Parieto-premotor Areas Mediate Directional Interference During Bimanual Movements

The effects of task demands on bimanual skill acquisition

Bimanual coordination is essential for everyday activities. It is thought that different degrees of demands may affect learning of new bimanual patterns. One demand is at the level of performance and involves breaking the tendency to produce mirror-symmetric movements. A second is at a perceptual level and involves controlling each hand to separate (i.e., split) goals. A third demand involves switching between different task contexts (e.g., a different uni- or bimanual task), instead of continuously practicing one task repeatedly. Here, we studied the effect of these task demands on motor planning (reaction time) and execution (error) while subjects learned a novel bimanual isometric pinch force task. In Experiment 1, subjects continuously practiced in one of the two extremes of the following bimanual conditions: (1) symmetric force demands and a perceptually unified target for each hand or (2) asymmetric force demands and perceptually split targets. Subjects performing in the asymmetric condition showed some interference between hands, but all subjects, regardless of group, could learn the isometric pinch force task similarly. In Experiment 2, subjects practiced these and two other conditions, but in a paradigm where practice was briefly interrupted by the performance of either a unimanual or a different bimanual condition. Reaction times were longer and errors were larger well after the interruption when the main movement to be learned required asymmetric forces. There was no effect when the main movement required symmetric forces. These findings demonstrate two main points. First, people can learn bimanual tasks with very different demands on the same timescale if they are not interrupted. Second, interruption during learning can negatively impact both planning and execution and this depends on the demands of the bimanual task to be learned. This information will be important for training patient populations, who may be more susceptible to increased task demands.

Spatiotemporal re-organization of large-scale neural assemblies underlies bimanual coordination

Bimanual coordination engages a distributed network of brain areas, the spatiotemporal organization of which has given rise to intense debates. Do bimanual movements require information processing in the same set of brain areas that are engaged by movements of the individual components (left and right hands)? Or is it necessary that other brain areas are recruited to help in the act of coordination? These two possibilities are often considered as mutually exclusive, with studies yielding support for one or the other depending on techniques and hypotheses. However, as yet there is no account of how the two views may work together dynamically. Using the method of Mode-Level Cognitive Subtraction (MLCS) on high density EEG recorded during unimanual and bimanual movements, we expose spatiotemporal reorganization of large-scale cortical networks during stable inphase and antiphase coordination and transitions between them. During execution of stable bimanual coordination patterns, neural dynamics were dominated by temporal modulation of unimanual networks. At instability and transition, there was evidence for recruitment of additional areas. Our study provides a framework to quantify large-scale network mechanisms underlying complex cognitive tasks often studied with macroscopic neurophysiological recordings.

Two distinct ipsilateral cortical representations for individuated finger movements

Movements of the upper limb are controlled mostly through the contralateral hemisphere. Although overall activity changes in the ipsilateral motor cortex have been reported, their functional significance remains unclear. Using human functional imaging, we analyzed neural finger representations by studying differences in fine-grained activation patterns for single isometric finger presses. We demonstrate that cortical motor areas encode ipsilateral movements in 2 fundamentally different ways. During unimanual ipsilateral finger presses, primary sensory and motor cortices show, underneath global suppression, finger-specific activity patterns that are nearly identical to those elicited by contralateral mirror-symmetric action. This component vanishes when both motor cortices are functionally engaged during bimanual actions. We suggest that the ipsilateral representation present during unimanual presses arises because otherwise functionally idle circuits are driven by input from the opposite hemisphere. A second type of representation becomes evident in caudal premotor and anterior parietal cortices during bimanual actions. In these regions, ipsilateral actions are represented as nonlinear modulation of activity patterns related to contralateral actions, an encoding scheme that may provide the neural substrate for coordinating bimanual movements. We conclude that ipsilateral cortical representations change their informational content and functional role, depending on the behavioral context.

Premotor Cortex Is Sensitive to Auditory–Visual Congruence for Biological Motion

The auditory and visual perception systems have developed special processing strategies for ecologically valid motion stimuli, utilizing some of the statistical properties of the real world. A well-known example is the perception of biological motion, for example, the perception of a human walker. The aim of the current study was to identify the cortical network involved in the integration of auditory and visual biological motion signals. We first determined the cortical regions of auditory and visual coactivation (Experiment 1); a conjunction analysis based on unimodal brain activations identified four regions: middle temporal area, inferior parietal lobule, ventral premotor cortex, and cerebellum. The brain activations arising from bimodal motion stimuli (Experiment 2) were then analyzed within these regions of coactivation. Auditory footsteps were presented concurrently with either an intact visual point-light walker (biological motion) or a scrambled point-light walker; auditory and visual motion in depth (walking direction) could either be congruent or incongruent. Our main finding is that motion incongruency (across modalities) increases the activity in the ventral premotor cortex, but only if the visual point-light walker is intact. Our results extend our current knowledge by providing new evidence consistent with the idea that the premotor area assimilates information across the auditory and visual modalities by comparing the incoming sensory input with an internal representation.

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.

