Timing of rhythmic movements in patients with cerebellar degeneration

Roles of the cerebellum and basal ganglia in temporal integration: Insights from a synchronized tapping task

OBJECTIVE

The aim of this study was to clarify the roles of the cerebellum and basal ganglia for temporal integration.

METHODS

We studied 39 patients with spinocerebellar degeneration (SCD), comprising spinocerebellar atrophy 6 (SCA6), SCA31, Machado-Joseph disease (MJD, also called SCA3), and multiple system atrophy (MSA). Thirteen normal subjects participated as controls. Participants were instructed to tap on a button in synchrony with isochronous tones. We analyzed the inter-tap interval (ITI), synchronizing tapping error (STE), negative asynchrony, and proportion of delayed tapping as indicators of tapping performance.

RESULTS

The ITI coefficient of variation was increased only in MSA patients. The standard variation of STE was larger in SCD patients than in normal subjects, especially for MSA. Negative asynchrony, which is a tendency to tap the button before the tones, was prominent in SCA6 and MSA patients, with possible basal ganglia involvement. SCA31 patients exhibited normal to supranormal performance in terms of the variability of STE, which was surprising.

CONCLUSIONS

Cerebellar patients generally showed greater STE variability, except for SCA31. The pace of tapping was affected in patients with possible basal ganglia pathology.

SIGNIFICANCE

Our results suggest that interaction between the cerebellum and the basal ganglia is essential for temporal processing. The cerebellum and basal ganglia and their interaction regulate synchronized tapping, resulting in distinct tapping pattern abnormalities among different SCD subtypes.

Cerebellum encodes and influences the initiation, performance, and termination of discontinuous movements in mice

The cerebellum is hypothesized to represent timing information important for organizing salient motor events during periodically performed discontinuous movements. To provide functional evidence validating this idea, we measured and manipulated Purkinje cell (PC) activity in the lateral cerebellum of mice trained to volitionally perform periodic bouts of licking for regularly allocated water rewards. Overall, PC simple spiking modulated during task performance, mapping phasic tongue protrusions and retractions, as well as ramping prior to both lick-bout initiation and termination, two important motor events delimiting movement cycles. The ramping onset occurred earlier for the initiation of uncued exploratory licking that anticipated water availability relative to licking that was reactive to water allocation, suggesting that the cerebellum is engaged differently depending on the movement context. In a subpopulation of PCs, climbing-fiber-evoked responses also increased during lick-bout initiation, but not termination, highlighting differences in how cerebellar input pathways represent task-related information. Optogenetic perturbation of PC activity disrupted the behavior by degrading lick-bout rhythmicity in addition to initiating and terminating licking bouts confirming a causative role in movement organization. Together, these results substantiate that the cerebellum contributes to the initiation and timing of repeated motor actions.

Automatic Classification and Severity Estimation of Ataxia From Finger Tapping Videos

Digital assessments enable objective measurements of ataxia severity and provide informative features that expand upon the information obtained during a clinical examination. In this study, we demonstrate the feasibility of using finger tapping videos to distinguish participants with Ataxia (N = 169) from participants with parkinsonism (N = 78) and from controls (N = 58), and predict their upper extremity and overall disease severity. Features were extracted from the time series representing the distance between the index and thumb and its derivatives. Classification models in ataxia archived areas under the receiver-operating curve of around 0.91, and regression models estimating disease severity obtained correlation coefficients around r = 0.64. Classification and prediction model coefficients were examined and they not only were in accordance, but were in line with clinical observations of ataxia phenotypes where rate and rhythm are altered during upper extremity motor movement.

A comprehensive scheme for the objective upper body assessments of subjects with cerebellar ataxia

Background

Cerebellar ataxia refers to the disturbance in movement resulting from cerebellar dysfunction. It manifests as inaccurate movements with delayed onset and overshoot, especially when movements are repetitive or rhythmic. Identification of ataxia is integral to the diagnosis and assessment of severity, and is important in monitoring progression and improvement. Ataxia is identified and assessed by clinicians observing subjects perform standardised movement tasks that emphasise ataxic movements. Our aim in this paper was to use data recorded from motion sensors worn while subjects performed these tasks, in order to make an objective assessment of ataxia that accurately modelled the clinical assessment.

