Rate dependence of regional cerebral activation during performance of a repetitive motor task: a PET study

Functional significance of age-related differences in motor activation patterns

Recent functional MRI (fMRI) studies have revealed an increased task-related activation in older subjects during a variety of cognitive or perceptual tasks, which may signal beneficial compensatory activity to counteract structural and neurochemical changes associated with aging. Under the assumption that incremental movement rates are associated with an increased functional demand on the motor system, we used fMRI and acoustically paced movements of the right index finger at six different frequencies (2.0, 2.5, 3.0, 4.0, 5.0 and 6.0 Hz) to investigate the behavioral significance of additionally recruited brain regions in a group of healthy, older subjects (mean age 66 +/- 8 years) compared with a group of young (mean age 23 +/- 7 years) subjects. The actual tapping frequency (F(1,14) = 0.049, P = 0.829), the tapping interval (F(1,14) = 0.043, P = 0.847), and the error rates (F(1,14) = 0.058, P = 0.743) did not differ significantly between both groups, whereas there was a significant increase in reaction time in the older subjects (F(1,14) = 281.786, P < or = 0.001). At all frequencies, the older subjects demonstrated significant overactivation within the ipsilateral sensorimotor and premotor cortex. However, we did not observe an increased age-related overactivation during higher movements rates in these or other motor regions. Moreover, the magnitude of the hemodynamic response in overactivated regions remained constant across all frequencies. In contrast to cognitive tasks, these findings indicate that an age-related overactivation within the motor system is not related to the functional demand and does not necessarily reflect reorganization to compensate for the neurobiological changes of aging.

Changes in muscle coordination with training

Three core concepts, activity-dependent coupling, the composition of muscle synergies, and Hebbian adaptation, are discussed with a view to illustrating the nature of the constraints imposed by the organization of the central nervous system on the changes in muscle coordination induced by training. It is argued that training invoked variations in the efficiency with which motor actions can be generated influence the stability of coordination by altering the potential for activity-dependent coupling between the cortical representations of the focal muscles recruited in a movement task and brain circuits that do not contribute directly to the required behavior. The behaviors that can be generated during training are also constrained by the composition of existing intrinsic muscle synergies. In circumstances in which attempts to produce forceful or high velocity movements would otherwise result in the generation of inappropriate actions, training designed to promote the development of control strategies specific to the desired movement outcome may be necessary to compensate for protogenic muscle recruitment patterns. Hebbian adaptation refers to processes whereby, for neurons that release action potentials at the same time, there is an increased probability that synaptic connections will be formed. Neural connectivity induced by the repetition of specific muscle recruitment patterns during training may, however, inhibit the subsequent acquisition of new skills. Consideration is given to the possibility that, in the presence of the appropriate sensory guidance, it is possible to gate Hebbian plasticity and to promote greater subsequent flexibility in the recruitment of the trained muscles in other task contexts.

Finger motion sensors for fMRI motor studies

The kinematics of motor task performance affect brain activity. However, few functional magnetic resonance imaging (fMRI) motor studies have accounted for on-line kinematics because there are currently few MRI-compatible devices to record motor performance. We built a device based on Micro-Electro-Mechanical System (MEMS) gyroscopes that measures the angular velocity of one segment of each of the 10 fingers while a subject performs a finger motor task during fMRI. Finger position, acceleration, and jerk were computed from the angular velocity measurements. The signal-to-noise ratio (SNR) of the MEMS sensors (range: 27.10-34.36 dB) allowed for clear detection of velocity of finger motion during fMRI motor task performance, and showed good stability over time. We demonstrate that use of the MEMS-based device, while negligibly increasing radiofrequency (RF) noise in the scanning environment, did not cause MR image artifacts nor alter fMRI statistical activation maps. Further, we show that signal from the MEMS sensors was not affected by the high static magnetic field (3 T). Increasing the RF power transmitted during fMRI by using a body coil, as compared to a head coil, decreased the sensor's SNR from 30.7 to 24.2 dB, though this loss in SNR did not interfere with the ability to measure velocity of finger motion. We demonstrate the utility of the MEMS-based device in fMRI motor studies through two experiments that examined the relationship between finger movement kinematics and fMRI activation in the healthy and injured brain. On-line acquisition of motor performance during fMRI, through the use of the MEMS-based device, promises to allow for a more detailed understanding of the relationship between movement kinematics and activation in the healthy and injured brain.

Evolution of brain activation with good and poor motor recovery after stroke

OBJECTIVE

To characterize the evolution of brain activation in stroke patients with variable motor recovery and quantify changes relative to healthy controls.

METHODS

Serial PET activation studies, using a simple finger-tapping task, and quantitative measures of motor performance were obtained in 9 patients (2-7 weeks poststroke and 6 months later) and compared with serial healthy volunteer data.

RESULTS

Patients with moderate impairment and good recovery (n = 5) activated the primary sensorimotor cortex (SM1) contralateral to the paretic hand moved, bilateral supplementary motor area (SMA), contralateral cingulate gyrus, and ipsilateral lateral premotor cortex. Activation in the bilateral SMA was greater at the initial study but reduced over time compared to healthy controls and poor recoverers. Patients with severe impairment and poor recovery (n =4) showed limited activation of contralateral SM1 and SMA at both studies and no significant change over time. A posterior shift in SM1 activation was evident in good and poor recoverers.

CONCLUSIONS

Activation of typical motor regions and recruitment of additional sites occur subacutely poststroke, with evolution to normal patterns in moderately impaired patients who recover well. In comparison, severely impaired, poor-recovery patients show persistent, reduced activation. Dynamic changes in SMA, differentially observed in good recoverers over 6 months, highlight its importance in recovery.

