The superior colliculus motor region does not respond to finger tapping movements in humans

Electrophysiological studies in macaques and functional neuroimaging in humans revealed a motor region in the superior colliculus (SC) for upper limb reaching movements. Connectivity studies in macaques reported direct connections between this SC motor region and cortical premotor arm, hand, and finger regions. These findings motivated us to investigate if the human SC is also involved in sequential finger tapping movements. We analyzed fMRI task data of 130 subjects executing finger tapping from the Human Connectome Project. While we found strong signals in the SC for visual cues, we found no signals related to simple finger tapping. In subsequent experimental measurements, we searched for responses in the SC corresponding to complex above simple finger tapping sequences. We observed expected signal increases in cortical motor and premotor regions for complex compared to simple finger tapping, but no signal increases in the motor region of the SC. Despite evidence for direct anatomical connections of the SC motor region and cortical premotor hand and finger areas in macaques, our results suggest that the SC is not involved in simple or complex finger tapping in humans.

Activity in the human superior colliculus associated with reaching for tactile targets

The superior colliculus (SC) plays a major role in orienting movements of eyes and the head and in the allocation of attention. Functions of the SC have been mostly investigated in animal models, including non-human primates. Differences in the SC's anatomy and function between different species question extrapolations of these studies to humans without further validation. Few electrophysiological and neuroimaging studies in animal models and humans have reported a role of the SC in visually guided reaching movements. Using BOLD fMRI imaging, we sought to decipher if the SC is also active during reaching movements guided by tactile stimulation. Participants executed reaching movements to visual and tactile target positions. When contrasted against visual and tactile stimulation without reaching, we found increased SC activity with reaching not only for visual but also for tactile targets. We conclude that the SC's involvement in reaching does not rely on visual inputs. It is also independent from a specific sensory modality. Our results indicate a general involvement of the human SC in upper limb reaching movements.

Characterization of the blood oxygen level dependent hemodynamic response function in human subcortical regions with high spatiotemporal resolution

Subcortical brain regions are absolutely essential for normal human function. These phylogenetically early brain regions play critical roles in human behaviors such as the orientation of attention, arousal, and the modulation of sensory signals to cerebral cortex. Despite the critical health importance of subcortical brain regions, there has been a dearth of research on their neurovascular responses. Blood oxygen level dependent (BOLD) functional MRI (fMRI) experiments can help fill this gap in our understanding. The BOLD hemodynamic response function (HRF) evoked by brief (<4 s) neural activation is crucial for the interpretation of fMRI results because linear analysis between neural activity and the BOLD response relies on the HRF. Moreover, the HRF is a consequence of underlying local blood flow and oxygen metabolism, so characterization of the HRF enables understanding of neurovascular and neurometabolic coupling. We measured the subcortical HRF at 9.4T and 3T with high spatiotemporal resolution using protocols that enabled reliable delineation of HRFs in individual subjects. These results were compared with the HRF in visual cortex. The HRF was faster in subcortical regions than cortical regions at both field strengths. There was no significant undershoot in subcortical areas while there was a significant post-stimulus undershoot that was tightly coupled with its peak amplitude in cortex. The different BOLD temporal dynamics indicate different vascular dynamics and neurometabolic responses between cortex and subcortical nuclei.

Effects of arm weight and target height on hand selection: A low-cost virtual reality paradigm

We evaluated the ability of a virtual reality (VR) system to reliably detect the reaching frequency midline position of a user; the distinguishing plane between free-choice use of the left and right hand. The paradigm utilized the Leap Motion Hand Tracker along with a custom script written in C# and was realized through a Unity3D application. Stimuli appeared in random locations on the computer screen and required the participant to reach with the hand of their choice to contact them with a virtually coupled hand inside the virtual space. We investigated the effects of two manipulations of effort on the free-choice reaching of either the left or right hand. We varied the height of target positions and applied an additional weight to the non-dominant, left hand. We observed main effects of height and weight on reaching frequency midline positions across the group. We found increased use of the dominant hand as stimuli height increased, as well as a significant increase in overall use of the dominant, right hand when a weighted-glove was worn by the non-dominant, left hand. Our results are in line with previously published research on hand selection from similar paradigms, supporting the use of our VR paradigm in future experiments and applications.