Methods

Inertial measurement units and a Kinect© system were used to record motion data while control and ataxic subjects performed four instrumented version of upper extremities tests, i.e. finger chase test (FCT), finger tapping test (FTT), finger to nose test (FNT) and dysdiadochokinesia test (DDKT). Kinematic features were extracted from this data and correlated with clinical ratings of severity of ataxia using the Scale for the Assessment and Rating of Ataxia (SARA). These features were refined using Feed Backward feature Elimination (the best performing method of four). Using several different learning models, including Linear Discrimination, Quadratic Discrimination Analysis, Support Vector Machine and K-Nearest Neighbour these extracted features were used to accurately discriminate between ataxics and control subjects. Leave-One-Out cross validation estimated the generalised performance of the diagnostic model as well as the severity predicting regression model.

Results

The selected model accurately (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$96.4\%$$\end{document}96.4%) predicted the clinical scores for ataxia and correlated well with clinical scores of the severity of ataxia (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$rho = 0.8$$\end{document}rho=0.8, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$p < 0.001$$\end{document}p<0.001). The severity estimation was also considered in a 4-level scale to provide a rating that is familiar to the current clinically-used rating of upper limb impairments. The combination of FCT and FTT performed as well as all four test combined in predicting the presence and severity of ataxia.

Conclusion

Individual bedside tests can be emulated using features derived from sensors worn while bedside tests of cerebellar ataxia were being performed. Each test emphasises different aspects of stability, timing, accuracy and rhythmicity of movements. Using the current models it is possible to model the clinician in identifying ataxia and assessing severity but also to identify those test which provide the optimum set of data.

Trial registration Human Research and Ethics Committee, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia (HREC Reference Number: 11/994H/16).

Modulation of cerebellar brain inhibition during temporal adaptive learning in a coincident timing task

In the present study, we examined the role of the cerebellum in temporal adaptive learning during a coincident timing task, i.e., a baseball-like hitting task involving a moving ball presented on a computer monitor. The subjects were required to change the timing of their responses based on imposed temporal perturbations. Using paired-pulse transcranial magnetic stimulation, we measured cerebellar brain inhibition (CBI) before, during, and after the temporal adaptive learning. Reductions in CBI only occurred during and after the temporal adaptive learning, regardless of the direction of the temporal perturbations. In addition, the changes in CBI were correlated with the magnitude of the adaptation. Here, we showed that the cerebellum is essential for learning about and controlling the timing of movements during temporal adaptation. Furthermore, changes in cerebellar-primary motor cortex connectivity occurred during temporal adaptation, as has been previously reported for spatial adaptation.

The Cerebellum and Implicit Sequencing: Evidence from Cerebellar Ataxia

The cerebellum recognizes sequences from prior experiences and uses this information to generate internal models that predict future outcomes in a feedforward manner [Front Hum Neurosci 8: 475, 2014; Cortex 47: 137-44, 2011; Cerebellum 7: 611-5, 2008; J Neurosci 26: 9107-16, 2006]. This process has been well documented in the motor domain, but the cerebellum's role in cognitive sequencing, within the context of implicit versus explicit processes, is not well characterized. In this study, we tested individuals with cerebellar ataxia and healthy controls to clarify the role of the cerebellum sequencing using variations on implicit versus explicit and motor versus cognitive demands across five experiments. Converging results across these studies suggest that cerebellar feedforward mechanisms may be necessary for sequencing in the implicit domain only. In the ataxia group, rhythmic tapping, rate of motor learning, and implicit sequence learning were impaired. However, for cognitive sequencing that could be accomplished using explicit strategies, the cerebellar group performed normally, as though they shifted to extra-cerebellar mechanisms to compensate. For example, when cognitive and motor functions relied on cerebellar function simultaneously, the ataxia group's motor function was unaffected, in contrast to that of controls whose motor performance declined as a function of cognitive load. These findings indicated that the cerebellum is not critical for all forms of sequencing per se. Instead, it plays a fundamental role for sequencing within the implicit domain, whether functions are motor or cognitive. Moreover, individuals with cerebellar ataxia are generally able to compensate for cognitive sequencing when explicit strategies are available in order to preserve resources for motor function.