Motor memory consolidation in sleep shapes more effective neuronal representations

Learning a motor skill involves a latent process of consolidation that develops after training to enhance the skill in the absence of any practice and crucially depends on sleep. Here, we show that this latent consolidation during sleep changes the brain representation of the motor skill by reducing overall the neocortical contributions to the representation. Functional magnetic resonance brain imaging was performed during initial training and 48 h later, at retesting, on a sequential finger movement task with training followed by either a night of regular sleep or sleep deprivation. An additional night of sleep for all subjects served to rule out unspecific effects of sleep loss at retrieval testing. Posttraining sleep, but not sleep deprivation, led to improved motor skill performance at retrieval. This sleep-dependent improvement was linked to greatly reduced brain activation in prefrontal, premotor, and primary motor cortical areas, along with a stronger involvement of left parietal cortical regions. Our findings indicate that storing a motor skill during sleep reorganizes its brain representation toward enhanced efficacy.

Stroke recovery and its imaging

Functional imaging of stroke recovery is a unique source of information that might be useful in the development of restorative treatments. Several features of brain function change spontaneously after stroke. Current studies define many of the most common events. Key challenges for the future are to develop standardized approaches to help address certain questions, determine the psychometric qualities of these measures, and define the clinical usefulness of these methods.

Neither simple nor sequential arm movements are bradykinetic in parkinsonian patients with peak-dose dyskinesias

OBJECTIVE

To find out whether parkinsonian patients with levodopa-induced peak-dose dyskinesias are bradykinetic.

METHODS

The performance of a sequential internally determined arm movement and a simple externally triggered arm movement was studied in a group of dyskinetic parkinsonian patients during their best clinical condition and when they were OFF treatment. Patients' performance was compared with that of an age-matched control group. Movements in the three-dimensional space were recorded by the ELITE motion analysis system. Kinematic variables analysed for the sequential motor task were total movement duration and total pause duration; for the simple motor task, movement duration and reaction time; and for both tasks, movement inaccuracy.

RESULTS

When patients were OFF therapy they performed sequential and simple movement tasks slower than healthy subjects whereas when they were dyskinetic they did not. During the sequential task, when the patients were dyskinetic total pause duration shortened and movement inaccuracy increased.

CONCLUSIONS

Our kinematic finding indicates that parkinsonian patients' with peak-dose dyskinesias are not bradykinetic.

SIGNIFICANCE

Parkinsonian patients with peak-dose dyskinesias are not bradykinetic, probably because dopamine at peak doses functionally normalizes the mechanisms controlling movement speed.

"Central command" and insular activation during attempted foot lifting in paraplegic humans

The relationship between cardiovascular regulation and brain activation was investigated during attempted foot lifting in paraplegic subjects and during rhythmic handgrip exercise at one-third of maximum voluntary contraction force. Brain areas of interest were the primary sensory-motor area and the insula, a hypothesized center for a central nervous feed-forward mechanism involved in cardiovascular control ("central command"). This mechanism is complementary to the usual known feedback pathways such as skeletal muscle afferent signals. Regional cerebral blood flow (rCBF) was measured in eight normal and three paraplegic subjects using positron emission tomography (PET) and oxygen-15-labeled water. Statistical parametric maps were calculated from the images comparing rest and handgrip. Paraplegics were also scanned during attempted foot lifting, a condition without sensory feedback. During activation tasks, heart rate and mean arterial pressure increased. PET activation responses (P < 0.05, corrected for multiple comparisons) were found in the contralateral primary sensory-motor area, the supplementary motor area, ipsilateral cerebellum, and bilaterally in the insula. A conjunction analysis showing responses common to handgrip and attempted foot lifting revealed activation in the right central insula (P < 0.05, corrected) in concordance with the concept of a central command feed-forward hypothesis.

Language lateralization in young children assessed by functional transcranial Doppler sonography

Compared to adults, children show superior recovery of language function after damage to the dominant brain hemisphere. Possible explanations are that children have different patterns of language representation or display different patterns of reorganization. Information about language lateralization in children could provide insights into the repair mechanisms of the young brain. While functional magnetic resonance imaging (fMRI) is usually difficult to perform in children younger than 5 years, functional transcranial Doppler sonography (fTCD) is nonfrightening and readily applicable in young and very young children. However, for serial examinations, sufficient validity and reliability are required. To this end, we designed a picture-description language task (PDLT) for fTCD examinations in children, compared the outcome to established protocols and determined the 1 month retest-reliability of the measurement in 16 children aged 2-9 years. The dependent variable was the task-related hemispheric perfusion difference based on averaged relative cerebral blood flow velocity (CBFV) increases in the middle cerebral arteries. This picture-description language lateralization index was compared to language lateralization by a phonetic word generation task (PWGT) in adults revealing good intermethod validity (r=0.70; P <or= 0.05). The 1 month retest-reliability of the PDLT in the children was r=0.87 (P <or= 0.05). With this degree of reliability, fTCD seems a promising tool for the assessment of changes in hemispheric involvement in language in young and very young children.

Asymmetry of cortical activation during maximum and convenient tapping speed

An effect of finger tapping rate on the hemodynamic response in primary motor cortex and the cerebellum has been well established over the last years (the rate effect). The present study compares the magnitude of this effect when either the dominant or subdominant hand is used by right and left handers. In contrast to previous studies maximum and convenient tapping rate for both hands are used as tapping tasks. The results confirm "rate effects" for the primary motor cortex and the cerebellum. In addition, a "rate effect" was found for the cingulate motor area. A novel finding is that the cortical and cerebellar "rate effects" are similar for the subdominant and for the dominant hand even though tapping rates are lower for the subdominant hand. This result demonstrates that the subdominant motor cortex and neurally connected cerebellar areas operate at suboptimal control levels although maximum neurophysiological activation has been reached during the maximum tapping task.