The effects of bromazepam over the temporo-parietal areas during the performance of a visuomotor task: a qEEG study

This study investigated the effects of bromazepam on qEEG when 14 healthy subjects were asked to perform a visuomotor task (i.e., motor vehicle driving task). The subjects were exposed to two experimental conditions: the placebo (PL) and 6 mg of bromazepam (Br 6 mg), following a randomized, double-blind design on different days. Specifically, we observe absolute power extracted from qEEG data for theta band. We expected to see a decrease in absolute theta power in the temporal and parietal areas due to the influence of bromazepam for the experimental group when compared with the placebo group. We found a main effect for the condition factor for electrodes T3, T4, P3 and P4. We also observed a main effect for the period factor for electrodes P3 and P4. We observed that the ingestion of 6 mg of bromazepam induces different patterns in theta power at the temporal and parietal sites. We concluded that 6 mg of bromazepam was an important factor in the fluctuation of the activities in the temporal and parietal areas. We then hypothesize about the specific role of this drug during the execution of a visuomotor task and within the sensorimotor integration process.

Hemispheric integration is critical for intact error processing

We provide for the first time direct clinical evidence for the critical role of hemispheric integration in intact error processing. We tested three patients with partial callosal disconnection. Two anterior patients could not correct their errors in a unilateral version of a visuomotor learning task for which they previously exhibited callosal disconnection, whereas, they corrected most of their errors in two visual matching tasks (comparing abstract shapes or faces) that they could transfer between the hemispheres. An opposite pattern emerged in a posterior patient. He could not correct his errors in unilateral versions of the same visual matching tasks, for which he previously exhibited callosal disconnection. However, he corrected most of his errors in the visuomotor learning task he was able to transfer between the hemispheres.

Morphological patterns of the postcentral sulcus in the human brain

The morphological structure of the postcentral sulcus and its variability were investigated in 40 structural magnetic resonance images of the human brain registered to the Montreal Neurological Institute (MNI) proportional stereotaxic space. This analysis showed that the postcentral sulcus is not a single sulcus, but rather a complex of sulcal segments separated by gyri, which merge their banks at distinct locations. Most of these gyri are submerged deep within the sulcus and can be observed only by examining the depth of the sulcus, although a small proportion may be observed from the surface of the brain. In the majority of the examined cerebral hemispheres (73.75%), the postcentral sulcus is separated into two or three segments or, less frequently, into four or five segments (12.5%), or it remains continuous (13.75%). Examination of the in-depth relationship between the postcentral sulcus and the intraparietal sulcus revealed that these two sulci may appear to join on the surface of the brain but they are in fact always separated by a gyrus in the cortical depth. In 32.5% of the examined hemispheres, a dorsoventrally oriented sulcus, the transverse postcentral sulcus, is located anterior to the postcentral sulcus on the lower part of the postcentral gyrus. Systematic examination of the morphology of the postcentral sulcus in the proportional stereotaxic space that is used in functional neuroimaging studies is the first step toward the establishment of anatomical-functional correlations in the anterior parietal lobe.

Monitoring coordination during bimanual movements: where is the mastermind?

One remarkable aspect of the human motor repertoire is the multitude of bimanual actions it contains. Still, the neural correlates of coordinated movements, in which the two hands share a common goal, remain debated. To address this issue, we designed two bimanual circling tasks that differed only in terms of goal conceptualization: a "coordination" task that required movements of both hands to adapt to each other to reach a common goal and an "independent" task that imposed a separate goal to each hand. fMRI allowed us to pinpoint three areas located in the right hemisphere that were more strongly activated in the coordination condition: the superior temporal gyrus (STG), the SMA, and the primary motor cortex (M1). We then used transcranial magnetic stimulation (TMS) to disrupt transiently the function of those three regions to determine their causal role in bimanual coordination. Right STG virtual lesions impaired bimanual coordination, whereas TMS to right M1 enhanced hand independence. TMS over SMA, left STG, or left M1 had no effect. The present study provides direct insight into the neural correlates of coordinated bimanual movements and highlights the role of right STG in such bimanual movements.

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.

Neural correlates of bimanual anti-phase and in-phase movements in Parkinson's disease

Patients with Parkinson's disease have great difficulty in performing bimanual movements; this problem is more obvious when they perform bimanual anti-phase movements. The underlying mechanism of this problem remains unclear. In the current study, we used functional magnetic resonance imaging to study the bimanual coordination associated changes of brain activity and inter-regional interactions in Parkinson's disease. Subjects were asked to perform right-handed, bimanual in-phase and bimanual anti-phase movements. After practice, normal subjects performed all tasks correctly. Patients with Parkinson's disease performed in-phase movements correctly. However, some patients still made infrequent errors during anti-phase movements; they tended to revert to in-phase movement. Functional magnetic resonance imaging results showed that the supplementary motor area was more activated during anti-phase movement than in-phase movement in controls, but not in patients. In performing anti-phase movements, patients with Parkinson's disease showed less activity in the basal ganglia and supplementary motor area, and had more activation in the primary motor cortex, premotor cortex, inferior frontal gyrus, precuneus and cerebellum compared with normal subjects. The basal ganglia and dorsolateral prefrontal cortex were less connected with the supplementary motor area, whereas the primary motor cortex, parietal cortex, precuneus and cerebellum were more strongly connected with the supplementary motor area in patients with Parkinson's disease than in controls. Our findings suggest that dysfunction of the supplementary motor area and basal ganglia, abnormal interactions of brain networks and disrupted attentional networks are probably important reasons contributing to the difficulty of the patients in performing bimanual anti-phase movements. The patients require more brain activity and stronger connectivity in some brain regions to compensate for dysfunction of the supplementary motor area and basal ganglia in order to perform bimanual movements correctly.

