aimed to investigate whether oxygenated hemoglobin (oxy-Hb) generated during a motor imagery (MI) task is associated with the motor learning level of the task.

Methods

We included 16 right-handed healthy participants who were trained to perform a ball rotation (BR) task. Hemodynamic brain activity was measured using near-infrared spectroscopy to monitor changes in oxy-Hb concentration during the BR MI task. The experimental protocol used a block design, and measurements were performed three times before and after the initial training of the BR task as well as after the final training. The BR count during training was also measured. Furthermore, subjective vividness of MI was evaluated three times after NIRS measurement using the Visual Analog Scale (VAS).

Results

The results showed that the number of BRs increased significantly with training (P < 0.001). VAS scores also improved with training (P < 0.001). Furthermore, oxy-Hb concentration and the region of interest (ROI) showed a main effect (P = 0.001). An interaction was confirmed (P < 0.001), and it was ascertained that the change in oxy-Hb concentrations due to training was different for each ROI. The most significant predictor of subjective MI vividness was supplementary motor area (SMA) oxy-Hb concentration (coefficient = 0.365).

Discussion

Hemodynamic brain activity during MI tasks may be correlated with task motor learning levels, since significant changes in oxy-Hb concentrations were observed following initial and final training in the SMA. In particular, hemodynamic brain activity in the SMA was suggested to reflect the MI vividness of participants.

Excitability of the Ipsilateral Primary Motor Cortex During Unilateral Goal-Directed Movement

Introduction

Previous transcranial magnetic stimulation (TMS) studies have revealed that the activity of the primary motor cortex ipsilateral to an active hand (ipsi-M1) plays an important role in motor control. The aim of this study was to investigate whether the ipsi-M1 excitability would be influenced by goal-directed movement and laterality during unilateral finger movements.

Method

Ten healthy right-handed subjects performed four finger tapping tasks with the index finger: (1) simple tapping (Tap) task, (2) Real-word task, (3) Pseudoword task, and (4) Visually guided tapping (VT) task. In the Tap task, the subject performed self-paced simple tapping on a touch screen. In the real-word task, the subject tapped letters displayed on the screen one by one to create a Real-word (e.g., apple). Because the action had a specific purpose (i.e., creating a word), this task was considered to be goal-directed as compared to the Tap task. In the Pseudoword task, the subject tapped the letters to create a pseudoword (e.g., gdiok) in the same manner as in the Real-word task; however, the word was less meaningful. In the VT task, the subject was required to touch a series of illuminated buttons. This task was considered to be less goal-directed than the Pseudoword task. The tasks were performed with the right and left hand, and a rest condition was added as control. Single- and paired-pulse TMS were applied to the ipsi-M1 to measure corticospinal excitability and short- and long-interval intracortical inhibition (SICI and LICI) in the resting first dorsal interosseous (FDI) muscle.

Results

We found the smaller SICI in the ipsi-M1 during the VT task compared with the resting condition. Further, both SICI and LICI were smaller in the right than in the left M1, regardless of the task conditions.

Discussion

We found that SICI in the ipsi-M1 is smaller during visual illumination-guided finger movement than during the resting condition. Our finding provides basic data for designing a rehabilitation program that modulates the M1 ipsilateral to the moving limb, for example, for post-stroke patients with severe hemiparesis.

Use of computational fluid dynamics for 3D fiber tract visualization on human high-thickness histological slices: histological mesh tractography

Understanding the intricate three-dimensional relationship between fiber bundles and subcortical nuclei is not a simple task. It is of paramount importance in neurosciences, especially in the field of functional neurosurgery. The current methods for in vivo and post mortem fiber tract visualization have shortcomings and contributions to the field are welcome. Several tracts were chosen to implement a new technique to help visualization of white matter tracts, using high-thickness histology and dark field images. Our study describes the use of computational fluid dynamic simulations for visualization of 3D fiber tracts segmented from dark field microscopy in high-thickness histological slices (histological mesh tractography). A post mortem human brain was MRI scanned prior to skull extraction, histologically processed and serially cut at 430 µm thickness as previously described by our group. High-resolution dark field images were used to segment the outlines of the structures. These outlines served as basis for the construction of a 3D structured mesh, were a Finite Volume Method (FVM) simulation of water flow was performed to generate streamlines representing the geometry. The simulations were accomplished by an open source computer fluid dynamics software. The resulting simulation rendered a realistic 3D impression of the segmented anterior commissure, the left anterior limb of the internal capsule, the left uncinate fascicle, and the dentato-rubral tracts. The results are in line with clinical findings, diffusion MR imaging and anatomical dissection methods.

Response preparation involves a release of intracortical inhibition in task-irrelevant muscles

Action preparation involves widespread modulation of motor system excitability, but the precise mechanisms are unknown. In this study, we investigated whether intracortical inhibition changes in task-irrelevant muscle representations during action preparation. We used transcranial magnetic stimulation (TMS) combined with electromyography in healthy human adults to measure motor-evoked potentials (MEPs) and cortical silent periods (CSPs) in task-irrelevant muscles during the preparatory period of simple delayed response tasks. In experiment 1, participants responded with the left index finger in one task condition and the right index finger in another task condition, whereas MEPs and CSPs were measured from the contralateral nonresponding and tonically contracted index finger. During experiment 2, participants responded with the right pinky finger whereas MEPs and CSPs were measured from the tonically contracted left index finger. In both experiments, MEPs and CSPs were compared between the task preparatory period and a resting intertrial baseline. The CSP duration during response preparation decreased from baseline in every case. A laterality difference was also observed in experiment 1, with a greater CSP reduction during the preparation of left finger responses compared to right finger responses. Despite reductions in CSP duration, consistent with a release of intracortical inhibition, MEP amplitudes were smaller during action preparation when accounting for background levels of muscle activity, consistent with earlier studies that reported decreased corticospinal excitability. These findings indicate that intracortical inhibition associated with task-irrelevant muscles is transiently released during action preparation and implicate a novel mechanism for the controlled and coordinated release of motor cortex inhibition.NEW & NOTEWORTHY In this study, we observed the first evidence of a release of intracortical inhibition in task-irrelevant muscle representations during response preparation. We applied transcranial magnetic stimulation to elicit cortical silent periods in task-irrelevant muscles during response preparation, and observed a consistent decrease in the silent period duration relative to a resting baseline. These findings address the question of whether cortical mechanisms underlie widespread modulation in motor excitability during response preparation.