Awake Surgery for Glioma Resection in Eloquent Areas-Zurich's Experience and Review-

Awake surgery was performed in a series of 21 patients with gliomas in eloquent areas with the use of intraoperative electrical mapping. Gross total removal was performed in 18 patients. There was no operative mortality. Postoperative findings included no change in symptoms and signs in 10 patients, improvement of the preoperative deficit in 11 patients. Four patients had improved Karnofsky performance status (KPS) scores after surgery, 17 patients were stable, and no patient had lower KPS score. Extensive radical resection of gliomas prolongs the overall survival and improves the patient's quality of life. However, surgical resection of gliomas located within the sensorimotor or language areas remains a neurosurgical challenge in reducing eloquent neurological sequelae. Awake surgery with intraoperative functional mapping is a safe approach to maximize the extent of tumor removal and to minimize the resultant neurological deficits in the treatment of glioma involving the eloquent cortex.

Effect of Transcranial Magnetic Stimulation on Bimanual Movements

Transcranial magnetic stimulation (TMS) of the motor cortex can interrupt voluntary contralateral rhythmic limb movements. Using the method of “resetting index” (RI), our study investigated the TMS effect on different types of bimanual movements. Six normal subjects participated. For unimanual movement, each subject tapped either the right or left index finger at a comfortable rate. For bimanual movement, index fingers of both hands tapped in the same (in-phase) direction or in the opposite (antiphase) direction. TMS was applied to each hemisphere separately at various intensities from 0.5 to 1.5 times motor threshold (MT). TMS interruption of rhythm was quantified by RI. For the unimanual movements, TMS disrupted both contralateral and ipsilateral rhythmic hand movements, although the effect was much less in the ipsilateral hand. For the bimanual in-phase task, TMS could simultaneously reset the rhythmic movements of both hands, but the effect on the contralateral hand was less and the effect on the ipsilateral hand was more compared with the unimanual tasks. Similar effects were seen from right and left hemisphere stimulation. TMS had little effect on the bimanual antiphase task. The equal effect of right and left hemisphere stimulation indicates that neither motor cortex is dominant for simple bimanual in-phase movement. The smaller influence of contralateral stimulation and the greater effect of ipsilateral stimulation during bimanual in-phase movement compared with unimanual movement suggest hemispheric coupling. The antiphase movements were resistant to TMS disruption, and this suggests that control of rhythm differs in the 2 tasks. TMS produced a transient asynchrony of movements on the 2 sides, indicating that both motor cortices might be downstream of the clocking command or that the clocking is a consequence of the 2 hemispheres communicating equally with each other.

Prefrontal and premotor cortices are involved in adapting walking and running speed on the treadmill: an optical imaging study

We investigated changes of regional activation in the frontal cortices as assessed by changes of hemoglobin oxygenation during walking at 3 and 5 km/h and running at 9 km/h on a treadmill using a near-infrared spectroscopic (NIRS) imaging technique. During the acceleration periods immediately preceded reaching the steady walking or running speed, the levels of oxygenated hemoglobin (oxyHb) increased, but those of deoxygenated hemoglobin (deoxyHb) did not in the frontal cortices. The changes were greater at the higher locomotor speed in the bilateral prefrontal cortex and the premotor cortex, but there were less speed-associated changes in the sensorimotor cortices. The medial prefrontal activation was most prominent during the running task. These results indicate that the prefrontal and premotor cortices are involved in adapting to locomotor speed on the treadmill. These areas might predominantly participate in the control of running rather than walking.

Cerebellar and premotor function in bimanual coordination: parametric neural responses to spatiotemporal complexity and cycling frequency

In the present functional magnetic resonance imaging (fMRI) study, we assessed the neural network governing bimanual coordination during manipulations of spatiotemporal complexity and cycling frequency. A parametric analysis was applied to determine the effects of each of both factors as well as their interaction. Subjects performed four different cyclical movement tasks of increasing spatiotemporal complexity (i.e., unimanual left-right hand movements, bimanual in-phase movements, bimanual anti-phase movements, and bimanual 90 degrees out-of-phase movements) across four frequency levels (0.9, 1.2, 1.5, and 1.8 Hz). Results showed that, within the network involved in bimanual coordination, functional subcircuits could be distinguished: Activation in the supplementary motor area, superior parietal cortex (SPS), and thalamic VPL Nc was mainly correlated with increasing spatiotemporal complexity of the limb movements, suggesting that these areas are involved in higher-order movement control. By contrast, activation within the primary motor cortex, cingulate motor cortex (CMC), globus pallidus, and thalamic VLo Nc correlated mainly with movement frequency, indicating that these areas play an important role during movement execution. Interestingly, the cerebellum and the dorsal premotor cortex were identified as the principal regions responding to manipulation of both parameters and exhibiting clear interaction effects. Therefore, it is concluded that both areas represent critical sites for the control of bimanual coordination.

Changes in brain activation during the acquisition of a new bimanual coodination task

Motor skill acquisition is associated with the development of automaticity and induces neuroplastic changes in the brain. Using functional magnetic resonance imaging (fMRI), the present study traced learning-related activation changes during the acquisition of a new complex bimanual skill, requiring a difficult spatio-temporal relationship between the limbs, i.e., cyclical flexion-extension movements of both hands with a phase offset of 90 degrees. Subjects were scanned during initial learning and after the coordination pattern was established. Kinematics of the movements were accurately registered and showed that the new skill was acquired well. Learning-related decreases in activation were found in right dorsolateral prefrontal cortex (DLPFC), right premotor, bilateral superior parietal cortex, and left cerebellar lobule VI. Conversely, learning-related increases in activation were observed in bilateral primary motor cortex, bilateral superior temporal gyrus, bilateral cingulate motor cortex (CMC), left premotor cortex, cerebellar dentate nuclei/lobule III/IV/Crus I, putamen/globus pallidus and thalamus. Accordingly, bimanual skill learning was associated with a shift in activation among cortico-subcortical regions, providing further evidence for the existence of differential cortico-subcortical circuits preferentially involved during the early and advanced stages of learning. The observed activation changes account for the transition from highly attention-demanding task performance, involving processing of sensory information and corrective action planning, to automatic performance based on memory representations and forward control.