In-vivo quantitative structural imaging of the human midbrain and the superior colliculus at 9.4T

We explored anatomical details of the superior colliculus (SC) by in vivo magnetic resonance imaging (MRI) at 9.4T. The high signal-to-noise ratio allowed the acquisition of high resolution, multi-modal images with voxel sizes ranging between 176 × 132 × 600 μm and (800)³μm. Quantitative mapping of the longitudinal relaxation rate R1, the effective transverse relaxation rate R2*, and the magnetic susceptibility QSM was performed in 14 healthy volunteers. The images were analyzed in native space as well as after normalization to a common brain space (MNI). The coefficient-of-variation (CoV) across subjects was evaluated in prominent regions of the midbrain, reaching the best reproducibility (CoV of 5%) in the R2* maps of the SC in MNI space, while the CoV in the QSM maps remained high regardless of brain-space. To investigate whether more complex neurobiological architectural features could be detected, depth profiles through the SC layers towards the red nucleus (RN) were evaluated at different levels of the SC along the rostro-caudal axis. This analysis revealed alterations of the quantitative MRI parameters concordant with previous post mortem histology studies of the cyto- and myeloarchitecture of the SC. In general, the R1 maps were hyperintense in areas characterized by the presence of abundant myelinated fibers, and likely enabled detection of the deep white layer VII of the SC adjacent to the periaqueductal gray. While R1 maps failed to reveal finer details, possibly due to the relatively coarse spatial sampling used for this modality, these could be recovered in R2* maps and in QSM. In the central part of the SC along its rostro-caudal axis, increased R2* values and decreased susceptibility values were observed 2 mm below the SC surface, likely reflecting the myelinated fibers in the superficial optic layer (layer III). Towards the deeper layers, a second increase in R2* was paralleled by a paramagnetic shift in QSM suggesting the presence of an iron-rich layer about 3 mm below the surface of the SC, attributed to the intermediate gray layer (IV) composed of multipolar neurons. These results dovetail observations in histological specimens and animal studies and demonstrate that high-resolution multi-modal MRI at 9.4T can reveal several microstructural features of the SC in vivo.

Preserved Expert Object Recognition in a Case of Visual Hemiagnosia

We examined a stroke patient (HWS) with a unilateral lesion of the right medial ventral visual stream, involving the right fusiform and parahippocampal gyri. In a number of object recognition tests with lateralized presentations of target stimuli, HWS showed significant symptoms of hemiagnosia with contralesional recognition deficits for everyday objects. We further explored the patient's capacities of visual expertise that were acquired before the current perceptual impairment became effective. We confronted him with objects he was an expert for already before stroke onset and compared this performance with the recognition of familiar everyday objects. HWS was able to identify significantly more of the specific (“expert”) than of the everyday objects on the affected contralesional side. This observation of better expert object recognition in visual hemiagnosia allows for several interpretations. The results may be caused by enhanced information processing for expert objects in the ventral system in the affected or the intact hemisphere. Expert knowledge could trigger top–down mechanisms supporting object recognition despite of impaired basic functions of object processing. More importantly, the current work demonstrates that top–down mechanisms of visual expertise influence object recognition at an early stage, probably before visual object information propagates to modules of higher object recognition. Because HWS showed a lesion to the fusiform gyrus and spared capacities of expert object recognition, the current study emphasizes possible contributions of areas outside the ventral stream to visual expertise.

Depth-dependence of visual signals in the human superior colliculus at 9.4 T

The superior colliculus (SC) is a layered structure located in the midbrain. We exploited the improved spatial resolution and BOLD signal strength available at 9.4 T to investigate the depth profile of visual BOLD responses in the human SC based on distortion-corrected EPI data with a 1 mm isotropic resolution. We used high resolution (350 µm in-plane) anatomical images to determine regions-of-interest of the SC and applied a semi-automated method to segment it into superficial, intermediate, and deep zones. A greater than linear increase in sensitivity of the functional signal at 9.4 T allowed us to detect a statistically significant depth pattern in a group analysis with a 20 min stimulation paradigm. Descriptive data showed consistent depth profiles also in single individuals. The highest signals were localized to the superficial layers of the right and left SC during contralateral stimulation, which was in good agreement with its functional architecture known from non-human primates. This study thus demonstrates the potential of 9.4 T MRI for functional neuroimaging even in deeply located, particularly challenging brain structures such as the SC. Hum Brain Mapp 38:574-587, 2017. © 2016 Wiley Periodicals, Inc.

Memory-guided reaching in a patient with visual hemiagnosia

The two-visual-systems hypothesis (TVSH) postulates that memory-guided movements rely on intact functions of the ventral stream. Its particular importance for memory-guided actions was initially inferred from behavioral dissociations in the well-known patient DF. Despite of rather accurate reaching and grasping movements to visible targets, she demonstrated grossly impaired memory-guided grasping as much as impaired memory-guided reaching. These dissociations were later complemented by apparently reversed dissociations in patients with dorsal damage and optic ataxia. However, grasping studies in DF and optic ataxia patients differed with respect to the retinotopic position of target objects, questioning the interpretation of the respective findings as a double dissociation. In contrast, the findings for reaching errors in both types of patients came from similar peripheral target presentations. However, new data on brain structural changes and visuomotor deficits in DF also questioned the validity of a double dissociation in reaching. A severe visuospatial short-term memory deficit in DF further questioned the specificity of her memory-guided reaching deficit. Therefore, we compared movement accuracy in visually-guided and memory-guided reaching in a new patient who suffered a confined unilateral damage to the ventral visual system due to stroke. Our results indeed support previous descriptions of memory-guided movements' inaccuracies in DF. Furthermore, our data suggest that recently discovered optic-ataxia like misreaching in DF is most likely caused by her parieto-occipital and not by her ventral stream damage. Finally, multiple visuospatial memory measurements in HWS suggest that inaccuracies in memory-guided reaching tasks in patients with ventral damage cannot be explained by visuospatial short-term memory or perceptual deficits, but by a specific deficit in visuomotor processing.