Characterizing hemodynamic response alterations during basketball dribbling

Knowledge on neural processing during complex non-stationary motion sequences of sport-specific movements still remains elusive. Hence, we aimed at investigating hemodynamic response alterations during a basketball slalom dribbling task (BSDT) using multi-distance functional near-infrared spectroscopy (fNIRS) in 23 participants (12 females). Additionally, we quantified how the brain adapts its processing as a function of altered hand use (dominant right hand (DH) vs. non-dominant left hand (NDH) vs. alternating hands (AH)) and pace of execution (slow vs. fast) in BSDT. We found that BSDT activated bilateral premotor cortex (PMC), supplementary motor cortex (SMA), primary motor cortex (M1) as well as inferior parietal cortex and somatosensory association cortex. Slow dominant hand dribbling (DH_slow) evoked lower contralateral hemodynamic responses in sensorimotor regions compared to fast dribbling (DH_fast). Furthermore, during DH_slow dribbling, we found lower hemodynamic responses in ipsilateral M1 as compared to dribbling with alternating hands (AH_slow). Hence, altered task complexity during BSDT induced differential hemodynamic response patterns. Furthermore, a correlation analysis revealed that lower levels of perceived task complexity are associated with lower hemodynamic responses in ipsilateral PMC-SMA, which is an indicator for neuronal efficiency in participants with better basketball dribbling skills. The present study extends previous findings by showing that varying levels of task complexity are reflected by specific hemodynamic response alterations even during sports-relevant motor behavior. Taken together, we suggest that quantifying brain activation during complex movements is a prerequisite for assessing brain-behavior relations and optimizing motor performance.

Effects of Transcranial Direct Current Stimulation on Hand Dexterity in Multiple Sclerosis: A Design for a Randomized Controlled Trial

BACKGROUND

Cerebellar and motor tracts are frequently impaired in multiple sclerosis (MS). Altered hand dexterity constitutes a challenge in clinical practice, since medical treatment shows very limited benefits in this domain. Cerebellar control is made via several cerebellocortical pathways, of which the most studied one links the cerebellum to the contralateral motor cortex via the contralateral ventro-intermediate nucleus of the thalamus influencing the corticospinal outputs. Modulating the activity of the cerebellum or of the motor cortex could be of help.

METHOD

The main interest here is to evaluate the efficacy of transcranial direct current stimulation (tDCS), a noninvasive brain stimulation technique, in treating altered dexterity in MS. Forty-eight patients will be recruited in a randomized, double-blind, sham-controlled, and crossover study. They will randomly undergo one of the three interventions: anodal tDCS over the primary motor area, cathodal tDCS over the cerebellum, or sham. Each block consists of five consecutive daily sessions with direct current (2 mA), lasting 20 min each. The primary outcome will be the improvement in manual dexterity according to the change in the time required to complete the nine-hole pegboard task. Secondary outcomes will include fatigue, pain, spasticity, and mood. Patients' safety and satisfaction will be rated.

DISCUSSION

Due to its cost-effective, safe, and easy-to-use profile, motor or cerebellar tDCS may constitute a potential tool that might improve dexterity in MS patients and therefore ameliorate their quality of life.

Effects of Task Complexity on Motor Imagery-Based Brain-Computer Interface

The performance of electroencephalogram (EEG)-based brain-computer interfaces (BCIs) still needs improvements for real world applications. An improvement on BCIs could be achieved by enhancing brain signals from the source via subject intention-based modulation. In this work, we aim to investigate the effects of task complexity on performance of motor imagery (MI) based BCIs. In specific, we studied the effects of motor imagery of a complex task versus a simple task on discriminability of brain activation patterns using EEG. The results show an increase of up to 7.25% in BCI classification accuracy for motor imagery of the complex task in comparison to the simple task. Furthermore, spectral power analysis in low frequency bands, alpha and beta, shows a significant decrease in power value for the complex task. However, high frequency gamma band analysis unveils a significant increase for the complex task. These findings may lead to designing better BCIs with high performance.

Neural Organization of Hierarchical Motor Sequence Representations in the Human Neocortex

Although it is widely accepted that the brain represents movement sequences hierarchically, the neural implementation of this organization is still poorly understood. To address this issue, we experimentally manipulated how participants represented sequences of finger presses at the levels of individual movements, chunks, and entire sequences. Using representational fMRI analyses, we then examined how this hierarchical structure was reflected in the fine-grained brain activity patterns of the participants while they performed the 8 trained sequences. We found clear evidence of each level of the movement hierarchy at the representational level. However, anatomically, chunk and sequence representations substantially overlapped in the premotor and parietal cortices, whereas individual movements were uniquely represented in the primary motor cortex. The findings challenge the common hypothesis of an orderly anatomical separation of different levels of an action hierarchy and argue for a special status of the distinction between individual movements and sequential context.