Spatially dissociated flow-metabolism coupling in brain activation

The relationships among cerebral blood flow (CBF), oxygen consumption (CMRO(2)) and glucose use (CMR(glc)) constitute the basis of functional brain-imaging. Here we report spatially dissociated changes of CMRO(2) and CBF during motor activity that lead us to propose a revision of conventional CBF-CMRO(2) coupling models. In the left primary and supplementary motor cortices, CBF and CMRO(2) rose significantly during finger-thumb tapping. However, in the right putamen CBF did not rise, despite a significant increase in CMRO(2). We explain these observations by invoking a central command mechanism that regulates CBF in the putamen in anticipation of movement. By this mechanism, CBF rose in the putamen before the measurements of CBF and CMRO(2) while CMRO(2) rose when actual motion commenced.

Left hemisphere specialization for the control of voluntary movement rate

Although persuasive behavioral evidence demonstrates the superior dexterity of the right hand in most people under a variety of conditions, little is known about the neural mechanisms responsible for this phenomenon. As this lateralized superiority is most evident during the performance of repetitive, speeded movement, we used parametric rate variations to compare visually paced movement of the right and left hands. Twelve strongly right-handed subjects participated in a functional magnetic resonance imaging (fMRI) experiment involving variable rate thumb movements. For movements of the right hand, contralateral rate-related activity changes were identified in the precentral gyrus, thalamus, and posterior putamen. For left-hand movements, activity was seen only in the contralateral precentral gyrus, consistent with the existence of a rate-sensitive motor control subsystem involving the left, but not the right, medial premotor corticostriatal loop in right-handed individuals. We hypothesize that the right hemisphere system is less skilled at controlling variable-rate movements and becomes maximally engaged at a lower movement rate without further modulation. These findings demonstrate that right- and left-hand movements engage different neural systems to control movement, even during a relatively simple thumb flexion task. Specialization of the left hemisphere corticostriatal system for dexterity is reflected in asymmetric mechanisms for movement rate control.

The use of positron emission tomography in cerebrovascular disease

Even with rapid development of other neuroimaging modalities such as MR imaging and CT, PET is the only technique that provides accurate, quantitative measurements of regional hemodynamics and metabolism in human subjects. Through the use of these combined measurements, we have greatly expanded our knowledge of the pathophysiology of cerebrovascular disease of different types. It has been possible to document the compensatory responses of the brain to reductions in perfusion pressure and to directly relate these responses to prognosis. PET measurements of OEF identify a subgroup of patients who have carotid occlusion and who are at increased risk for recurrent stroke who cannot be identified by any other clinical or arteriographic means. These measurements of OEF are being used to identify high-risk patients for inclusion in a clinical trial to assess the efficacy of surgical revascularization in reducing the subsequence of ipsilateral ischemic stroke. In acute ischemic stroke, attempts have been made to define the "ischemic penumbra" and to predict tissue viability and clinical outcome, although the reliability of PET markers of ischemia in distinguishing viable from irreversibly damaged tissue needs to be confirmed with independent data sets. Much work has been devoted to the investigation of the metabolic effects of infarcts and hemorrhages on remote areas of the brain; the clinical importance of such findings appears to be minimal. Early studies of recovery from stroke suggested functional reorganization of the brain, but further investigations with more rigorous experimental design need to be performed. Given the case of performing such studies with functional MR imaging, it is likely that this technology will supplant PET for this specific indication. The importance of ischemia as a secondary mechanism of brain injury has been addressed in ICH and SAH. PET demonstrated that hematomas exert a primary depression of metabolism rather than inducing ischemia in the surrounding tissue. It also documented the integrity of autoregulation and provided clinically useful information regarding the safety of blood pressure reduction after ICH. Studies in SAH have differentiated the primary effects of the hemorrhage on cerebral hemodynamics and metabolism from those of vasospasm. PET studies are time-consuming, expensive, and require extensive facilities and technical support. In the field of cerebrovascular disease, PET has served as a specialized research tool at a few centers to help elucidate the pathophysiology of stroke. Up until now, however, PET scans in individual patients have not been demonstrated to be necessary for making patient care decisions. Whether the role of PET expands to impact the management of individual patients will depend on the results of investigations like the Carotid Occlusion Surgery Study that directly assess the ability of PET to influence patient outcome.

Effect of Slow Movement Execution on Cognitive Function

We investigated the effect of slow paced movement on cognitive function. The task movement was a dual-task performance composed of a continuous forearm rotation for the right hand and a simple reaction task for the left hand. Exp. 1 was designed to compare reaction time during performance at a slow pace to that at medium pace by 14 female undergraduate students. The mean reaction time for the left hand under the Slow Pace was significantly longer than that under the Middle Pace condition ( p<.05), which showed that the subjects were required to give more attention to right-hand performance at the slow pace as it was difficult. Exp. 2 examined changes in reaction time when using the left hand that were associated with the learning of a slow paced task while using the right hand. Twenty-three female undergraduate students participated and repeated the task 6 times. The 3 sec. prior to and the 3 sec. after each auditory stimulus were used to establish rotation speed and mean coefficients of variation. The mean coefficients of variation, evaluated as within-subject variability, showed a significantly positive correlation with reaction time at Trials 1 and 6 for prestimulus and Trials 5 and 6 for poststimulus. Over successive trials participants continued performing the primary forearm task at a constant slow pace before and after receiving auditory stimuli, and this progress was related to a decrease in reaction time. Further, the sense of concentration evaluated by the subjects poststimulus was significantly higher than that prestimulus ( p<.01). Performance at a constant speed, which was much slower than the ordinary or preferred speed of each subject, may have had a strong effect on their ability to remain conscious of movement execution.

