Voluntary reaction time and long-latency reflex modulation

Stretching a muscle of the upper limb elicits short (M1) and long-latency (M2) reflexes. When the participant is instructed to actively compensate for a perturbation, M1 is usually unaffected and M2 increases in size and is followed by the voluntary response. It remains unclear if the observed increase in M2 is due to instruction-dependent gain modulation of the contributing reflex mechanism(s) or results from voluntary response superposition. The difficulty in delineating between these alternatives is due to the overlap between the voluntary response and the end of M2. The present study manipulated response accuracy and complexity to delay onset of the voluntary response and observed the corresponding influence on electromyographic activity during the M2 period. In all active conditions, M2 was larger compared with a passive condition where participants did not respond to the perturbation; moreover, these changes in M2 began early in the appearance of the response (∼ 50 ms), too early to be accounted for by voluntary overlap. Voluntary response latency influenced the latter portion of M2, with the largest activity seen when accuracy of limb position was not specified. However, when participants aimed for targets of different sizes or performed movements of various complexities, reaction time differences did not influence M2 period activity, suggesting voluntary activity was sufficiently delayed. Collectively, our results show that while a perturbation applied to the upper limbs can trigger a voluntary response at short latency (<100 ms), instruction-dependent reflex gain modulation remains an important contributor to EMG changes during the M2 period.

A startling acoustic stimulus interferes with upcoming motor preparation: Evidence for a startle refractory period

When a startling acoustic stimulus (SAS) is presented in a simple reaction time (RT) task, response latency is significantly shortened. The present study used a SAS in a psychological refractory period (PRP) paradigm to determine if a shortened RT1 latency would be propagated to RT2. Participants performed a simple RT task with an auditory stimulus (S1) requiring a vocal response (R1), followed by a visual stimulus (S2) requiring a key-lift response (R2). The two stimuli were separated by a variable stimulus onset asynchrony (SOA), and a typical PRP effect was found. When S1 was replaced with a 124dB SAS, R1 onset was decreased by 40-50ms; however, rather than the predicted propagation of a shortened RT, significantly longer responses were found for RT2 on startle trials at short SOAs. Furthermore, the 100ms SOA condition exhibited reduced peak EMG for R2 on startle trials, as compared to non-startle trials. These results are attributed to the startling stimulus temporarily interfering with cognitive processing, delaying and altering the execution of the second response. In addition to this "startle refractory period," results also indicated that RT1 latencies were significantly lengthened for trials that immediately followed a startle trial, providing evidence for longer-term effects of the startling stimulus.

Unified nature of bimanual movements revealed by separating the preparation of each arm

Movement preparation of bimanual asymmetric movements is longer than bimanual symmetric movements in choice reaction time conditions, even when movements are cued directly by illuminating the targets (Blinch et al. in Exp Brain Res 232(3):947-955, 2014). This bimanual asymmetric cost may be caused by increased processing demands on response programming, but this requires further investigation. The present experiment tested the demands on response programming for bimanual movements by temporally separating the preparation of each arm. This was achieved by precuing the target of one arm before the imperative stimulus. We asked: What was prepared in advance when one arm was precued? The answer to this question would suggest which process causes the bimanual asymmetric cost. Advance movement preparation was examined by comparing reaction times with and without a precue for the left target and by occasionally replacing the imperative stimulus with a loud, startling tone (120 dB). A startle tone releases whatever movement is prepared in advance with a much shorter reaction time than control trials (Carlsen et al. in Clin Neurophysiol 123(1):21-33, 2012). Participants made bimanual symmetric and asymmetric reaching movements in simple and 2-choice reaction time conditions and a condition with a precue for the left target. We found a bimanual asymmetric cost in 2-choice conditions, and the asymmetric cost was significantly smaller when the left target was precued. These results, and the results from startle trials, suggest (1) that the precued movement was not fully programmed but partially programmed before the imperative stimulus and (2) that the asymmetric cost was caused by increased processing demands on response programming. Overall, the results support the notion that bimanual movements are not the sum of two unimanual movements; instead, the two arms of a bimanual movement are unified into a functional unit. When one target is precued, this critical unification likely occurs during response programming.

