Kinematic Assessment of Fine Motor Skills in Children: Comparison of a Kinematic Approach and a Standardized Test

Deficits in fine motor skills have been reported in some children with neurodevelopmental disorders such as amblyopia or strabismus. Therefore, monitoring the development of motor skills and any potential improvement due to therapy is an important clinical goal. The aim of this study was to test the feasibility of performing a kinematic assessment within an optometric setting using inexpensive, portable, off-the-shelf equipment. The study also assessed whether kinematic data could enhance the information provided by a routine motor function screening test (the Movement Assessment Battery for Children, MABC). Using the MABC-2, upper limb dexterity was measured in a cohort of 47 typically developing children (7-15 years old), and the Leap motion capture system was used to record hand kinematics while children performed a bead-threading task. Two children with a history of amblyopia were also tested to explore the utility of a kinematic assessment in a clinical population. For the typically developing children, visual acuity and stereoacuity were within the normal range; however, the average standardized MABC-2 scores were lower than published norms. Comparing MABC-2 and kinematic measures in the two children with amblyopia revealed that both assessments provide convergent results and revealed deficits in fine motor control. In conclusion, kinematic assessment can augment standardized tests of fine motor skills in an optometric setting and may be useful for measuring visuomotor function and monitoring treatment outcomes in children with binocular vision anomalies.

Baseline Cerebro-Cerebellar Functional Connectivity in Afferent and Efferent Pathways Reveal Dissociable Improvements in Visuomotor Learning

Visuomotor coordination is a complex process involving several brain regions, primarily the cerebellum and motor cortex. Studies have shown inconsistent resting-state functional magnetic resonance imaging (rsfMRI) results in the cerebellar cortex and dentate nucleus of the cerebro-cerebellar connections. Echoing anatomical pathways, these two different cerebellar regions are differentially responsible for afferent and efferent cerebro-cerebellar functional connections. The aim of this study was to measure the baseline resting-state functional connectivity of different cerebellar afferent and efferent pathways and to investigate their relationship to visuomotor learning abilities. We used different cerebellar repetitive transcranial magnetic stimulation (rTMS) frequencies before a pursuit rotor task to influence visuomotor performance. Thirty-eight right-handed participants were included and randomly assigned to three different rTMS frequency groups (1 Hz, 10 Hz and sham) and underwent baseline rsfMRI and pursuit rotor task assessments. We report that greater baseline functional connectivity in the afferent cerebro-cerebellar pathways was associated with greater accuracy improvements. Interestingly, lower baseline functional connectivity in the efferent dentato-thalamo-cortical pathways was associated with greater stability in visuomotor performance, possibly associated with the inhibitory role of the dentate nucleus and caused a reduction in the efferent functional connectivity. The functional dissociation of the cerebellar cortex and dentate nucleus and their connections, suggests that distinct mechanisms in the cerebellum regarding visuomotor learning, which should be investigated in future research.

Unusual cortical symptoms of dural arteriovenous fistula mimicking transient ischemic attack

The clinical presentation of dural arteriovenous fistula (DAVF) can vary. A 47-year-old man complained of transient difficulty playing badminton and speech disturbance for 10 minutes. His symptoms were suspected to be visuomotor coordination deficit similar to optic ataxia and anomic aphasia. Magnetic resonance imaging and angiography revealed vasogenic edema and perfusion delay in the left temporo-occipital area and an abnormal connection between the left occipital artery and transverse sinus. Transverse sinus DAVF was diagnosed by conventional cerebral angiography. We believe that this is the unique case of DAVF manifested as visuomotor coordination deficit suspected optic ataxia and anomic aphasia.

Looking at the Road When Driving Around Bends: Influence of Vehicle Automation and Speed

When negotiating bends car drivers perform gaze polling: their gaze shifts between guiding fixations (GFs; gaze directed 1–2 s ahead) and look-ahead fixations (LAFs; longer time headway). How might this behavior change in autonomous vehicles where the need for constant active visual guidance is removed? In this driving simulator study, we analyzed this gaze behavior both when the driver was in charge of steering or when steering was delegated to automation, separately for bend approach (straight line) and the entry of the bend (turn), and at various speeds. The analysis of gaze distributions relative to bend sections and driving conditions indicate that visual anticipation (through LAFs) is most prominent before entering the bend. Passive driving increased the proportion of LAFs with a concomitant decrease of GFs, and increased the gaze polling frequency. Gaze polling frequency also increased at higher speeds, in particular during the bend approach when steering was not performed. LAFs encompassed a wide range of eccentricities. To account for this heterogeneity two sub-categories serving distinct information requirements are proposed: mid-eccentricity LAFs could be more useful for anticipatory planning of steering actions, and far-eccentricity LAFs for monitoring potential hazards. The results support the idea that gaze and steering coordination may be strongly impacted in autonomous vehicles.