Motor subcircuits mediating the control of movement extent and speed

The functional correlates of movement extent, speed, and covariates were investigated using PET mapping of regional cerebral blood flow (rCBF) in 13 healthy right-handed adults. A whole-arm smooth pursuit tracking task was used to strictly control potential confounds such as movement duration, error, and feedback control. During each of four scans, images of relative rCBF were obtained while subjects matched the constant velocity movements of a target using a joystick-controlled cursor. Between scans, subjects were completely adapted to one of four joystick-to-cursor gains, thereby allowing constant visual stimulation and eye movements across arm movements that ranged in extent from 6 to 24 cm. Subjects were unaware of the changes in visuomotor gain. Analyses of arm and eye movements indicated that the only significant difference in behavior across the four gain conditions was the extent and velocity of arm movements, which were closely correlated with each other. Parametric statistical methods identified brain areas where rCBF covaried with the mean movement extent of individual subjects during individual scans. Increasing movement extent was associated with parallel increases of rCBF in bilateral basal ganglia (BG; putamen and globus pallidus) and ipsilateral cerebellum. Modest extent effects were detected also in the sensorimotor cortices bilaterally. No significant inverse relations were found. We conclude that a small subcircuit within the motor control system contributes to the control of movement extent and covariates and that the BG and cerebellum play central roles in the operation of that circuit.

Governing coordination: behavioural principles and neural correlates

The coordination of movement is governed by a coalition of constraints. The expression of these constraints ranges from the concrete--the restricted range of motion offered by the mechanical configuration of our muscles and joints; to the abstract--the difficulty that we experience in combining simple movements into complex rhythms. We seek to illustrate that the various constraints on coordination are complementary and inclusive, and the means by which their expression and interaction are mediated systematically by the integrative action of the central nervous system (CNS). Beyond identifying the general principles at the behavioural level that govern the mutual interplay of constraints, we attempt to demonstrate that these principles have as their foundation specific functional properties of the cortical motor systems. We propose that regions of the brain upstream of the motor cortex may play a significant role in mediating interactions between the functional representations of muscles engaged in sensorimotor coordination tasks. We also argue that activity in these "supramotor" regions may mediate the stabilising role of augmented sensory feedback.

Predicting performance from functional imaging data: methods matter

In the standard approach to functional imaging studies, brain-behavior relationships are studied by contrasting data obtained during different behavioral states. It is generally assumed that relative change yields meaningful data about relevant brain processes, and that the magnitude of the change reflects the extent of a region's involvement in the behavior being studied. The present study takes a different approach by asking the question, Can functional imaging data predict performance? Regional cerebral blood flow was measured using positron emission tomography in a group of 13 right-handed, normal volunteers during speech production and quiet baseline. A number of methodological assumptions were addressed by examining the relationships between different imaging measures derived from the same raw data and performance on the speech task. The results demonstrate that several common assumptions are not necessarily true. First, although measures based on "activated" scans alone had predictive value with respect to speech rate, measures based on contrasts between "baseline" and "activated" states did not. This was true regardless of whether the contrast was based on subtraction or covariance analyses. Second, while many regions demonstrated large signal increases during speech, speech rate could be predicted by a linear combination of data from two regions, neither of which had the highest "activation" peak, and one of which had a negative relationship with performance. The results demonstrate that contrasting experimental conditions do not necessarily isolate or enhance brain activity related to performance, and that the current assumptions about activation in functional imaging need to be reconsidered.

Reappraisal of the motor role of basal ganglia: a functional magnetic resonance image study

The importance of the basal ganglia in controlling motor function is well known. However, neuroimaging studies have failed to show either movement-rate dependence or different activation patterns caused by self-initiated (SI) and externally triggered (ET) movements in the basal ganglia-thalamo-motor loop. We herein report the functional magnetic resonance image (fMRI) mapping of sequential left-hand finger movements at five different rates under SI and ET conditions. Significant movement-rate dependence was found in the whole right basal ganglia-thalamo-motor loop only during the SI task. Network analysis also showed strong interactions within this loop during SI movement, whereas interactions were present only from the premotor cortex to the putamen via the sensorimotor cortex during the ET task. Furthermore, psychophysiological interaction analysis confirmed the different modulation between the two tasks in the putamen. fMRI provides evidence that the basal ganglia-thalamo-motor loop plays a key role in controlling the rate of sequential finger movements in SI movement but not in ET movement.

Relation between regional functional MRI activation and vascular reactivity to carbon dioxide during normal aging

Recent blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging studies have shown a reduction of cerebral activation during aging, which may be associated with age-related changes of the cerebral vascular system. The authors used a global hypercapnic breath-holding challenge to define nonneuronal contributions to a significantly reduced activation in the primary sensorimotor cortex during finger tapping in a group of old (n = 6; mean age 65 years) compared with a group of young (n = 6; mean age 27 years) subjects. Within significantly activated voxels in both groups during finger tapping, the mean BOLD signal amplitudes were significantly smaller in the group of older subjects for both tasks. In those voxels showing significant activation only in young subjects during finger tapping, the response to hypercapnia was also greatly diminished in older subjects. The attenuated hypercapnic BOLD signal response in older subjects within this region suggests that age-dependent changes of the cerebral vasculature may alter the neuronal-vascular coupling. In older subjects, cerebral vessels may not react as effectively in response to a vasodilating stimulus, which will lead to differences in the number of voxels that pass a criterion threshold despite similar neuronal activation.