From adaptive licensing to adaptive pathways: delivering a flexible life-span approach to bring new drugs to patients

The concept of adaptive licensing (AL) has met with considerable interest. Yet some remain skeptical about its feasibility. Others argue that the focus and name of AL should be broadened. Against this background of ongoing debate, we examine the environmental changes that will likely make adaptive pathways the preferred approach in the future. The key drivers include: growing patient demand for timely access to promising therapies, emerging science leading to fragmentation of treatment populations, rising payer influence on product accessibility, and pressure on pharma/investors to ensure sustainability of drug development. We also discuss a number of environmental changes that will enable an adaptive paradigm. A life-span approach to bringing innovation to patients is expected to help address the perceived access vs. evidence trade-off, help de-risk drug development, and lead to better outcomes for patients.

Cortical contributions to control of posture during unrestricted and restricted stance

There is very little consensus regarding the mechanisms underlying postural control. Whereas some theories suggest that posture is controlled at lower levels (i.e., brain stem and spinal cord), other theories have proposed that upright stance is controlled using higher centers, including the motor cortex. In the current investigation, we used corticomuscular coherence (CMC) to investigate the relationship between cortical and shank muscle activity during conditions of unrestricted and restricted postural sway. Participants were instructed to stand as still as possible in an apparatus that allowed the center of mass to move freely (“Unlocked”) or to be stabilized (“Locked”) without subject awareness. EEG (Cz) and electromyography (soleus and lateral/medial gastrocnemii) were collected and used to estimate CMC over the Unlocked and Locked periods. Confirming our previous results, increases in center of pressure (COP) displacements were observed in 9 of 12 participants in the Locked compared with Unlocked condition. Across these 9 participants, CMC was low or absent in both the Unlocked and Locked conditions. The results from the current study suggest that this increase is not associated with an increase in the relationship between cortical and shank muscle activities. Rather, it may be that increases in COP displacement with locking are mediated by subcortical structures as a means of increasing sway to provide the central nervous system with a critical level of sensory information.

Cortical involvement in the StartReact effect

The rapid release of prepared movements by a loud acoustic stimulus capable of eliciting a startle response has been termed the StartReact effect (Valls-Solé et al., 1999), and premotor reaction times (PMTs) of <70 ms are often observed. Two explanations have been given for these short latency responses. The subcortical storage and triggering hypothesis suggests movements that can be prepared in advance of a "go" signal are stored and triggered from subcortical areas by a startling acoustic stimulus (SAS) without cortical involvement. Alternatively, it has been hypothesized that the SAS can trigger movements from cortical areas through a faster pathway ascending from subcortical structures. Two experiments were designed to examine the possible role of the primary motor cortex in the StartReact effect. In Experiment 1, we used suprathreshold transcranial magnetic stimulation (TMS) during the reaction time (RT) interval to induce a cortical silent period in the contralateral primary motor cortex (M1). Thirteen participants performed 20° wrist extension movements as fast as possible in response to either a control stimulus (82 dB) or SAS (124 dB). PMTs for startle trials were faster than for control trials, while TMS significantly delayed movement onset compared to No TMS or Sham TMS conditions. In Experiment 2, we examined the StartReact effect in a highly cortically represented action involving speech of a consonant-vowel (CV) syllable. Similar to previous work examining limb movements, a robust StartReact effect was found. Collectively, these experiments provide evidence for cortical (M1) involvement in the StartReact effect.

Comparing movement preparation of unimanual, bimanual symmetric, and bimanual asymmetric movements

The goal of this study was to determine the process or processes most likely to be involved in reaction-time costs for spatially cued bimanual reaching. We used reaction time to measure the cost of bimanual symmetric movements compared to unimanual movements (a bimanual symmetric cost) and the cost for bimanual asymmetric movements compared to symmetric movements (a bimanual asymmetric cost). The results showed that reaction times were comparable for all types of movements in simple reaction time; that is, there was neither a bimanual symmetric cost nor an asymmetric cost. Therefore, unimanual, bimanual symmetric, and bimanual asymmetric movements have comparable complexity during response initiation. In choice conditions, there was no bimanual symmetric cost but there was a bimanual asymmetric cost, indicating that the preparation of asymmetric movements is more complex than symmetric movements. This asymmetric cost is likely the result of interference during response programming.