Involvement of the TPJ Area in Processing of Novel Global Forms

The neuropsychological syndrome “simultanagnosia” is characterized by the inability to integrate local elements into a global entity. This deficit in Gestalt perception is mainly apparent for novel global structures administered in clinical tests or unfamiliar visual scenes. Recognition of familiar complex objects or well-known visual scenes is often unaffected. Recent neuroimaging studies and reports from simultanagnosia patients suggest a crucial involvement of temporoparietal brain areas in processing of hierarchically organized visual material. In this study, we investigated the specific role of the TPJ in Gestalt perception. On the basis of perceptual characteristics known from simultanagnosia, we hypothesized that TPJ is dominantly involved in processing of novel object arrangements. To answer this question, we performed a learning study with hierarchical stimuli and tested behavioral and neuronal characteristics of Gestalt perception pre- and posttraining. The study included 16 psychophysical training sessions and two neuroimaging sessions. Participants improved their behavioral performance for trained global stimuli and showed limited transfer to untrained global material. We found significant training dependent neuronal signal modulations in anterior right hemispheric TPJ regions. These activation changes were specific to trained global stimuli, whereas no systematic neuronal response changes were observed for recognition of untrained global stimuli, local elements and regular objects that served as control stimuli. In line with perceptual characteristics in simultanagnosia, the results argue for an involvement of TPJ in processing of novel global structures. We discuss the signal modulations in the context of a more efficient or different neuronal strategy to process familiar global stimuli.

Limb apraxia in acute ischemic stroke: a neglected clinical challenge?

Symptoms of limb apraxia and executive dysfunctions are currently not explicitly considered by the National Institutes of Health Stroke Scale and, thus, not routinely tested by clinicians in the acute care of patients with suspected stroke. Neuropsychological testing, clinical examination, MRI, and functional magnetic resonance imaging (fMRI) were performed in a right-handed patient with acute onset of left-sided sensorimotor hemiparesis due to a right hemisphere ischemic stroke. Deficits in the execution of meaningless and meaningful gestures were not detected properly on initial clinical examination but were revealed later on through neuropsychological testing. Instead, the patient's inability to respond to specific instructions in the acute care setting was mistaken to reflect severe deficits in auditory comprehension. fMRI revealed right-hemispheric localization of language in the right-handed patient. We suggest including a bedside test for limb apraxia symptoms in acute clinical care of stroke patients. The distinction between deficits in limb praxis and impairments of language can be complicated owing to the common hemispheric co-localization of the two functions.

The temporo-parietal junction contributes to global gestalt perception-evidence from studies in chess experts

In a recent neuroimaging study the comparison of intact vs. disturbed perception of global gestalt indicated a significant role of the temporo-parietal junction (TPJ) in the intact perception of global gestalt (Huberle and Karnath, 2012). This location corresponded well with the areas known to be damaged or impaired in patients with simultanagnosia after stroke or due to neurodegenerative diseases. It was concluded that the TPJ plays an important role in the integration of individual items to a holistic percept. Thus, increased BOLD signals should be found in this region whenever a task calls for the integration of multiple visual items. Behavioral experiments in chess experts suggested that their superior skills in comparison to chess novices are partly based on fast holistic processing of chess positions with multiple pieces. We thus analyzed BOLD data from four fMRI studies that compared chess experts with chess novices during the presentation of complex chess-related visual stimuli (Bilalić et al., 2010, 2011a,b, 2012). Three regions of interests were defined by significant TPJ clusters in the abovementioned study of global gestalt perception (Huberle and Karnath, 2012) and BOLD signal amplitudes in these regions were compared between chess experts and novices. These cross-paradigm ROI analyses revealed higher signals at the TPJ in chess experts in comparison to novices during presentations of complex chess positions. This difference was consistent across the different tasks in five independent experiments. Our results confirm the assumption that the TPJ region identified in previous work on global gestalt perception plays an important role in the processing of complex visual stimulus configurations.