Parametric analysis of rate-dependent hemodynamic response functions of cortical and subcortical brain structures during auditorily cued finger tapping: a fMRI study

A multitude of functional imaging studies revealed a mass activation effect at the level of the sensorimotor cortex during repetitive finger-tapping or finger-to-thumb opposition tasks in terms of either a stepwise or a monotonic relationship between movement rate and hemodynamic response. With respect to subcortical structures of the centralmotor system, there is, by contrast, some preliminary evidence for nonlinear rate/response functions within basal ganglia and cerebellum. To further specify these hemodynamic mechanisms, functional magnetic resonance imaging (fMRI) was performed during a finger-tapping task in response to acoustic stimuli (six different frequencies: 2.0, 2.5, 3.0, 4.0, 5.0 and 6.0 Hz; applied via headphones). Passive listening to the same auditory stimuli served as a control condition. Statistical evaluation of the obtained data considered two approaches: categorical and parametric analysis. As expected, the magnitude of the elicited hemodynamic response within left sensorimotor cortex (plateau phase at frequencies above 4 Hz) and mesiofrontal cortex paralleled movement rate. The observed bipartite mesial response pattern, most presumably, reflects functional compartmentalization of supplementary motor area (SMA) in a rostral component (pre-SMA) and in a caudal (SMA proper) component. At the level of the cerebellum, two significant hemodynamic responses within the hemisphere ipsilateral to the hand engaged into finger tapping (anterior/posterior quadrangular lobule and posterior quadrangular lobule) could be observed. Both activation foci exhibited a stepwise rate/response function. In accordance with clinical data, these data indicate different cerebellar contributions to motor control at frequencies below or above about 3 Hz, respectively. Caudate nucleus, putamen, and external pallidum of the left hemisphere displayed, by contrast, a negative linear rate/response relationship. The physiological significance of these latter findings remains to be clarified.

Motor and parietal cortical areas both underlie kinaesthesia

Tendon vibration has long been known to evoke perception of illusory movements through activation of muscle spindle primary endings. Few studies, however, have dealt with the cortical processes resulting in these kinaesthetic illusions. We conceived an fMRI experiment to investigate the cortical structures taking part in these illusory perceptions. Since muscle spindle afferents project onto different cortical areas involved in motor control it was necessary to discriminate between activation related to sensory processes and activation related to perceptual processes. To this end, we designed and compared different conditions. In two illusion conditions, covibration at different frequencies of the tendons of the right wrist flexor and extensor muscle groups evoked perception of slow or fast illusory movements. In a no illusion condition, covibration at the same frequency of the tendons of these antagonist muscle groups did not evoke a sensation of movement. Results showed activation of most cortical areas involved in sensorimotor control in both illusion conditions. However, in most areas, activation tended to be larger when the movement perceived was faster. In the no illusion condition, motor and premotor areas were little or not activated. Specific contrasts showed that perception of an illusory movement was specifically related to activation in the left premotor, sensorimotor, and parietal cortices as well as in bilateral supplementary motor and cingulate motor areas. We conclude that activation in motor as well as in parietal areas is necessary for a kinaesthetic sensation to arise.

Movement rate effect on activation and functional coupling of motor cortical areas

We investigated changes in the activation and functional coupling of bilateral primary sensorimotor (SM1) and supplementary motor (SMA) areas with different movement rates in eight normal volunteers. An auditory-cued repetitive right-thumb movement was performed at rates of 0.5, 0.75, 1, 2, 3, and 4 Hz. As a control condition, subjects listened to pacing tones with no movements. Electroencephalogram (EEG) was recorded from 28 scalp electrodes and electromyogram was obtained from the hand muscles. The event-related changes in EEG band-power (ERpow: activation of each area) and correlation (ERcor: functional coupling between each pair of cortical areas) were computed every 32 ms. Modulations of ERpow and ERcor were inspected in alpha (8-12 Hz) and beta (16-20 Hz) bands. Motor cortical activation and coupling was greater for faster movements. With increasing movement rate, the timing relationship between movement and tone switched from synchronization (for 0.5-1 Hz) to syncopation (for 3-4 Hz). The results suggested that for slow repetitive movements (0.5-1 Hz), each individual movement is separately controlled, and EEG activation and coupling of the motor cortical areas were immediately followed by transient deactivation and decoupling, having clear temporal modulation locked to each movement. In contrast, for fast repetitive movements (3-4 Hz), it appears that the rhythm is controlled and the motor cortices showed sustained EEG activation and continuous coupling.

Ipsilesional deficits during fast diadochokinetic hand movements following unilateral brain damage

Impaired sensorimotor function of the hand ipsilateral to a unilateral brain lesion has been reported in a variety of motor tasks; however, elementary diadochokinetic movements, such as tapping with the index finger, seem to be preserved in chronic-lesion patients. Three different diadochokinetic movements (forearm diadochokinesis, hand tapping (HT) and finger tapping (FT)) were tested in patients with left brain damage (LBD) and right brain damage (RBD) and control subjects. Movements were measured three-dimensionally and the kinematics of joint angles were analyzed. While the patients' measures of movement speed and symmetry appeared normal, detailed kinematic analysis revealed clear deficits in several measures of movement variability, which reflected decreased regularity of the alternating movement cycles. This impairment was greater in LBD patients and tended to be greater during forearm diadochokinesis. The necessity of ipsilateral control in addition to dominant, contralateral control, especially during left hand and more complex or more proximal manual tasks may account for these findings. In addition, the role of apraxia (defined by impairments during the imitation of gestures) in the performance deficits of LBD patients was also assessed. Although, some performance decrements were associated with the presence of apraxia, these were different from the group findings and restricted to the two tapping tasks. Thus, although apraxia may have caused deficits in establishing dynamic representations of the elementary postures in conditions of high speed and low complexity, the disturbances during diadochokinetic movements must for the most part be attributed to more motor-related deficits of ipsilateral sensorimotor control, which are particularly apparent when the motor dominant left hemisphere is affected. The absence of clear correlations between performance deficits and lesion characteristics suggests that a distributed network is involved in this ipsilateral control.