Are increases in COP variability observed when participants are provided explicit verbal cues prior to COM stabilization?

Previous research has shown that when the COM is stabilized without participant awareness, COP displacements increase. This finding suggests that postural sway under normal conditions may be exploratory and used as a means of acquiring sensory information. However, based on the theory that posture is controlled using internal models, it could be argued that increases in COP displacement reflect errors that arise as the central nervous system attempts to adapt the internal model used to control posture to the new conditions. The current study provided an explicit verbal cue to the participants indicating how and when COM stabilization would occur. Based on evidence suggesting that explicit verbal cues can reduce errors when the dynamics of the task are altered, we hypothesized that when participants were aware of COM stabilization, COP displacements would be reduced. However, we found that anterior-posterior COP displacements increased independent of cueing, suggesting that increases in COP displacements with locking were not the result of an attempt to adapt the internal model of postural control. The results provide further support for an exploratory role of postural sway.

First trial and StartReact effects induced by balance perturbations to upright stance

Postural responses (PR) to a balance perturbation differ between the first and subsequent perturbations. One explanation for this first trial effect is that perturbations act as startling stimuli that initiate a generalized startle response (GSR) as well as the PR. Startling stimuli, such as startling acoustic stimuli (SAS), are known to elicit GSRs, as well as a StartReact effect, in which prepared movements are initiated earlier by a startling stimulus. In this study, a StartReact effect paradigm was used to determine if balance perturbations can also act as startle stimuli. Subjects completed two blocks of simple reaction time trials involving wrist extension to a visual imperative stimulus (IS). Each block included 15 CONTROL trials that involved a warning cue and subsequent IS, followed by 10 repeated TEST trials, where either a SAS (TESTSAS) or a toes-up support-surface rotation (TESTPERT) was presented coincident with the IS. StartReact effects were observed during the first trial in both TESTSAS and TESTPERT conditions as evidenced by significantly earlier wrist movement and muscle onsets compared with CONTROL. Likewise, StartReact effects were observed in all repeated TESTSAS and TESTPERT trials. In contrast, GSRs in sternocleidomastoid and PRs were large in the first trial, but significantly attenuated over repeated presentation of the TESTPERT trials. Results suggest that balance perturbations can act as startling stimuli. Thus first trial effects are likely PRs which are superimposed with a GSR that is initially large, but habituates over time with repeated exposure to the startling influence of the balance perturbation.

Startle reveals independent preparation and initiation of triphasic EMG burst components in targeted ballistic movements

Muscles involved in rapid, targeted movements about a single joint often display a triphasic [agonist (AG1)-antagonist (ANT)-agonist (AG2)] electromyographic (EMG) pattern. Early work using movement perturbations suggested that for short movements, the entire EMG pattern was prepared and initiated in advance (Wadman WJ, Dernier van der Gon JJ, Geuze RH, Mol CR. J Hum Mov Stud 5: 3-17, 1979), whereas more recent transcranial magnetic stimulation evidence indicates that the ANT may be programmed separately (MacKinnon CD, Rothwell JC. J Physiol 528: 633-645, 2000) with execution of the bursts occurring serially (Irlbacher K, Voss M, Meyer BU, Rothwell JC. J Physiol 574: 917-928, 2006). The purpose of the current study was to investigate the generation of triphasic EMG bursts for movements of different amplitudes. In experiment 1, participants performed rapid elbow extension movements to 20° and 60° targets, and on some trials, a startling acoustic stimulus (SAS), which is thought to trigger prepared motor commands at short latency, was delivered at the onset of AG1. For short movements, this perturbation elicited ANT and AG2 early, suggesting the agonist and antagonist bursts may have been programmed independently. In contrast, the same manipulation did not disrupt EMG timing parameters for the long movements, raising the possibility that ANT and AG2 were not fully programmed in advance of movement onset. In experiment 2, an SAS was delivered later in the movement, which produced early onset of both ANT and AG2. We propose that the triphasic pattern is executed serially but believe the trigger signal for initiating the ANT burst occurs not in relation to the AG1 burst, but rather in close temporal proximity to the expected onset of ANT.