The effect of walnut rolling training on hand function and corticospinal tract

Background

We investigated the effect of the walnut rolling training for two weeks on the hand function and corticospinal tract (CST) in normal subjects.

Methods

Seventeen right-handed normal subjects performed walnut rolling training with their non-dominant (left) hand, with the right hand defined as the control side. The walnut rolling training was performed three times daily, for 30 minutes at a time, over two weeks. The Purdue Pegboard Test (PPT), tip pinch and grip strength (GS) were used evaluate the change of hand function, and diffusion tensor tractography (DTT) evaluated change of the CST and transcallosal fibers for the hand motor somatotopy.

Results

All of the clinical scores in terms of PPT, tip pinch and GS increased significantly in the post-training (PPT: 16.59±1.09, tip pinch: 5.03±2.18, GS: 40.61±10.99) in the left hand compared with pre-training (PPT: 14.94±1.36, tip pinch: 3.66±1.44, GS: 33.58±11.08) (P<0.05). By contrast, the clinical scores for the right hand did not differ significantly between pre- (PPT: 16.25±1.98, tip pinch: 5.75±2.26, GS: 37.58±14.61) and post-training (PPT: 16.97±1.67, tip pinch: 5.66±2.31, GS: 37.82±14.25). The fiber numbers (FN) of the right CST increased significantly in post-training DTT (2,123.05±529.07) compared with pre-training DTT (1,734.73±581.84) (P<0.05), whereas fractional anisotropy (FA) (pre-training: 0.50±0.02, post-training: 0.51±0.01) did not change significantly. Neither FA nor FN of the left CST and transcallosal fibers changed significantly from pre- (FA: 0.44±0.02, FN: 1,871.15±636.36) to post-training DTTs (FA: 0.45±0.03, FN: 1,823.84±701.14).

Conclusions

We demonstrated improvement of hand function and facilitation of the contralateral CST by walnut rolling training in normal subjects. Our results suggest that walnut rolling training can be used for improvement of hand function and facilitation of the contralateral CST.

Evaluating Peripersonal Space through the Functional Transcranial Doppler: Are We Paving the Way for Early Detecting Mild Cognitive Impairment to Dementia Conversion?

BACKGROUND

Identifying the patients with mild cognitive impairment (MCI) who may develop dementia (MDC) is challenging. The study of peripersonal space (PPS) by using functional transcranial Doppler (fTCD) could be used for this purpose.

OBJECTIVE

To identify changes in cerebral blood flow (CBF) during motor tasks targeting PPS, which can predict MDC.

METHODS

We evaluated the changes in CBF in 22 patients with MCI and 23 with dementia [Alzheimer's disease (AD) and vascular dementia (VaD)] during a motor task (passive mobilization, motor imagery, and movement observation) in which the hand of the subject moved forward and backward the face.

RESULTS

CBF increased when the hand approached the face and decreased when the hand moved from the face in the healthy controls (HCs). CBF changed were detectable only in patients with MCI but not in those with the AD and those who were MDC after 8-month follow-up. On the other hand, the patients with VaD presented a paradoxical response to the motor task (i.e., a decrease of CBF rather than an increase, as observed in HCs and MCI). Therefore, we found a modulation of PPS-related CBF only in HCs and patients with stable MCI (at the 8-month follow-up).

CONCLUSIONS

fTCD may allow preliminarily differentiating and following-up the patients with MCI and MDC, thus allowing the physician to plan beforehand more individualized cognitive rehabilitative training.

The Role of Human Primary Motor Cortex in the Production of Skilled Finger Sequences

Human primary motor cortex (M1) is essential for producing dexterous hand movements. Although distinct subpopulations of neurons are activated during single-finger movements, it remains unknown whether M1 also represents sequences of multiple finger movements. Using novel multivariate functional magnetic resonance imaging (fMRI) analysis techniques and combining evidence from both 3T and 7T fMRI data, we found that after 5 d of intense practice, premotor and parietal areas encoded the different movement sequences. There was little or no evidence for a sequence representation in M1. Instead, activity patterns in M1 could be fully explained by a linear combination of patterns for the constituent individual finger movements, with the strongest weight on the first finger of the sequence. Using passive replay of sequences, we show that this first-finger effect is due to neuronal processes involved in the active execution, rather than to a hemodynamic nonlinearity. These results suggest that M1 receives increased input from areas with sequence representations at the initiation of a sequence, but that M1 activity itself relates to the execution of component finger presses only. These results improve our understanding of the representation of finger sequences in the human neocortex after short-term training and provide important methodological advances for the study of long-term skill development.SIGNIFICANCE STATEMENT There is clear evidence that human primary motor cortex (M1) is essential for producing individuated finger movements, such as pressing a button. Over and above its involvement in movement execution, it is less clear whether M1 also plays a role in learning and controlling sequences of multiple finger movements, such as when playing the piano. Using cutting-edge multivariate fMRI analysis and carefully controlled experiments, we demonstrate here that, while premotor areas clearly show a sequence representation, activity patterns in M1 can be fully explained from the patterns for individual finger movements. The results provide important new insights into the interplay of M1 and premotor cortex for learning of sequential movements.