Parallel learning processes of a visuomotor adaptation task in a changing environment

During the control of reaching movements, a key contribution of the visual system is the localization of relevant environmental targets. In motor adaptation processes, the visual evaluation of effector motor behavior enables learning from errors, which demands continuous visual attentional focus. However, most current adaptation paradigms include static targets; therefore, when a learning situation develops in a highly variable environment and there is a double demand for visual resources (environment and motor performance), the evolution of learning processes is unknown. In order to understand how learning processes evolve in a variable environment, a video game task was designed in which subjects were asked to manage a 60° counterclockwise-rotated cursor to capture descending targets with initially unpredictable trajectories. During the task, the cursor and eye movements were recorded to dissect visuomotor coordination. We observed that the pursuit of the targets conditioned a predominant and continuous visual inspection of the environment instead of the rotated cursor. As learning progressed, subjects exhibited a linear reduction in directional error and selected a motor strategy based on the degree of reward, which improved the performance. These results suggest that when the environment demands high visual attention, error-based and reinforced motor learning processes are implemented simultaneously, thus enabling efficient predictive behavior.

The quality of visual information about the lower extremities influences visuomotor coordination during virtual obstacle negotiation

Successful negotiation of obstacles during walking relies on the integration of visual information about the environment with ongoing locomotor commands. When information about the body and the environment is removed through occlusion of the lower visual field, individuals increase downward head pitch angle, reduce foot placement precision, and increase safety margins during crossing. However, whether these effects are mediated by loss of visual information about the lower extremities, the obstacle, or both remains to be seen. Here we used a fully immersive, virtual obstacle negotiation task to investigate how visual information about the lower extremities is integrated with information about the environment to facilitate skillful obstacle negotiation. Participants stepped over virtual obstacles while walking on a treadmill with one of three types of visual feedback about the lower extremities: no feedback, end-point feedback, and a link-segment model. We found that absence of visual information about the lower extremities led to an increase in the variability of leading foot placement after crossing. The presence of a visual representation of the lower extremities promoted greater downward head pitch angle during the approach to and subsequent crossing of an obstacle. In addition, having greater downward head pitch was associated with closer placement of the trailing foot to the obstacle, further placement of the leading foot after the obstacle, and higher trailing foot clearance. These results demonstrate that the fidelity of visual information about the lower extremities influences both feedforward and feedback aspects of visuomotor coordination during obstacle negotiation. NEW & NOTEWORTHY Here we demonstrate that visual information about the lower extremities is utilized for precise foot placement and control of safety margins during obstacle negotiation. We also found that when a visual representation of the lower extremities is present, this information is used in the online control of foot trajectory. Together, our results highlight how visual information about the body and the environment is integrated with motor commands for planning and online control of obstacle negotiation.

Is effect of transcranial direct current stimulation on visuomotor coordination dependent on task difficulty?

Transcranial direct current stimulation (tDCS), an emerging technique for non-invasive brain stimulation, is increasingly used to induce changes in cortical excitability and modulate motor behavior, especially for upper limbs. The purpose of this study was to investigate the effects of tDCS of the primary motor cortex on visuomotor coordination based on three levels of task difficulty in healthy subjects. Thirty-eight healthy participants underwent real tDCS or sham tDCS. Using a single-blind, sham-controlled crossover design, tDCS was applied to the primary motor cortex. For real tDCS conditions, tDCS intensity was 1 mA while stimulation was applied for 15 minutes. For the sham tDCS, electrodes were placed in the same position, but the stimulator was turned off after 5 seconds. Visuomotor tracking task, consisting of three levels (levels 1, 2, 3) of difficulty with higher level indicating greater difficulty, was performed before and after tDCS application. At level 2, real tDCS of the primary motor cortex improved the accurate index compared to the sham tDCS. However, at levels 1 and 3, the accurate index was not significantly increased after real tDCS compared to the sham tDCS. These findings suggest that tasks of moderate difficulty may improve visuomotor coordination in healthy subjects when tDCS is applied compared with easier or more difficult tasks.

Interpersonal variability in timing strategy and temporal accuracy in rapid interception task with variable time-to-contact

In rapid interceptive actions such as hitting a baseball, cricket ball or tennis ball, ball speed varies between trials, and players have to compensate the time lag by controlling the moment of movement onset and movement duration. Previous studies have found that these two variables can flexibly co-vary and are robustly influenced by target speed (i.e. velocity-coupling effect: faster movement for faster target). However, some studies reported an interpersonal variability in the timing control strategy and the relationship between the strategy and temporal accuracy in rapid interception is unclear. We used a baseball-simulated rapid interceptive task to assess this issue. Under relatively easy time constraints, there was a large interpersonal variability, and participants were distinctively divided into two groups: those who mainly modulated their movement duration and those who mainly controlled their movement onset. When the time constraint became severe, the second strategy shifted to the first strategy in most of the second group participants. In the both cases, being able to mainly control movement onset resulted in higher temporal accuracy. These results suggest that minimising the velocity-coupling effect is an important factor to achieve high temporal accuracy in rapid interception.

Looking away before moving forward: changes in optic-flow perception precede locomotor development

Voluntary locomotion is one of the most important motor actions performed by animals, including humans, and vision plays an important role in controlling such action. We conducted cross-sectional (Experiment 1) and longitudinal (Experiment 2) investigations and found that the perception of visual motion (optic flow), a critical cue for perceiving and controlling the direction of locomotion, drastically changes just before the emergence of locomotion in infancy. The results suggest that developmental change in particular visual perceptions precedes and potentially promotes the emergence of related motor actions in early development. Our findings offer a new perspective on the development of visuomotor coordination, which has long been thought to derive from the development of motor actions rather than from changes in visual perceptions.