How the brain handles temporally uncoupled bimanual movements

Whereas the cerebral representation of bimanual spatial coordination has been subject to prior research, the networks mediating bimanual temporal coordination are still unclear. The present study used functional imaging to investigate cerebral networks mediating temporally uncoupled bimanual finger movements. Three bimanual tasks were designed for the execution of movements with different timing and amplitude, with same timing but different amplitude, and with same timing and amplitude. Functional magnetic resonance imaging results showed an increase of activation within right premotor and dorsolateral prefrontal, bilateral inferior parietal, basal ganglia, and cerebellum areas related to temporally uncoupled bilateral finger movements. Further analyses showed a decrease of connectivity between homologous primary hand motor regions. In contrast, there was an increase of connectivity between motor regions and anterior cingulate, premotor and posterior parietal regions during bimanual movements that were spatially or both temporally and spatially uncoupled, compared with bimanual movements that were both spatially and temporally coupled. These results demonstrate that the extent of bihemispheric coupling of M1 areas is related to the degree of temporal synchronization of bimanual finger movements. Furthermore, inferior parietal and premotor regions play a key role for the implementation not only of spatial but also of temporal movement parameters in bimanual coordination.

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.

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.

Bilateral movement therapy post-stroke: underlying mechanisms and review

Aims

Up to 66% of individuals with stroke never regain functional use of their upper extremities. Bilateral movement training (BMT) is a task-specific rehabilitation technique that has recently been investigated for its influence on upper extremity recovery in individuals post-stroke. BMT is thought to affect the hemiparetic upper extremity by a phenomenon referred to as cross education, or the cross transfer effect.

Methods

This article reviews the theoretical accounts underlying the cross transfer effect and explain the means by which BMT may facilitate recovery of function in the hemiparetic arm. The current research evidence supporting the use of BMT as a therapeutic approach to stroke rehabilitation is discussed, and implications for clinical practice and recommendations for further research are presented.

Findings

Evidence is emerging that BMT improves impairments and function in people with hemiparesis after stroke. The main limitations of existing research on BMT include small sample sizes, varying initial impairment levels, and lack of control groups.

Conclusions

Future research needs to establish which individuals are most likely to benefi tfrom BMT, as well as the optimal dose of BMT, and whether BMT can be used as an adjunct to existing rehabilitation approaches for upper extremity rehabilitation.

Your mind's hand: motor imagery of pointing movements with different accuracy

Jeannerod (2001) postulated that motor control and motor simulation states are functionally equivalent. If this is the case, the specifically relevant task parameters in online motor control should also be represented in motor imagery. We tested whether the different spatial accuracy demands of manual pointing movements are reflected on a neural level in motor imagery. During functional magnetic resonance imaging (fMRI) scanning, 23 participants imagined hand movements that differed systematically in terms of pointing accuracy needs (i.e., none, low, high). In a low-accuracy condition, two big squares were presented visually prior to the imagery phase. These squares had to be pointed at alternately on a mental level. In the high-accuracy condition, two little squares had to be hit. As expected on the basis of speed-accuracy trade-off principles, results showed that participants required more time when accuracy of the imagined movements increased. The fMRI results showed a stepwise increase in activation in the anterior cerebellum and the anterior part of the superior parietal lobe (SPL) with rising accuracy needs. Moreover, we found increased activation of the anterior part of the SPL and of the dorsal premotor cortex (dPMC) when imagery included a square (i.e., in the low- and high-accuracy conditions) compared to the no-square condition. These areas have also been discussed in relation to online motor control, suggesting that specific task parameters relevant in the domain of motor control are also coded in motor imagery. We suggest that the functional equivalence of action states is due mostly to internal estimations of the expected sensory feedback in both motor control and motor imagery.

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.

Perceptual influence on bimanual coordination: an fMRI study

In bimanual coordination subjects typically show a spontaneous preference for movement symmetry. While there is experimental evidence for the principle of muscle homology, recent evidence suggested that bimanual coordination may be mediated as perceptual goals (Mechsner et al., 2001). To explore this controversy we performed a fMRI study in 11 healthy, right-handed subjects using bimanual index finger abductions and adductions in a congruous condition, i.e. both palms down, and incongruous conditions with either the left or right palm up. Our fMRI data showed a widespread bihemispheric network mediating proprioceptive coordination of the two hands with significant differences mainly for a perceptual dissociation: in the incongruous conditions with the one palm up there was a BOLD signal increase in a bilateral frontoparietal network involving the motor and premotor cortical areas, particularly in the right palm-up condition. These results accord with the notion that perceptual cues play an important role in the control of bilateral hand movements.

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.

Upper extremity improvements in chronic stroke: coupled bilateral load training

BACKGROUND

The current treatment intervention study determined the effect of coupled bilateral training (i.e., bilateral movements and EMG-triggered neuromuscular stimulation) and resistive load (mass) on upper extremity motor recovery in chronic stroke.

METHODS

Thirty chronic stroke subjects were randomly assigned to one of three behavioral treatment groups and completed 6 hours of rehabilitation in 4 days: (1) coupled bilateral training with a load on the unimpaired hand, (2) coupled bilateral training with no load on the unimpaired hand, and (3) control (no stimulation assistance or load).

