Differential activity-dependent development of corticospinal control of movement and final limb position during visually guided locomotion

Baby HABIT-ILE intervention: study protocol of a randomised controlled trial in infants aged 6-18 months with unilateral cerebral palsy

INTRODUCTION

Research using animal models suggests that intensive motor skill training in infants under 2 years old with cerebral palsy (CP) may significantly reduce, or even prevent, maladaptive neuroplastic changes following brain injury. However, the effects of such interventions to tentatively prevent secondary neurological damages have never been assessed in infants with CP. This study aims to determine the effect of the baby Hand and Arm Bimanual Intensive Therapy Including Lower Extremities (baby HABIT-ILE) in infants with unilateral CP, compared with a control intervention.

METHODS AND ANALYSIS

This randomised controlled trial will include 48 infants with unilateral CP aged (corrected if preterm) 6-18 months at the first assessment. They will be paired by age and by aetiology of the CP, and randomised into two groups (immediate and delayed). Assessments will be performed at baseline and at 1 month, 3 months and 6 months after baseline. The immediate group will receive 50 hours of baby HABIT-ILE intervention over 2 weeks, between first and second assessment, while the delayed group will continue their usual activities. This last group will receive baby HABIT-ILE intervention after the 3-month assessment. Primary outcome will be the Mini-Assisting Hand Assessment. Secondary outcomes will include behavioural assessments for gross and fine motricity, visual-cognitive-language abilities as well as MRI and kinematics measures. Moreover, parents will determine and score child-relevant goals and fill out questionnaires of participation, daily activities and mobility.

ETHICS AND DISSEMINATION

Full ethical approval has been obtained by the Comité d'éthique Hospitalo-Facultaire/Université catholique de Louvain, Brussels (2013/01MAR/069 B403201316810g). The recommendations of the ethical board and the Belgian law of 7 May 2004 concerning human experiments will be followed. Parents will sign a written informed consent ahead of participation. Findings will be published in peer-reviewed journals and conference presentations.

TRIAL REGISTRATION NUMBER

NCT04698395. Registered on the International Clinical Trials Registry Platform (ICTRP) on 2 December 2020 and NIH Clinical Trials Registry on 6 January 2021. URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT04698395?term=bleyenheuft&draw=1&rank=7.

Intramuscular and intermuscular coherence analysis while obstacle crossing during treadmill gait

PURPOSE

This study aimed to identify the contribution of the common synaptic drives to motor units during obstacle avoidance, using coherence analysis between a-pair electromyography (EMG) signals (EMG-EMG coherence).

MATERIALS AND METHODS

Fourteen healthy volunteers walked on a treadmill with and without obstacle avoidance. During obstacle gait, subjects were instructed to step over an obstacle with their right leg while walking that would randomly and unpredictably appear. Surface EMG signals were recorded from the following muscles of the right leg: the proximal and distal ends of tibialis anterior (TAp and TAd), biceps femoris (BF), semitendinosus (ST), lateral gastrocnemius (LG), and medial gastrocnemius (MG). Beta-band (13-30 Hz) EMG-EMG coherence was analysed.

RESULTS

Beta-band EMG-EMG coherence of TAp-TAd during swing phase and BF-ST during pre and initial swing phase when stepping over an obstacle were significantly higher compared to normal gait (both p < 0.05). Beta-band EMG-EMG coherence of TAp-TAd, BF-ST, and LG-MG during stance phase were not significantly different between the two gait conditions (all p > 0.05).

CONCLUSIONS

The present findings suggest increased common synaptic drives to motor units in ankle dorsiflexor and knee flexor muscles during obstacle avoidance. It also may reflect an increased cortical contribution to modify the gait patterns to avoid an obstacle.

Activity of cat premotor cortex neurons during visually guided stepping

Visual control of steps is critical in everyday life. Several motor centers are implicated in visual control of steps on a complex surface, however, participation of a large cortical motor area, the premotor cortex, in visual guidance of steps during overground locomotion has not been examined. Here, we analyzed the activity of neurons in feline premotor cortex areas 6aα and 6aγ as cats walked on the flat surface where visual guidance of steps is not needed and stepped on crosspieces of a horizontally placed ladder or over barriers where visual control of steps is required. The comparison of neuronal firing between vision-dependent and vision-independent stepping revealed components of the activity related to visual guidance of steps. We found that the firing activity of 59% of neurons was modulated with the rhythm of strides on the flat surface, and the activity of 83-86% of the population changed upon transition to locomotion on the ladder or with barriers. The firing rate and the depth of the stride-related activity modulation of 33-44% of neurons changed, and the stride phases where neurons preferred to fire changed for 58-73% of neurons. These results indicate that a substantial proportion of areas 6aα and 6aγ neurons is involved in visual guidance of steps. Compared with the primary motor cortex, the proportion of cells, the firing activity of which changed upon transition from vision-independent to vision-dependent stepping, was lower and the preferred phases of the firing activity changed more often between the tasks.NEW & NOTEWORTHY Visual control of steps is critical for daily living, however, how it is achieved is not well understood. Here, we analyzed how neurons in the premotor cortex respond to the demand for visual control of steps on a complex surface. We conclude that premotor cortex neurons participate in the cortical network supporting visual control of steps by modifying the phase, intensity, and salience of their firing activity.

Emergence of Distinct Neural Subspaces in Motor Cortical Dynamics during Volitional Adjustments of Ongoing Locomotion

The ability to modulate ongoing walking gait with precise, voluntary adjustments is what allows animals to navigate complex terrains. However, how the nervous system generates the signals to precisely control the limbs while simultaneously maintaining locomotion is poorly understood. One potential strategy is to distribute the neural activity related to these two functions into distinct cortical activity coactivation subspaces so that both may be conducted simultaneously without disruptive interference. To investigate this hypothesis, we recorded the activity of primary motor cortex in male nonhuman primates during obstacle avoidance on a treadmill. We found that the same neural population was active during both basic unobstructed locomotion and volitional obstacle avoidance movements. We identified the neural modes spanning the subspace of the low-dimensional dynamics in primary motor cortex and found a subspace that consistently maintains the same cyclic activity throughout obstacle stepping, despite large changes in the movement itself. All of the variance corresponding to this large change in movement during the obstacle avoidance was confined to its own distinct subspace. Furthermore, neural decoders built for ongoing locomotion did not generalize to decoding obstacle avoidance during locomotion. Our findings suggest that separate underlying subspaces emerge during complex locomotion that coordinates ongoing locomotor-related neural dynamics with volitional gait adjustments. These findings may have important implications for the development of brain-machine interfaces.SIGNIFICANCE STATEMENT Locomotion and precise, goal-directed movements are two distinct movement modalities with known differing requirements of motor cortical input. Previous studies have characterized the cortical activity during obstacle avoidance while walking in rodents and felines, but, to date, no such studies have been completed in primates. Additionally, in any animal model, it is unknown how these two movements are represented in primary motor cortex (M1) low-dimensional dynamics when both activities are performed at the same time, such as during obstacle avoidance. We developed a novel obstacle avoidance paradigm in freely moving nonhuman primates and discovered that the rhythmic locomotion-related dynamics and the voluntary, gait-adjustment movement separate into distinct subspaces in M1 cortical activity. Our analysis of decoding generalization may also have important implications for the development of brain-machine interfaces.

Corticospinal Excitability Quantification During a Visually-Guided Precision Walking Task in Humans: Potential for Neurorehabilitation

The corticospinal tract has been shown to be involved in normal walking in humans. However, its contribution during more challenging locomotor tasks is still unclear. As the corticospinal tract can be a potential target to promote gait recovery after neurological injury, it is of primary importance to quantify its use during human walking. The aims of the current study were to: (1) quantify the effects of precision walking on corticospinal excitability as compared to normal walking; (2) assess if corticospinal modulation is related to task difficulty or participants' performance. Sixteen healthy participants walked on a treadmill during 2 tasks: regular walking (simple task) and stepping onto virtual targets (precision task). Virtual targets appeared randomly at 3 different step lengths: preferred, and ±20%. To assess corticospinal excitability, 25 motor evoked potentials (MEPs) were recorded from the tibialis anterior muscle in each task during walking. Performance for each participant (global success score; % of target hit) and task difficulty related to step length adjustments (success score for each step length) were also calculated. MEP size was larger during the precision task in all participants (mean increase of 93% ± 72%; P < .05) compared to the simple task. There was a correlation between MEP facilitation and individual performance (r = -.64; P < .05), but no difference in MEP size associated with task difficulty (P > .05). In conclusion, corticospinal excitability exhibits a large increase during the precision task. This effect needs to be confirmed in neurological populations to potentially provide a simple and non-invasive approach to increase corticospinal drive during gait rehabilitation.

