White matter fractional anisotropy predicts balance performance in older adults

Aging is characterized by brain structural changes that may compromise motor functions. In the context of postural control, white matter integrity is crucial for the efficient transfer of visual, proprioceptive and vestibular feedback in the brain. To determine the role of age-related white matter decline as a function of the sensory feedback necessary to correct posture, we acquired diffusion weighted images in young and old subjects. A force platform was used to measure changes in body posture under conditions of compromised proprioceptive and/or visual feedback. In the young group, no significant brain structure-balance relations were found. In the elderly however, the integrity of a cluster in the frontal forceps explained 21% of the variance in postural control when proprioceptive information was compromised. Additionally, when only the vestibular system supplied reliable information, the occipital forceps was the best predictor of balance performance (42%). Age-related white matter decline may thus be predictive of balance performance in the elderly when sensory systems start to degrade.

Testing multiple coordination constraints with a novel bimanual visuomotor task

The acquisition of a new bimanual skill depends on several motor coordination constraints. To date, coordination constraints have often been tested relatively independently of one another, particularly with respect to isofrequency and multifrequency rhythms. Here, we used a new paradigm to test the interaction of multiple coordination constraints. Coordination constraints that were tested included temporal complexity, directionality, muscle grouping, and hand dominance. Twenty-two healthy young adults performed a bimanual dial rotation task that required left and right hand coordination to track a moving target on a computer monitor. Two groups were compared, either with or without four days of practice with augmented visual feedback. Four directional patterns were tested such that both hands moved either rightward (clockwise), leftward (counterclockwise), inward or outward relative to each other. Seven frequency ratios (3∶1, 2∶1, 3∶2, 1∶1, 2∶3. 1∶2, 1∶3) between the left and right hand were introduced. As expected, isofrequency patterns (1∶1) were performed more successfully than multifrequency patterns (non 1∶1). In addition, performance was more accurate when participants were required to move faster with the dominant right hand (1∶3, 1∶2 and 2∶3) than with the non-dominant left hand (3∶1, 2∶1, 3∶2). Interestingly, performance deteriorated as the relative angular velocity between the two hands increased, regardless of whether the required frequency ratio was an integer or non-integer. This contrasted with previous finger tapping research where the integer ratios generally led to less error than the non-integer ratios. We suggest that this is due to the different movement topologies that are required of each paradigm. Overall, we found that this visuomotor task was useful for testing the interaction of multiple coordination constraints as well as the release from these constraints with practice in the presence of augmented visual feedback.

Action and emotion recognition from point light displays: an investigation of gender differences

Folk psychology advocates the existence of gender differences in socio-cognitive functions such as 'reading' the mental states of others or discerning subtle differences in body-language. A female advantage has been demonstrated for emotion recognition from facial expressions, but virtually nothing is known about gender differences in recognizing bodily stimuli or body language. The aim of the present study was to investigate potential gender differences in a series of tasks, involving the recognition of distinct features from point light displays (PLDs) depicting bodily movements of a male and female actor. Although recognition scores were considerably high at the overall group level, female participants were more accurate than males in recognizing the depicted actions from PLDs. Response times were significantly higher for males compared to females on PLD recognition tasks involving (i) the general recognition of 'biological motion' versus 'non-biological' (or 'scrambled' motion); or (ii) the recognition of the 'emotional state' of the PLD-figures. No gender differences were revealed for a control test (involving the identification of a color change in one of the dots) and for recognizing the gender of the PLD-figure. In addition, previous findings of a female advantage on a facial emotion recognition test (the 'Reading the Mind in the Eyes Test' (Baron-Cohen, 2001)) were replicated in this study. Interestingly, a strong correlation was revealed between emotion recognition from bodily PLDs versus facial cues. This relationship indicates that inter-individual or gender-dependent differences in recognizing emotions are relatively generalized across facial and bodily emotion perception. Moreover, the tight correlation between a subject's ability to discern subtle emotional cues from PLDs and the subject's ability to basically discriminate biological from non-biological motion provides indications that differences in emotion recognition may - at least to some degree - be related to more basic differences in processing biological motion per se.

Bimanual coordination and corpus callosum microstructure in young adults with traumatic brain injury: a diffusion tensor imaging study

Bimanual actions are ubiquitous in daily life. Many coordinated movements of the upper extremities rely on precise timing, which requires efficient interhemispheric communication via the corpus callosum (CC). As the CC in particular is known to be vulnerable to traumatic brain injury (TBI), furthering our understanding of its structure-function association is highly valuable for TBI diagnostics and prognosis. In this study, 21 young adults with TBI and 17 controls performed object manipulation tasks (insertion of pegs with both hands and bilateral daily life activities) and cognitive control tasks (i.e., switching maneuvers during spatially and temporally coupled bimanual circular motions). The structural organization of 7 specific subregions of the CC (prefrontal, premotor/supplementary motor, primary motor, primary sensory, parietal, temporal, and occipital) was subsequently investigated in these subjects with diffusion tensor imaging (DTI). Findings revealed that bimanual coordination was impaired in TBI patients as shown by elevated movement time values during daily life activities, a decreased number of peg insertions, and slower response times during the switching task. Furthermore, the DTI analysis demonstrated a significantly decreased fractional anisotropy and increased radial diffusivity in prefrontal, primary sensory, and parietal regions in TBI patients versus controls. Finally, multiple regression analyses showed evidence of the high specificity of callosal subregions accounting for the variance associated with performance of the different bimanual coordination tasks. Whereas disruption in commissural pathways between occipital areas played a role in performance on the clinical tests of bimanual coordination, deficits in the switching task were related to disrupted interhemispheric communication in prefrontal, sensory, and parietal regions. This study provides evidence that structural alterations of several subregional callosal fibers in adults with TBI are associated with differential behavioral manifestations of bimanual motor functioning.