RESULTS

Separate mixed design ANOVAs revealed improved motor capabilities by the coupled bilateral groups. From the pretest to the posttest, both the coupled bilateral no load and load groups moved a higher number of blocks and demonstrated more regularity in the sustained contraction task. Faster motor reaction times across test sessions for the coupled bilateral load group provided additional evidence for improved motor capabilities.

CONCLUSIONS

Together these behavioral findings lend support to the contribution of coupled bilateral training with a load on the unimpaired arm to improved motor capabilities on the impaired arm. This evidence supports a neural explanation in that simultaneously moving both limbs during stroke rehabilitation training appears to activate balanced interhemispheric interactions while an extra load on the unimpaired limb provides stability to the system.

Systems neuroplasticity in the aging brain: recruiting additional neural resources for successful motor performance in elderly persons

Functional imaging studies have shown that seniors exhibit more elaborate brain activation than younger controls while performing motor tasks. Here, we investigated whether this age-related overactivation reflects compensation or dedifferentiation mechanisms. "Compensation" refers to additional activation that counteracts age-related decline of brain function and supports successful performance, whereas "dedifferentiation" reflects age-related difficulties in recruiting specialized neural mechanisms and is not relevant to task performance. To test these predictions, performance on a complex interlimb coordination task was correlated with brain activation. Findings revealed that coordination resulted in activation of classical motor coordination regions, but also higher-level sensorimotor regions, and frontal regions in the elderly. Interestingly, a positive correlation between activation level in these latter regions and motor performance was observed in the elderly. This performance enhancing additional recruitment is consistent with the compensation hypothesis and characterizes neuroplasticity at the systems level in the aging brain.

Human Superior Parietal Lobule Is Involved in Somatic Perception of Bimanual Interaction With an External Object

The question of how the brain represents the spatial relationship between the own body and external objects is fundamental. Here we investigate the neural correlates of the somatic perception of bimanual interaction with an external object. A novel bodily illusion was used in conjunction with functional magnetic resonance imaging (fMRI). During fMRI scanning, seven blindfolded right-handed participants held a cylinder between the palms of the two hands while the tendon of the right wrist extensor muscle was vibrated. This elicited a kinesthetic illusion that the right hand was flexing and that the hand-held cylinder was shrinking from the right side. As controls, we vibrated the skin surface over the nearby bone beside the tendon or vibrated the tendon when the hands were not holding the object. Neither control condition elicited this illusion. The significance of the illusion was also confirmed in supplementary experiments outside the scanner on another 16 participants. The “bimanual shrinking-object illusion” activated anterior parts of the superior parietal lobule (SPL) bilaterally. This region has never been activated in previous studies on unimanual hand or hand-object illusion. The illusion also activated left-hemispheric brain structures including area 2 and inferior parietal lobule, an area related to illusory unimanual hand-object interaction between a vibrated hand and a touched object in our previous study. The anterior SPL seems to be involved in the somatic perception of bimanual interaction with an external object probably by computing the spatial relationship between the two hands and a hand-held object.

Bimanual passive movement: functional activation and inter-regional coupling

The aim of this study was to investigate intra-regional activation and inter-regional connectivity during passive movement. During fMRI, a mechanic device was used to move the subject's index and middle fingers. We assessed four movement conditions (unimanual left/right, bimanual symmetric/asymmetric), plus Rest. A conventional intra-regional analysis identified the passive stimulation network, including motor cortex, primary and secondary somatosensory cortex, plus the cerebellum. The posterior (sensory) part of the sensory-motor activation around the central sulcus showed a significant modulation according to the symmetry of the bimanual movement, with greater activation for asymmetric compared to symmetric movements. A second set of fMRI analyses assessed condition-dependent changes of coupling between sensory-motor regions around the superior central sulcus and the rest of the brain. These analyses showed a high inter-regional covariation within the entire network activated by passive movement. However, the specific experimental conditions modulated these patterns of connectivity. Highest coupling was observed during the Rest condition, and the coupling between homologous sensory-motor regions around the left and right central sulcus was higher in bimanual than unimanual conditions. These findings demonstrate that passive movement can affect the connectivity within the sensory-motor network. We conclude that implicit detection of asymmetry during bimanual movement relies on associative somatosensory region in post-central areas, and that passive stimulation reduces the functional connectivity within the passive movement network. Our findings open the possibility to combine passive movement and inter-regional connectivity as a tool to investigate the functionality of the sensory-motor system in patients with very poor mobility.

Combining functional and structural brain magnetic resonance imaging in Huntington disease

OBJECTIVE

To concurrently investigate with magnetic resonance (MR) the brain activation and regional brain atrophy in patients with Huntington disease (HD).

METHODS

Nine symptomatic HD patients and 11 healthy subjects underwent an MR study including functional MR acquisition during finger tapping of the right hand and high-resolution T1-weighted images. Functional and structural data were analyzed using Statistical Parametric Mapping 2 software.