Autologous cellular therapy for cerebral palsy: a randomized, crossover trial

We examined an autologous mononuclear-cell-therapy-based approach to treat cerebral palsy using autologous umbilical cord blood or bone-marrow-derived mononuclear cells. The primary objective was to determine if autologous cells are safe to administer in children with cerebral palsy. The secondary objectives were to determine if there was improvement in motor function of patients 12 months after infusion using the Gross Motor Function Measure and to evaluate impact of treatment on corticospinal tract microstructure as determined by radial diffusivity measurement. This Phase 1/2a trial was a randomized, blinded, placebo-controlled, crossover study in children aged 2-10 years of age with cerebral palsy enrolled between November 2013 and November 2016. Participants were randomized to 2:1 treatment:placebo. Treatment was either autologous bone-marrow-derived mononuclear cells or autologous umbilical cord blood. All participants who enrolled and completed their baseline visit planned to return for follow-up visits at 6 months, 12 months and 24 months after the baseline visit. At the 12-month post-treatment visit, participants who originally received the placebo received either bone-marrow-derived mononuclear cell or umbilical cord blood treatment. Twenty participants were included; 7 initially randomized to placebo, and 13 randomized to treatment. Five participants randomized to placebo received bone-marrow-derived mononuclear cells, and 2 received umbilical cord blood at the 12-month visit. None of the participants experienced adverse events related to the stem cell infusion. Cell infusion at the doses used in our study did not dramatically alter motor function. We observed concordant bilateral changes in radial diffusivity in 10 of 15 cases where each corticospinal tract could be reconstructed in each hemisphere. In 60% of these cases (6/10), concordant decreases in bilateral corticospinal tract radial diffusivity occurred post-treatment. In addition, 100% of unilateral corticospinal tract cases (3/3) exhibited decreased corticospinal tract radial diffusivity post-treatment. In our discordant cases (n = 5), directionality of changes in corticospinal tract radial diffusivity appeared to coincide with handedness. There was a significant improvement in corticospinal tract radial diffusivity that appears related to handedness. Connectivity strength increased in either or both pathways (corticio-striatal and thalamo-cortical) in each participant at 12 months post-treatment. These data suggest that both stem cell infusions are safe. There may be an improvement in myelination in some groups of patients that correlate with small improvements in the Gross Motor Function Measure scales. A larger autologous cord blood trial is impractical at current rates of blood banking. Either increased private banking or matched units would be required to perform a larger-scale trial.

Signals from posterior parietal area 5 to motor cortex during locomotion

Area 5 of the parietal cortex is part of the "dorsal stream" cortical pathway which processes visual information for action. The signals that area 5 ultimately conveys to motor cortex, the main area providing output to the spinal cord, are unknown. We analyzed area 5 neuronal activity during vision-independent locomotion on a flat surface and vision-dependent locomotion on a horizontal ladder in cats focusing on corticocortical neurons (CCs) projecting to motor cortex from the upper and deeper cortical layers and compared it to that of neighboring unidentified neurons (noIDs). We found that upon transition from vision-independent to vision-dependent locomotion, the low discharge of CCs in layer V doubled and the proportion of cells with 2 bursts per stride tended to increase. In layer V, the group of 2-bursters developed 2 activity peaks that coincided with peaks of gaze shifts along the surface away from the animal, described previously. One-bursters and either subpopulation in supragranular layers did not transmit any clear unified stride-related signal to the motor cortex. Most CC group activities did not mirror those of their noID counterparts. CCs with receptive fields on the shoulder, elbow, or wrist/paw discharged in opposite phases with the respective groups of pyramidal tract neurons of motor cortex, the cortico-spinal cells.

Heterozygous Dcc Mutant Mice Have a Subtle Locomotor Phenotype

Axon guidance receptors such as deleted in colorectal cancer (DCC) contribute to the normal formation of neural circuits, and their mutations can be associated with neural defects. In humans, heterozygous mutations in DCC have been linked to congenital mirror movements, which are involuntary movements on one side of the body that mirror voluntary movements of the opposite side. In mice, obvious hopping phenotypes have been reported for bi-allelic Dcc mutations, while heterozygous mutants have not been closely examined. We hypothesized that a detailed characterization of Dcc heterozygous mice may reveal impaired corticospinal and spinal functions. Anterograde tracing of the Dcc^+/− motor cortex revealed a normally projecting corticospinal tract, intracortical microstimulation (ICMS) evoked normal contralateral motor responses, and behavioral tests showed normal skilled forelimb coordination. Gait analyses also showed a normal locomotor pattern and rhythm in adult Dcc^+/− mice during treadmill locomotion, except for a decreased occurrence of out-of-phase walk and an increased duty cycle of the stance phase at slow walking speed. Neonatal isolated Dcc^+/− spinal cords had normal left-right and flexor-extensor coupling, along with normal locomotor pattern and rhythm, except for an increase in the flexor-related motoneuronal output. Although Dcc^+/− mice do not exhibit any obvious bilateral impairments like those in humans, they exhibit subtle motor deficits during neonatal and adult locomotion.

Neuronal activity reorganization in motor cortex for successful locomotion after a lesion in the ventrolateral thalamus

Thalamic stroke leads to ataxia if the cerebellum-receiving ventrolateral thalamus (VL) is affected. The compensation mechanisms for this deficit are not well understood, particularly the roles that single neurons and specific neuronal subpopulations outside the thalamus play in recovery. The goal of this study was to clarify neuronal mechanisms of the motor cortex involved in mitigation of ataxia during locomotion when part of the VL is inactivated or lesioned. In freely ambulating cats, we recorded the activity of neurons in layer V of the motor cortex as the cats walked on a flat surface and horizontally placed ladder. We first reversibly inactivated ∼10% of the VL unilaterally using glutamatergic transmission antagonist CNQX and analyzed how the activity of motor cortex reorganized to support successful locomotion. We next lesioned 50%-75% of the VL bilaterally using kainic acid and analyzed how the activity of motor cortex reorganized when locomotion recovered. When a small part of the VL was inactivated, the discharge rates of motor cortex neurons decreased, but otherwise the activity was near normal, and the cats walked fairly well. Individual neurons retained their ability to respond to the demand for accuracy during ladder locomotion; however, most changed their response. When the VL was lesioned, the cat walked normally on the flat surface but was ataxic on the ladder for several days after lesion. When ladder locomotion normalized, neuronal discharge rates on the ladder were normal, and the shoulder-related group was preferentially active during the stride's swing phase.NEW & NOTEWORTHY This is the first analysis of reorganization of the activity of single neurons and subpopulations of neurons related to the shoulder, elbow, or wrist, as well as fast- and slow-conducting pyramidal tract neurons in the motor cortex of animals walking before and after inactivation or lesion in the thalamus. The results offer unique insights into the mechanisms of spontaneous recovery after thalamic stroke, potentially providing guidance for new strategies to alleviate locomotor deficits after stroke.

Reliability of robotic transcranial magnetic stimulation motor mapping

Robotic transcranial magnetic stimulation (TMS) is a noninvasive and safe tool that produces cortical motor maps using neuronavigational and neuroanatomical images. Motor maps are individualized representations of the primary motor cortex (M1) topography that may reflect developmental and interventional plasticity. Results of TMS motor map reliability testing have been variable, and robotic measures are undefined. We aimed to determine the short- and long-term reliability of robotic TMS motor maps. Twenty healthy participants underwent motor mapping at baseline, 24 h, and 4 wk. A 12 × 12 grid (7-mm spacing) was placed over the left M1, centered over the hand knob area. Four suprathreshold stimulations were delivered at each grid point. First dorsal interosseous (FDI) motor-evoked potentials (MEPs) were analyzed offline to generate map characteristics of area, volume, center of gravity (COG), and hotspot magnitude. Subsets of each outcome corresponding to 75%, 50%, and 25% of each map were determined. Reliability measures including intraclass correlation coefficient (ICC), minimal detectable change (MDC), and standard error of measure (SEM) were calculated. Map volume, COG, and hotspot magnitude were the most reliable measures (good-to-excellent) over both short- and long-term sessions. Map area reliability was poor-to-moderate for short- and long-term sessions. Smaller map percentile subsets showed decreased variability but only minimal improvements in reliability. MDC for most outcomes was >50%. Procedures were well tolerated with no serious adverse events. Robotic TMS motor mapping is relatively reliable over time, but careful consideration of specific outcomes is required for this method to interrogate plasticity in the human motor system.NEW & NOTEWORTHY Robotic transcranial magnetic stimulation (TMS) is a noninvasive and safe tool that produces cortical motor maps-individualized representations of the primary motor cortex (M1) topography-that may reflect developmental and interventional plasticity. This study is the first to evaluate short- and long-term relative and absolute reliability of TMS mapping outcomes at various M1 excitability levels using novel robotic neuronavigated TMS.