Dysmetria and Errors in Predictions: The Role of Internal Forward Model

The terminology of cerebellar dysmetria embraces a ubiquitous symptom in motor deficits, oculomotor symptoms, and cognitive/emotional symptoms occurring in cerebellar ataxias. Patients with episodic ataxia exhibit recurrent episodes of ataxia, including motor dysmetria. Despite the consensus that cerebellar dysmetria is a cardinal symptom, there is still no agreement on its pathophysiological mechanisms to date since its first clinical description by Babinski. We argue that impairment in the predictive computation for voluntary movements explains a range of characteristics accompanied by dysmetria. Within this framework, the cerebellum acquires and maintains an internal forward model, which predicts current and future states of the body by integrating an estimate of the previous state and a given efference copy of motor commands. Two of our recent studies experimentally support the internal-forward-model hypothesis of the cerebellar circuitry. First, the cerebellar outputs (firing rates of dentate nucleus cells) contain predictive information for the future cerebellar inputs (firing rates of mossy fibers). Second, a component of movement kinematics is predictive for target motions in control subjects. In cerebellar patients, the predictive component lags behind a target motion and is compensated with a feedback component. Furthermore, a clinical analysis has examined kinematic and electromyography (EMG) features using a task of elbow flexion goal-directed movements, which mimics the finger-to-nose test. Consistent with the hypothesis of the internal forward model, the predictive activations in the triceps muscles are impaired, and the impaired predictive activations result in hypermetria (overshoot). Dysmetria stems from deficits in the predictive computation of the internal forward model in the cerebellum. Errors in this fundamental mechanism result in undershoot (hypometria) and overshoot during voluntary motor actions. The predictive computation of the forward model affords error-based motor learning, coordination of multiple degrees of freedom, and adequate timing of muscle activities. Both the timing and synergy theory fit with the internal forward model, microzones being the elemental computational unit, and the anatomical organization of converging inputs to the Purkinje neurons providing them the unique property of a perceptron in the brain. We propose that motor dysmetria observed in attacks of ataxia occurs as a result of impaired predictive computation of the internal forward model in the cerebellum.

Cerebral Substrates for Controlling Rhythmic Movements

Our daily lives are filled with rhythmic movements, such as walking, sports, and dancing, but the mechanisms by which the brain controls rhythmic movements are poorly understood. In this review, we examine the literature on neuropsychological studies of patients with focal brain lesions, and functional brain imaging studies primarily using finger-tapping tasks. These studies suggest a close connection between sensory and motor processing of rhythm, with no apparent distinction between the two functions. Thus, we conducted two functional brain imaging studies to survey the rhythm representations relatively independent of sensory and motor functions. First, we determined brain activations related to rhythm processing in a sensory modality-independent manner. Second, we examined body part-independent brain activation related to rhythm reproduction. Based on previous literature, we discuss how brain areas contribute rhythmic motor control. Furthermore, we also discuss the mechanisms by which the brain controls rhythmic movements.

Duration reproduction in regular and irregular contexts after unilateral brain damage: Evidence from voxel-based lesion-symptom mapping and atlas-based hodological analysis

It has been proposed that not completely overlapping brain networks support interval timing depending on whether or not an external, predictable temporal cue is provided during the task, aiding time estimation. Here we tested this hypothesis in a neuropsychological study, using both a topological approach - through voxel-based lesion-symptom mapping (VLSM), that assesses the relation between continuous behavioral scores and lesion information on a voxel-by-voxel basis - and a hodological approach, using an atlas-based tractography. A group of patients with unilateral focal brain lesions and their matched controls performed a duration reproduction task assessing time processing in two conditions, namely with regularly spaced stimuli during encoding and reproduction (Regular condition), and with irregularly spaced stimuli during the same task (Irregular condition). VLSM analyses showed that scores in the two conditions were associated with lesions involving partly separable clusters of voxels, with lower performance only in the Irregular condition being related to lesions involving the right insular cortex. Performance in both conditions correlated with the probability of disconnection of the right frontal superior longitudinal tract, and of the superior and middle branches of the right superior longitudinal fasciculus. These findings suggest that the dissociation between timing in regular and irregular contexts is not complete, since performance in both conditions relies on the integrity of a common suprasecond timing network. Furthermore, they are consistent with the hypothesis that tracking time without the aid of external cues selectively relies on the integration of psychophysiological changes in the right insula.