RESULTS

As compared with control subjects, HD patients showed decreased activation in the left caudate nucleus and medial frontal and anterior cingulate gyri and increased activation in the right supplementary motor area and supramarginal gyrus and left intraparietal sulcus. The pattern of atrophy included thinning of the gray matter (GM) in the insula, inferior frontal gyrus, caudate, lentiform nucleus, and thalamus, bilaterally, in the left middle frontal, middle occipital, and middle temporal gyri, and of periventricular, subinsular, right temporal lobe, and left internal capsule white matter. Only the decreased activation in the caudate nucleus correlated topographically with the caudate GM loss.

CONCLUSION

The cortical areas of functional changes do not correspond to those of GM atrophy in patients with HD and are likely to reflect decreased output of the motor basal ganglia-thalamo-cortical circuit and compensatory recruitment of accessory motor pathways.

Changes in quantitative EEG absolute power during the task of catching an object in free fall

The aim of this study was to verify changes in absolute power (qEEG), in theta, during the catch of a free falling object. The sample consisted of 10 healthy individuals, of both genders, with ages between 25 and 40 years. A three-way ANOVA followed by Post-Hoc analysis was applied. The results demonstrated main effects for time and position. In conclusion, a motor task that involves expectation produces deactivation of non-relevant areas in the ipsilateral hemisphere of the active limb. On the other hand, the patterns of results showed activation in areas responsible for planning and selection of motor repertories in the contralateral hemisphere.

Functional activation in parieto-premotor and visual areas dependent on congruency between hand movement and visual stimuli during motor-visual priming

Electrophysiological studies in monkeys and neuroimaging studies of humans have shown that action execution and action observation share neural processing sites traditionally thought to be responsible for motor execution alone. This experiment investigates a behavioral phenomenon in which a visual discrimination task is influenced by concurrent motor performance. Functional magnetic resonance imaging (fMRI) was used to determine whether this discrimination task uses components of the motor system. Participants viewed and responded to an animated hand while performing either congruent or incongruent right hand actions; the visual presentation was either a sequence showing a hand opening and closing, or randomly ordered frames from this series. The participant responded to onscreen target hand postures on a left footpedal. Previous behavioral results have shown a reaction time advantage on this discrimination task when performing congruent compared to incongruent hand actions, but only for sequential visual presentation. Left superior parietal lobule (SPL) and dorsal premotor cortex were more strongly activated when visual series and hand action did not match, as were dorsal premotor cortex and primary visual cortex. These results suggest that mismatches between performed action and visual feedback produce an inaccurate neural representation of limb state, which we suggest causes the contralateral SPL activation. This representation could not be used in the visual discrimination task, requiring increased reliance on direct visual inputs in order to perform the discrimination task accurately.

Intermanual interactions during initiation and production of rhythmic and discrete movements in individuals lacking a corpus callosum

Three individuals lacking a corpus callosum, two due to callosotomy and one agenesis, and three age-matched healthy controls were tested on a bimanual task in which a discrete or rhythmic arm movement was initiated following a visual signal while the other arm produced continuous, rhythmic movements. The control participants initiated the secondary, rhythmic movement in phase with the ongoing rhythmic base movement and the two limbs were coupled in an inphase mode across the duration of the trial. In contrast, the acallosal individuals failed to show phase entrainment at the initiation of the secondary, rhythmic movements. Moreover, the callosotomy patients exhibited weak coupling between the rhythmically moving limbs while the individual with callosal agenesis consistently synchronized in an antiphase mode. The control participants exhibited increased perturbation of the ongoing base movement when initiating a discrete movement; for the acallosal participants, the base movement was similarly perturbed in both secondary movement conditions. These results are consistent with the hypothesis that intermanual interactions observed during bimanual movements arise from various levels of control, and that these are distinct for discrete and rhythmic movements. Temporal coupling during rhythmic movements arises in large part from transcallosal interactions between the two hemispheres. The imposition of a secondary movement may transiently disrupt an ongoing rhythmic movement even in the absence of the corpus callosum. This may reflect subcortical interactions associated with response initiation, or, due to dual task demands, a transient shift in attentional resources.

Concurrent adaptation to opposing visual displacements during an alternating movement

It has been suggested that, during tasks in which subjects are exposed to a visual rotation of cursor feedback, alternating bimanual adaptation to opposing rotations is as rapid as unimanual adaptation to a single rotation (Bock et al. in Exp Brain Res 162:513–519, 2005). However, that experiment did not test strict alternation of the limbs but short alternate blocks of trials. We have therefore tested adaptation under alternate left/right hand movement with opposing rotations. It was clear that the left and right hand, within the alternating conditions, learnt to adapt to the opposing displacements at a similar rate suggesting that two adaptive states were formed concurrently. We suggest that the separate limbs are used as contextual cues to switch between the relevant adaptive states. However, we found that during online correction the alternating conditions had a significantly slower rate of adaptation in comparison to the unimanual conditions. Control conditions indicate that the results are not directly due the alternation between limbs or to the constant switching of vision between the two eyes. The negative interference may originate from the requirement to dissociate the visual information of these two alternating displacements to allow online control of the two arms.

