Oscillatory beta dynamics inform biomarker-driven treatment optimization for Parkinson's disease

Parkinson's disease (PD) is a neurodegenerative disorder characterized by loss of dopaminergic neurons and dysregulation of the basal ganglia. Cardinal motor symptoms include bradykinesia, rigidity, and tremor. Deep brain stimulation (DBS) of select subcortical nuclei is standard of care for medication-refractory PD. Conventional open-loop DBS delivers continuous stimulation with fixed parameters that do not account for a patient's dynamic activity state or medication cycle. In comparison, closed-loop DBS, or adaptive DBS (aDBS), adjusts stimulation based on biomarker feedback that correlates with clinical state. Recent work has identified several neurophysiological biomarkers in local field potential recordings from PD patients, the most promising of which are 1) elevated beta (∼13-30 Hz) power in the subthalamic nucleus (STN), 2) increased beta synchrony throughout basal ganglia-thalamocortical circuits, notably observed as coupling between the STN beta phase and cortical broadband gamma (∼50-200 Hz) amplitude, and 3) prolonged beta bursts in the STN and cortex. In this review, we highlight relevant frequency and time domain features of STN beta measured in PD patients and summarize how spectral beta power, oscillatory beta synchrony, phase-amplitude coupling, and temporal beta bursting inform PD pathology, neurosurgical targeting, and DBS therapy. We then review how STN beta dynamics inform predictive, biomarker-driven aDBS approaches for optimizing PD treatment. We therefore provide clinically useful and actionable insight that can be applied toward aDBS implementation for PD.

OpenSense: An open-source toolbox for inertial-measurement-unit-based measurement of lower extremity kinematics over long durations

Background

The ability to measure joint kinematics in natural environments over long durations using inertial measurement units (IMUs) could enable at-home monitoring and personalized treatment of neurological and musculoskeletal disorders. However, drift, or the accumulation of error over time, inhibits the accurate measurement of movement over long durations. We sought to develop an open-source workflow to estimate lower extremity joint kinematics from IMU data that was accurate and capable of assessing and mitigating drift.

Methods

We computed IMU-based estimates of kinematics using sensor fusion and an inverse kinematics approach with a constrained biomechanical model. We measured kinematics for 11 subjects as they performed two 10-min trials: walking and a repeated sequence of varied lower-extremity movements. To validate the approach, we compared the joint angles computed with IMU orientations to the joint angles computed from optical motion capture using root mean square (RMS) difference and Pearson correlations, and estimated drift using a linear regression on each subject’s RMS differences over time.

Results

IMU-based kinematic estimates agreed with optical motion capture; median RMS differences over all subjects and all minutes were between 3 and 6 degrees for all joint angles except hip rotation and correlation coefficients were moderate to strong (r = 0.60–0.87). We observed minimal drift in the RMS differences over 10 min; the average slopes of the linear fits to these data were near zero (− 0.14–0.17 deg/min).

Conclusions

Our workflow produced joint kinematics consistent with those estimated by optical motion capture, and could mitigate kinematic drift even in the trials of continuous walking without rest, which may obviate the need for explicit sensor recalibration (e.g. sitting or standing still for a few seconds or zero-velocity updates) used in current drift-mitigation approaches when studying similar activities. This could enable long-duration measurements, bringing the field one step closer to estimating kinematics in natural environments.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12984-022-01001-x.

High-fidelity musculoskeletal modeling reveals that motor planning variability contributes to the speed-accuracy tradeoff

A long-standing challenge in motor neuroscience is to understand the relationship between movement speed and accuracy, known as the speed-accuracy tradeoff. Here, we introduce a biomechanically realistic computational model of three-dimensional upper extremity movements that reproduces well-known features of reaching movements. This model revealed that the speed-accuracy tradeoff, as described by Fitts’ law, emerges even without the presence of motor noise, which is commonly believed to underlie the speed-accuracy tradeoff. Next, we analyzed motor cortical neural activity from monkeys reaching to targets of different sizes. We found that the contribution of preparatory neural activity to movement duration (MD) variability is greater for smaller targets than larger targets, and that movements to smaller targets exhibit less variability in population-level preparatory activity, but greater MD variability. These results propose a new theory underlying the speed-accuracy tradeoff: Fitts’ law emerges from greater task demands constraining the optimization landscape in a fashion that reduces the number of ‘good’ control solutions (i.e., faster reaches). Thus, contrary to current beliefs, the speed-accuracy tradeoff could be a consequence of motor planning variability and not exclusively signal-dependent noise.

The effects of motor modularity on performance, learning and generalizability in upper-extremity reaching: a computational analysis

It has been hypothesized that the central nervous system simplifies the production of movement by limiting motor commands to a small set of modules known as muscle synergies. Recently, investigators have questioned whether a low-dimensional controller can produce the rich and flexible behaviours seen in everyday movements. To study this issue, we implemented muscle synergies in a biomechanically realistic model of the human upper extremity and performed computational experiments to determine whether synergies introduced task performance deficits, facilitated the learning of movements, and generalized to different movements. We derived sets of synergies from the muscle excitations our dynamic optimizations computed for a nominal task (reaching in a plane). Then we compared the performance and learning rates of a controller that activated all muscles independently to controllers that activated the synergies derived from the nominal reaching task. We found that a controller based on synergies had errors within 1 cm of a full-dimensional controller and achieved faster learning rates (as estimated from computational time to converge). The synergy-based controllers could also accomplish new tasks-such as reaching to targets on a higher or lower plane, and starting from alternative initial poses-with average errors similar to a full-dimensional controller.

Trajectory optimization for full-body movements with complex contacts

This paper presents the first method for full-body trajectory optimization of physics-based human motion that does not rely on motion capture, specified key-poses, or periodic motion. Optimization is performed using a small set of simple goals, for example, one hand should be on the ground, or the center-of-mass should be above a particular height. These objectives are applied to short spacetime windows which can be composed to express goals over an entire animation. Specific contact locations needed to achieve objectives are not required by our method. We show that the method can synthesize many different kinds of movement, including walking, hand walking, breakdancing, flips, and crawling. Most of these movements have never been previously synthesized by physics-based methods.