Premotor Cortex Provides a Substrate for the Temporal Transformation of Information During the Planning of Gait Modifications

We tested the hypothesis that the premotor cortex (PMC) in the cat contributes to the planning and execution of visually guided gait modifications. We analyzed single unit activity from 136 cells localized within layer V of cytoarchitectonic areas 6iffu and that part of 4δ within the ventral bank of the cruciate sulcus while cats walked on a treadmill and stepped over an obstacle that advanced toward them. We found a rich variety of discharge patterns, ranging from limb-independent cells that discharged several steps in front of the obstacle to step-related cells that discharged either during steps over the obstacle or in the steps leading up to that step. We propose that this population of task-related cells within this region of the PMC contributes to the temporal evolution of a planning process that transforms global information of the presence of an obstacle into the precise spatio-temporal limb adjustment required to negotiate that obstacle.

Contribution of the ventrolateral thalamus to the locomotion-related activity of motor cortex

The activity of motor cortex is necessary for accurate stepping on a complex terrain. How this activity is generated remains unclear. The goal of this study was to clarify the contribution of signals from the ventrolateral thalamus (VL) to formation of locomotion-related activity of motor cortex during vision-independent and vision-dependent locomotion. In two cats, we recorded the activity of neurons in layer V of motor cortex as cats walked on a flat surface and a horizontal ladder. We reversibly inactivated ~10% of the VL unilaterally with the glutamatergic transmission antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) and analyzed how this affected the activity of motor cortex neurons. We examined neuronal subpopulations with somatosensory receptive fields on different segments of the forelimb and pyramidal tract projecting neurons (PTNs). We found that the VL contribution to the locomotion-related activity of motor cortex is very powerful and has both excitatory and inhibitory components. The magnitudes of both the excitatory and inhibitory contributions fluctuate over the step cycle and depend on locomotion task. On a flat surface, the VL contributes more excitation to the shoulder- and elbow-related neurons than the wrist/paw-related cells. The VL excites the shoulder-related group the most during the transition from stance to swing phase, while most intensively exciting the elbow-related group during the transition from swing to stance. The VL contributes more excitation for the fast- than slow-conducting PTNs. Upon transition to vision-dependent locomotion on the ladder, the VL contribution increases more for the wrist/paw-related neurons and slow-conducting PTNs.NEW & NOTEWORTHY How the activity of motor cortex is generated and the roles that different inputs to motor cortex play in formation of response properties of motor cortex neurons during movements remain unclear. This is the first study to characterize the contribution of the input from the ventrolateral thalamus (VL), the main subcortical input to motor cortex, to the activity of motor cortex neurons during vision-independent and vision-dependent locomotion.

Animal models of developmental motor disorders: parallels to human motor dysfunction in cerebral palsy

Cerebral palsy (CP) is the most common motor disability in children. Much of the previous research on CP has focused on reducing the severity of brain injuries, whereas very few researchers have investigated the cause and amelioration of motor symptoms. This research focus has had an impact on the choice of animal models. Many of the commonly used animal models do not display a prominent CP-like motor phenotype. In general, rodent models show anatomically severe injuries in the central nervous system (CNS) in response to insults associated with CP, including hypoxia, ischemia, and neuroinflammation. Unfortunately, most rodent models do not display a prominent motor phenotype that includes the hallmarks of spasticity (muscle stiffness and hyperreflexia) and weakness. To study motor dysfunction related to developmental injuries, a larger animal model is needed, such as rabbit, pig, or nonhuman primate. In this work, we describe and compare various animal models of CP and their potential for translation to the human condition.

Transneuronal Downregulation of the Premotor Cholinergic System After Corticospinal Tract Loss

Injury to the supraspinal motor systems, especially the corticospinal tract, leads to movement impairments. In addition to direct disruption of descending motor pathways, spinal motor circuits that are distant to and not directly damaged by the lesion undergo remodeling that contributes significantly to the impairments. Knowing which spinal circuits are remodeled and the underlying mechanisms are critical for understanding the functional changes in the motor pathway and for developing repair strategies. Here, we target spinal premotor cholinergic interneurons (IN) that directly modulate motoneuron excitability via their cholinergic C-bouton terminals. Using a model of unilateral medullary corticospinal tract lesion in male rats, we found transneuronal downregulation of the premotor cholinergic pathway. Phagocytic microglial cells were upregulated in parallel with cholinergic pathway downregulation and both were blocked by minocycline, a microglia activation inhibitor. Additionally, we found a transient increase in interneuronal complement protein C1q expression that preceded cell loss. 3D reconstructions showed ongoing phagocytosis of C1q-expressing cholinergic INs by microglia 3 d after injury, which was complete by 10 d after injury. Unilateral motor cortex inactivation using the GABA_A receptor agonist muscimol replicated the changes detected at 3 d after lesion, indicating activity dependence. The neuronal loss after the lesion was rescued by increasing spinal activity using cathodal trans-spinal direct current stimulation. Our finding of activity-dependent modulation of cholinergic premotor INs after CST injury provides the mechanistic insight that maintaining activity, possibly during a critical period, helps to protect distant motor circuits from further damage and, as a result, may improve motor functional recovery and rehabilitation.SIGNIFICANCE STATEMENT Supraspinal injury to the motor system disrupts descending motor pathways, leading to movement impairments. Whether and how intrinsic spinal circuits are remodeled after a brain injury is unclear. Using a rat model of unilateral corticospinal tract lesion in the medulla, we show activity-dependent, transneuronal downregulation of the spinal premotor cholinergic system, which is mediated by microglial phagocytosis, possibly involving a rapid and transient increase in neuronal C1q before neuronal loss. Spinal cord neuromodulation after injury to augment spinal activity rescued the premotor cholinergic system. Our findings provide the mechanistic insight that maintaining activity, possibly during an early critical period, could protect distant motor circuits from further damage mediated by microglia and interneuronal complement protein and improve motor functional outcomes.

The role of intersegmental dynamics in coordination of the forelimb joints during unperturbed and perturbed skilled locomotion

Joint coordination during locomotion and how this coordination changes in response to perturbations remains poorly understood. We investigated coordination among forelimb joints during the swing phase of skilled locomotion in the cat. While cats walked on a horizontal ladder, one of the cross-pieces moved before the cat reached it, requiring the cat to alter step size. Direction and timing of the cross-piece displacement were manipulated. We found that the paw was transported in space through body translation and shoulder and elbow rotations, whereas the wrist provided paw orientation required to step on cross-pieces. Kinetic analysis revealed a consistent joint control pattern in all conditions. Although passive interaction and gravitational torques were the main sources of shoulder and elbow motions for most of the movement time, shoulder muscle torque influenced movement of the entire limb at the end of the swing phase, accelerating the shoulder and causing interaction torque that determined elbow motion. At the wrist, muscle and passive torques predominantly compensated for each other. In all perturbed conditions, although all joints and the body slightly contributed to changes in the step length throughout the entire movement, the major adjustment was produced by the shoulder at the movement end. We conclude that joint coordination during the swing phase is produced mainly passively, by exploiting gravity and the limb's intersegmental dynamics, which may simplify the neural control of locomotion. The use of shoulder musculature at the movement end enables flexible responses to environmental disturbances. NEW & NOTEWORTHY This is the first study to investigate joint control during the swing phase of skilled, accuracy-dependent locomotion in the cat and how this control is altered to adapt to known and unexpected perturbations. We demonstrate that a pattern of joint control that exploits gravitational and interaction torques is used in all conditions and that movement modifications are produced mainly by shoulder muscle torque during the last portion of the movement.

Motor system plasticity after unilateral injury in the developing brain

In maturity, motor skills depend on the corticospinal tract (CST) and brainstem pathways that together synapse on interneurons and motoneurons in the spinal cord. Descending signals to spinal neurons that mediate voluntary control can be distinguished from peripheral sensory signals, primarily for feedback control. These motor system circuits depend initially on developmental genetic mechanisms to establish their connections and neural activity- and use-dependent synaptic refinement during the early postnatal period to enable motor skills to develop. In this review we consider four key activity-dependent developmental mechanisms that provide insights into how the motor systems establish the proper connections for skilled movement control and how the same mechanisms also inform the mechanisms of motor impairments and developmental plasticity after corticospinal system injury: (1) synaptic competition between the CSTs from each hemisphere; (2) interactions between the CST and spinal cord neurons; (3) synaptic competition between the CST and proprioceptive sensory fibres; and (4) interactions between the developing corticospinal motor system and the rubrospinal tract. Our findings suggest that the corticospinal motor system effectively 'oversees' development of its subcortical targets through synaptic competition and trophic-like interactions and this has important implications for motor impairments after perinatal cortical stroke.