Involvement of the primary motor cortex in controlling movements executed with the ipsilateral hand differs between left- and right-handers

Unimanual motor tasks, specifically movements that are complex or require high forces, activate not only the contralateral primary motor cortex (M1) but evoke also ipsilateral M1 activity. This involvement of ipsilateral M1 is asymmetric, such that the left M1 is more involved in motor control with the left hand than the right M1 in movements with the right hand. This suggests that the left hemisphere is specialized for movement control of either hand, although previous experiments tested mostly right-handed participants. In contrast, research on hemispheric asymmetries of ipsilateral M1 involvement in left-handed participants is relatively scarce. In the present study, left- and right-handed participants performed complex unimanual movements, whereas TMS was used to disrupt the activity of ipsilateral M1 in accordance with a "virtual lesion" approach. For right-handed participants, more disruptions were induced when TMS was applied over the dominant (left) M1. For left-handed participants, two subgroups could be distinguished, such that one group showed more disruptions when TMS was applied over the nondominant (left) M1, whereas the other subgroup showed more disruptions when the dominant (right) M1 was stimulated. This indicates that functional asymmetries of M1 involvement during ipsilateral movements are influenced by both hand dominance as well as left hemisphere specialization. We propose that the functional asymmetries in ipsilateral M1 involvement during unimanual movements are primarily attributable to asymmetries in the higher-order areas, although the contribution of transcallosal pathways and ipsilateral projections cannot be completely ruled out.

Correlations between white matter integrity and motor function in traumatic brain injury patients

BACKGROUND

Deterioration of motor function is one of several clinical manifestations following traumatic brain injury (TBI) in children and adolescents.

OBJECTIVE

To investigate the relationship between white matter (WM) integrity using diffusion tensor imaging (DTI) and motor functioning in young TBI patients.

METHODS

A group with moderate to severe TBI (n = 24) and a control group (n = 17) were scanned using DTI along with standard anatomical scans. Using ExploreDTI software, WM regions/tracts that carry efferent output (motor) from the brain were evaluated, as well as the corpus callosum, brainstem, internal capsule, and subcortical WM structures. Motor function was assessed using the Movement Assessment Battery for Children (M-ABC), consisting of manual dexterity, ball skills, and static and dynamic balance items.

RESULTS

TBI patients were less successful on the M-ABC than the controls and showed lower WM fractional anisotropy (FA) in the corpus callosum, anterior corona radiata, corticospinal tract, and cerebellum. Decreased FA was associated with lower motor performance in the TBI group but not in the control group.

CONCLUSION

This study provides evidence for a structural alteration of motor pathways and regions in children and adolescents with TBI that are correlated with motor functioning. Further studies may be able to identify therapeutic targets and monitor the effects of new interventions.

The neural basis of central proprioceptive processing in older versus younger adults: an important sensory role for right putamen

Our sense of body position and movement independent of vision (i.e., proprioception) relies on muscle spindle feedback and is vital for performing motor acts. In this study, we first sought to elucidate age-related differences in the central processing of proprioceptive information by stimulating foot muscle spindles and by measuring neural activation with functional magnetic resonance imaging. We found that healthy older adults activated a similar, distributed network of primary somatosensory and secondary-associative cortical brain regions as young individuals during the vibration-induced muscle spindle stimulation. A significant decrease in neural activity was also found in a cluster of right putamen voxels for the older age group when compared with the younger age group. Given these differences, we performed two additional analyses within each group that quantified the degree to which age-dependent activity was related to (1) brain structure and (2) a behavioral measure of proprioceptive ability. Using diffusion tensor imaging, older (but not younger) adults with higher mean fractional anisotropy were found to have increased right putamen neural activity. Age-dependent right putamen activity seen during tendon vibration was also correlated with a behavioral test of proprioceptive ability measuring ankle joint position sense in both young and old age groups. Partial correlation tests determined that the relationship between elderly joint position sense and neural activity in right putamen was mediated by brain structure, but not vice versa. These results suggest that structural differences within the right putamen are related to reduced activation in the elderly and potentially serve as biomarker of proprioceptive sensibility in older adults.

Excitability of the motor cortex ipsilateral to the moving body side depends on spatio-temporal task complexity and hemispheric specialization

Unilateral movements are mainly controlled by the contralateral hemisphere, even though the primary motor cortex ipsilateral (M1_ipsi) to the moving body side can undergo task-related changes of activity as well. Here we used transcranial magnetic stimulation (TMS) to investigate whether representations of the wrist flexor (FCR) and extensor (ECR) in M1_ipsi would be modulated when unilateral rhythmical wrist movements were executed in isolation or in the context of a simple or difficult hand-foot coordination pattern, and whether this modulation would differ for the left versus right hemisphere. We found that M1_ipsi facilitation of the resting ECR and FCR mirrored the activation of the moving wrist such that facilitation was higher when the homologous muscle was activated during the cyclical movement. We showed that this ipsilateral facilitation increased significantly when the wrist movements were performed in the context of demanding hand-foot coordination tasks whereas foot movements alone influenced the hand representation of M1_ipsi only slightly. Our data revealed a clear hemispheric asymmetry such that MEP responses were significantly larger when elicited in the left M1_ipsi than in the right. In experiment 2, we tested whether the modulations of M1_ipsi facilitation, caused by performing different coordination tasks with the left versus right body sides, could be explained by changes in short intracortical inhibition (SICI). We found that SICI was increasingly reduced for a complex coordination pattern as compared to rest, but only in the right M1_ipsi. We argue that our results might reflect the stronger involvement of the left versus right hemisphere in performing demanding motor tasks.