Brain activation during the fist-edge-palm test: a functional MRI study

The purpose of our study is to clarify, using functional MRI, brain regions activated during the fist-edge-palm task (FEP) compared to relatively simple hand motor tasks using either the right or the left hand in right-handed normal volunteers. The FEP was introduced to detect a disorder of voluntary movement, and it is believed to be closely related to contralateral frontal lobe damage. However, this assumption still remains controversial. Ten subjects participated in this study. Hand motor tasks were as follows: (1) the FEP, in which the subjects were requested to place their hand in three different positions sequentially: a fist resting horizontally, a palm resting vertically, and a palm resting horizontally; (2) a fist-palm task (FP), in which the subjects were asked to clench and unclench their fist alternately; and (3) a control task requiring the subjects to knock lightly with their clenched fist. The contralateral sensomotor and premotor areas were activated in the FP with the right hand and the contralateral sensorimotor, premotor, and supplementary motor areas (SMA) were activated in the FP with the left hand. In the FEP with either hand, bilateral premotor and left parietal areas and ipsilateral cerebellum were also activated as well as contralateral sensorimotor area and SMA. Our results suggest that successful performance of the FEP requires the participation of more brain areas than FP, which may explain why some patients without frontal lobe damage failed to perform the FEP.

Sound repetition rate in the human auditory pathway: representations in the waveshape and amplitude of fMRI activation

Sound repetition rate plays an important role in stream segregation, temporal pattern recognition, and the perception of successive sounds as either distinct or fused. This study was aimed at elucidating the neural coding of repetition rate and its perceptual correlates. We investigated the representations of rate in the auditory pathway of human listeners using functional magnetic resonance imaging (fMRI), an indicator of population neural activity. Stimuli were trains of noise bursts presented at rates ranging from low (1-2/s; each burst is perceptually distinct) to high (35/s; individual bursts are not distinguishable). There was a systematic change in the form of fMRI response rate-dependencies from midbrain to thalamus to cortex. In the inferior colliculus, response amplitude increased with increasing rate while response waveshape remained unchanged and sustained. In the medial geniculate body, increasing rate produced an increase in amplitude and a moderate change in waveshape at higher rates (from sustained to one showing a moderate peak just after train onset). In auditory cortex (Heschl's gyrus and the superior temporal gyrus), amplitude changed somewhat with rate, but a far more striking change occurred in response waveshape-low rates elicited a sustained response, whereas high rates elicited an unusual phasic response that included prominent peaks just after train onset and offset. The shift in cortical response waveshape from sustained to phasic with increasing rate corresponds to a perceptual shift from individually resolved bursts to fused bursts forming a continuous (but modulated) percept. Thus at high rates, a train forms a single perceptual "event," the onset and offset of which are delimited by the on and off peaks of phasic cortical responses. While auditory cortex showed a clear, qualitative correlation between perception and response waveshape, the medial geniculate body showed less correlation (since there was less change in waveshape with rate), and the inferior colliculus showed no correlation at all. Overall, our results suggest a population neural representation of the beginning and the end of distinct perceptual events that is weak or absent in the inferior colliculus, begins to emerge in the medial geniculate body, and is robust in auditory cortex.

When finding words becomes difficult: is there activation of the subdominant hemisphere?

Language-related activation has been observed in the right cerebral hemisphere by functional imaging in dysphasic patients who had partially recovered from a left hemispheric ischemic stroke with aphasia. It has been cautioned that, because dysphasic patients have difficulties in retrieving words, a right-hemisphere activation could be the result of an unspecific increase in global brain activation because of an increased effort. To test this hypothesis, we increased the difficulty of finding words in a word completion task in healthy subjects (n = 14) and measured hemispheric activation by functional transcranial Doppler sonography (fTCD). The sensitivity of fTCD for this approach was validated with an established motor paradigm by detecting a steady increase in bilateral cerebral perfusion in parallel to increasing the speed of finger tapping. Conversely, in the linguistic task, increasing the difficulty of word completion did not change task related perfusion of the dominant or subdominant hemisphere (repeated measurement ANOVA: P = 0.8). These results demonstrate that difficult to perform word searches do not lead to an additional involvement of the subdominant hemisphere. This suggests that after stroke, language-related activation of the subdominant hemisphere is not simply an effort-related effect.

Slow movement execution in event-related potentials (P300)

We examined whether slow movement execution has an effect on cognitive and information processing by measuring the P300 component. 8 subjects performed a continuous slow forearm rotational movement using 2 task speeds. Slow (a 30-50% decrease from the subject's Preferred speed) and Very Slow (a 60-80% decrease). The mean coefficient of variation for rotation speed under Very Slow was higher than that under Slow, showing that the subjects found it difficult to perform the Very Slow task smoothly. The EEG score of alpha-1 (8-10 Hz) under Slow Condition was increased significantly more than under the Preferred Condition; however, the increase under Very Slow was small when compared with Preferred. After performing the task. P300 latency under Very Slow increased significantly as compared to that at pretask. Further, P300 amplitude decreased tinder both speed conditions when compared to that at pretask, and a significant decrease was seen under the Slow Condition at Fz, whereas the decrease under the Very Slow Condition was small. These differences indicated that a more complicated neural composition and an increase in subjects' attention might have been involved when the task was performed under the Very Slow Condition. We concluded that slow movement execution may have an influence on cognitive function and may depend on the percentage of decrease from the Preferred speed of the individual.

Changes of cerebral blood flow, oxygenation, and oxidative metabolism during graded motor activation

In the present studies fMRI and a hypercapnic calibration procedure were used to monitor simultaneous changes in cerebral blood flow (CBF), cerebral blood oxygenation, and cerebral metabolic rate of oxygen (CMRO(2)) during activation in the sensorimotor cortex. In the first set of experiments seven volunteers performed bilateral, self-paced finger tapping and in the second set of experiments six volunteers performed bilateral finger tapping with six different frequencies (0.5-3 Hz). During the latter task relative CBF and BOLD signal intensity changes varied linearly as a function of stimulus frequency. In good agreement with recent PET and fMRI data increases in CMRO(2) were smaller than the corresponding changes in CBF during self-paced finger tapping and at all levels of graded motor activation. At a single level of activation and during graded activation there was a positive linear relationship between CBF and CMRO(2) with ratios of approximately 3:1. Comparable proportionality constants have been found in the visual cortex and primary sensory cortex, indicating similarities between the relationship of CBF and CMRO(2) in various cortical regions.