Reversible Block of Cerebellar Outflow Reveals Cortical Circuitry for Motor Coordination

Coordinated movements are achieved by well-timed activation of selected muscles. This process relies on intact cerebellar circuitry, as demonstrated by motor impairments following cerebellar lesions. Based on anatomical connectivity and symptoms observed in cerebellar patients, we hypothesized that cerebellar dysfunction should disrupt the temporal patterns of motor cortical activity, but not the selected motor plan. To test this hypothesis, we reversibly blocked cerebellar outflow in primates while monitoring motor behavior and neural activity. This manipulation replicated the impaired motor timing and coordination characteristic of cerebellar ataxia. We found extensive changes in motor cortical activity, including loss of response transients at movement onset and decoupling of task-related activity. Nonetheless, the spatial tuning of cells was unaffected, and their early preparatory activity was mostly intact. These results indicate that the timing of actions, but not the selection of muscles, is regulated through cerebellar control of motor cortical activity.

Quantitative Assessment of Cerebellar Ataxia With Kinematic Sensing During Rhythmic Tapping

The aim of this study is to investigate the validity of an entropy-based objective assessment of cerebellar ataxia patients performing rhythmic tapping. Previous research conducted, particularly in time and frequency domains, tested the adherence of patients to more stringent experimental requirements. These requirements may inadvertently cause higher level brain functions to influence the performance and possibly obscure the cerebella related disabilities in the data stream. In this study, a multiscale entropy-based learning process that overcomes this practical limitation was considered. In particular, assessment techniques with less restrictions on the tapping duration were considered. Thirty-three patients were engaged in the test, with three levels of severity 0 (normal), 1 (moderate) and 2 (severe) ranked by specialist clinicians. The performance of each model was evaluated using leave-oneout cross validation. Results from both time-frequency features and entropy features extracted and characterized the cerebellar condition captured during the finger and foot tapping tests (with over 80% accuracy). Strong correlations with clinical assessment-based scoring were observed with the entropy based approach for both tests, although the correlation with timefrequency features were less convincing.

Entrained neuronal activity to periodic visual stimuli in the primate striatum compared with the cerebellum

Rhythmic events recruit neuronal activity in the basal ganglia and cerebellum, but their roles remain elusive. In monkeys attempting to detect a single omission of isochronous visual stimulus, we found that neurons in the caudate nucleus showed increased activity for each stimulus in sequence, while those in the cerebellar dentate nucleus showed decreased activity. Firing modulation in the majority of caudate neurons and all cerebellar neurons was proportional to the stimulus interval, but a quarter of caudate neurons displayed a clear duration tuning. Furthermore, the time course of population activity in the cerebellum well predicted stimulus timing, whereas that in the caudate reflected stochastic variation of response latency. Electrical stimulation to the respective recording sites confirmed a causal role in the detection of stimulus omission. These results suggest that striatal neurons might represent periodic response preparation while cerebellar nuclear neurons may play a role in temporal prediction of periodic events.

Linking Pathological Oscillations With Altered Temporal Processing in Parkinsons Disease: Neurophysiological Mechanisms and Implications for Neuromodulation

Emerging evidence suggests that Parkinson's disease (PD) results from disrupted oscillatory activity in cortico-basal ganglia-thalamo-cortical (CBGTC) and cerebellar networks which can be partially corrected by applying deep brain stimulation (DBS). The inherent dynamic nature of such oscillatory activity might implicate that is represents temporal aspects of motor control. While the timing of muscle activities in CBGTC networks constitute the temporal dimensions of distinct motor acts, these very networks are also involved in somatosensory processing. In this respect, a temporal aspect of somatosensory processing in motor control concerns matching predicted (feedforward) and actual (feedback) sensory consequences of movement which implies a distinct contribution to demarcating the temporal order of events. Emerging evidence shows that such somatosensory processing is altered in movement disorders. This raises the question how disrupted oscillatory activity is related to impaired temporal processing and how/whether DBS can functionally restore this. In this perspective article, the neural underpinnings of temporal processing will be reviewed and translated to the specific alternated oscillatory neural activity specifically found in Parkinson's disease. These findings will be integrated in a neurophysiological framework linking somatosensory and motor processing. Finally, future implications for neuromodulation will be discussed with potential implications for strategy across a range of movement disorders.