Motor learning with augmented feedback: modality-dependent behavioral and neural consequences

Sensory information is critical to correct performance errors online during the execution of complex tasks and can be complemented by augmented feedback (FB). Here, 2 groups of participants acquired a new bimanual coordination pattern under different augmented FB conditions: 1) visual input reflecting coordination between the 2 hands and 2) auditory pacing integrating the timing of both hands into a single temporal structure. Behavioral findings revealed that the visual group became dependent on this augmented FB for performance, whereas the auditory group performed equally well with or without augmented FB by the end of practice. Functional magnetic resonance imaging (fMRI) results corroborated these behavioral findings: the visual group showed neural activity increases in sensory-specific areas during practice, supporting increased reliance on augmented FB. Conversely, the auditory group showed a neural activity decrease, specifically in areas associated with cognitive/sensory monitoring of motor task performance, supporting the development of a control mode that was less reliant on augmented FB sources. Finally, some remnants of brain activity in sensory-specific areas in the absence of augmented FB were found for the visual group only, illustrating ongoing reliance on these areas. These findings provide the first neural account for the "guidance hypothesis of information FB," extensively supported by behavioral research.

Brain-behavior relationships in young traumatic brain injury patients: DTI metrics are highly correlated with postural control

Traumatic brain injury (TBI) is a major cause of impairment and functional disability in children and adolescents, including deterioration in fine as well as gross motor skills. The aim of this study was to assess deficits in sensory organization and postural ability in a young group of TBI patients versus controls by using quantitative force-platform recordings, and to test whether balance deficits are related to variation in structural properties of the motor and sensory white matter pathways. Twelve patients with TBI and 14 controls (aged 8-20 years) performed the Sensory Organisation Test (SOT) protocol of the EquiTest (Neurocom). All participants were scanned using Diffusion Tensor Imaging (DTI) along with standard anatomical scans. Quantitative comparisons of DTI parameters (fractional anisotropy, axial and radial diffusivity) between TBI patients and controls were performed. Correlations between DTI parameters and SOT balance scores were determined. Findings revealed that the TBI group scored generally lower than the control group on the SOT, indicative of deficits in postural control. In the TBI group, reductions in fractional anisotropy were noted in the cerebellum, posterior thalamic radiation, and corticospinal tract. Degree of white matter deterioration was highly correlated with balance deficits. This study supports the view that DTI is a valuable tool for assessing the integrity of white matter structures and for selectively predicting functional motor deficits in TBI patients.

Hemispheric asymmetries of motor versus nonmotor processes during (visuo)motor control

Language and certain aspects of motor control are typically served by the left hemisphere, whereas visuospatial and attentional control are lateralized to the right. Here a (visuo)motor tracing task was used to identify hemispheric lateralization beyond the general, contralateral organization of the motor system. Functional magnetic resonance imaging (fMRI) was applied in 40 male right-handers (19-30 yrs) during line tracing with dominant and nondominant hand, with and without visual guidance. Results revealed a network of areas activating more in the right than left hemisphere, irrespective of the effector. Inferior portions of frontal gyrus and parietal lobe overlapped largely with a previously described ventral attention network responding to unexpected or behaviourally relevant stimuli. This demonstrates a hitherto unreported functionality of this circuit that also seems to activate when spatial information is continuously exploited to adapt motor behaviour. Second, activation of left dorsal premotor and postcentral regions during tracing with the nondominant left hand was more pronounced than that in their right hemisphere homologues during tracing with the dominant right hand. These activation asymmetries of motor areas ipsilateral to the moving hand could not be explained by asymmetries in skill performance, the degree of handedness, or interhemispheric interactions. The latter was measured by a double-pulse transcranial magnetic stimulation paradigm, whereby a conditioning stimulus was applied over one hemisphere and a test stimulus over the other. We propose that the left premotor areas contain action representations strongly related to movement implementation which are also accessed during movements performed with the left body side.

The neural control of bimanual movements in the elderly: Brain regions exhibiting age-related increases in activity, frequency-induced neural modulation, and task-specific compensatory recruitment

Coordinated hand use is an essential component of many activities of daily living. Although previous studies have demonstrated age-related behavioral deficits in bimanual tasks, studies that assessed the neural basis underlying such declines in function do not exist. In this fMRI study, 16 old and 16 young healthy adults performed bimanual movements varying in coordination complexity (i.e., in-phase, antiphase) and movement frequency (i.e., 45, 60, 75, 90% of critical antiphase speed) demands. Difficulty was normalized on an individual subject basis leading to group performances (measured by phase accuracy/stability) that were matched for young and old subjects. Despite lower overall movement frequency, the old group "overactivated" brain areas compared with the young adults. These regions included the supplementary motor area, higher order feedback processing areas, and regions typically ascribed to cognitive functions (e.g., inferior parietal cortex/dorsolateral prefrontal cortex). Further, age-related increases in activity in the supplementary motor area and left secondary somatosensory cortex showed positive correlations with coordinative ability in the more complex antiphase task, suggesting a compensation mechanism. Lastly, for both old and young subjects, similar modulation of neural activity was seen with increased movement frequency. Overall, these findings demonstrate for the first time that bimanual movements require greater neural resources for old adults in order to match the level of performance seen in younger subjects. Nevertheless, this increase in neural activity does not preclude frequency-induced neural modulations as a function of increased task demand in the elderly.