Neural mechanism and heritability of complex motor sequence and audiovisual integration: A healthy twin study

Complex motor sequencing and sensory integration are two key items in scales assessing neurological soft signs. However, the underlying neural mechanism and heritability of these two functions is not known. Using a healthy twin design, we adopted two functional brain imaging tasks focusing on fist-edge-palm (FEP) complex motor sequence and audiovisual integration (AVI). Fifty-six monozygotic twins and 56 dizygotic twins were recruited in this study. The pre- and postcentral, temporal and parietal gyri, the supplementary motor area, and the cerebellum were activated during the FEP motor sequence, whereas the precentral, temporal, and fusiform gyri, the thalamus, and the caudate were activated during AVI. Activation in the supplementary motor area during FEP motor sequence and activation in the precentral gyrus and the thalamic nuclei during AVI exhibited significant heritability estimates, ranging from 0.5 to 0.62. These results suggest that activation in cortical motor areas, the thalamus and the cerebellum associated with complex motor sequencing and audiovisual integration function may be heritable.

Neural pattern similarity between contra- and ipsilateral movements in high-frequency band of human electrocorticograms

The cortical motor areas are activated not only during contralateral limb movements but also during ipsilateral limb movements. Although these ipsilateral activities have been observed in several brain imaging studies, their functional role is poorly understood. Due to its high temporal resolution and low susceptibility to artifacts from body movements, the electrocorticogram (ECoG) is an advantageous measurement method for assessing the human brain function of motor behaviors. Here, we demonstrate that contra- and ipsilateral movements share a similarity in the high-frequency band of human ECoG signals. The ECoG signals were measured from the unilateral sensorimotor cortex while patients conducted self-paced movements of different body parts, contra- or ipsilateral to the measurement side. The movement categories (wrist, shoulder, or ankle) of ipsilateral movements were decoded as accurately as those of contralateral movements from spatial patterns of the high-frequency band of the precentral motor area (the primary motor and premotor areas). The decoder, trained in the high-frequency band of ipsilateral movements generalized to contralateral movements, and vice versa, confirmed that the activity patterns related to ipsilateral limb movements were similar to contralateral ones in the precentral motor area. Our results suggest that the high-frequency band activity patterns of ipsilateral and contralateral movements might be functionally coupled to control limbs, even during unilateral movements.

Primary Motor Area Activation during Precision-Demanding versus Simple Finger Movement

The authors used functional magnetic resonance imaging to explore whether the primary motor area (M1) serves a processing role in a finger-movement tracking task, emphasizing attention to accuracy, beyond its execution role of simple movements, with no attention to accuracy. Twenty healthy subjects performed alternating conditions: Rest, involving no finger movement; Track, involving careful control of a cursor along a target pathway with finger extension/flexion movements; and Move, involving finger extension/flexion movements without careful control. The authors compared volume of activated voxels in the M1, blood-oxygen-level-dependent (BOLD) signal intensity of activated voxels in the M1, and BOLD signal intensity of all voxels in the M1 between the Track and Move conditions. The results showed greater volume and signal intensity in both the contralateral and ipsilateral M1 during Track than during Move. Overall, the results suggest that the M1 is engaged not only in the execution of movements but also in spatial and temporal processing to produce accurately controlled movements. These findings invite further work exploring whether precision-demanding movements, such as tracking, form a more potent stimulus for promoting helpful brain reorganization in the M1 during the recovery from stroke than simple repetitive movements.

Motor Lateralization Provides a Foundation for Predicting and Treating Non-paretic Arm Motor Deficits in Stroke

Brain lateralization is a ubiquitous feature of neural organization across the vertebrate spectrum. We have developed a model of motor lateralization that attributes different motor control processes to each cerebral hemisphere. This bilateral hemispheric model of motor control has successfully predicted hemisphere-specific motor control and motor learning deficits in the ipsilesional, or non-paretic, arm of patients with unilateral stroke. We now show across large number and range of stroke patients that these motor performance deficits in the non-paretic arm of stroke patients vary with both the side of the lesion, as well as with the severity of contralesional impairment. This last point can be functionally devastating for patients with severe contralesional paresis because for these individuals, performance of upper extremity activities of daily living depends primarily and often exclusively on ipsilesional arm function. We present a pilot study focused on improving the speed and coordination of ipsilesional arm function in a convenience sample of three stroke patients with severe contralesional impairment. Over a three-week period, patients received a total of nine 1.5 h sessions of training that included intense practice of virtual reality and real-life tasks. Our results indicated substantial improvements in ipsilesional arm movement kinematics, functional performance, and that these improvements carried over to improve functional independence. In addition, the contralesional arm improved in our measure of contralesional impairment, which was likely due to improved participation in activities of daily living. We discuss of our findings for physical rehabilitation.

Changes in Cerebellar Activation After Onabotulinumtoxin A Injections for Spasticity After Chronic Stroke: A Pilot Functional Magnetic Resonance Imaging Study

OBJECTIVE

To investigate the effect of reducing spasticity via onabotulinumtoxin A (Obtx-A) injection on cerebellar activation after chronic stroke during unilateral gripping.

DESIGN

Pre-post, case series.

SETTING

Outpatient spasticity clinic.

PARTICIPANTS

Individuals with chronic spasticity (N=4).

INTERVENTIONS

Upper-limb Obtx-A injection.

MAIN OUTCOME MEASURES

Functional magnetic resonance imaging (fMRI) was used to measure changes in cerebellar activation before and after upper-limb Obtx-A injection. During fMRI testing, participants performed the same motor task before and after injection, which was 15% and 30% of maximum voluntary isometric gripping measured before Obtx-A injection.

RESULTS

After Obtx-A injection, cerebellar activation increased bilaterally during gripping with the paretic hand and during rest. During both pre- and postinjection scans, the paretic hand showed larger cerebellar activation during gripping compared with the nonparetic hand. Cerebellar activation during gripping with the nonparetic hand did not change significantly after Obtx-A injection.