Multiple frames of reference for bimanual co-ordination

Different movement characteristics can be governed by different frames of reference. The present study serves to identify the frames of reference, which govern intermanual interactions with respect to movement directions. Previous studies had shown that intermanual interactions are adjusted to task requirements during motor preparation: for parallel movements directional coupling becomes parallel, and for symmetric movements it becomes symmetric. The timed-response procedure allows to trace these adjustments as they are reflected in the intermanual correlations between left-hand and right-hand directions. In the present study the adjustments remained unchanged when all target directions were rotated laterally, indicating a critical role of hand-centered frames of reference. The additional role of a body-centered frame of reference was indicated by the finding of overall higher intermanual correlations with the rotated target configurations. Intermanual interference at long preparation intervals was absent even when eccentricities in the body-centered frame of reference were different. These findings converge with results on the frames of reference that govern intermanual interactions with respect to movement amplitudes. They suggest a role of both body-centered and hand-centered frames of reference for the adjustments of intermanual interactions to task requirements, but of a hand-centered frame of reference only for the intermanual interference, which remains in spite of the adjustments.

Bilateral movement training and stroke rehabilitation: A systematic review and meta-analysis

OBJECTIVE AND DESIGN

Bilateral movement training is being increasingly used as a post-stroke motor rehabilitation protocol. The contemporary emphasis on evidence-based medicine warrants a prospective meta-analysis to determine the overall effectiveness of rehabilitating with bilateral movements.

METHODS

After searching reference lists of bilateral motor recovery articles as well as PubMed and Cochrane databases, 11 stroke rehabilitation studies qualified for this systematic review. An essential requirement for inclusion was that the bilateral training protocols involved either functional tasks or repetitive arm movements. Each study had one of three common arm and hand functional outcome measures: Fugl-Meyer, Box and Block, and kinematic performance.

RESULTS

The fixed effects model primary meta-analysis revealed an overall effect size (ES=0.732, S.D.=0.13). These findings indicate that bilateral movement training was beneficial for improving motor recovery post-stroke. Moreover, a fail-safe analysis indicated that 48 null effects would be necessary to lower the mean effect size to an insignificant level.

CONCLUSION

These meta-analysis findings indicate that bilateral movements alone or in combination with auxiliary sensory feedback are effective stroke rehabilitation protocols during the sub-acute and chronic phases of recovery.

Neural basis of aging: the penetration of cognition into action control

Although functional imaging studies have frequently examined age-related changes in neural recruitment during cognitive tasks, much less is known about such changes during motor performance. In the present study, we used functional magnetic resonance imaging to investigate age-related changes in cyclical hand and/or foot movements across different degrees of complexity. Right-handed volunteers (11 young, 10 old) were scanned while performing isolated flexion-extension movements of the right wrist and foot as well as their coordination, according to the "easy" isodirectional and "difficult" nonisodirectional mode. Findings revealed activation of a typical motor network in both age groups, but several additional brain areas were involved in the elderly. Regardless of the performed motor task, the elderly exhibited additional activation in areas involved in sensory processing and integration, such as contralateral anterior insula, frontal operculum, superior temporal gyrus, supramarginal gyrus, secondary somatosensory area, and ipsilateral precuneus. Age-related activation differences during coordination of both segments were additionally observed in areas reflecting increased cognitive monitoring of motor performance, such as the pre-supplementary motor area, pre-dorsal premotor area, rostral cingulate, and prefrontal cortex. In the most complex coordination task, the elderly exhibited additional activation in anterior rostral cingulate and dorsolateral prefrontal cortex, known to be involved in suppression of prepotent response tendencies and inhibitory cognitive control. Overall, these findings are indicative of an age-related shift along the continuum from automatic to more controlled processing of movement. This increased cognitive monitoring of movement refers to enhanced attentional deployment, more pronounced processing of sensory information, and intersensory integration.

Information processing in human parieto-frontal circuits during goal-directed bimanual movements

It is known that, in macaques, movements guided by somatosensory information engage anterior parietal and posterior precentral regions. Movements performed with both visual and somatosensory feedback additionally activate posterior parietal and anterior precentral areas. It remains unclear whether the human parieto-frontal circuits exhibit a similar functional organization. Here, we employed a directional interference task requiring a continuous update of sensory information for the on-line control of movement direction, while brain activity was measured by functional magnetic resonance imaging (fMRI). Directional interference arises when bimanual movements occur along different directions in joint space. Under these circumstances, the presence of visual information does not substantially alter performance, such that we could vary the amount and type of sensory information used during on-line guidance of goal-directed movements without affecting motor output. Our results confirmed that in humans, as in macaques, movements guided by somatosensory information engages anterior parietal and posterior precentral regions, while movements performed with both visual and somatosensory information activate posterior parietal and anterior precentral areas. We provide novel evidence on how the interaction of specific portions of the dorsal parietal and precentral cortex in the right hemisphere might generate spatial representations by integrating different sensory modalities during goal-directed movements.

Dynamics of hemispheric specialization and integration in the context of motor control

Behavioural and neurophysiological evidence convincingly establish that the left hemisphere is dominant for motor skills that are carried out with either hand or those that require bimanual coordination. As well as this prioritization, we argue that specialized functions of the right hemisphere are also indispensable for the realization of goal-directed behaviour. As such, lateralization of motor function is a dynamic and multifaceted process that emerges across different timescales and is contingent on task- and performer-related determinants.