The effect of long-term TENS on persistent neuroplastic changes in the human cerebral cortex

The long-term effect of daily somatosensory stimulation with transcutaneous electrical nerve stimulation (TENS) on reorganization of the motor cortex was investigated in a group of neurologically intact humans. The scalp representation of the corticospinal projection to the finger (APB, ADM) and forearm (FCR, ECR) muscles was mapped by means of transcranial magnetic stimulation (TMS) before and after a 3-week intervention period, using map area and volume, and topographical overlaps between the cortical motor representations of these muscles as primary dependent measures. Findings revealed a significant increase in cortical motor representation of all four muscles for the TENS group from pre to posttest (all, P ≤ 0.026). No significant changes in cortical motor representations were observed in the control group. The present observations highlight the potential benefit of sensory training by means of TENS as a useful complementary therapy in neurorehabilitation.

Action perception in individuals with congenital blindness or deafness: how does the loss of a sensory modality from birth affect perception-induced motor facilitation?

Seeing or hearing manual actions activates the mirror neuron system, that is, specialized neurons within motor areas which fire when an action is performed but also when it is passively perceived. Using TMS, it was shown that motor cortex of typically developed subjects becomes facilitated not only from seeing others' actions, but also from merely hearing action-related sounds. In the present study, TMS was used for the first time to explore the "auditory" and "visual" responsiveness of motor cortex in individuals with congenital blindness or deafness. TMS was applied over left primary motor cortex (M1) to measure cortico-motor facilitation while subjects passively perceived manual actions (either visually or aurally). Although largely unexpected, congenitally blind or deaf subjects displayed substantially lower resonant motor facilitation upon action perception compared to seeing/hearing control subjects. Moreover, muscle-specific changes in cortico-motor excitability within M1 appeared to be absent in individuals with profound blindness or deafness. Overall, these findings strongly argue against the hypothesis that an increased reliance on the remaining sensory modality in blind or deaf subjects is accompanied by an increased responsiveness of the "auditory" or "visual" perceptual-motor "mirror" system, respectively. Moreover, the apparent lack of resonant motor facilitation for the blind and deaf subjects may challenge the hypothesis of a unitary mirror system underlying human action recognition and may suggest that action perception in blind and deaf subjects engages a mode of action processing that is different from the human action recognition system recruited in typically developed subjects.

Hemispheric asymmetries of the premotor cortex are task specific as revealed by disruptive TMS during bimanual versus unimanual movements

The premotor cortex (PMC) is functionally lateralized, such that the left PMC is activated for unimanual movements of either hand, whereas the right PMC is particularly active during complex bimanual movements. Here we ask the question whether the high activation of right PMC in the bimanual context reflects either hemispheric specialization or handedness. Left- and right-handed subjects performed a bimanual antiphase tapping task at different frequencies while transcranial magnetic stimulation (TMS) was used to temporarily disrupt left versus right PMC during complex bimanual movements. For both handedness groups, more disruptions were induced when TMS was applied over the motor nondominant PMC than over the motor dominant PMC or when sham-TMS was used. In a second experiment, right-handers performed complex unimanual tapping with either hand, while TMS was applied to the PMC in both hemispheres. The novel result was that the high susceptibility of the motor nondominant PMC was specific to the bimanual context, indicating that hemispheric asymmetries of the PMC depend on the bimanual versus unimanual nature of the motor task. We hypothesize that asymmetries of PMC involvement in bimanual control reflect interhemispheric interactions, whereby the motor nondominant PMC appears to prevent motor cross talk arising from the dominant hemisphere.

Reduced basal ganglia function when elderly switch between coordinated movement patterns

Structural and neurochemical changes in frontostriatal circuits are thought to underlie age-related behavioral deficits on cognitive tasks. Here, we test the hypothesis that age-related motor switching deficits are associated with reduced basal ganglia (BG) function. Right-handed volunteers (15 Old, and 15 Young) made spatially and temporally coupled bimanual circular motions during event-related FMRI. A visual cue signaled the right hand to Switch or Continue its circling direction. Switching from mirror symmetric to asymmetric (SW»ASYMM) took longer and resulted in more contralateral (left-) hand disruptions than vice versa. These effects were more pronounced in the elderly, showing that the ability to suppress and flexibly adapt motor behavior (agility) declines with age. For both groups, switching activated the BG and a typical network for task-set implementation, including dorsal anterior cingulate cortex/supplementary motor area (pre-SMA, SMA-proper) and anterior insula/inferior frontal gyrus. A region of interest analysis revealed significantly reduced SW»ASYMM activation in bilateral subthalamic nucleus and right globus pallidus, only in the elderly. Age-related behavioral deficits may be related to inefficient recruitment of cortico-BG loops to suppress undesired movements. The elderly may use an alternative strategy to select the required movement pattern as indicated by increased activation of prefrontal cortex.

Limitations on coupling of bimanual movements caused by arm dominance: when the muscle homology principle fails

Studies of bimanual movements typically report interference between motions of the two arms and preference to perform mirror-symmetrical patterns. However, recent studies have demonstrated that the two arms differ in the ability to control interaction torque (INT). This predicts limitations in the capability to perform mirror-symmetrical movements. Here, two experiments were performed to test this prediction. The first experiment included bimanual symmetrical and asymmetrical circle drawing at two frequency levels. Unimanual circle drawing was also recorded. The increases in cycling frequency caused differences between the two arms in movement trajectories in both bimanual modes, although the differences were more pronounced in the asymmetrical compared with the symmetrical mode. Based on torque analysis, the differences were attributed to the nondominant arm's decreased capability to control INT. The intraarm differences during the symmetrical pattern of bimanual movements were similar (although more pronounced) to those during unimanual movements. This finding was verified in the second experiment for symmetrical bimanual oval drawing. Four oval orientations were used to provide variations in INT. Similar to the first experiment, increases in cycling frequency caused spontaneous deviations from perfect bimanual symmetry associated with inefficient INT control in the nondominant arm. This finding supports the limitations in performing mirror-symmetrical bimanual movements due to differences in joint control between the arms. Based on our results and previous research, we argue that bimanual interference occurs during specification of characteristics of required motion, whereas lower-level generation of muscle forces is independent between the arms. A hierarchical model of bimanual control is proposed.