CONCLUSIONS

Reducing spasticity via Obtx-A injection may increase cerebellar activation both during gripping tasks with the paretic hand and during rest. To our knowledge, this is the first study that examines changes in cerebellar activation after spasticity treatment with Obtx-A.

Activity in the brain network for dynamic manipulation of unstable objects is robust to acute tactile nerve block: An fMRI study

OBJECTIVE

To study whether a temporary block of the tactile afferents from the fingers causes altered activity in the neural network for dexterous manipulation.

METHODS

Whole-brain functional Magnetic Resonance Imaging (fMRI) was conducted in 18 healthy subjects, while they compressed an unstable spring between the thumb and index finger of the right hand. Two sensory conditions--with and without tactile input from the fingers--were employed. In the latter condition the digital nerves were blocked by local anesthesia.

RESULTS

Compression of the unstable spring was associated with activity in an earlier described network for object manipulation. We found that this entire network remained active after a nerve block, and the activity was increased in the dorsal premotor cortex.

CONCLUSIONS

The neural network for dexterous manipulation is robust with only minor alterations after acute loss of tactile information from the fingers. There was no loss of activity, but, unexpectedly, an increased activity in some parts of the network.

SIGNIFICANCE

This study gives new insights to possible neural compensatory mechanisms that make fine motor control possible after acute disruption of tactile information in natural situations like cold weather or wearing surgical gloves.

Activity-Dependent Factors Affecting Poststroke Functional Outcomes

Over the last several years, there has been increasing recognition of the potential for central nervous system (CNS) recovery after brain damage. One commonality across the recovery and brain plasticity literature is that practice induces plastic, dynamic changes in the CNS. However, more than simply repetition, it is the manipulation of specific practice variables that appears to drive these dynamic processes in the CNS. The experimental manipulations used in the studies on neuroplasticity largely derive from the concept that in the undamaged or healthy brain neuronal connections and cortical maps are continuously remodeled by experience and by the performance of specific, intensive, and complex movements used to solve motor problems and attain goals. Intervention designed to promote recovery rather than compensation after stroke would then manipulate these same practice variables that have consistently promoted behavioral recovery and neuroplasticity in laboratory settings. Three current intervention strategies that incorporate these practice variables are reviewed. Preliminary results provide evidence that manipulation of task intensity and specificity and the sensorimotor experience of the task training are the necessary ingredients for maximizing the tremendous potential for recovery in patients with stroke.

Handedness can be explained by a serial hybrid control scheme

Our previous studies on healthy individuals and stroke patients led us to propose that the dominant and nondominant arms are specialized for distinct motor control processes. We hypothesize that the dominant arm is specialized for predictive control of limb dynamics, and the nondominant arm is specialized for impedance control. We previously introduced a hybrid control scheme to explain lateralization of single-joint elbow movements. In this paper we apply a similar computational framework to explore interlimb differences in multi-joint reaching movements: the movements of both arms are initiated using predictive control mechanisms, and terminated using impedance mechanisms. Four parameters characterize predictive mechanisms, four parameters characterize impedance mechanisms, and the ninth parameter describes the instant of switch between the two modes of control. Based on our hypothesis of motor lateralization, we predict an early switch to impedance control for the nondominant arm, but a late switch, near the end of motion, for the dominant arm. We fit our model to multi-joint reaching movements of each arm, made in the horizontal plane. Our results reveal that the more curved trajectories of the nondominant arm are characterized by an early switch to impedance mechanisms, in the initial phase of motion near peak velocity. In contrast, the trajectories of the dominant arm were best fit, when the switch to impedance mechanisms occurred late in the deceleration phase of motion. These results support a model of motor lateralization in which the dominant controller is specialized for predictive control of task dynamics, while the nondominant arm is specialized for impedance control mechanisms. For the first time, we are able to operationally define handedness expressed during multi-joint movements by applying a computational control model.

Changes in electroencephalographic activity during observation, preparation, and execution of a motor learning task

This study aimed to compare electroencephalographic (EEG) activity between high- and low-motor learning groups (n = 10 each) during observation of, preparation for, and execution of a motor learning task. The subjects performed a ball rotation task in which two balls were rotated clockwise with the right hand. Each trial started with a rest period (5 s), subjects then observed the task action on a computer screen (30 s), this was followed by another rest (5 s), preparation for performing the action (5 s), and finally action execution (30 s); five trials were performed. The number of rotations during execution and EEG activities during observation, preparation, and execution were recorded. The EEG data of the high-motor learning group were compared with those of the low-motor learning group and were analyzed using exact low-resolution electromagnetic tomography (eLORETA). The left sensorimotor and parietal areas of the high-motor learning group showed a greater decrease in the alpha-2 (10.5-12.0 Hz) and beta-2 (18.5-21.0 Hz) rhythms than those of the low-motor learning group during all three phases of the trials. The study results suggest that the decreases in the alpha-2 and beta-2 rhythms in these areas during observation, preparation, and execution are associated with motor skill improvement.