Muscle-specific modulation of vestibular reflexes with increased locomotor velocity and cadence

Vestibular information is one of the many sensory signals used to stabilize the body during locomotion. When locomotor velocity increases, the influence of these signals appears to wane. It is unclear whether vestibular signals are globally attenuated with velocity or are influenced by factors such as whether a muscle is contributing to balance control. Here we investigate how vestibular sensory signals influence muscles of the leg during locomotion and what causes their attenuation with increasing locomotor velocity. We hypothesized that 1) vestibular signals influence the activity of all muscles engaged in the maintenance of medio-lateral stability during locomotion and 2) increases in both cadence and velocity would be associated with attenuation of these signals. We used a stochastic vestibular stimulus and recorded electromyographic signals from muscles of the ankle, knee, and hip. Participants walked using two cadences (52 and 78 steps/min) and two walking velocities (0.4 and 0.8 m/s). We observed phase-dependent modulation of vestibular influence over ongoing muscle activity in all recorded muscles. Within a stride, reversals of the muscle responses were observed in the biceps femoris, tibialis anterior, and rectus femoris. Vestibular-muscle coupling decreases with increases in both cadence and walking velocity. These results show that the observed vestibular suppression is muscle- and phase dependent. We suggest that the phase- and muscle-specific influence of vestibular signals on locomotor activity is organized according to each muscle's functional role in body stabilization during locomotion.

Effects of postural threat on spinal stretch reflexes: evidence for increased muscle spindle sensitivity?

Standing balance is often threatened in everyday life. These threats typically involve scenarios in which either the likelihood or the consequence of falling is higher than normal. When cats are placed in these scenarios they respond by increasing the sensitivity of muscle spindles imbedded in the leg muscles, presumably to increase balance-relevant afferent information available to the nervous system. At present, it is unknown whether humans also respond to such postural threats by altering muscle spindle sensitivity. Here we present two studies that probed the effects of postural threat on spinal stretch reflexes. In study 1 we manipulated the threat associated with an increased consequence of a fall by having subjects stand at the edge of an elevated surface (3.2 m). In study 2 we manipulated the threat by increasing the likelihood of a fall by occasionally tilting the support surface on which subjects stood. In both scenarios we used Hoffmann (H) and tendon stretch (T) reflexes to probe the spinal stretch reflex circuit of the soleus muscle. We observed increased T-reflex amplitudes and unchanged H-reflex amplitudes in both threat scenarios. These results suggest that the synaptic state of the spinal stretch reflex is unaffected by postural threat and that therefore the muscle spindles activated in the T-reflexes must be more sensitive in the threatening conditions. We propose that this increase in sensitivity may function to satisfy the conflicting needs to restrict movement with threat, while maintaining a certain amount of sensory information related to postural control.

Adapting to target error without visual feedback

What information is necessary for the motor system to adapt its behaviour? Visual hand-to-target error provides salient information about reach performance, but can learning proceed without this information? We investigated adaptation to an unperceived target perturbation under visual open-loop conditions. Participants looked and reached, without any vision of their hand, to a target that jumped rightward at saccade onset (Perturbation condition) or remained stationary throughout the trial (Stationary condition). The target jump in the Perturbation condition was tied to the saccade, such that participants were unaware that it had occurred. Each type of exposure was followed by a posttest, in which participants reached to a target that disappeared at saccade onset. In the posttest, participants reached farther following exposure to the perturbation than they did following exposure to the stationary target, indicating that participants had learned from systematic exposure to the jump. These findings imply that online error induces motor learning, even when participants receive no visual information about their performance.