WHAT THIS PAPER ADDS

Neural activity-dependent processes inform the brain and spinal cord response to injury. The corticospinal motor system may 'oversee' development of its downstream subcortical targets through activity, trophic-like interactions, and synaptic competition.

Skilled Movements Require Non-apoptotic Bax/Bak Pathway-Mediated Corticospinal Circuit Reorganization

Early postnatal mammals, including human babies, can perform only basic motor tasks. The acquisition of skilled behaviors occurs later, requiring anatomical changes in neural circuitry to support the development of coordinated activation or suppression of functionally related muscle groups. How this circuit reorganization occurs during postnatal development remains poorly understood. Here we explore the connectivity between corticospinal (CS) neurons in the motor cortex and muscles in mice. Using trans-synaptic viral and electrophysiological assays, we identify the early postnatal reorganization of CS circuitry for antagonistic muscle pairs. We further show that this synaptic rearrangement requires the activity-dependent, non-apoptotic Bax/Bak-caspase signaling cascade. Adult Bax/Bak mutant mice exhibit aberrant co-activation of antagonistic muscle pairs and skilled grasping deficits but normal reaching and retrieval behaviors. Our findings reveal key cellular and molecular mechanisms driving postnatal motor circuit reorganization and the resulting impacts on muscle activation patterns and the execution of skilled movements.

Motor Cortex Activity Organizes the Developing Rubrospinal System

The corticospinal and rubrospinal systems function in skilled movement control. A key question is how do these systems develop the capacity to coordinate their motor functions and, in turn, if the red nucleus/rubrospinal tract (RN/RST) compensates for developmental corticospinal injury? We used the cat to investigate whether the developing rubrospinal system is shaped by activity-dependent interactions with the developing corticospinal system. We unilaterally inactivated M1 by muscimol microinfusion between postnatal weeks 5 and 7 to examine activity-dependent interactions and whether the RN/RST compensates for corticospinal tract (CST) developmental motor impairments and CST misprojections after M1 inactivation. We examined the RN motor map and RST cervical projections at 7 weeks of age, while the corticospinal system was inactivated, and at 14 weeks, after activity returned. During M1 inactivation, the RN on the same side showed normal RST projections and reduced motor thresholds, suggestive of precocious development. By contrast, the RN on the untreated/active M1 side showed sparse RST projections and an immature motor map. After M1 activity returned later in adolescent cat development, RN on the active M1/CST side continued to show a substantial loss of spinal terminations and an impaired motor map. RN/RST on the inactivated side regressed to a smaller map and fewer axons. Our findings suggest that the developing rubrospinal system is under activity-dependent regulation by the corticospinal system for establishing mature RST connections and RN motor map. The lack of RS compensation on the non-inactivated side can be explained by development of ipsilateral misprojections from the active M1 that outcompete the RST. Significance statement: Skilled movements reflect the activity of multiple descending motor systems and their interactions with spinal motor circuits. Currently, there is little insight into whether motor systems interact during development to coordinate their emerging functions and, if so, the mechanisms underlying this process. This study examined activity-dependent interactions between the developing corticospinal and rubrospinal systems, two key systems for skilled limb movements. We show that the developing rubrospinal system competes with the corticospinal system in establishing the red nucleus motor map and rubrospinal tract connections. This is the first demonstration of one motor system steering development, and ultimately function, of another. Knowledge of activity-dependent competition between these two systems helps predict the response of the rubrospinal system following corticospinal system developmental injury.

Slow maturation of planning in obstacle avoidance in humans

Complex gait (e.g., obstacle avoidance) requires a higher cognitive load than simple steady-state gait, which is a more automated movement. The higher levels of the central nervous system, responsible for adjusting motor plans to complex gait, develop throughout childhood into adulthood. Therefore, we hypothesize that gait strategies in complex gait are likely to mature until adulthood as well. However, little is known about the maturation of complex gait from childhood into adolescence and adulthood. To address this issue, we investigated obstacle avoidance in forty-four 8- to 18-yr-old participants who walked at preferred speed along a 6-m walkway on which a planar obstacle (150% of step length, 1 m wide) was projected. Participants avoided the obstacle by stepping over this projection, while lower body kinematics were recorded. Results showed that step length and speed adjustments during successful obstacle avoidance were similar across all ages, even though younger children modified step width to a greater extent. Additionally, the younger children used larger maximal toe elevations and take-off distances than older children. Moreover, during unsuccessful trials, younger children deployed exaggerated take-off distances, which resulted in obstacle contact upon the consecutive heel strike. These results indicate that obstacle avoidance is not fully matured in younger children, and that the inability to plan precise foot placements is an important factor contributing to failures in obstacle avoidance.

Accurate stepping on a narrow path: mechanics, EMG, and motor cortex activity in the cat

How do cats manage to walk so graciously on top of narrow fences or windowsills high above the ground while apparently exerting little effort? In this study we investigated cat full-body mechanics and the activity of limb muscles and motor cortex during walking along a narrow 5-cm path on the ground. We tested the hypotheses that during narrow walking 1) lateral stability would be lower because of the decreased base-of-support area and 2) the motor cortex activity would increase stride-related modulation because of imposed demands on lateral stability and paw placement accuracy. We measured medio-lateral and rostro-caudal dynamic stability derived from the extrapolated center of mass position with respect to the boundaries of the support area. We found that cats were statically stable in the frontal plane during both unconstrained and narrow-path walking. During narrow-path walking, cats walked slightly slower with more adducted limbs, produced smaller lateral forces by hindlimbs, and had elevated muscle activities. Of 174 neurons recorded in cortical layer V, 87% of forelimb-related neurons (from 114) and 90% of hindlimb-related neurons (from 60) had activities during narrow-path walking distinct from unconstrained walking: more often they had a higher mean discharge rate, lower depth of stride-related modulation, and/or longer period of activation during the stride. These activity changes appeared to contribute to control of accurate paw placement in the medio-lateral direction, the width of the stride, rather than to lateral stability control, as the stability demands on narrow-path and unconstrained walking were similar.

Known and unexpected constraints evoke different kinematic, muscle, and motor cortical neuron responses during locomotion

During navigation through complex natural environments, people and animals must adapt their movements when the environment changes. The neural mechanisms of such adaptations are poorly understood, especially with respect to constraints that are unexpected and must be adapted to quickly. In this study, we recorded forelimb-related kinematics, muscle activity, and the activity of motor cortical neurons in cats walking along a raised horizontal ladder, a complex locomotion task requiring accurate limb placement. One of the crosspieces was motorized, and displaced before the cat stepped on the ladder or at different points along the cat's progression over the ladder, either towards or away from the cat. We found that, when the crosspiece was displaced before the cat stepped onto the ladder, the kinematic modifications were complex and involved all forelimb joints. When the crosspiece displaced unexpectedly while the cat was on the ladder, the kinematic modifications were minimalistic and primarily involved distal joints. The activity of M. triceps and M. extensor digitorum communis differed based on the direction of displacement. Out of 151 neurons tested, 69% responded to at least one condition; however, neurons were significantly more likely to respond when crosspiece displacement was unexpected. Most often they responded during the swing phase. These results suggest that different neural mechanisms and motor control strategies are used to overcome constraints for locomotor movements depending on whether they are known or emerge unexpectedly.

Activity of somatosensory-responsive neurons in high subdivisions of SI cortex during locomotion

Responses of neurons in the primary somatosensory cortex during movements are poorly understood, even during such simple tasks as walking on a flat surface. In this study, we analyzed spike discharges of neurons in the rostral bank of the ansate sulcus (areas 1-2) in 2 cats while the cats walked on a flat surface or on a horizontal ladder, a complex task requiring accurate stepping. All neurons (n = 82) that had receptive fields (RFs) on the contralateral forelimb exhibited frequency modulation of their activity that was phase locked to the stride cycle during simple locomotion. Neurons with proximal RFs (upper arm/shoulder) and pyramidal tract-projecting neurons (PTNs) with fast-conducting axons tended to fire at peak rates in the middle of the swing phase, whereas neurons with RFs on the distal limb (wrist/paw) and slow-conducting PTNs typically showed peak firing at the transition between swing and stance phases. Eleven of 12 neurons with tactile RFs on the volar forepaw began firing toward the end of swing, with peak activity occurring at the moment of foot contact with floor, thereby preceding the evoked sensory volley from touch receptors. Requirement to step accurately on the ladder affected 91% of the neurons, suggesting their involvement in control of accuracy of stepping. During both tasks, neurons exhibited a wide variety of spike distributions within the stride cycle, suggesting that, during either simple or ladder locomotion, they represent the cycling somatosensory events in their activity both predictively before and reflectively after these events take place.