Long-Term TENS Treatment Improves Tactile Sensitivity in MS Patients

Background. Transcutaneous electrical nerve stimulation (TENS) is commonly used in neurorehabilitation for the treatment of pain and spasticity. Objective. The long-term effects of sensory stimulation by means of TENS on hand sensitivity were investigated in patients with multiple sclerosis (MS). Methods. TENS was applied for 3 weeks (1 hour per day) on the median nerve region of the dominant hand. Sensitivity was assessed by the Semmes—Weinstein monofilaments before and 12 hours following the last intervention as well as 3 weeks later. Results. Long-lasting increases in tactile sensitivity were achieved by repetitive stimulation of sensory afferents with TENS in MS patients but not in healthy subjects. This increased sensitivity was not only restricted to the median nerve area but also expanded to the ulnar nerve area. Remarkably, MS patients reached the same level of sensitivity as healthy subjects immediately after the intervention, and long-term effects were reported 3 weeks later. Conclusions. The findings of this study demonstrated lasting improvements in tactile sensitivity of the fingers as a result of a long-term TENS intervention in MS patients, who ultimately reached a level comparable with that of healthy subjects.

Children with a learning disorder show prospective control impairments during visuomanual tracking

To examine whether children with a learning disorder (LD) are able to use prospective motor control, 30 children with LD (mean age 8 years and 11 months) and an age- and gender-matched control group were asked to smoothly track an accelerating dot presented on a monitor by moving an electronic pen on a digitizer. Children with LD performed worse than controls: the number of drawn circles was smaller, the maximum target velocity lower, and the number of submovements was higher. It is suggested that a decreased ability to predict the movement of the target leads to impaired visuomanual tracking in children with LD. Furthermore, children with LD did not improve from the 1st to the 2nd trial, possibly as a result of slower visuomotor adaptation processes.

Shared neural resources between left and right interlimb coordination skills: the neural substrate of abstract motor representations

Functional magnetic resonance imaging was used to reveal the shared neural resources between movements performed with effectors of the left versus right body side. Prior to scanning, subjects extensively practiced a complex coordination pattern involving cyclical motions of the ipsilateral hand and foot according to a 90 degrees out-of-phase coordination mode. Brain activity associated with this (nonpreferred) coordination pattern was contrasted with pre-existing isodirectional (preferred) coordination to extract the learning-related brain networks. To identify the principal candidates for effector-independent movement encoding, the conjunction of training-related activity for left and right limb coordination was determined. A dominantly left-lateralized parietal-to-(pre)motor activation network was identified, with activation in inferior and superior parietal cortex extending into intraparietal sulcus and activation in the premotor areas, including inferior frontal gyrus (pars opercularis). Similar areas were previously identified during observation of complex coordination skills by expert performers. These parietal-premotor areas are principal candidates for abstract (effector-independent) movement encoding, promoting motor equivalence, and they form the highest level in the action representation hierarchy.

Conceptual binding: integrated visual cues reduce processing costs in bimanual movements

In discrete reaction time (RT) tasks, it has been shown that nonsymmetric bimanual movements are initiated slower than symmetric movements in response to symbolic cues. By contrast, no such RT differences are found in response to direct cues ("direct cue effect"). Here, we report three experiments showing that the direct cue effect generalizes to rhythmical bimanual movements and that RT cost depends on different cue features: 1) symbolic versus direct or 2) integrated (i.e., action of both hands is indicated as one entity) versus dissociated (i.e., action of each hand is indicated separately). Our main finding was that dissociated symbolic cues were most likely processed serially, resulting in the longest RTs, which were substantially reduced with integrated symbolic cues. However, extra RT costs for switching to nonsymmetrical bimanual movements were overcome only when the integrated cues were direct. We conclude that computational resources might have been exceeded when the response needs to be determined for each hand separately, but not when a common response for both hands is selected. This supports the idea that bimanual control benefits from conceptual binding.

Coordination of complex bimanual multijoint movements under increasing cycling frequencies: the prevalence of mirror-image and translational symmetry

The present study examined the principles underlying inter and intralimb coordination constraints during performance of bimanual elbow-wrist movements at different cycling frequencies (from 0.75 Hz to 2.50 Hz). Participants performed eight coordination tasks that consisted of a combination of in-phase (IN) and/or anti-phase (AN) coordination modes between both elbows and wrists (interlimb), with isodirectional (Iso) or non-isodirectional (NonI) coordination modes within each limb (intralimb). As expected, the principle of muscle homology (in-phase coordination), giving rise to mirror symmetrical movements with respect to the mid-sagittal plane, had a powerful influence on the quality of global coordinative behavior both between and within limbs. When this principle was violated (i.e., when the anti-phase mode was introduced in one or both joint pairs), the non-isodirectional intralimb mode exhibited a (de)stabilizing role in coordination, which became more pronounced at higher cycling frequencies. However, pattern loss with increasing cycling frequency resulted not only in convergence toward the more stable in-phase patterns with the elbows and wrists but also to the anti-phase patterns (which were associated with directional compatibility of within-limb motions). Moreover, participants generally preserved their initial mode of coordination (either in-phase or anti-phase) in the proximal joints (i.e., elbows) while shifting from anti-phase to in-phase (or vice versa) with their distal joint pair (i.e., wrists). Taken together, these findings reflect the impact of two immanent types of symmetry in bimanual coordination: mirror-image and translational symmetry.