Guidelines and quality measures for the diagnosis of optic ataxia

Since the first description of a systematic mis-reaching by Bálint in 1909, a reasonable number of patients showing a similar phenomenology, later termed optic ataxia (OA), has been described. However, there is surprising inconsistency regarding the behavioral measures that are used to detect OA in experimental and clinical reports, if the respective measures are reported at all. A typical screening method that was presumably used by most researchers and clinicians, reaching for a target object in the peripheral visual space, has never been evaluated. We developed a set of instructions and evaluation criteria for the scoring of a semi-standardized version of this reaching task. We tested 36 healthy participants, a group of 52 acute and chronic stroke patients, and 24 patients suffering from cerebellar ataxia. We found a high interrater reliability and a moderate test-retest reliability comparable to other clinical instruments in the stroke sample. The calculation of cut-off thresholds based on healthy control and cerebellar patient data showed an unexpected high number of false positives in these samples due to individual outliers that made a considerable number of errors in peripheral reaching. This study provides first empirical data from large control and patient groups for a screening procedure that seems to be widely used but rarely explicitly reported and prepares the grounds for its use as a standard tool for the description of patients who are included in single case or group studies addressing optic ataxia similar to the use of neglect, extinction, or apraxia screening tools.

Effects of pictorial cues on reaching depend on the distinctiveness of target objects

There is an ongoing debate under what conditions learned object sizes influence visuomotor control under preserved stereovision. Using meaningful objects (matchboxes of locally well-known brands in the UK) a previous study has nicely shown that the recognition of these objects influences action programming by means of reach amplitude and grasp pre-shaping even under binocular vision. Using the same paradigm, we demonstrated that short-term learning of colour-size associations was not sufficient to induce any visuomotor effects under binocular viewing conditions. Now we used the same matchboxes, for which the familiarity effect was shown in the UK, with German participants who have never seen these objects before. We addressed the question whether simply a high degree of distinctness, or whether instead actual prior familiarity of these objects, are required to affect motor computations. We found that under monocular and binocular viewing conditions the learned size and location influenced the amplitude of the reaching component significantly. In contrast, the maximum grip aperture remained unaffected for binocular vision. We conclude that visual distinctness is sufficient to form reliable associations in short-term learning to influence reaching even for preserved stereovision. Grasp pre-shaping instead seems to be less susceptible to such perceptual effects.

Fiber pathways connecting cortical areas relevant for spatial orienting and exploration

By implementing a task that closely resembled a clinical test for diagnosing spatial neglect in stroke patients, Himmelbach et al. (: Neuroimage 32:1747-1759) found significantly increased activation during active exploration in those cortical areas in healthy subjects that are known to induce spatial neglect in case of a lesion. The present study investigated whether direct intra-hemispheric cortico-cortical connections could be found between these activated clusters using a probabilistic fiber-tracking approach in 52 healthy subjects. We found that parts of the extreme capsule (EmC) and the middle longitudinal fascicle (MdLF) connected the functional cluster in the prefrontal cortex with the superior temporal cortex and the temporo-parietal junction (TPJ) area in both hemispheres. The activation peak in the TPJ was additionally connected to the inferior frontal cortex by parts of the arcuate fascicle and the superior longitudinal fascicle (SLF II) in the right hemisphere. Our study elucidates the connections constituting the perisylvian network for spatial orienting and attention. Hence, we complement the knowledge from patients suffering from spatial neglect by giving first empirical evidence for the complete postulated network in healthy subjects.

The recognition of everyday objects changes grasp scaling

Current concepts of action and perception emphasise a dissociation between conscious visual recognition and visual action control. These models do not expect an effect of the recognisable identity of an object on the kinematic parameterisation of grasping movements under binocular viewing conditions without pre-test learning periods. We performed two experiments presenting participants with familiar everyday objects or neutral geometrical objects. The participants grasped either with full vision or without visual feedback after movement onset without an explicit training phase before the experiment. In general, the familiarity of objects increased the sensitivity to physical object size changes measured by the slope of the maximal grip aperture relative to object size. We conclude that associations between object identity and a particular size, presumably encoded in long-term memory, are integrated in the parameterisation of grasping movements upon the identification of individual objects.

Direct electrical stimulation of human cortex - the gold standard for mapping brain functions?

Despite its clinical relevance, direct electrical stimulation (DES) of the human brain is surprisingly poorly understood. Although we understand several aspects of electrical stimulation at the cellular level, surface DES evokes a complex summation effect in a large volume of brain tissue, and the effect is difficult to predict as it depends on many local and remote physiological and morphological factors. The complex stimulation effects are reflected in the heterogeneity of behavioural effects that are induced by DES, which range from evocation to inhibition of responses - sometimes even when DES is applied at the same cortical site. Thus, it is a misconception that DES - in contrast to other neuroscience techniques - allows us to draw unequivocal conclusions about the role of stimulated brain areas.