Gait training facilitates central drive to ankle dorsiflexors in children with cerebral palsy

Foot drop and toe walking are frequent concerns in children with cerebral palsy. The main underlying cause of these problems is early damage and lack of maturation of the corticospinal tract. In the present study we investigated whether 4 weeks of daily treadmill training with an incline may facilitate corticospinal transmission and improve the control of the ankle joint in children with cerebral palsy. Sixteen children with cerebral palsy (Gross Motor Classification System I:6, II:6, III:4) aged 5-14 years old, were recruited for the study. Evaluation of gait ability and intramuscular coherence was made twice before and twice after training with an interval of 1 month. Gait kinematics were recorded by 3D video analysis during treadmill walking with a velocity chosen by the child at the first evaluation. Foot pressure was measured by force sensitive foot soles during treadmill and over ground walking. EMG-EMG coherence was calculated from two separate electrode recordings placed over the tibialis anterior muscle. Training involved 30 min of walking daily on a treadmill with an incline for 30 days. Gait training was accompanied by significant increases in gait speed, incline on the treadmill, the maximal voluntary dorsiflexion torque, the number and amplitude of toe lifts late in the swing phase during gait and the weight exerted on the heel during the early stance phase of the gait cycle. EMG-EMG coherence in the beta and gamma frequency bands recorded from tibialis anterior muscle increased significantly when compared to coherence before training. The largest changes in coherence with training were observed for children <10 years of age. Importantly, in contrast to training-induced EMG increases, the increase in coherence was maintained at the follow-up measurement 1 month after training. Changes in the strength of coherence in the beta and gamma band were positively correlated with improvements in the subjects' ability to lift the toes in the swing phase. These data show that daily intensive gait training increases beta and gamma oscillatory drive to ankle dorsiflexor motor neurons and that it improves toe lift and heel strike in children with cerebral palsy. We propose that intensive gait training may produce plastic changes in the corticospinal tract, which are responsible for improvements in gait function.

The intrinsic operation of the networks that make us locomote

The spinal cord of all vertebrates contains the networks that coordinate the locomotor movements. In lamprey, zebrafish and amphibian tadpoles these networks generate the swimming movements and depend primarily on ipsilateral excitatory premotor interneurons of the V2a type (zebrafish) generate the segmental burst pattern. In zebrafish they can be further subdivided into three subclasses activating slow, intermediate and fast muscle fibers. Inhibitory commissural neurons are responsible for the alternating pattern between the two sides of the body. Stretch receptor neurons sense the movements and provide sensory feedback. In mammals the locomotor pattern in each limb comprises four different phases including flexor-extensor alternation. Also in this case local ipsilateral excitatory V2 interneurons can drive rhythmic burst activity in individual muscle groups. The coordination between the two hind limbs appears to be controlled by separate sets of commissural interneurons (V0) most likely engaged in walk, trot and gallop respectively.

Cholinergic systems are essential for late-stage maturation and refinement of motor cortical circuits

Previous studies reported that early postnatal cholinergic lesions severely perturb early cortical development, impairing neuronal cortical migration and the formation of cortical dendrites and synapses. These severe effects of early postnatal cholinergic lesions preclude our ability to understand the contribution of cholinergic systems to the later-stage maturation of topographic cortical representations. To study cholinergic mechanisms contributing to the later maturation of motor cortical circuits, we first characterized the temporal course of cortical motor map development and maturation in rats. In this study, we focused our attention on the maturation of cortical motor representations after postnatal day 25 (PND 25), a time after neuronal migration has been accomplished and cortical volume has reached adult size. We found significant maturation of cortical motor representations after this time, including both an expansion of forelimb representations in motor cortex and a shift from proximal to distal forelimb representations to an extent unexplainable by simple volume enlargement of the neocortex. Specific cholinergic lesions placed at PND 24 impaired enlargement of distal forelimb representations in particular and markedly reduced the ability to learn skilled motor tasks as adults. These results identify a novel and essential role for cholinergic systems in the late refinement and maturation of cortical circuits. Dysfunctions in this system may constitute a mechanism of late-onset neurodevelopmental disorders such as Rett syndrome and schizophrenia.

Activity-Based Therapies for Repair of the Corticospinal System Injured during Development

This review presents the mechanistic underpinnings of corticospinal tract (CST) development, derived from animal models, and applies what has been learned to inform neural activity-based strategies for CST repair. We first discuss that, in normal development, early bilateral CST projections are later refined into a dense crossed CST projection, with maintenance of sparse ipsilateral projections. Using a novel mouse genetic model, we show that promoting the ipsilateral CST projection produces mirror movements, common in hemiplegic cerebral palsy (CP), suggesting that ipsilateral CST projections become maladaptive when they become abnormally dense and strong. We next discuss how animal studies support a developmental “competition rule” whereby more active/used connections are more competitive and overtake less active/used connections. Based on this rule, after unilateral injury the damaged CST is less able to compete for spinal synaptic connections than the uninjured CST. This can lead to a progressive loss of the injured hemisphere’s contralateral projection and a reactive gain of the undamaged hemisphere’s ipsilateral CST. Knowledge of the pathophysiology of the developing CST after injury informs interventional strategies. In an animal model of hemiplegic CP, promoting injured system activity or decreasing the uninjured system’s activity immediately after the period of a developmental injury both increase the synaptic competitiveness of the damaged system, contributing to significant CST repair and motor recovery. However, delayed intervention, despite significant CST repair, fails to restore skilled movements, stressing the need to consider repair strategies for other neural systems, including the rubrospinal and spinal interneuronal systems. Our interventional approaches harness neural activity-dependent processes and are highly effective in restoring function. These approaches are minimally invasive and are poised for translation to the human.

EphA4-mediated ipsilateral corticospinal tract misprojections are necessary for bilateral voluntary movements but not bilateral stereotypic locomotion

In this study, we took advantage of the reported role of EphA4 in determining the contralateral spinal projection of the corticospinal tract (CST) to investigate the effects of ipsilateral misprojections on voluntary movements and stereotypic locomotion. Null EphA4 mutations produce robust ipsilateral CST misprojections, resulting in bilateral corticospinal tracts. We hypothesize that a unilateral voluntary limb movement, not a stereotypic locomotor movement, will become a bilateral movement in EphA4 knock-out mice with a bilateral CST. However, in EphA4 full knock-outs, spinal interneurons also develop bilateral misprojections. Aberrant bilateral spinal circuits could thus transform unilateral corticospinal control signals into bilateral movements. We therefore studied mice with conditional forebrain deletion of the EphA4 gene under control by Emx1, a gene expressed in the forebrain that affects the developing CST but spares brainstem motor pathways and spinal motor circuits. We examined two conditional knock-outs targeting forebrain EphA4 during performance of stereotypic locomotion and voluntary movement: adaptive locomotion over obstacles and exploratory reaching. We found that the conditional knock-outs used alternate stepping, not hopping, during overground locomotion, suggesting normal central pattern generator function and supporting our hypothesis of minimal CST involvement in the moment-to-moment control of stereotypic locomotion. In contrast, the conditional knock-outs showed bilateral voluntary movements under conditions when single limb movements are normally produced and, as a basis for this aberrant control, developed a bilateral motor map in motor cortex that is driven by the aberrant ipsilateral CST misprojections. Therefore, a specific change in CST connectivity is associated with and explains a change in voluntary movement.

Burst firing of neurons in the thalamic reticular nucleus during locomotion

This study examined the burst firing of neurons in the motor sector of the thalamic reticular nucleus (RE) of the cat. These neurons are inhibitory cells that project to the motor thalamus. The firing activity of RE neurons was studied during four behaviors: sleep, standing, walking on a flat surface, and accurate stepping on crosspieces of a horizontal ladder. Extracellularly recorded firing activity was analyzed in 58 neurons that were identified according to their receptive fields on the contralateral forelimb. All neurons generated bursts of spikes during sleep, half generated bursts of spikes during standing, and one-third generated bursts of spikes during walking. The majority of bursts were sequences of spikes with an exponential buildup of the firing rate followed by exponential decay with time constants in the range of 10-30 ms. We termed them "full-scale" bursts. All neurons also generated "atypical" bursts, in which the buildup of the firing rate deviated from the characteristic order. Burst firing was most likely to occur in neurons with receptive fields on the distal forelimb and least likely in neurons related to the proximal limb. Full-scale bursts were more frequent than atypical bursts during unconstrained walking on the flat surface. Bursts of both types occurred with similar probability during accurate stepping on the horizontal ladder, a task that requires forebrain control of locomotion. We suggest that transformations of the temporal pattern of bursts in the inhibitory RE neurons facilitate the tuning of thalamo-cortical signals to the complexity of ongoing locomotor tasks.