Double dissociation of single-interval and rhythmic temporal prediction in cerebellar degeneration and Parkinson's disease

Predicting the timing of upcoming events is critical for successful interaction in a dynamic world, and is recognized as a key computation for attentional orienting. Temporal predictions can be formed when recent events define a rhythmic structure, as well as in aperiodic streams or even in isolation, when a specified interval is known from previous exposure. However, whether predictions in these two contexts are mediated by a common mechanism, or by distinct, context-dependent mechanisms, is highly controversial. Moreover, although the basal ganglia and cerebellum have been linked to temporal processing, the role of these subcortical structures in temporal orienting of attention is unclear. To address these issues, we tested individuals with cerebellar degeneration or Parkinson's disease, with the latter serving as a model of basal ganglia dysfunction, on temporal prediction tasks in the subsecond range. The participants performed a visual detection task in which the onset of the target was predictable, based on either a rhythmic stream of stimuli, or a single interval, specified by two events that occurred within an aperiodic stream. Patients with cerebellar degeneration showed no benefit from single-interval cuing but preserved benefit from rhythm cuing, whereas patients with Parkinson's disease showed no benefit from rhythm cuing but preserved benefit from single-interval cuing. This double dissociation provides causal evidence for functionally nonoverlapping mechanisms of rhythm- and interval-based temporal prediction for attentional orienting, and establishes the separable contributions of the cerebellum and basal ganglia to these functions, suggesting a mechanistic specialization across timing domains.

Deficits in Coordinative Bimanual Timing Precision in Children With Specific Language Impairment

PURPOSE

Our objective was to delineate components of motor performance in specific language impairment (SLI); specifically, whether deficits in timing precision in one effector (unimanual tapping) and in two effectors (bimanual clapping) are observed in young children with SLI.

METHOD

Twenty-seven 4- to 5-year-old children with SLI and 21 age-matched peers with typical language development participated. All children engaged in a unimanual tapping and a bimanual clapping timing task. Standard measures of language and motor performance were also obtained.

RESULTS

No group differences in timing variability were observed in the unimanual tapping task. However, compared with typically developing peers, children with SLI were more variable in their timing precision in the bimanual clapping task. Nine of the children with SLI performed greater than 1 SD below the mean on a standardized motor assessment. The children with low motor performance showed the same profile as observed across all children with SLI, with unaffected unimanual and impaired bimanual timing precision.

CONCLUSIONS

Although unimanual timing is unaffected, children with SLI show a deficit in timing that requires bimanual coordination. We propose that the timing deficits observed in children with SLI are associated with the increased demands inherent in bimanual performance.

Children with developmental coordination disorder (DCD) can adapt to perceptible and subliminal rhythm changes but are more variable

Children with DCD demonstrate impairments in bimanual finger tapping during self-paced tapping and tapping in synchrony to different frequencies. In this study, we investigated the ability of children with DCD to adapt motorically to perceptible or subliminal changes of the auditory stimuli without a change in frequency, and compared their performance to typically developing controls (TDC). Nineteen children with DCD between ages 6-11years (mean age±SD=114±21months) and 17 TDC (mean age±SD=113±21months) participated in this study. Auditory perceptual threshold was established. Children initially tapped bimanually to an antiphase beat and then to either a perceptible change in rhythm or to gradual subliminal changes in rhythm. Children with DCD were able to perceive changes in rhythm similar to TDC. They were also able to adapt to both perceptible and subliminal changes in rhythms similar to their age- and gender- matched TDC. However, these children were significantly more variable compared with TDC in all phasing conditions. The results suggest that the performance impairments in bilateral tapping are not a result of poor conscious or sub-conscious perception of the auditory cue. The increased motor variability may be associated with cerebellar dysfunction but further behavioral and neurophysiological studies are needed.

Brain Bases of Working Memory for Time Intervals in Rhythmic Sequences

Perception of auditory time intervals is critical for accurate comprehension of natural sounds like speech and music. However, the neural substrates and mechanisms underlying the representation of time intervals in working memory are poorly understood. In this study, we investigate the brain bases of working memory for time intervals in rhythmic sequences using functional magnetic resonance imaging. We used a novel behavioral paradigm to investigate time-interval representation in working memory as a function of the temporal jitter and memory load of the sequences containing those time intervals. Human participants were presented with a sequence of intervals and required to reproduce the duration of a particular probed interval. We found that perceptual timing areas including the cerebellum and the striatum were more or less active as a function of increasing and decreasing jitter of the intervals held in working memory respectively whilst the activity of the inferior parietal cortex is modulated as a function of memory load. Additionally, we also analyzed structural correlations between gray and white matter density and behavior and found significant correlations in the cerebellum and the striatum, mirroring the functional results. Our data demonstrate neural substrates of working memory for time intervals and suggest that the cerebellum and the striatum represent core areas for representing temporal information in working memory.