Neural correlates of motor dysfunction in children with traumatic brain injury: exploration of compensatory recruitment patterns

Traumatic brain injury (TBI) is a common form of disability in children. Persistent deficits in motor control have been documented following TBI but there has been less emphasis on changes in functional cerebral activity. In the present study, children with moderate to severe TBI (n = 9) and controls (n = 17) were scanned while performing cyclical movements with their dominant and non-dominant hand and foot according to the easy isodirectional (same direction) and more difficult non-isodirectional (opposite direction) mode. Even though the children with TBI were shown to be less successful on various items of a clinical motor test battery than the control group, performance on the coordination task during scanning was similar between groups, allowing a meaningful interpretation of their brain activation differences. fMRI analysis revealed that the TBI children showed enhanced activity in medial and anterior parietal areas as well as posterior cerebellum as compared with the control group. Brain activation generally increased during the non-isodirectional as compared with the isodirectional mode and additional regions were involved, consistent with their differential degree of difficulty. However, this effect did not interact with group. Overall, the findings indicate that motor impairment in TBI children is associated with changes in functional cerebral activity, i.e. they exhibit compensatory activation reflecting increased recruitment of neural resources for attentional deployment and somatosensory processing.

Evidence for adaptive shoulder-elbow control in cyclical movements with different amplitudes, frequencies, and orientations

The evolution of joint dynamics and muscle patterning in the shoulder and elbow was studied for cyclical line drawing tasks at different frequencies, amplitudes, and orientations in the horizontal plane. Three main modes of control were identified: elbow-centered, shoulder-centered, and elbow-shoulder, each referring to the principal joints or joint combinations that were used to achieve the behavioral goals. The contribution of the shoulder joint was most prominent across the majority of movement orientations and largely paralleled changes in the dynamic (inertial) forces in the end effector (shoulder-centered control). The two joints either exchanged roles during the performance of the right diagonal movement (elbow-centered control) or shifted from a single-joint strategy to a dual-joint strategy during the performance of large amplitudes with low or medium cycling frequencies (shoulder-elbow control). These behavioral results support the existence of a modular control mode that allows the central nervous system to effectively tune motor commands to meet a broad variety of orientations, amplitudes, and frequencies. This refers to the emergence of a context-dependent control mode for the shoulder and elbow that optimizes the implementation of the underlying motor goals under a rich combination of spatial and temporal manipulations.

Unimanual muscle activation increases interhemispheric inhibition from the active to the resting hemisphere

Interhemispheric inhibition (IHI) is an important mechanism to maximize the independent functioning of each hemisphere and is most likely mediated by transcallosal fibres. IHI can be investigated by paired pulse transcranial magnetic stimulation (TMS) whereby, in half of the trials, a test stimulus (TS) over one hemisphere is preceded by a conditioning stimulus (CS) over the other hemisphere. Whereas various studies have investigated IHI in rest, less is known about interhemispheric interactions during voluntary muscle activation. Here, we investigated the influence of tonic muscle activity (5% of the maximal voluntary contraction) in either the right wrist flexor or extensor versus rest on IHI from the active (left) to the resting (right) hemisphere. Our main finding was that tonic activation of the right wrist flexor, led to an increase in IHI from the active (dominant left) to the resting (non-dominant right) hemisphere as compared to rest. A control experiment employed the same design but CS intensity was lowered to match MEP amplitudes of the conditioning hand between active and rest conditions. This resulted in a relative decrease of IHI. It is hypothesized that functional regulation of IHI might prevent the occurrence of mirror activity in the primary motor cortex (M1) of the resting hemisphere and, thus, might play an important role in the execution of unimanual actions.

Proprioceptive sensibility in the elderly: degeneration, functional consequences and plastic-adaptive processes

As the percentage of individuals over the age of 60 years continues to rise, determining the extent and functional significance of age-related declines in sensorimotor performance is of increasing importance. This review examines the specific contribution of proprioceptive feedback to sensorimotor performance in older adults. First, a global perspective of proprioceptive acuity is provided assimilating information from studies where only one of several aspects of proprioceptive function (e.g. sense of position, motion or dynamic position) was quantified, and/or a single joint or limb segment tested. Second, the consequences of proprioceptive deficits are established with particular emphasis placed on postural control. Lastly, the potential for plastic changes in the aging proprioceptive system is highlighted, including studies which relate physical activity to enhanced proprioceptive abilities in older adults. Overall, this review provides a foundation for future studies regarding the proprioceptive feedback abilities of elderly individuals. Such studies may lead to greater advances in the treatment and prevention of the sensorimotor deficits typically associated with the aging process.

Directional constraints during bimanual coordination: the interplay between intrinsic and extrinsic directions as revealed by head motions

The role of directional compatibility was investigated during the production of in-phase and anti-phase coordination patterns involving both arms as well as the head. Our first aim was to compare the quality of coordination between both arms when symmetrical arm posture manipulations were used to disentangle muscle homology from the mutual direction of limb motions in extrinsic space. Findings revealed that in-phase coordination, characterized by the simultaneous activation of homologous muscle groups, was resistant to posture manipulations. Conversely, during anti-phase coordination, the influence of extrinsic direction became more prevalent whereby isodirectionality in extrinsic space contributed to stabilization of anti-phase coordination patterns. The second aim was to study the effect of periodic head movements upon the assembling of a coordinative synergy among the body segments. The findings demonstrated that the in-phase patterns were hardly affected by directionality of head motion. Conversely, the anti-phase patterns were more vulnerable to the directional influence of head movements, showing less accurate and stable coordination during non-isodirectional than isodirectional head motions. These observations underscore the robust nature of coordination patterns based on muscle homology, even in the absence of symmetric arm positions. Moreover, isodirectional head movements became easily integrated with the overall coordination pattern, whereas head-limb coupling was poor when the head moved anti-directional with the limbs.