Startle induces early initiation of classically conditioned postural responses

Startling acoustic stimuli (SAS) induce the early release of prepared motor responses. The current study used SAS, in conjunction with a classical conditioning paradigm, to examine advanced motor preparation of conditioned postural responses (PRs). After generalized startle responses were induced, standing posture was perturbed in 2 blocks of 15 Conditioning trials, where in each trial the onset of a nonstartling auditory cue [i.e., a conditioned stimulus (CS)] preceded a leftward support-surface translation. Upon completion of each block, a single trial was conducted. After block 1, a CS-Only trial was used to induce conditioned PRs in the absence of balance perturbations. After block 2, a post-Conditioning Startle trial that involved a CS subsequently followed by a SAS was used to examine motor preparation of conditioned PRs. PRs were quantified in terms of center of pressure displacements, ankle and hip kinematics, as well as surface electromyography of proximal and distal bilateral muscle pairs. Results indicated that repeated experience with cued balance perturbations led to PR conditioning and, more importantly, motor preparation of PRs. Conditioning was evidenced in biomechanical and electromyographic responses observed in CS-Only trials, as well as the progressive changes to evoked response parameters during repeated Conditioning trials. SAS presented in post-Conditioning Startle trials evoked early onsets of biomechanical and electromyographic responses, while preserving relative response parameters that were each distinct from generalized startle responses. These results provide important insight into both the consequences of using cues in dynamic postural control studies and the neural mechanisms governing PRs.

Limited interlimb transfer of locomotor adaptations to a velocity-dependent force field during unipedal walking

Several studies have demonstrated that motor adaptations to a novel task environment can be transferred between limbs. Such interlimb transfer of motor commands is consistent with the notion of centrally driven strategies that can be generalized across different frames of reference. So far, studies of interlimb transfer of locomotor adaptations have yielded disparate results. Here we sought to determine whether locomotor adaptations in one (trained) leg show transfer to the other (test) leg during a unipedal walking task. We hypothesized that adaptation in the test leg to a velocity-dependent force field previously experienced by the trained leg will be faster, as revealed by faster recovery of kinematic errors and earlier onset of aftereffects. Twenty able-bodied adults walked unipedally in the Lokomat robotic gait orthosis, which applied velocity-dependent resistance to the legs. The amount of resistance was scaled to 10% of each individual's maximum voluntary contraction of the hip flexors. Electromyography and kinematics of the lower limb were recorded. All subjects were right-leg dominant and were tested for transfer of motor adaptations from the right leg to the left leg. Catch trials, consisting of unexpected removal of resistance, were presented after the first step with resistance and after a period of adaptation to test for aftereffects. We found no significant differences in the sizes of the aftereffects between the two legs, except for peak hip flexion during swing, or in the rate at which peak hip flexion adapted during steps against resistance between the two legs. Our results indicate that interlimb transfer of these types of locomotor adaptation is not a robust phenomenon. These findings add to our current understanding of motor adaptations and provide further evidence that generalization of adaptations may be dependent on the movement task.

Motor preparation and the effects of practice: evidence from startle

To examine sequential movement preparation, participants practiced unimanual movements that differed in amplitude and number of elements for 4 days in either a simple (Experiment 1) or choice (Experiment 2) reaction time (RT) paradigm. On Day 1 and 4, a startling stimulus was used to probe the preparation process. For simple RT, we found increased premotor RT for the two component movement during control trials on Day 1, which was minimized with practice. During startle trials, all movements were triggered at a short latency with similar consistency to control trials, suggesting full advance preparation of all movements. For choice RT, we also found increased premotor RT for control trials for the two component movement. As advance preparation could not occur, the startling stimulus did not trigger any of the movements. We hypothesized that complexity may relate to the neural commands needed to produce the movement, rather than a sequencing requirement.

The effects of prepulse inhibition timing on the startle reflex and reaction time

A loud acoustic stimulus has been shown to provoke a reflexive startle response and accelerate simple reaction times. However, an auditory prepulse presented in advance of a startling stimulus can reduce the effect of the startling stimulus. The current study examined the effect of the timing of the prepulse on startle-induced reaction times and the startle reflex. The task was to perform a 30° arm extension movement in response to a visual "go" stimulus. On selected trials, an auditory prepulse (80dB) was presented either 100ms, 500ms or 1000ms prior to the "go" signal. In addition, an auditory startling stimulus (124dB) was presented in conjunction with the "go" signal on some trials. Our results indicated that an auditory prepulse presented 100ms, and to a lesser extent 500ms, significantly decreased the amplitude of the startle reflex; however, the reaction time acceleration associated with the startling acoustic stimulus (SAS) was unaffected. The differential effect of the prepulse on the startle reflex and reaction time acceleration confirm different neural pathways for these effects while the differential effect of the prepulse on the control and startle RTs suggest different mechanisms for movement initiation.