Timing control of gait: a study of essential tremor patients vs. age-matched controls

Background

Essential tremor (ET) is a common movement disorder characterized by kinetic, postural and intention tremors. Mounting evidence suggests an underlying dysfunction of the cerebellum or cerebellar system. While few recent studies report impairments in timing control of finger movements in ET, timing control of gait has not been examined to date. We compared timing control of gait in ET patients vs. controls, and further assessed the association of these timing impairments with tremor severity among the ET patients. One-hundred-fifty-five ET patients and 60 age-matched controls underwent a comprehensive neurological assessment and gait analysis, which included walking at a criterion step frequency (cadence) with a metronome (timing production) and walking at a criterion step frequency after the metronome was turned off (timing reproduction). Outcomes of interest for both conditions were timing accuracy (measured by cadence error) and timing precision (measured by cadence variability). We also assessed cadence and step time across conditions.

Results

Cadence was lower in ET patients than controls (p < 0.03), whereas step time was similar for ET patients and controls. Accuracy (cadence error) and precision (cadence variability) were not different in ET patients compared with controls. Cranial tremor score was significantly associated with cadence (timing production condition, p = 0.003 and timing reproduction condition, p = 0.0001) and cadence error (timing production condition, p = 0.01). Kinetic tremor and intention tremor scores were not associated with gait measures.

Conclusions

ET patients do not demonstrate impairments in timing control of gait as compared with matched controls. Prior work shows that patients with cerebellar dysfunction demonstrate selective impairments in timing of discrete movements (such as finger tapping) but not continuous movements (such as circle drawing). Taken together, these results support the hypothesis that the cerebellum may be important for timing control of discrete rather than continuous movements.

The 3-second rule in hereditary pure cerebellar ataxia: a synchronized tapping study

The '3-second rule' has been proposed based on miscellaneous observations that a time period of around 3 seconds constitutes the fundamental unit of time related to the neuro-cognitive machinery in normal humans. The aim of paper was to investigate the temporal processing in patients with spinocerebellar ataxia type 6 (SCA6) and SCA31, pure cerebellar types of spinocerebellar degeneration, using a synchronized tapping task. Seventeen SCA patients (11 SCA6, 6 SCA31) and 17 normal age-matched volunteers participated. The task required subjects to tap a keyboard in synchrony with sequences of auditory stimuli presented at fixed interstimulus intervals (ISIs) between 200 and 4800 ms. In this task, the subjects required non-motor components to estimate the time of forthcoming tone in addition to motor components to tap. Normal subjects synchronized their taps to the presented tones at shorter ISIs, whereas as the ISI became longer, the normal subjects displayed greater latency between the tone and the tapping (transition zone). After the transition zone, normal subjects pressed the button delayed relative to the tone. On the other hand, SCA patients could not synchronize their tapping with the tone even at shorter ISIs, although they pressed the button delayed relative to the tone earlier than normal subjects did. The earliest time of delayed tapping appearance after the transition zone was 4800 ms in normal subjects but 1800 ms in SCA patients. The span of temporal integration in SCA patients is shortened compared to that in normal subjects. This could represent non-motor cerebellar dysfunction in SCA patients.

A little elastic for a better performance: kinesiotaping of the motor effector modulates neural mechanisms for rhythmic movements