Acquisition of a new bimanual coordination pattern modulates the cerebral activations elicited by an intrinsic pattern: an fMRI study

Intensive practice of a new complex motor skill results in progressive improvement of performance. This induces neuroplastic changes, reflecting the transition from attention-demanding to more automatic performance throughout the learning. In the present fMRI study, learning-related cerebral activation changes during the acquisition of a new complex bimanual coordination pattern were examined, i.e., the 90 degrees out-of-phase pattern (90Phi). Furthermore, we investigated whether practice of this new pattern influenced the neural correlates associated with performance of a preferred intrinsic pattern. Twelve young healthy subjects were intensively trained on the 90Phi task, and underwent two fMRI scanning sessions in early (PRE) and late (POST) learning. Scanning sessions included performance of the trained 90Phi pattern, as well as the nontrained intrinsic in-phase pattern (InPhi). Kinematics registered during training and scanning experiments showed that the new 90Phi pattern was acquired successfully, resulting in learning-related brain activation changes. Activation decreases were observed in the right prefrontal cortex (DLPFC and dorsal premotor), in the right middle temporal and occipital cortices and in the posterior cerebellum. Conversely, increases were found in the basal ganglia and hippocampus. Interestingly, activity elicited by the InPhi task also evidenced within-subjects PRE/POST differences (although kinematics InPhi performance was equivalent in both sessions). In particular, the learning-related decreases found for the 90Phi pattern in the cerebellum, the occipital and temporal gyri were similarly observed for the intrinsic InPhi pattern. Moreover, InPhi performance induced PRE/POST increases of activity in the left superior frontal gyrus. Our fMRI results suggest that intensive practice of a new complex coordination pattern impacted, at least temporarily, on the neural correlates of preferred intrinsic coordination patterns. Additional neural recruitment might reflect increased mental effort to prevent negative transfer from the learned mode onto the intrinsic coordination mode.

Expert performance on a virtual reality simulation system

The objective of this research was to determine if the essence of expert performance could be captured on a virtual reality simulation system. Six experts in operative dentistry, six experts in periodontology, and six novice dental students performed a Class II tooth preparation task on the lower left second premolar. All subjects performed a pre-test to assess the basic skill level of each group. During the (limited) training component of the study, the three groups practiced three tooth preparations and received augmented feedback. At both a one-minute and one-day interval, subjects performed a final test in the absence of augmented feedback. All preparations were graded by the simulation system. The results showed at pre-test a significantly better performance of the experts in operative dentistry as compared to the novices. During the practice (acquisition) phase, the experts in operative dentistry outperformed both the periodontologists and novices, whereas the experts in periodontology performed more accurately than the novices. After one minute and one day following practice, similar results were obtained. Retention performance was most accurate after a one-day delay. Based on these results, the simulator appears to be a valid and reliable tool to capture expert performance. It is an effective screening device for assessing the level of expert performance.

The missing link between action and cognition

The study of the neural correlates of motor behaviour at the systems level has received increasing consideration in recent years. One emerging observation from this research is that neural regions typically associated with cognitive operations may also be recruited during the performance of motor tasks. This apparent convergence between action and cognition - domains that have most often been studied in isolation - becomes especially apparent when examining new complex motor skills such as those involving sequencing or coordination, and when taking into account external (environment-related) factors such as feedback availability and internal (performer-related) factors such as pathology. Neurally, overlap between action and cognition is prominent in frontal lobe areas linked to response selection and monitoring. Complex motor tasks are particularly suited to reveal the crucial link between action and cognition and the generic brain areas at the interface between these domains.

Posture Control and Complex Arm Coordination: Analysis of Multijoint Coordinative Movements and Stability of Stance

The authors addressed the interactions between control of bimanual multijoint coordination tasks and posture. Participants (N = 6) performed 8 coordination patterns that differed in degree of complexity by using their bilateral elbows and wrists under 3 scaled motion speeds while standing on 2 force plates. Results indicated that producing complex bimanual multijoint coordinative tasks affected postural sway, thus resulting in an increase of sway activity. Behavioral as well as mechanical factors accounted for the increased disturbance in postural sway. Those findings suggest that performing complex coordination tasks disrupts postural control in normal young adults.

Whether feeling or seeing is more accurate depends on tracking direction within the perception-action cycle

Coordination in biological systems requires a continuous updating of the perception-action cycle. How the different sources of sensory information contribute uniquely to performance is still debated. Here, we directly compared the role of vision and kinesthesis by means of a tracking task in which the left wrist mimicked the passive motions imposed on the right wrist with a torque motor. The passive movements were perceived visually (alien hand) or kinesthetically (own hand), or a combination thereof (own hand, feel and see). Tracking occurred according to the same (isodirectional) or opposite (mirror-image) directions. Findings revealed that visual tracking was performed most successfully in the isodirectional and kinesthetic tracking in the mirror-image mode. Tracking was most successful when both sources of sensory information were present. These results suggest that vision and proprioception obey direction-dependent constraints that are consistent with extrinsic and intrinsic reference frames within which the perception-action cycle resides. Thus, each sensory modality contributes uniquely as a function of the spatial requirements of the tracking task, rather than one being superior over the other.