Bilateral hand representations in human primary proprioceptive areas

Sensory representations in the postcentral gyrus are supposed to be strictly lateralised and to provide spatially unbiased representations of limb positions. However, electrophysiological and behavioural measurements in humans and non-human primates tentatively suggested some degree of bilateral processing even in early somatosensory areas. We report a patient who suffered a small and confined lesion of the hand area in the postcentral gyrus that resulted in a proprioceptive deficit without any concomitant primary motor impairment. We performed a finger position-matching task with target locations being defined proprioceptively. Without visual feedback of either hand, the patient demonstrated a significant leftward shift of perceived locations when reaching with the ipsilesional right hand to her contralesional left hand and an opposite rightward shift when reaching with the left hand to the position of the right hand. Although these directional errors improved when vision of the active hand was allowed, errors were still significantly larger than those of age-matched healthy controls with unconstrained view of the active contralesional hand. Reaching to visual targets without visual online feedback the patient revealed comparable errors with both hands. Reaching to visual targets with full visual feedback, she was as accurate as controls with either hand. In summary, our data demonstrate an effect of the right postcentral lesion on proprioceptive information processing for both hands. The results suggest an integration of contralateral and ipsilateral proprioceptive information already at this early processing stage possibly mediated by callosal connections.

Functional neuroimaging of the oculomotor brainstem network in humans

The cortical systems involved in eye movement control in humans have been investigated extensively using fMRI. In contrast, there is virtually no data concerning the functional status of the human oculomotor brainstem nuclei. This lack of evidence has usually been explained by technical constraints of EPI based imaging and anatomical characteristics of the brainstem. Against this assumption, we successfully localised nuclei of the oculomotor system using high-resolution fMRI based on standard EPI sequences in a group of healthy subjects executing reflexive horizontal saccades. A random-effects group analysis revealed task-related BOLD increases in the superior colliculus, the oculomotor nucleus, the abducens nucleus and in the paramedian pontine reticular formation. This group analysis was complemented by individual positive findings in up to 94% of single subject analyses. A visual control paradigm led to increased signal levels in the superior colliculus consistent with its visual properties but no corresponding signal changes in other brainstem nuclei. These results are consistent with findings in animal studies and demonstrate the feasibility to detect BOLD signal increases associated with oculomotor tasks even in the human brainstem using conventional EPI imaging techniques.

Brain activation during immediate and delayed reaching in optic ataxia

Patients with optic ataxia after lesions of the occipito-parietal cortex demonstrate gross deviations of movements to visual targets in their peripheral visual field. When the same patients point to remembered target locations their accuracy improves considerably. Taking into account opposite findings in a single patient suffering from visual form agnosia due to bilateral occipito-temporal lesions (D.F.), this paradoxical improvement was attributed to brain structures outside the dorsal stream, and supposed to be specifically associated with delayed movement execution. This conclusion was based on the still unverified assumption that the dorsal system is almost completely lacking any localization function in patients with optic ataxia who demonstrate the paradoxical delay effect. We thus investigated brain activity associated with immediately executed and delayed movements in a patient with optic ataxia due to extensive bilateral lesions (I.G.) and in 16 healthy subjects using functional magnetic resonance imaging. Our analysis revealed robust and indistinguishable activation of intact dorsal occipital and parietal areas adjacent to the patient's lesions for both types of movements. In healthy subjects, we found the same visuomotor network activated during immediate and delayed movements as well as additionally higher signal increases for movements to visible targets than for delayed movements in bilateral occipito-parietal and occipito-temporal areas. Our results suggest that in healthy subjects as well as in the optic ataxia patient I.G. dorsal areas are not only involved in immediate but also in delayed reaching. This observation questions the hypothesis that residual visuospatial abilities in patients with optic ataxia could only be mediated by a system outside of the dorsal stream.

Activation of superior colliculi in humans during visual exploration

Background

Visual, oculomotor, and – recently – cognitive functions of the superior colliculi (SC) have been documented in detail in non-human primates in the past. Evidence for corresponding functions of the SC in humans is still rare. We examined activity changes in the human tectum and the lateral geniculate nuclei (LGN) in a visual search task using functional magnetic resonance imaging (fMRI) and anatomically defined regions of interest (ROI). Healthy subjects conducted a free visual search task and two voluntary eye movement tasks with and without irrelevant visual distracters. Blood oxygen level dependent (BOLD) signals in the SC were compared to activity in the inferior colliculi (IC) and LGN.

Results

Neural activity increased during free exploration only in the SC in comparison to both control tasks. Saccade frequency did not exert a significant effect on BOLD signal changes. No corresponding differences between experimental tasks were found in the IC or the LGN. However, while the IC revealed no signal increase from the baseline, BOLD signal changes at the LGN were consistently positive in all experimental conditions.