Pathophysiological mechanisms of impaired limb use and repair strategies for motor systems after unilateral injury of the developing brain

The corticospinal tract (CST) is important for limb control. In humans, it begins developing prenatally but CST connections do not have a mature pattern until about 6 months of age and its capacity to evoke muscle contraction does not mature until mid-adolescence. An initially bilateral projection is subsequently refined, so that most ipsilateral CST connections are eliminated. Unilateral brain damage during refinement leads to bilateral developmental impairments. The damaged side develops sparse and weak contralateral spinal connections and the non-involved hemisphere maintains its ipsilateral projection to develop an aberrant bilateral spinal projection. In a kitten model of unilateral spastic cerebral palsy, we replicate key features of the CST circuit changes: robust bilateral CST projections from the non-involved hemisphere, sparse contralateral connections from the affected hemisphere, and motor impairments. We discuss the role of activity-dependent synaptic competition in development of bilateral CSTs and consider several experimental strategies for restoring a more normal pattern of CST connections from the damaged and non-involved sides. We highlight recent results stressing the importance of combined repair of CST axons, restoration of a more normal motor cortex motor representation, and key involvement of spinal cholinergic interneurons in restoring skilled motor function.

Modification of cutaneous reflexes during visually guided walking

Although it has become apparent that cutaneous reflexes can be adjusted based on the phase and context of the locomotor task, it is not clear to what extent these reflexes are regulated when locomotion is modified under visual guidance. To address this, we compared the amplitude of cutaneous reflexes while subjects performed walking tasks that required precise foot placement. In one experiment, subjects walked overground and across a horizontal ladder with narrow raised rungs. In another experiment, subjects walked and stepped onto a series of flat targets, which required different levels of precision (large vs. narrow targets). The superficial peroneal or tibial nerve was electrically stimulated in multiple phases of the gait cycle in each condition and experiment. Reflexes between 50 and 120 ms poststimulation were sorted into 10 equal phase bins, and the amplitudes were then averaged. In each experiment, differences in cutaneous reflexes between conditions occurred predominantly during swing phase when preparation for precise foot placement was necessary. For instance, large excitatory cutaneous reflexes in ipsilateral tibialis anterior were present in the ladder condition and when stepping on narrow targets compared with inhibitory responses in the other conditions, regardless of the nerve stimulated. In the ladder experiments, additional effects of walking condition were evident during stance phase when subjects had to balance on the narrow ladder rungs and may be related to threat and/or the unstable foot-surface interaction. Taken together, these results suggest that cutaneous reflexes are modified when visual feedback regarding the terrain is critical for successful walking.

Effect of light on the activity of motor cortex neurons during locomotion

The motor cortex plays a critical role in accurate visually guided movements such as reaching and target stepping. However, the manner in which vision influences the movement-related activity of neurons in the motor cortex is not well understood. In this study we have investigated how the locomotion-related activity of neurons in the motor cortex is modified when subjects switch between walking in the darkness and in light. Three adult cats were trained to walk through corridors of an experimental chamber for a food reward. On randomly selected trials, lights were extinguished for approximately 4s when the cat was in a straight portion of the chamber's corridor. Discharges of 146 neurons from layer V of the motor cortex, including 51 pyramidal tract cells (PTNs), were recorded and compared between light and dark conditions. It was found that while cats' movements during locomotion in light and darkness were similar (as judged from the analysis of three-dimensional limb kinematics and the activity of limb muscles), the firing behavior of 49% (71/146) of neurons was different between the two walking conditions. This included differences in the mean discharge rate (19%, 28/146 of neurons), depth of stride-related frequency modulation (24%, 32/131), duration of the period of elevated firing ([PEF], 19%, 25/131), and number of PEFs among stride-related neurons (26%, 34/131). 20% of responding neurons exhibited more than one type of change. We conclude that visual input plays a very significant role in determining neuronal activity in the motor cortex during locomotion by altering one, or occasionally multiple, parameters of locomotion-related discharges of its neurons.

Distinct Thalamo-Cortical Controls for Shoulder, Elbow, and Wrist during Locomotion

Recent data from this laboratory on differential controls for the shoulder, elbow, and wrist exerted by the thalamo-cortical network during locomotion is presented, based on experiments involving chronically instrumented cats walking on a flat surface and along a horizontal ladder. The activity of the following three groups of neurons is characterized: (1) neurons of the motor cortex that project to the pyramidal tract (PTNs), (2) neurons of the ventrolateral thalamus (VL), many identified as projecting to the motor cortex (thalamo-cortical neurons, TCs), and (3) neurons of the reticular nucleus of thalamus (RE), which inhibit TCs. Neurons were grouped according to their receptive field into shoulder-, elbow-, and wrist/paw-related categories. During simple locomotion, shoulder-related PTNs were most active in the late stance and early swing, and on the ladder, often increased activity and stride-related modulation while reducing discharge duration. Elbow-related PTNs were most active during late swing/early stance and typically remained similar on the ladder. Wrist-related PTNs were most active during swing, and on the ladder often decreased activity and increased modulation while reducing discharge duration. In the VL, shoulder-related neurons were more active during the transition from swing-to-stance. Elbow-related cells tended to be more active during the transition from stance-to-swing and on the ladder often decreased their activity and increased modulation. Wrist-related neurons were more active throughout the stance phase. In the RE, shoulder-related cells had low discharge rates and depths of modulation and long periods of activity distributed evenly across the cycle. In sharp contrast, wrist/paw-related cells discharged synchronously during the end of stance and swing with short periods of high activity, high modulation, and frequent sleep-type bursting. We conclude that thalamo-cortical network processes information related to different segments of the forelimb differently and exerts distinct controls over the shoulder, elbow, and wrist during locomotion.

Lesion in the lateral cerebellum specifically produces overshooting of the toe trajectory in leading forelimb during obstacle avoidance in the rat

During locomotion, stepping over an obstacle under visual guidance is crucial to continuous safe walking. Studies of the role of the central nervous system in stepping movements have focused on cerebral cortical areas such as the primary motor cortex and posterior parietal cortex. There is speculation that the lateral cerebellum, which has strong anatomical connections with the cerebral cortex, also plays a key role in stepping movements over an obstacle, although this function of the lateral cerebellum has not yet been elucidated. Here we investigated the role of the lateral cerebellum during obstacle avoidance locomotion in rats with a lateral cerebellar lesion. A unilateral lesion in the lateral cerebellum did not affect limb movements during overground locomotion. Importantly, however, the lesioned animals showed overshooting of the toe trajectory specific to the leading forelimb ipsilateral to the lesion when stepping over an obstacle, and the peak toe position, in which the toe is maximally raised during stepping, shifted away from the upper edge of the obstacle. Recordings of EMG activity from elbow flexor and extensor muscles suggested that the overshooting toe trajectory in the ipsilateral leading forelimb possibly resulted from sustained elbow flexion and delayed elbow extension following prolonged activity of the biceps brachii. These results suggest that the lateral cerebellum specifically contributes to generating appropriate toe trajectories in the ipsilateral leading forelimb and to controlling related muscle activities in stepping over an obstacle, especially when accurate control of the distal extremity is achieved under visual guidance.

Differential responses of fast- and slow-conducting pyramidal tract neurons to changes in accuracy demands during locomotion

Most movements need to be accurate. The neuronal mechanisms controlling accuracy during movements are poorly understood. In this study we compare the activity of fast- and slow-conducting pyramidal tract neurons (PTNs) of the motor cortex in cats as they walk over both a flat surface, a task that does not require accurate stepping and can be accomplished without the motor cortex, as well as along a horizontal ladder, a task that requires accuracy and the activity of the motor cortex to be successful. Fast- and slow-conducting PTNs are known to have distinct biophysical properties as well as different afferent and efferent connections. We found that while the activity of all PTNs changes substantially upon transition from simple locomotion to accurate stepping on the ladder, slow-conducting PTNs respond in a much more concerted manner than fast-conducting ones. As a group, slow-conducting PTNs increase discharge rate, especially during the late stance and early swing phases, decrease discharge variability, have a tendency to shift their preferred phase of the discharge into the swing phase, and almost always produce a single peak of activity per stride during ladder locomotion. In contrast, the fast-conducting PTNs do not display such concerted changes to their activity. In addition, upon transfer from simple locomotion to accurate stepping on the ladder slow-conducting PTNs more profoundly increase the magnitude of their stride-related frequency modulation compared with fast-conducting PTNs. We suggest that slow-conducting PTNs are involved in control of accuracy of locomotor movements to a greater degree than fast-conducting PTNs.