A method to produce evolving functional connectivity maps during the course of an fMRI experiment using wavelet-based time-varying Granger causality

Functional magnetic resonance imaging (fMRI) is widely used to identify neural correlates of cognitive tasks. However, the analysis of functional connectivity is crucial to understanding neural dynamics. Although many studies of cerebral circuitry have revealed adaptative behavior, which can change during the course of the experiment, most of contemporary connectivity studies are based on correlational analysis or structural equations analysis, assuming a time-invariant connectivity structure. In this paper, a novel method of continuous time-varying connectivity analysis is proposed, based on the wavelet expansion of functions and vector autoregressive model (wavelet dynamic vector autoregressive-DVAR). The model also allows identification of the direction of information flow between brain areas, extending the Granger causality concept to locally stationary processes. Simulation results show a good performance of this approach even using short time intervals. The application of this new approach is illustrated with fMRI data from a simple AB motor task experiment.

The modulation of intermanual interactions during the specification of the directions of bimanual movements

In two experiments bimanual movements with various combinations of target directions were studied by means of the timed-response procedure. The findings revealed an adaptive modulation of intermanual interactions during direction specifications depending on particular target directions. For symmetric movements intermanual correlations of movement directions are positive, indicating a symmetric coupling. For parallel movements the positive intermanual correlations, observed at short preparation intervals, turn into negative correlations as the time available for motor preparation increases. Biases of mean directions, that can be observed for movements to targets with different eccentricities, reflect one or the other kind of coupling, symmetrical for symmetric target directions and parallel for parallel target directions. These biases are static, that is, they are present at long preparation times, and they are phasically enhanced at shorter preparation intervals. The task-adaptive modulation of intermanual interactions is superposed on a basic symmetry bias.

Spatial interference during bimanual coordination: differential brain networks associated with control of movement amplitude and direction

Bimanual interference emerges when spatial features, such as movement direction or amplitude, differ between limbs, as indicated by a mutual bias of limb trajectories. Although first insights into the neural basis of directional interference have been revealed recently, little is known about the neural network associated with amplitude interference. We investigated whether amplitude versus directional interference activates differential networks. Functional magnetic resonance imaging (fMRI) was applied while subjects performed cyclical, bimanual joystick movements with either the same vs. different amplitudes, directions, or both. The kinematic analysis confirmed that subjects experienced amplitude interference when they moved with different as compared to the same amplitude, and directional interference when they moved along different as compared to the same direction. On the brain level, amplitude and directional interference both resulted in activation of a bilateral superior parietal-premotor network, which is known to contribute to sensorimotor transformations during goal-directed movements. Interestingly, amplitude but not directional interference exclusively activated a bilateral network containing the dorsolateral prefrontal cortex, anterior cingulate, and supramarginal gyrus, which was shown previously to contribute to executive functions. Even though the encoding of amplitude and directional information converged and activated the same neural substrate, our data thus show that additional and partly independent mechanisms are involved in bimanual amplitude as compared to that in directional control.

Neural correlates of the spontaneous phase transition during bimanual coordination

Repetitive bimanual finger-tapping movements tend toward mirror symmetry: There is a spontaneous transition from less stable asymmetrical movement patterns to more stable symmetrical ones under frequency stress but not vice versa. During this phase transition, the interaction between the signals controlling each hand (cross talk) is expected to be prominent. To depict the regions of the brain in which cortical cross talk occurs during bimanual coordination, we conducted event-related functional magnetic resonance imaging using a bimanual repetitive-tapping task. Transition-related activity was found in the following areas: the bilateral ventral premotor cortex, inferior frontal gyrus, middle frontal gyrus, inferior parietal lobule, insula, and thalamus; the right rostral portion of the dorsal premotor cortex and midbrain; the left cerebellum; and the presupplementary motor area, rostral cingulate zone, and corpus callosum. These regions were discrete from those activated by bimanual movement execution. The phase-transition-related activation was right lateralized in the prefrontal, premotor, and parietal regions. These findings suggest that the cortical neural cross talk occurs in the distributed networks upstream of the primary motor cortex through asymmetric interhemispheric interaction.

Bimanual Coordination During Rhythmic Movements in the Absence of Somatosensory Feedback

We investigated the role of somatosensory feedback during bimanual coordination by testing a bilaterally deafferented patient, a unilaterally deafferented patient, and three control participants on a repetitive bimanual circle-drawing task. Circles were drawn symmetrically or asymmetrically at varying speeds with full, partial, or no vision of the hands. Strong temporal coupling was observed between the hands at all movement rates during symmetrical drawing and at the comfortable movement rate during asymmetrical drawing in all participants. When making asymmetric movements at the comfortable and faster rates, the patients and controls exhibited similar evidence of pattern instability, including a reduction in temporal coupling and trajectory deformation. The patients differed from controls on measures of spatial coupling and variability. The amplitudes and shapes of the two circles were less similar across limbs for the patients than the controls and the circles produced by the patients tended to drift in extrinsic space across successive cycles. These results indicate that somatosensory feedback is not critical for achieving temporal coupling between the hands nor does it contribute significantly to the disruption of asymmetrical coordination at faster movement rates. However, spatial consistency and position, both within and between limbs, were disrupted in the absence of somatosensory feedback.