A quantitative meta-analysis and review of motor learning in the human brain

Neuroimaging studies have improved our understanding of which brain structures are involved in motor learning. Despite this, questions remain regarding the areas that contribute consistently across paradigms with different task demands. For instance, sensorimotor tasks focus on learning novel movement kinematics and dynamics, while serial response time task (SRTT) variants focus on sequence learning. These differing task demands are likely to elicit quantifiably different patterns of neural activity on top of a potentially consistent core network. The current study identified consistent activations across 70 motor learning experiments using activation likelihood estimation (ALE) meta-analysis. A global analysis of all tasks revealed a bilateral cortical–subcortical network consistently underlying motor learning across tasks. Converging activations were revealed in the dorsal premotor cortex, supplementary motor cortex, primary motor cortex, primary somatosensory cortex, superior parietal lobule, thalamus, putamen and cerebellum. These activations were broadly consistent across task specific analyses that separated sensorimotor tasks and SRTT variants. Contrast analysis indicated that activity in the basal ganglia and cerebellum was significantly stronger for sensorimotor tasks, while activity in cortical structures and the thalamus was significantly stronger for SRTT variants. Additional conjunction analyses then indicated that the left dorsal premotor cortex was activated across all analyses considered, even when controlling for potential motor confounds. The highly consistent activation of the left dorsal premotor cortex suggests it is a critical node in the motor learning network.

Stop-event-related potentials from intracranial electrodes reveal a key role of premotor and motor cortices in stopping ongoing movements

In humans, the ability to withhold manual motor responses seems to rely on a right-lateralized frontal–basal ganglia–thalamic network, including the pre-supplementary motor area and the inferior frontal gyrus (IFG). These areas should drive subthalamic nuclei to implement movement inhibition via the hyperdirect pathway. The output of this network is expected to influence those cortical areas underlying limb movement preparation and initiation, i.e., premotor (PMA) and primary motor (M1) cortices. Electroencephalographic (EEG) studies have shown an enhancement of the N200/P300 complex in the event-related potentials (ERPs) when a planned reaching movement is successfully stopped after the presentation of an infrequent stop-signal. PMA and M1 have been suggested as possible neural sources of this ERP complex but, due to the limited spatial resolution of scalp EEG, it is not yet clear which cortical areas contribute to its generation. To elucidate the role of motor cortices, we recorded epicortical ERPs from the lateral surface of the fronto-temporal lobes of five pharmacoresistant epileptic patients performing a reaching version of the countermanding task while undergoing presurgical monitoring. We consistently found a stereotyped ERP complex on a single-trial level when a movement was successfully cancelled. These ERPs were selectively expressed in M1, PMA, and Brodmann's area (BA) 9 and their onsets preceded the end of the stop process, suggesting a causal involvement in this executive function. Such ERPs also occurred in unsuccessful-stop (US) trials, that is, when subjects moved despite the occurrence of a stop-signal, mostly when they had long reaction times (RTs). These findings support the hypothesis that motor cortices are the final target of the inhibitory command elaborated by the frontal–basal ganglia–thalamic network.

Two distinct ipsilateral cortical representations for individuated finger movements

Movements of the upper limb are controlled mostly through the contralateral hemisphere. Although overall activity changes in the ipsilateral motor cortex have been reported, their functional significance remains unclear. Using human functional imaging, we analyzed neural finger representations by studying differences in fine-grained activation patterns for single isometric finger presses. We demonstrate that cortical motor areas encode ipsilateral movements in 2 fundamentally different ways. During unimanual ipsilateral finger presses, primary sensory and motor cortices show, underneath global suppression, finger-specific activity patterns that are nearly identical to those elicited by contralateral mirror-symmetric action. This component vanishes when both motor cortices are functionally engaged during bimanual actions. We suggest that the ipsilateral representation present during unimanual presses arises because otherwise functionally idle circuits are driven by input from the opposite hemisphere. A second type of representation becomes evident in caudal premotor and anterior parietal cortices during bimanual actions. In these regions, ipsilateral actions are represented as nonlinear modulation of activity patterns related to contralateral actions, an encoding scheme that may provide the neural substrate for coordinating bimanual movements. We conclude that ipsilateral cortical representations change their informational content and functional role, depending on the behavioral context.

Processing of hand-related verbs specifically affects the planning and execution of arm reaching movements

Even though a growing body of research has shown that the processing of action language affects the planning and execution of motor acts, several aspects of this interaction are still hotly debated. The directionality (i.e. does understanding action-related language induce a facilitation or an interference with the corresponding action?), the time course, and the nature of the interaction (i.e. under what conditions does the phenomenon occur?) are largely unclear. To further explore this topic we exploited a go/no-go paradigm in which healthy participants were required to perform arm reaching movements toward a target when verbs expressing either hand or foot actions were shown, and to refrain from moving when abstract verbs were presented. We found that reaction times (RT) and percentages of errors increased when the verb involved the same effector used to give the response. This interference occurred very early, when the interval between verb presentation and the delivery of the go signal was 50 ms, and could be elicited until this delay was about 600 ms. In addition, RTs were faster when subjects used the right arm than when they used the left arm, suggesting that action–verb understanding is left-lateralized. Furthermore, when the color of the printed verb and not its meaning was the cue for movement execution the differences between RTs and error percentages between verb categories disappeared, unequivocally indicating that the phenomenon occurs only when the semantic content of a verb has to be retrieved. These results are compatible with the theory of embodied language, which hypothesizes that comprehending verbal descriptions of actions relies on an internal simulation of the sensory–motor experience of the action, and provide a new and detailed view of the interplay between action language and motor acts.