Conclusion

Our data demonstrate the involvement of the SC in a visual search task. In contrast to the results of previous studies, signal changes could not be seen to be driven by either visual stimulation or oculomotor control on their own. Further, we can exclude the influence of any nearby neural structures (e.g. pulvinar, tegmentum) or of typical artefacts at the brainstem on the observed signal changes at the SC. Corresponding to findings in non-human primates, our data support a dependency of SC activity on functions beyond oculomotor control and visual processing.

Exploring the visual world: The neural substrate of spatial orienting

Inspecting the visual environment, humans typically direct their attention across space by means of voluntary saccadic eye movements. Neuroimaging studies in healthy subjects have identified the superior parietal cortex and intraparietal sulcus as important structures involved in visual search. However, in apparent contrast, spatial disturbance of free exploration typically is observed after damage of brain structures located far more ventrally. Lesion studies in such patients disclosed the inferior parietal lobule (IPL) and temporo-parietal junction (TPJ), the superior temporal gyrus (STG) and insula, as well as the inferior frontal gyrus (IFG) of the right hemisphere. Here we used functional magnetic resonance imaging to investigate the involvement of these areas in active visual exploration in the intact brain. We conducted a region of interest analysis comparing free visual exploration of a dense stimulus array with the execution of stepwise horizontal and vertical saccades. The comparison of BOLD responses revealed significant signal increases during exploration in TPJ, STG, and IFG. This result calls for a reappraisal of the previous thinking on the function of these areas in visual search processes. In agreement with lesion studies, the data suggest that these areas are part of the network involved in human spatial orienting and exploration. The IPL dorsally of TPJ seem to be of minor importance for free visual exploration as these areas appear to be equally involved in the execution of spatially predetermined saccades.

A general deficit of the 'automatic pilot' with posterior parietal cortex lesions?

Lesions of the parieto-occipital junction (POJ) in humans cause gross deviations of reaching movements and impaired grip formation if the targets are located in the subjects' peripheral visual field. Movements to central targets are typically less impaired. This disorder has been termed "optic ataxia". It has been suggested that a general deficit of online corrections under central as well as peripheral viewing conditions might be sufficient to explain this discrepancy. According to this hypothesis, patients with optic ataxia should demonstrate an impaired online correction of grip aperture under central viewing conditions if the target object changes its size during the grasping movement. We investigated this prediction in a patient with optic ataxia (I.G.) in a virtual visuo-haptic grasping task. We imposed an isolated need for online corrections of the hand aperture independently of positional changes of the target object. While we found some general inaccuracies of her grasping movements, the patient did not show a specific impairment of online adjustment of grip aperture. On the contrary, I.G. smoothly adjusted her grip aperture comparable to healthy subjects. A general deficit of fast movement correction affecting targets in peripheral as well as central visual fields thus does not appear to account for the overt visuomotor deficits in optic ataxia. Rather, it seems more likely that an anatomical dissociation between visuomotor pathways related to actions in the central and in the peripheral visual field underlies the dissociation of visuomotor performance depending on the retinotopic target position in optic ataxia.

Dorsal and Ventral Stream Interaction: Contributions from Optic Ataxia

In monkeys and humans, two functionally specialized cortical streams of visual processing emanating from V1 have been proposed: a dorsal, action-related system and a ventral, perception-related pathway. Traditionally, a separate organization of the two streams is assumed; the extent of functional interaction is unknown. After lesions of the dorsal stream in patients with optic ataxia, it has recently been shown that the ventral perception-related system might contribute to visuo-motor processing if movements rely on remembered target positions. The ventral pathway thus seemed to participate in goal-directed movements, a function that previously has been assigned exclusively to the dorsal stream. We wondered whether different types of pointing movements are controlled by switching between two separated cortical pathways or whether a variable interaction of interconnected systems should be assumed. Our study investigated two acute stroke patients with optic ataxia following lesions of the dorsal stream in a delayed pointing task. The delays ranged from 0 to 10 sec. The patients' pointing error decreased in a linear manner with the length of time. The finding suggests a gradual change between dorsal and ventral control of reaching behavior, rather than a sudden switch between two separated cortical processing streams. Although our observations with two patients require further validation, the results suggest that the ventral and dorsal systems interact closely in the sensorimotor control of reaching behavior.

Goal-directed hand movements are not affected by the biased space representation in spatial neglect

Patients with spatial neglect exhibit a severe shift of spontaneous explorative movements to the right side, indicating a bias of long-living representations of space. Whether or not goal-directed movements likewise are affected by this rightward bias has been controversially discussed throughout the last decade. Unfortunately, substantial differences regarding patient selection and data analysis prevented a direct comparison of these results. We thus studied pointing movements in a new sample of subjects covering all different patient groups previously investigated on this issue. We analyzed all the different measures of hand path curvature used so far and, in addition, suggest a new measure that avoids the disadvantages of the previously used parameters. Despite their severe bias for exploratory movements, we did not find systematic, direction-specific deviations of goal-directed hand movements that were specific for the patients with spatial neglect. The results strongly suggest that the disturbance of long-living spatial representations underlying the bias of exploratory behavior in patients with neglect does not influence the performance of goal-directed movements. The data support the view of a dual mode of space representation in the posterior parietal and the superior temporal cortex.