A rhythmic motor performance is brought about by an integration of timing information with movements. Investigations on the millisecond time scale distinguish two forms of time control, event-based timing and emergent timing. While event-based timing asserts the existence of a central internal timekeeper for the control of repetitive movements, the emergent timing perspective claims that timing emerges from dynamic control of nontemporal movements parameters. We have recently demonstrated that the precision of an isochronous performance, defined as performance of repeated movements having a uniform duration, was insensible to auditory stimuli of various characteristics (Bravi et al., 2014). Such finding has led us to investigate whether the application of an elastic therapeutic tape (Kinesio® Tex taping; KTT) used for treating athletic injuries and a variety of physical disorders, is able to reduce the timing variability of repetitive rhythmic movement. Young healthy subjects, tested with and without KTT, have participated in sessions in which sets of repeated isochronous wrist's flexion-extensions (IWFEs) were performed under various auditory conditions and during their recall. Kinematics was recorded and temporal parameters were extracted and analyzed. Our results show that the application of KTT decreases the variability of rhythmic movements by a 2-fold effect: on the one hand KTT provides extra proprioceptive information activating cutaneous mechanoreceptors, on the other KTT biases toward the emergent timing thus modulating the processes for rhythmic movements. Therefore, KTT appears able to render movements less audio dependent by relieving, at least partially, the central structures from time control and making available more resources for an augmented performance.

Disrupted sensorimotor synchronization, but intact rhythm discrimination, in children treated for a cerebellar medulloblastoma

The aim of this study was to investigate the temporal abilities of children treated by surgery for a malignant tumor in the cerebellum, both in the perception and the production of rhythm. Children with a diagnosed medulloblastoma and age-matched control children were tested in a rhythm discrimination task and a sensorimotor synchronization task. Their motor and cognitive capabilities were also assessed through a battery of age-adapted neuropsychological tests. The results did not show any significant difference in performance between groups for the discrimination task. On the contrary, children with cerebellar lesions produced longer and more variable inter-tap intervals (ITI) in their spontaneous motor tempo (SMT) than did the control children. However, the length and, to a lesser extent, the variability of their SMT decreased after a synchronization phase, when they had been instructed to tap in synchrony with a beep. During the synchronization task, the children with medulloblastoma succeeded to modify the length of their ITI in response to an auditory rhythm, although with better success when the inter-stimuli intervals (ISI) were shorter than when they were longer than the ITIs of their own SMT. Correlational analyses revealed that children's poorer synchronization performance was related to lower scores in neuropsychological tests assessing motor dexterity and processing speed.

Dyspraxia, motor function and visual-motor integration in autism

This project assessed dyspraxia in high-functioning school aged children with autism with a focus on Ideational Praxis. We examined the association of specific underlying motor function including eye movement with ideational dyspraxia (sequences of skilled movements) as well as the possible role of visual-motor integration in dyspraxia. We found that compared to IQ-, sex- and age-matched typically developing children, the children with autism performed significantly worse on: Ideational and Buccofacial praxis; a broad range of motor tests, including measures of simple motor skill, timing and accuracy of saccadic eye movements and motor coordination; and tests of visual-motor integration. Impairments in individual children with autism were heterogeneous in nature, although when we examined the praxis data as a function of a qualitative measure representing motor timing, we found that children with poor motor timing performed worse on all praxis categories and had slower and less accurate eye movements while those with regular timing performed as well as typical children on those same tasks. Our data provide evidence that both motor function and visual-motor integration contribute to dyspraxia. We suggest that dyspraxia in autism involves cerebellar mechanisms of movement control and the integration of these mechanisms with cortical networks implicated in praxis.

Temporal aspects of prediction in audition: cortical and subcortical neural mechanisms

Tracing the temporal structure of acoustic events is crucial in order to efficiently adapt to dynamic changes in the environment. In turn, regularity in temporal structure may facilitate tracing of the acoustic signal and its likely spatial source. However, temporal processing in audition extends beyond a domain-general facilitatory function. Temporal regularity and temporal order of auditory events correspond to contextually extracted, statistically sampled relations among sounds. These relations are the backbone of prediction in audition, determining both when an event is likely to occur (temporal structure) and also what type of event can be expected at a specific point in time (formal structure, e.g. spectral information). Here, we develop a model of temporal processing in audition and speech that involves a division of labor between the cerebellum and the basal ganglia in tracing acoustic events in time. As for the cerebellum and its associated thalamo-cortical connections, we refer to its role in the automatic encoding of event-based temporal structure with high temporal precision, while the basal ganglia-thalamo-cortical system engages in the attention-dependent evaluation of longer-range intervals. Recent electrophysiological and neurofunctional evidence suggests that neocortical processing of spectral structure relies on concurrent extraction of event-based temporal information. We propose that spectrotemporal predictive processes may be facilitated by subcortical coding of relevant changes in sound energy as temporal event markers.