Changes in corticomotor excitability and inhibition after exercise are influenced by hand dominance and motor demand

Previous studies on handedness have often reported functional asymmetries in corticomotor excitability (CME) associated with voluntary movement. Recently, we have shown that the degree of post-exercise corticomotor depression (PED) and increase in short-interval cortical inhibition (SICI) after a repetitive finger movement task was less when the task was performed at a maximal voluntary rate (MVR) than when it was performed at a submaximal sustainable rate (SR). In the current study, we have compared the time course of PED and SICI in the dominant (DOM) and nondominant (NDOM) hands after an MVR and SR finger movement task to determine the influence of hand dominance and task demand. We tracked motor-evoked potential (MEP) amplitude from the first dorsal interosseous muscle of the DOM and NDOM hand for 20 min after a 10-s index finger flexion-extension task at MVR and SR. For all hand-task combinations, we report a period of PED and increased SICI lasting for up to 8 min. We find that the least demanding task, one that involved index finger movement of the DOM hand at SR, was associated with the greatest change in PED and SICI from baseline (63.6±5.7% and 79±2%, P<0.001, PED and SICI, respectively), whereas the most demanding task (MVR of the NDOM hand) was associated with the least change from baseline (PED: 88.1±3.6%, SICI: 103±2%; P<0.001). Our findings indicate that the changes in CME and inhibition associated with repetitive finger movement are influenced both by handedness and the degree of demand of the motor task and are inversely related to task demand, being smallest for an MVR task of the NDOM hand and greatest for an SR task of the DOM hand. The findings provide additional evidence for differences in neuronal processing between the dominant and nondominant hemispheres in motor control.

Interhemispheric plasticity in humans

INTRODUCTION

Chronic unimanual motor practice increases the motor output not only in the trained but also in the nonexercised homologous muscle in the opposite limb. We examined the hypothesis that adaptations in motor cortical excitability of the nontrained primary motor cortex (iM1) and in interhemispheric inhibition from the trained to the nontrained M1 mediate this interlimb cross education.

METHODS

Healthy, young volunteers (n=12) performed 1000 submaximal voluntary contractions (MVC) of the right first dorsal interosseus (FDI) at 80% MVC during 20 sessions.

RESULTS

Trained FDI's MVC increased 49.9%, and the untrained FDI's MVC increased 28.1%. Although corticospinal excitability in iM1, measured with transcranial magnetic stimulation (TMS) before and after every fifth session, increased 6% at rest, these changes, as those in intracortical inhibition and facilitation, did not correlate with cross education. When weak and strong TMS of iM1 were delivered on a background of a weak and strong muscle contraction, respectively, of the right FDI, excitability of iM1 increased dramatically after 20 sessions. Interhemispheric inhibition decreased 8.9% acutely within sessions and 30.9% chronically during 20 sessions and these chronic reductions progressively became more strongly associated with cross education. There were no changes in force or TMS measures in the trained group's left abductor minimi digiti and there were no changes in the nonexercising control group (n=8).

CONCLUSIONS

The findings provide the first evidence for plasticity of interhemispheric connections to mediate cross education produced by a simple motor task.

Improving human plateaued motor skill with somatic stimulation

Procedural motor learning includes a period when no substantial gain in performance improvement is obtained even with repeated, daily practice. Prompted by the potential benefit of high-frequency transcutaneous electrical stimulation, we examined if the stimulation to the hand reduces redundant motor activity that likely exists in an acquired hand motor skill, so as to further upgrade stable motor performance. Healthy participants were trained until their motor performance of continuously rotating two balls in the palm of their right hand became stable. In the series of experiments, they repeated a trial performing this cyclic rotation as many times as possible in 15 s. In trials where we applied the stimulation to the relaxed thumb before they initiated the task, most reported that their movements became smoother and they could perform the movements at a higher cycle compared to the control trials. This was not possible when the dorsal side of the wrist was stimulated. The performance improvement was associated with reduction of amplitude of finger displacement, which was consistently observed irrespective of the task demands. Importantly, this kinematic change occurred without being noticed by the participants, and their intentional changes of motor strategies (reducing amplitude of finger displacement) never improved the performance. Moreover, the performance never spontaneously improved during one-week training without stimulation, whereas the improvement in association with stimulation was consistently observed across days during training on another week combined with the stimulation. The improved effect obtained in stimulation trials on one day partially carried over to the next day, thereby promoting daily improvement of plateaued performance, which could not be unlocked by the first-week intensive training. This study demonstrated the possibility of effectively improving a plateaued motor skill, and pre-movement somatic stimulation driving this behavioral change.

Short-term effects of unilateral lesion of the primary motor cortex (M1) on ipsilesional hand dexterity in adult macaque monkeys

Although the arrangement of the corticospinal projection in primates is consistent with a more prominent role of the ipsilateral motor cortex on proximal muscles, rather than on distal muscles involved in manual dexterity, the role played by the primary motor cortex on the control of manual dexterity for the ipsilateral hand remains a matter a debate, either in the normal function or after a lesion. We, therefore, tested the impact of permanent unilateral motor cortex lesion on the manual dexterity of the ipsilateral hand in 11 macaque monkeys, within a time window of 60 days post-lesion. For comparison, unilateral reversible pharmacological inactivation of the motor cortex was produced in an additional monkey. Manual dexterity was assessed quantitatively based on three motor parameters derived from two reach and grasp manual tasks. In contrast to the expected dramatic, complete deficit of manual dexterity of the contralesional hand that persists for several weeks, the impact on the manual dexterity of the ipsilesional hand was generally moderate (but statistically significant) and, when present, lasted less than 20 days. Out of the 11 monkeys, only 3 showed a deficit of the ipsilesional hand for 2 of the 3 motor parameters, and 4 animals had a deficit for only one motor parameter. Four monkeys did not show any deficit. The reversible inactivation experiment yielded results consistent with the permanent lesion data. In conclusion, the primary motor cortex exerts a modest role on ipsilateral manual dexterity, most likely in the form of indirect hand postural control.