Neglect-like behavior in healthy subjects: dissociation of space exploration and goal-directed pointing after vestibular stimulation

Evidence has been reported favoring the view of a dual mode of space representation for action and spatial cognition. While the dorsal system seems to be mainly involved in direct coding of space for action by means of several effector-specific representations, the ventral system appears to be responsible for more enduring and conscious representations underlying spatial cognition and awareness. In accordance with this view are recent studies documenting dissociations between exploratory and goal-directed movements in patients with brain damage. Patients with neglect exhibit a spatial bias of exploratory movements to the ipsilesional side, while goal-directed movements land precisely on target. The exploratory bias was found susceptible to asymmetric sensory stimulation such as caloric vestibular stimulation, inducing transient reduction of contralateral neglect. The present study compared exploratory and goal-directed hand movements in healthy subjects following cold caloric stimulation of the right vestibular organ. We observed a rightward shift of tactile exploration, while goal-directed pointing remained unaffected. Asymmetric vestibular stimulation in healthy subjects thus produced a neglect-like behavior with a similar dissociation between impaired exploratory and nonimpaired goal-directed hand movements. The stimulation provoked a further, very characteristic symptom of neglect patients: a deviation of spontaneous head orientation toward the right. The present observations strengthen substantially the assumption of different modes of space representation for action and spatial cognition in humans.

The cortical substrate of visual extinction

Neuroimaging studies investigated the attentional systems of the human brain revealing two networks, one for voluntary allocation of attention and another for stimulus-driven attentional processes. Whereas lesions of the latter system were supposed to lead to spatial neglect, we show that such lesions rather are typical for the occurrence of visual extinction. Extinction describes the inability of brain-damaged patients to detect a contralesional target in the presence of a competing ipsilesional stimulus. In a sample of consecutively admitted patients with right hemisphere stroke, we found dissociable cortical substrates for spatial neglect and visual extinction. There was a surprising congruency between the typical lesion site in patients with extinction and the activation clusters found in previous neuroimaging studies of healthy subjects. The results show that the temporo-parietal junction (TPJ), considered to be a crucial part of the stimulus-driven attentional network, is the neural substrate of visual extinction.

The subcortical anatomy of human spatial neglect: putamen, caudate nucleus and pulvinar

Various studies have documented that right hemispheric lesions restricted to the basal ganglia or to the thalamus may evoke spatial neglect. However, for methodological reasons, the exact anatomical correlate of spatial neglect within these two subcortical structures still remained uncertain. The present study identified these locations by comparing the anatomy of subcortical lesions to the basal ganglia or thalamus between neglect and control patients. Analysis revealed that the putamen, the pulvinar and, to a smaller degree, the caudate nucleus are the subcortical structures typically associated with spatial neglect in humans. All these structures have direct anatomical connections to the superior temporal gyrus (STG), which recently has been identified as the neural correlate of spatial neglect in the human cortex. Therefore, it is assumed that the right putamen, caudate nucleus, pulvinar and STG form a coherent corticosubcortical anatomical network in the genesis of spatial neglect in humans.

Spatial awareness is a function of the temporal not the posterior parietal lobe

Our current understanding of spatial behaviour and parietal lobe function is largely based on the belief that spatial neglect in humans (a lack of awareness of space on the side of the body contralateral to a brain injury) is typically associated with lesions of the posterior parietal lobe. However, in monkeys, this disorder is observed after lesions of the superior temporal cortex, a puzzling discrepancy between the species. Here we show that, contrary to the widely accepted view, the superior temporal cortex is the neural substrate of spatial neglect in humans, as it is in monkeys. Unlike the monkey brain, spatial awareness in humans is a function largely confined to the right superior temporal cortex, a location topographically reminiscent of that for language on the left. Hence, the decisive phylogenetic transition from monkey to human brain seems to be a restriction of a formerly bilateral function to the right side, rather than a shift from the temporal to the parietal lobe. One may speculate that this lateralization of spatial awareness parallels the emergence of an elaborate representation for language on the left side.