Symmetry Constraints Mediate the Learning and Transfer of Bimanual Coordination Patterns Across Planes of Motion

The authors investigated whether neuromuscular and directional constraints are dissociable limitations that affect learning and transfer of a bimanual coordination pattern. Participants (N = 9) practiced a 45 degrees muscular relative phasing pattern in the transverse plane over 4 days. The corresponding to-be-learned spatial relative phasing was 225 degrees. Before, during, and following practice, the authors administered probe tests in the sagittal plane to assess transfer of learning. In the probe tests, participants performed various patterns characterized by different muscular and spatial relative phasing (45 degrees, 45 degrees, 45 degrees, 225 degrees, 225 degrees, 45 degrees, and 225 degrees, 225 degrees). The acquisition of the to-be-learned pattern in the transverse plane resulted in spontaneous positive transfer of learning only to coordination patterns having 45 degrees of spatial relative phase, irrespective of muscular phasing. Moreover, transfer occurred in the sagittal plane to coordination patterns that had symmetry properties similar to those of the to-be-learned pattern. The authors conclude that learning and transfer of spatial features of coordination patterns from the transverse to the sagittal plane of motion are mediated by mirror-symmetry constraints.

Online movement control in multiple sclerosis patients with tremor: effects of tendon vibration

Patients with intention tremor due to multiple sclerosis (MS) exhibit an increased reliance on visual feedback in the sensorimotor control of slow goal-directed movements. In the present study, the use of proprioceptive information was investigated in MS patients with intention tremor compared to MS patients without tremor and healthy controls. Tendon vibration was applied to the wrist extensor muscles during a memory-guided slow wrist step-tracking task to investigate the use of muscle spindle afferent information in online movement control. A significant reduction of movement amplitude was induced by tendon vibration in all three groups, but the effect was found to be smaller in MS patients with tremor (28%) than in subjects without tremor (50%). Vibration also induced an increase of overall tremor amplitude in the MS tremor group; however, its effect on movement amplitude was not directly related to (changes in) tremor severity. The results suggest that the decreased online use of proprioceptive information in MS patients with tremor reflects an adaptation over time to cope with a tremor-related noisy background. Abnormalities in proprioceptive processing may explain why MS patients with tremor show an increased reliance on visual feedback for online motor control.

The coalition of constraints during coordination of the ipsilateral and heterolateral limbs

Previous work on the coordination between the upper and lower limbs has invariably shown that its accuracy/stability is primarily determined by the mutual direction between limbs in extrinsic space and not by muscle relationships. Here we show that muscle grouping does play a critical role in coordination of the arm and leg, in addition to direction. More specifically, the simultaneous activation of isofunctional muscles and/or limb movements proceeding in the same direction, results in more successful performance than the alternated activation of isofunctional muscles and/or movements occurring in different directions. In the absence of isofunctional muscle coupling, the mutual direction between the limbs plays a more prominent role in determining coordinative accuracy. These coordination constraints can largely account for the observed differences between ipsilateral and heterolateral limb coordination. The findings are discussed in view of the coalition of coordination constraints.

Changes in brain activation during the acquisition of a multifrequency bimanual coordination task: from the cognitive stage to advanced levels of automaticity

Little is known about activation changes reflecting overlearning, i.e., extensive motor training beyond asymptotic performance. Here we used functional magnetic resonance imaging to trace the neural shifts from an initial to a skilled (learning) and finally overlearned stage (automatization). Scanning occurred before training (PRE) and after 1 (MID) and 2 weeks (POST) of intensive practice on a new bimanual coordination task (>10,500 cycles). Kinematics revealed major improvements between PRE and MID sessions, whereas MID to POST session performance leveled off, indicative of learning and automatization, respectively. Imaging findings showed that activation decreased in bilateral opercular areas, bilateral ventrolateral prefrontal cortex, the right ventral premotor and supramarginal gyrus, and the anterior cingulate sulcus during the learning stage and in the supplementary motor area during the automatization stage. These changes are hypothesized to reflect decreases in attention-demanding sensory processing, as well as suppression of preferred coordination tendencies as a prelude to acquiring new coordination modes. Conversely, learning-related increases were observed in the primary motor cortex (M1), posterior cingulate zone (PCZ), putamen, and right anterior cerebellum. Importantly, both M1 and PCZ activation decreased again to initial level (PRE) during automated performance (POST). Only the putamen and anterior cerebellum remained more activated across both learning and automatization stages, supporting their crucial role in long-term motor memory formation for coordination tasks.

The advantage of cyclic over discrete movements remains evident following changes in load and amplitude

Previous studies suggested that the advantage in speed accuracy trade-off of cyclic over discrete aiming tasks with the upper limbs may be associated with the operation of spinal neural oscillators, as in locomotion. Similar to the locomotor rhythm that is fairly robust and can accommodate changes in loading or stride length, we predicted that cyclic aiming tasks would be equally resistant to changes in load or amplitude, thereby preserving the advantage over discrete tasks. To test the hypothesis, cyclic and discrete aiming movements were performed with and without loading of the hand. Furthermore a "complex" condition was introduced in which the distance between the targets that the participants moved to alternated between 2.5 and 5 cm. In all cases, two target sizes were used to test spatial accuracy and to be able to calculate the Index of Performance (IP). Findings revealed that even though part of the advantage of the cyclic over the discrete regime was lost during the complex movement pattern and with addition of weight, the former remained superior to the latter. Furthermore, adding weight did not change the oscillation frequency in the cyclic movements. It is concluded that the superiority of cyclic movements over discrete ones is fairly robust, consistent with the high degree of flexibility that is typically observed in neural oscillators.