Cortical gamma-oscillations modulated by auditory-motor tasks-intracranial recording in patients with epilepsy

Human activities often involve hand-motor responses following external auditory-verbal commands. It has been believed that hand movements are predominantly driven by the contralateral primary sensorimotor cortex, whereas auditory-verbal information is processed in both superior temporal gyri. It remains unknown whether cortical activation in the superior temporal gyrus during an auditory-motor task is affected by laterality of hand-motor responses. Here, event-related γ-oscillations were intracranially recorded as quantitative measures of cortical activation; we determined how cortical structures were activated by auditory-cued movement using each hand in 15 patients with focal epilepsy. Auditory-verbal stimuli elicited augmentation of γ-oscillations in a posterior portion of the superior temporal gyrus, whereas hand-motor responses elicited γ-augmentation in the pre- and postcentral gyri. The magnitudes of such γ-augmentation in the superior temporal, precentral, and postcentral gyri were significantly larger when the hand contralateral to the recorded hemisphere was required to be used for motor responses, compared with when the ipsilateral hand was. The superior temporal gyrus in each hemisphere might play a greater pivotal role when the contralateral hand needs to be used for motor responses, compared with when the ipsilateral hand does.

Ipsilateral motor cortical responses to TMS during lengthening and shortening of the contralateral wrist flexors

Unilateral lengthening contractions provide a greater stimulus for neuromuscular adaptation than shortening contractions in the active and non-active contralateral homologous muscle, although little is known of the potential mechanism. Here we examined the possibility that corticospinal and spinal excitability vary in a contraction-specific manner in the relaxed right flexor carpi radialis (FCR) when humans perform unilateral lengthening and shortening contractions of the left wrist flexors at the same absolute force. Corticospinal excitability in the relaxed right FCR increased more during lengthening than shortening at 80% and 100% of maximum voluntary contraction (MVC). Short-interval intracortical inhibition diminished during shortening contractions, and it became nearly abolished during lengthening. Intracortical facilitation lessened during shortening but increased during lengthening. Interhemispheric inhibition to the 'non-active' motor cortex diminished during shortening, and became nearly abolished during lengthening at 90% MVC. The amplitude of the Hoffman reflex in the relaxed right FCR decreased during and remained depressed for 20 s after lengthening and shortening of the left wrist flexors. We discuss the possibility that instead of the increased afferent input, differences in the descending motor command and activation of brain areas that link function of the motor cortices during muscle lengthening vs. shortening may cause the contraction-specific modulation of ipsilateral motor cortical output. In conclusion, ipsilateral motor cortex responses to transcranial magnetic stimulation are contraction-specific; unilateral lengthening and shortening contractions reduced contralateral spinal excitability, but uniquely modulated ipsilateral corticospinal excitability and the networks involved in intracortical and interhemispheric connections, which may have clinical implications.

Hemispheric asymmetries of motor versus nonmotor processes during (visuo)motor control

Language and certain aspects of motor control are typically served by the left hemisphere, whereas visuospatial and attentional control are lateralized to the right. Here a (visuo)motor tracing task was used to identify hemispheric lateralization beyond the general, contralateral organization of the motor system. Functional magnetic resonance imaging (fMRI) was applied in 40 male right-handers (19-30 yrs) during line tracing with dominant and nondominant hand, with and without visual guidance. Results revealed a network of areas activating more in the right than left hemisphere, irrespective of the effector. Inferior portions of frontal gyrus and parietal lobe overlapped largely with a previously described ventral attention network responding to unexpected or behaviourally relevant stimuli. This demonstrates a hitherto unreported functionality of this circuit that also seems to activate when spatial information is continuously exploited to adapt motor behaviour. Second, activation of left dorsal premotor and postcentral regions during tracing with the nondominant left hand was more pronounced than that in their right hemisphere homologues during tracing with the dominant right hand. These activation asymmetries of motor areas ipsilateral to the moving hand could not be explained by asymmetries in skill performance, the degree of handedness, or interhemispheric interactions. The latter was measured by a double-pulse transcranial magnetic stimulation paradigm, whereby a conditioning stimulus was applied over one hemisphere and a test stimulus over the other. We propose that the left premotor areas contain action representations strongly related to movement implementation which are also accessed during movements performed with the left body side.

Ipsilateral deficits in 1-handed shoe tying after left or right hemisphere stroke

Poole JL, Sadek J, Haaland KY. Ipsilateral deficits in 1-handed shoe tying after left or right hemisphere stroke.

OBJECTIVE

To examine 1-handed shoe tying performance and whether cognitive deficits more associated with left or right hemisphere damage differentially affect it after unilateral stroke.

DESIGN

Observational cohort comparing ipsilesional shoe tying, spatial and language skills, and limb praxis.

SETTING

Primary care Veterans Affairs and private medical center.

INTERVENTIONS

Not applicable.

PARTICIPANTS

Volunteer right-handed sample of adults with left or right hemisphere damage and healthy demographically matched adults.

MAIN OUTCOME MEASURE

The number of correct trials and the total time to complete 10 trials tying a shoe using the 1-handed method.

RESULTS

Both stroke groups had fewer correct trials and were significantly slower tying the shoe than the control group. Spatial skills predicted accuracy and speed after right hemisphere damage. After left hemisphere damage, accuracy was predicted by spatial skills and limb praxis, while speed was predicted by limb praxis only.

CONCLUSIONS

Ipsilesional shoe tying is similarly impaired after left or right hemisphere damage, but for different reasons. Spatial deficits had a greater influence after right hemisphere damage, and limb apraxia had a greater influence after left hemisphere damage. Language deficits did not affect performance, indicating that aphasia does not preclude using this therapy approach. These results suggest that rehabilitation professionals should consider assessment of limb apraxia and ipsilesional skill training in the performance of everyday tasks.