The effect of switching between sequential and repetitive movements on cortical activation

We used whole-head functional magnetic resonance imaging (fMRI) to investigate the effect of switching between different sequential and repetitive movements in the context of conditional and fixed tasks. Four different movement tasks were applied: (1) unpredictable switching between two movement sequences comprising six submovements each according to visual cues (SEQ-VC); (2) unpredictable switching between repetitive movement of one finger according to visual cues (REP-VC); (3) performance of the same sequential movements used for SEQ-VC but in a fixed mode triggered by a visual stimulus (SEQ-FIX); (4) performance of the repetitive movements used for REP-FIX but in a fixed mode by a visual stimulus (REP-FIX). The statistical group analysis of the hemodynamic responses revealed the following results: (1) the SEQ-VC compared to the SEQ-FIX condition (switching between movement sequences) engendered stronger activations in the left rostral supplementary motor area (pre-SMA), bilaterally in the posterior parietal lobule, the left ventral premotor area, and the visual cortices; (2) the REP-VC compared to the REP-FIX condition (switching between repetitive movements) only revealed stronger activation in extra-striate areas. We hypothesize that during switching of movement sequences higher motor control aspects are involved including movement selection, updating of motor plans, as well as recalling and restoring motor plans. The repetitive movements are too simple in order to evoke additional activations in the medial and lateral premotor areas, as well as in parietal areas.

fMRI study of bimanual coordination

Eleven right-handed subjects performed uni- and bimanual tapping tasks. Hemodynamic responses as measured with functional magnetic resonance imaging (fMRI) in the primary somato-motor cortex (SMC) showed that during bimanual activity the SMC contralateral to the hand taking the faster rate was more strongly activated than the SMC contralateral to hand taking the slower rate. There were no asymmetries, left SMC activation during the right fast/left slow tapping condition was comparable to the right SMC activation during the left fast/right slow condition. A given SMC showed similar activation levels for bimanual and unimanual activity (i.e. left SMC activation for right fast/left slow was similar to left SMC activation for the right fast unimanual condition). In contrast, a given supplementary motor area (SMA) showed significantly more activation for the bimanual than for the unimanual activity. In addition, an asymmetry was observed during bimanual activities: during the right fast/left slow activity, the left SMA showed more activation than the right SMA, but during the left fast/right slow activity, the right SMA was not significantly more activated than the left SMA. For unimanual activities, a clear rate effect (greater activation for faster rate) was seen in the SMC but not in the SMA.

Do patients with neglect show abnormal hand velocity profiles during tactile exploration of peripersonal space?

It has been suggested that the movement impairments experienced by patients with neglect are not restricted to spatial disorders, but also affect higher-order kinematics (velocity and acceleration) to the extent that movements towards the neglected side are slower than movements away from it. In a recent study, we could not confirm this hypothesis, but found that patients with unilateral neglect exhibited no distinct direction-specific deficits in hand velocity when performing goal-directed reaching movements. Here we investigated whether neglect patients might reveal direction-specific deficits during exploratory hand movements. Six patients with left-sided neglect and six age-matched healthy control subjects scanned with their right hands the surface of a large table searching for a (non-existent) tactile target. Movements were performed in darkness. Time-position data of the hand were recorded with an optoelectronic camera system. Median activity of the patients' exploratory hand movements was shifted to the right (Karnath and Perenin 1998). Hand trajectories were partitioned into sections of leftward/rightward or, along the sagittal plane, into sections of near/far movements. For each movement section average and peak velocities were computed. The patients' hand movements were bradykinetic when compared with the control group. However, we found no evidence that average or peak velocities of leftward intervals were systematically lower than during rightward motion. Direction-specific deficits in velocity were also not observed for movements to and away from the body (sagittal plane). In conclusion, we found evidence for general bradykinesia in neglect patients but not for a direction-specific deficit in the control of hand velocity during exploratory hand movements.

A parametric analysis of the 'rate effect' in the sensorimotor cortex: a functional magnetic resonance imaging analysis in human subjects

We studied the effects of different movement speeds of unimanual right hand movements on functional magnetic resonance signal changes in the sensorimotor cortex using echo planar imaging (EPI). Six healthy right-handed subjects were scanned at rest and while executing a finger tapping task with their right index finger. Movement frequency was visually paced at rates ranging from 0.5 to 5 Hz, separated by 0.5 Hz steps. The blood oxygen level dependent (BOLD) response within the left sensorimotor cortex was linearly and positively related to movement frequency. However, this relation holds (r2 = 0.91) only for movement frequencies faster than 1 Hz (1.5-5 Hz). For the slower frequencies there was an initial sharp increase of the BOLD response from 0.5 to 1 Hz followed by an activity drop for 1.5 Hz. These results are compatible with the idea that two different motor control modes are operative during slow or fast movements. During slow movements a computational demanding on-line feedback control mode is operative resulting in strong BOLD signals indicating extensive neural activity. During faster movements on the other hand a program-like motor control mode is operative resulting in less demanding neural computations. The amount of neural computation for the latter control mode increases with increasing movement speed.