Porencephaly in dogs and cats: magnetic resonance imaging findings and clinical signs

Magnetic resonance imaging (MRI) features of brain lesions in 5 dogs and 2 cats characterized by extensive cystic changes of the cerebral hemispheres in terms of a porencephaly are presented. Age at diagnosis ranged from 12 weeks to 7 years. MRI findings were confined to the forebrain. Porencephalic lesions appeared as wedge-shaped parenchymal defects connecting the ventricular system and the subarachnoid space or as large cystic defects in the cerebral hemispheres. Although in two adult dogs the porencephalic lesions were asymptomatic, the other animals showed clinical symptoms depending on the affected cerebral area. Three animals had seizures. Interestingly, four animals showed neurological signs normally not localized to the forebrain (nystagmus, hypermetria, ataxia). Whether these clinical signs are related to impaired function of the cerebral cortex or to not recognizable lesions in the cerebello-vestibular system could not be further clarified. Although the defects develop intrauterine or postnatal, the clinical symptoms can occur later in life. The definition of porencephaly as well as its subclassification is not uniform in veterinary medicine. We suggest the term encephaloclastic porencephaly unregarding the underlying cause of the defect, which cannot be further specified by diagnostic imaging.

Using motor behavior during an early critical period to restore skilled limb movement after damage to the corticospinal system during development

This study investigated the requirements for restoring motor function after corticospinal (CS) system damage during early postnatal development. Activity-dependent competition between the CS tracts (CSTs) of the two hemispheres is imperative for normal development. Blocking primary motor cortex (M1) activity unilaterally during a critical period [postnatal week 5 (PW5) to PW7] produces permanent contralateral motor skill impairments, loss of M1 motor map, aberrant CS terminations, and decreases in CST presynaptic sites and spinal cholinergic interneuron numbers. To repair these motor systems impairments and restore function, we manipulated motor experience in three groups of cats after this CST injury produced by inactivation. One group wore a jacket restraining the limb ipsilateral to inactivation, forcing use of the contralateral, impaired limb, for the month after M1 inactivation (PW8-PW13; "restraint alone"). A second group wore the restraint during PW8-PW13 and was also trained for 1 h/d in a reaching task with the contralateral forelimb ("early training"). To test the efficacy of intervention during adolescence, a third group wore the restraint and received reach training during PW20-PW24 ("delayed training"). Early training restored CST connections and the M1 motor map, increased cholinergic spinal interneurons numbers on the contralateral, relative to ipsilateral, side, and abrogated limb control impairments. Delayed training restored CST connectivity and the M1 motor map but not contralateral spinal cholinergic cell counts or motor performance. Restraint alone only restored CST connectivity. Our findings stress the need to reestablish the integrated functions of the CS system at multiple hierarchical levels in restoring skilled motor function after developmental injury.

Systems neurobiology of restorative neurology and future directions for repair of the damaged motor systems

Restoring movement control after central nervous system injury requires reconnecting the brain and spinal motoneurons, and doing so with sufficient precision and strength to enable robust voluntary muscle recruitment. Whereas the connection between the upper motoneuron in motor cortex and alpha-motoneurons was thought to be the only important connection for normal motor function in humans, we know that a multiplicity of motor circuits are recruited during normal motor control. Multiplicity of functionally important motor circuits points to the myriad possibilities of intervention that restorative neurology can turn to for repairing motor systems connections to recover movement control after injury. New motor systems repair strategies in animal models and humans are tapping into distributed motor control functions of the spinal cord; neural activity-based approaches, especially for corticospinal tract repair; and circuit-selective activation approaches. I focus on studies harnessing activity-based therapeutic approaches to promote sprouting of spared corticospinal tract axons after injury and redirecting potentially maladaptive plasticity. I discuss that we can see on the near horizon, many different strategies for repairing motor systems connections after injury.

Gait modification during approach phase when stepping over an obstacle in rats

Stepping over obstacles to avoid tripping is an essential component in safe and smooth locomotion. Obstacle avoidance during locomotion is completed in several steps during the approach phase toward the obstacle and stepping over the obstacle. The purpose of this study was to investigate gait modification during the approach phase when stepping over obstacles of different heights in rats. In all four limbs, the toe height when the toe was just above the obstacle increased depending on the obstacle height, leaving a safe margin. However, the horizontal distance between toe and obstacle just prior to stepping over was not influenced by obstacle height. In the fore- and hindlimbs that served as trailing limbs, it was found that the stride length and its related swing phase duration in the final step were significantly shorter than those in both the penultimate step and overground locomotion. These results suggest that adjustment of trailing limb in the final step during the approach phase is important in preparation for the stepping movement over an obstacle.

Harnessing activity-dependent plasticity to repair the damaged corticospinal tract in an animal model of cerebral palsy

The corticospinal tract (CST) is the principal motor control pathway for skilled movements. It has a protracted postnatal development, creating a protracted period of vulnerability to perinatal brain and spinal cord injury. Research has shown that the motor signs in cerebral palsy (CP) reflect the loss of CST connections as well as development of abnormal motor systems connections, especially between the developing CST and spinal motor circuits. In this paper, we discuss a feline model of CP that we have developed. The animals develop a pattern of abnormal CST connections that is remarkably similar to that seen in hemiplegic CP and visuomotor impairments. Using this model we devised neural activity-based therapeutic approaches to repair the abnormal CST connections and restore normal skilled movement control. Our studies stress that more active CST connections are better able to maintain strong synaptic connections with spinal motor circuits. We propose that perinatal trauma initiates a vicious cycle in which CST axons that are spared after an injury are at a disadvantage for maintaining spinal connections, leading to further reductions in connections and motor signs. If this is so, targeted activation of the spared CST might interrupt this process and lead to functional improvement.

Cortical control of adaptive locomotion in wild-type mice and mutant mice lacking the ephrin-Eph effector protein alpha2-chimaerin

In voluntary control, supraspinal motor systems select the appropriate response and plan movement mechanics to match task constraints. Spinal circuits translate supraspinal drive into action. We studied the interplay between motor cortex (M1) and spinal circuits during voluntary movements in wild-type (WT) mice and mice lacking the α2-chimaerin gene (Chn1(-/-)), necessary for ephrinB3-EphA4 signaling. Chn1(-/-) mice have aberrant bilateral corticospinal systems, aberrant bilateral-projecting spinal interneurons, and disordered voluntary control because they express a hopping gait, which may be akin to mirror movements. We addressed three issues. First, we determined the role of the corticospinal system in adaptive control. We trained mice to step over obstacles during treadmill locomotion. We compared performance before and after bilateral M1 ablation. WT mice adaptively modified their trajectory to step over obstacles, and M1 ablation increased substantially the incidence of errant steps over the obstacle. Chn1(-/-) mice randomly stepped or hopped during unobstructed locomotion but hopped over the obstacle. Bilateral M1 ablation eliminated this obstacle-dependent hop selection and increased forelimb obstacle contact errors. Second, we characterized the laterality of corticospinal action in Chn1(-/-) mice using pseudorabies virus retrograde transneuronal transport and intracortical microstimulation. We showed bilateral connections between M1 and forelimb muscles in Chn1(-/-) and unilateral connections in WT mice. Third, in Chn1(-/-) mice, we studied adaptive responses before and after unilateral M1 ablation. We identified a more important role for contralateral than ipsilateral M1 in hopping over the obstacle. Our findings suggest an important role for M1 in the mouse in moment-to-moment adaptive control, and further, using Chn1(-/-) mice, a role in mediating task-dependent selection of mirror-like hopping movements over the obstacle. Our findings also stress the importance of subcortical control during adaptive locomotion because key features of the trajectory remained largely intact after M1 ablation.