Cerebellar motor function in spina bifida meningomyelocele

Spina bifida meningomyelocele (SBM), a congenital neurodevelopmental disorder, involves dysmorphology of the cerebellum, and its most obvious manifestations are motor deficits. This paper reviews cerebellar neuropathology and motor function across several motor systems well studied in SBM in relation to current models of cerebellar motor and timing function. Children and adults with SBM have widespread motor deficits in trunk, upper limbs, eyes, and speech articulators that are broadly congruent with those observed in adults with cerebellar lesions. The structure and function of the cerebellum are correlated with a range of motor functions. While motor learning is generally preserved in SBM, those motor functions requiring predictive signals and precise calibration of the temporal features of movement are impaired, resulting in deficits in smooth movement coordination as well as in the classical cerebellar triad of dysmetria, ataxia, and dysarthria. That motor function in individuals with SBM is disordered in a manner phenotypically similar to that in adult cerebellar lesions, and appears to involve similar deficits in predictive cerebellar motor control, suggests that age-based cerebellar motor plasticity is limited in individuals with this neurodevelopmental disorder.

Timing and the control of rhythmic upper-limb movements

Accurate timing of limb displacement is crucial for effective motor control. The authors examined the effects of movement velocity, duration, direction, added mass, and auditory cueing on timing, spatial, and trajectory variability of single- and multijoint rhythmic movements. During single-joint movements, increased velocity decreased timing and spatial variability, whereas increased movement duration increased timing variability but decreased spatial variability. For multijoint movements, regardless of condition, increasing velocity decreased joint timing, spatial, and trajectory variability, but all hand variabilities were unaffected by velocity, duration, load, or direction. Timing, spatial, and trajectory variability was greater at the shoulder compared with the elbow and minimal at the hand, supporting the notion that reaching movements are planned in hand space as opposed to joint space.

Perception of strong-meter and weak-meter rhythms in children with spina bifida meningomyelocele

Neurodevelopmental disorders such as spina bifida meningomyelocele (SBM) are often associated with dysrhythmic movement. We studied rhythm discrimination in 21 children with SBM and in 21 age-matched controls, with the research question being whether both groups showed a strong-meter advantage whereby rhythm discrimination is better for rhythms with a strong-meter, in which onsets of longer intervals occurred on the beat, than those with a weak-meter, in which onsets of longer intervals occurred off the beat. Compared to controls, the SBM group was less able to discriminate strong-meter rhythms, although they performed comparably in discriminating weak-meter rhythms. The attenuated strong-meter advantage in children with SBM shows that their rhythm deficits occur at the level of both perception and action, and may represent a central processing disruption of the brain mechanisms for rhythm.

Cerebellar contributions to cognitive functions: a progress report after two decades of research

Accumulating evidence from both human lesion and functional neuroimaging studies appears to support the hypothesis that the cerebellum contributes to non-motor functions. Along similar lines, cognitive, affective and behavioural changes in psychiatric disorders, such as autism, schizophrenia and dyslexia, have been linked to structural cerebellar abnormalities. The aim of this special issue was to evaluate the current knowledge base after more than 20 years of controversial discussion. The contributions of the special issue cover the most important cognitive domains, i.e., attention, memory and learning, executive control, language and visuospatial function. The available empirical evidence suggests that cognitive changes in patients with cerebellar dysfunction are mild and clearly less severe than the impairments observed after lesions to neocortical areas to which the cerebellum is closely connected via different cerebro-cerebellar loops. Frequently cited early findings, e.g., with respect to a specific cerebellar involvement in attention, have not been replicated or might be confounded by motor or working memory demands of the respective attention task. On the other hand, there is now convincing evidence for a cerebellar involvement in the mediation of a range of cognitive domains, most notably verbal working memory. Verbal working memory problems may partly underlie the compromised performance of cerebellar lesion patients on at least some complex cognitive tasks. Although investigations have moved from anecdotical case reports to hypothesis-driven controlled clinical group studies based on sound methods which are complemented by state-of-the-art functional neuroimaging studies, the empirical evidence available so far does not yet allow a convincing theory of the mechanisms of a cerebellar involvement in cognitive function. Future studies are clearly needed to further elucidate the nature of the processes linked to cerebellar mediation of cognitive processes and their possible link to motor theories of cerebellar function, e.g., its role in prediction and/or timing.