The role of anterior cingulate cortex and precuneus in the coordination of motor behaviour

Behavioral studies in humans have shown that bimanual coordination imposes specific demands on the central nervous system that exceed unimanual task control. In the present study we used functional magnetic resonance imaging to investigate the neural correlate of this additional coordination effort, i.e. regions responding more strongly to bimanual movements than inferred from summing up the responses to the unimanual subtasks. Subjects were scanned while performing movements along different directions, either uni- or bimanually. During the bimanual condition, trajectories of movement of the left and right hand were spatially incompatible, such that additional effort was required to break away from intrinsically favored mirror-movements and to integrate movements of both limbs into a new spatial pattern. Our main finding was that the execution of spatially complex bimanual coordination as compared with the unimanual subtasks activated the anterior cingulate cortex (posterior part) as well as the dorso-anterior precuneus. We hypothesize that the anterior cingulate exerts its modulatory effect on other motor areas, such as the primary motor cortex and the supplementary motor area, in order to suppress intrinsically favored coordination tendencies. Conversely, the precuneus is likely to be involved in shifting attention between different locations in space, which was necessary for monitoring the trajectories of the left and right wrist when both limbs moved in parallel. Our findings suggest that the coordination effort during bimanual and perhaps other modes of coordinated behavior is mediated by regions contributing to higher order functions, which form an interface between cognition and action.

Transmitter receptors reveal segregation of cortical areas in the human superior parietal cortex: relations to visual and somatosensory regions

Regional distributions of ligand binding sites of 12 different neurotransmitter receptors (glutamatergic: AMPA, kainate, NMDA; GABAergic: GABA(A), GABA(B); cholinergic: muscarinic M2, nicotinic; adrenergic: alpha1, alpha2; serotonergic: 5-HT1A, 5-HT2; dopaminergic: D1) were studied in human postmortem brains by means of quantitative receptor autoradiography. Binding site densities were measured in the superior parietal lobule (SPL) (areas 5L, 5M, 5Ci, and different locations within Brodmann's area (BA) 7), somatosensory (BA 2), and visual cortical areas (BA 17, and different locations within BAs 18 and 19). Similarities of receptor distribution between cortical areas were analyzed by cluster analysis, uni- and multivariate statistics of mean receptor densities (averaged over all cortical layers), and profiles representing the laminar distribution patterns of receptors. A considerable heterogeneity of regional receptor densities and laminar patterns between the sites was found in the SPL and the visual cortex. The most prominent regional differences were found for M2 receptors. In the SPL, rostrocaudally oriented changes of receptor densities were more pronounced than those in mediolateral direction. The receptor distribution in the rostral SPL was more similar to that of the somatosensory cortex, whereas caudal SPL resembled the receptor patterns of the dorsolateral extrastriate visual areas. These results suggest a segregation of the different SPL areas based on receptor distribution features typical for somatosensory or visual areas, which fits to the dual functional role of this cortical region, i.e., the involvement of the human SPL in visuomotor and somatosensory motor transformations.

Effects of interlimb and intralimb constraints on bimanual shoulder-elbow and shoulder-wrist coordination patterns

The present study addressed the interactions between interlimb and intralimb constraints during the control of bimanual multi-joint movements. Participants performed eight coordination tasks involving bilateral shoulder-elbow (expt I) and shoulder-wrist (expt II) movements. Three principal findings were obtained. First, the principle of muscle homology (in-phase coordination), giving rise to mirror symmetrical movements with respect to the midsagittal plane, had a powerful influence on the quality of interlimb coordination. In both experiments, the accuracy and stability of inter- and/or intralimb coordination deteriorated as soon as the antiphase mode was introduced in one or both joint pairs. However, the mutual influences between bilateral distal and proximal joint pairs varied across coordination tasks and effectors. Second, the impact of intralimb coordination modes on the quality of intralimb coordination was inconsistent between adjacent (expt I) and non-adjacent joint (expt II) combinations. Third, the mode of interlimb coordination affected the quality of intralimb coordination, whereas strong support for the converse effect was not obtained. Taken together, these observations point to a hierarchical control structure whereby interlimb coordination constraints have a stronger impact on the global coordination of the system than intralimb constraints, whose impact is substantially dependent on effector and task. The finding that intralimb coordination is subordinate to interlimb coordination during the production of bimanual multi-joint coordination patterns indicates that symmetry is a major organizational principle in the neural control of complex movement.

Neural plasticity and bilateral movements: A rehabilitation approach for chronic stroke

Stroke interferes with voluntary control of motor actions. Although spontaneous recovery of function can occur, restoration of normal motor function in the hemiplegic upper limb is noted in fewer than 15% of individuals. However, there is increasing evidence to suggest that in addition to injury-related reorganization, motor cortex functions can be altered by individual motor experiences. Such neural plasticity has major implications for the type of rehabilitative training administered post-stroke. This review proposes that noteworthy upper extremity gains toward motor recovery evolve from activity-dependent intervention based on theoretical motor control constructs and interlimb coordination principles. Founded on behavioral and neurophysiological mechanisms, bilateral movement training/practice has shown great promise in expediting progress toward chronic stroke recovery in the upper extremity. Planning and executing bilateral movements post-stroke may facilitate cortical neural plasticity by three mechanisms: (a) motor cortex disinhibition that allows increased use of the spared pathways of the damaged hemisphere, (b) increased recruitment of the ipsilateral pathways from the contralesional or contralateral hemisphere to supplement the damaged crossed corticospinal pathways, and (c) upregulation of descending premotorneuron commands onto propriospinal neurons.