Chronic electrical stimulation of the intact corticospinal system after unilateral injury restores skilled locomotor control and promotes spinal axon outgrowth

Injury to the brain or spinal cord usually preserves some corticospinal (CS) connections. These residual circuits sprout spontaneously and in response to activity-based treatments. We hypothesized that augmenting activity in spared CS circuits would restore the skilled motor control lost after injury and augment outgrowth of CS terminations in the spinal cord. After selective injury of one half of the CS tract (CST) in the rat, we applied 10 d of electrical stimulation to the forelimb area of motor cortex of the spared half and tested motor performance for 30 d. Rats with injury and CST stimulation showed substantial improvements in skilled paw placement while walking over a horizontal ladder. By the end of the testing period, the walking errors of the previously impaired forelimb in rats with injury and stimulation returned to baseline, while the errors remained elevated in rats with injury only. Whereas the time to perform the task returned to normal in all animals, the pattern of errors returned to normal only in the stimulated group. Electrical stimulation also caused robust outgrowth of CST axon terminations in the ipsilateral spinal cord, the side of impairment, compared with rats with injury only. The outgrowth was directed to the normal gray matter territory of ipsilateral CST axon terminations. Thus, stimulation of spared CS circuits induced substantial axon outgrowth to the largely denervated side of the spinal cord and restored normal motor control in the previously impaired limbs.

Formation of descending pathways mediating cortical command to forelimb motoneurons in neonatally hemidecorticated rats

Neonatally hemidecorticated rats show fairly normal reaching and grasping behaviors of the forelimb contralateral to the lesion at the adult stage. Previous experiments using an anterograde tracer showed that the corticospinal fibers originating from the sensorimotor cortex of the intact side projected aberrant collaterals to the spinal gray matter on the ipsilateral side. The present study used electrophysiological methods to investigate whether the aberrant projections of the corticospinal tract mediated the pyramidal excitation to the ipsilateral forelimb motoneurons and, if so, which pathways mediate the effect in the hemidecorticated rats. Electrical stimulation to the intact medullary pyramid elicited bilateral negative field potentials in the dorsal horn of the spinal cord. In intracellular recordings of forelimb motoneurons, oligosynaptic pyramidal excitation was detected on both sides of the spinal cord in the hemidecorticated rats, whereas pyramidal excitation of motoneurons on the side ipsilateral to the stimulation was much smaller in normal rats. By lesioning the dorsal funiculus at the upper cervical level, we clarified that the excitation was transmitted to the ipsilateral motoneurons by at least two pathways: one via the corticospinal tract and spinal interneurons and the other via the cortico-reticulo-spinal pathways. These results suggested that in the neonatally hemidecorticated rats, the forelimb movements on the side contralateral to the lesion were modulated by motor commands through the indirect ipsilateral descending pathways from the sensorimotor cortex of the intact side either via the spinal interneurons or reticulospinal neurons.

How spinalized rats can walk: biomechanics, cortex, and hindlimb muscle scaling--implications for rehabilitation

Neonatal spinalized (NST) rats can achieve autonomous weight-supported locomotion never seen after adult injury. Mechanisms that support function in NST rats include increased importance of cortical trunk control and altered biomechanical control strategies for stance and locomotion. Hindlimbs are isolated from perturbations in quiet stance and act in opposition to forelimbs in locomotion in NST rats. Control of roll and yaw of the hindlimbs is crucial in their locomotion. The biomechanics of the hind limbs of NST rats are also likely crucial. We present new data showing the whole leg musculature scales proportional to normal rat musculature in NST rats, regardless of function. This scaling is a prerequisite for the NST rats to most effectively use pattern generation mechanisms and motor patterns that are similar to those present in intact rats. Pattern generation may be built into the lumbar spinal cord by evolution and matched to the limb biomechanics, so preserved muscle scaling may be essential to the NST function observed.

Differences in movement mechanics, electromyographic, and motor cortex activity between accurate and nonaccurate stepping

What are the differences in mechanics, muscle, and motor cortex activity between accurate and nonaccurate movements? We addressed this question in relation to walking. We assessed full-body mechanics (229 variables), activity of 8 limb muscles, and activity of 63 neurons from the motor cortex forelimb representation during well-trained locomotion with different demands on the accuracy of paw placement in cats: during locomotion on a continuous surface and along horizontal ladders with crosspieces of different widths. We found that with increasing accuracy demands, cats assumed a more bent-forward posture (by lowering the center of mass, rotating the neck and head down, and by increasing flexion of the distal joints) and stepped on the support surface with less spatial variability. On the ladder, the wrist flexion moment was lower throughout stance, whereas ankle and knee extension moments were higher and hip moment was lower during early stance compared with unconstrained locomotion. The horizontal velocity time histories of paws were symmetric and smooth and did not differ among the tasks. Most of the other mechanical variables also did not depend on accuracy demands. Selected distal muscles slightly enhanced their activity with increasing accuracy demands. However, in a majority of motor cortex cells, discharge rate means, peaks, and depths of stride-related frequency modulation changed dramatically during accurate stepping as compared with simple walking. In addition, in 30% of neurons periods of stride-related elevation in firing became shorter and in 20-25% of neurons activity or depth of frequency modulation increased, albeit not linearly, with increasing accuracy demands. Considering the relatively small changes in locomotor mechanics and substantial changes in motor cortex activity with increasing accuracy demands, we conclude that during practiced accurate stepping the activity of motor cortex reflects other processes, likely those that involve integration of visual information with ongoing locomotion.

Postnatal development of a segmental switch enables corticospinal tract transmission to spinal forelimb motor circuits

Development of skilled movements and the corticospinal tract (CST) begin prenatally and continue postnatally. Because the CST is required for skilled movements in maturity, it is accepted that motor skills cannot occur until the CST develops a mature organization. We recently showed that the CST plays an essential role in postnatal development of interneurons comprising the spinal circuits it engages. We proposed that CST signals are more effectively transmitted to ventral motor circuits after interneuron maturation, thereby enabling expression of CST motor functions, suggesting development of a segmental switch promoting transmission. We tested this by recording CST-evoked focal synaptic potentials, extracellularly, in the cervical enlargement of cats before and after interneuron maturation [postnatal week 5 (PW5) to PW7]. We compared monosynaptic CST amplitude input to segmental circuits with oligosynaptic ventral horn responses, as a measure of CST-evoked segmental response transmission from input to output. The M1 primary motor cortex was unilaterally inactivated between PW5 and PW7 to determine activity dependence. CST interneuron contacts were identified using confocal microscopy. CST terminals contact diverse interneuron classes. CST stimulation strongly activated ventral motor circuits at the ages when both interneurons and CST spinal terminations have developed a mature phenotype, supporting development of segmental transmission of CST signals. CST activity blockade impeded development of effective segmental transmission by the inactivated CST and created a novel path for transmission from the ipsilateral, unaffected, CST. Our findings show that development of segmental CST signal transmission regulates nascent CST motor control functions and provide insight into systems-level mechanisms for protracted motor skill development.

Neurophysiologic and rehabilitation insights from the split-belt and other locomotor adaptation paradigms

Locomotion is incredibly flexible. Humans are able to stay upright and navigate long distances in the face of ever-changing environments and varied task demands, such as walking while carrying a heavy object or in thick mud. The focus of this review is a behavior that is critical for this flexibility: motor adaptation. Adaptation is defined here as the process of adjusting a movement to new demands through trial-and-error practice. A key feature of adaptation is that more practice without the new demand is required to return the movement to its original state. Thus, motor adaptation is a short-term motor learning process. Several studies have been undertaken to determine how humans adapt walking to novel circumstances. Many of these studies have examined locomotor adaptation using a split-belt treadmill. The results of these studies of people who were healthy and people with neurologic damage suggest that the cerebellum is required for normal adaptation of walking and that the role of cerebral structures may be less critical. They also suggest that intersegmental and interlimb coordination is critical but readily adaptable to accommodate changes in the environment. Locomotor adaptation also can be used to determine the walking potential of people with specific neurologic deficits. For instance, split-belt and limb-weighting locomotor adaptation studies show that adults with chronic stroke are capable of improving weight-bearing and spatiotemporal symmetry, at least temporarily. Our challenge as rehabilitation specialists is to intervene in ways that maximize this capacity.

Dissociation of initial trajectory and final position errors during visuomotor adaptation following unilateral stroke

Previous studies have demonstrated that following stroke, motor impairment can occur ipsilateral to the lesion. Such impairments have provided insight into the contributions of each hemisphere to movement control, showing that left and right hemisphere damage produce different effects on movement: Left hemisphere damage produces deficits in specifying features of movement trajectory, while right hemisphere damage produces deficits in achieving an accurate and stable final position. We now propose that left and right hemisphere damage should also produce different deficits in the adaptation of trajectory and position. To test this idea, we examined adaptation to visuomotor rotations in the ipsilesional arms of hemiparetic stroke patients with left (LHD) and right hemisphere damage (RHD). We found that LHD interfered with adaptation of initial direction, but not with the ability to adapt the final position of the limb. In contrast, RHD interfered with online corrections to the final position during the course of adaptation. These findings support our hypothesis that the control of trajectory and steady-state position may be lateralized to the left and right hemispheres, respectively.