Differential effect of spinal cord injury and functional impairment on human brain activation

Reorganization of human brain function after spinal cord injury (SCI) has been shown in electrophysiological studies. However, it is less clear how far changes of brain activation in SCI patients are influenced by the extent of SCI (neuronal lesion) or the consequent functional impairment. Positron emission tomography ([15O]-H2O-PET) was performed during an unilateral hand movement in SCI patients and healthy subjects. SCI patients with paraplegia and normal hand function were compared to tetraplegic patients with impaired hand movements. Intergroup comparison between paraplegic patients and healthy subjects showed an increased activation of contralateral sensorimotor cortex (SMC), contralateral thalamus, ipsilateral superior parietal lobe, and bilateral cerebellum. In contrast to this, tetraplegic patients with impaired upper limb function revealed only a significant activation of supplementary motor area (SMA). Correlational analysis in the tetraplegic patients showed that the strength of hand movement was related to the activation of contralateral SMC. However, the severity of upper limb sensorimotor deficit was related to a reduced activation of contralateral SMA and ipsilateral cerebellum. The findings suggest that in paraplegic patients with normal hand function the spinal neuronal lesion itself induces a reorganization of brain activation unrelated to upper limb function. Compared to this, in tetraplegic patients changes of brain activation are related to the impaired upper limb function. Therefore, in patients with SCI a differential impact of spinal lesion and functional impairment on brain activation can be shown. The effect of impaired afferent feedback and/or increased compensatory use of non-impaired limbs in SCI patients needs further evaluation.

Cluster analysis of activity-time series in motor learning

Neuroimaging studies of learning focus on brain areas where the activity changes as a function of time. To circumvent the difficult problem of model selection, we used a data-driven analytic tool, cluster analysis, which extracts representative temporal and spatial patterns from the voxel-time series. The optimal number of clusters was chosen using a cross-validated likelihood method, which highlights the clustering pattern that generalizes best over the subjects. Data were acquired with PET at different time points during practice of a visuomotor task. The results from cluster analysis show practice-related activity in a fronto-parieto-cerebellar network, in agreement with previous studies of motor learning. These voxels were separated from a group of voxels showing an unspecific time-effect and another group of voxels, whose activation was an artifact from smoothing.

Brain areas involved in interlimb coordination: a distributed network

Whereas behavioral studies have made significant contributions toward the identification of the principles governing the coordination of limb movements, little is known about the role of higher brain areas that are involved in interlimb coordination. Functional magnetic resonance imaging (fMRI) was used to reveal the brain areas activated during the cyclical coordination of ipsilateral wrist and foot movements. Six normal subjects performed five different tasks that were presented in a random order, i.e., isolated flexion-extension movements of the right wrist (WRIST) and right foot (FOOT), cyclical coordination of wrist and foot according to the isodirectional (ISODIR) and nonisodirectional (NON-ISODIR) mode, and rest (REST). All movements were auditory paced at 66 beats/min. During the coordination of both limb segments, a distributed network was identified showing activation levels in the supplementary motor area (SMA), cingulate motor cortex (CMC), premotor cortex (PMC), primary sensorimotor cortex (M1/S1), and cerebellum that exceeded the sum of the activations observed during the isolated limb movements. In addition, coordination of the limb movements in different directions was associated with extra activation of the SMA as compared to movements in the same direction. It is therefore concluded that the SMA is substantially involved in the coordination of the nonhomologous limbs as part of a distributed motor network. Accordingly, the long-standing exclusive association that has been made between this medial frontal area and bimanual (homologous) coordination needs to be abandoned and extended towards other forms of interlimb coordination (nonhomologous).

Continuous transcranial magnetic stimulation during positron emission tomography: a suitable tool for imaging regional excitability of the human cortex

In six healthy volunteers, H(2)(15)O positron emission tomography (PET) was employed to evaluate rate-dependent functional activation of the left primary sensorimotor hand area (SM1(HAND)) during subthreshold repetitive transcranial magnetic stimulation (rTMS). Using an eight-shaped coil, continuous trains of rTMS were delivered during nine 50-s H(2)(15)O PET scans. Nine different stimulation frequencies were used, ranging from 1 to 5 Hz. Stimulus intensity was set at 10% below active motor threshold. During three additional PET scans, an ineffective rTMS was applied via another eight-shaped coil, which was held 10 cm above the vertex. Statistical parametric mapping was employed to assess relative differences in normalized regional cerebral blood flow (rCBF) across conditions. Compared with ineffective rTMS, subthreshold rTMS increased normalized rCBF in the stimulated SM1(HAND). Moreover, the increase in rCBF in the left SM1(HAND) showed a linear positive relationship with the rate of rTMS, indicating a rate-dependent functional activation of the stimulated SM1(HAND). These data demonstrate that, by varying the variables of rTMS across scans, continuous rTMS during H(2)(15)O PET provides a noninvasive tool to study the regional excitability profile of a distinct cortical area.

Brain correlates of fast and slow handwriting in humans: a PET-performance correlation analysis

The present study examined the cerebral control of velocity during handwriting. We employed H215O positron emission tomography (PET) to measure the regional cerebral blood flow (rCBF) in 10 healthy subjects. Participants were required to write the German verb 'bellen' ('to bark') either at their normal speed (i.e. fast open-loop handwriting) or to write at approximately half of their normal speed without visual feedback. The second task required a continuous modification of the motor output according to the kinaesthetic feedback from the hand (i.e. slow closed-loop handwriting). Pencil movements were recorded during PET scanning and analysed off-line using a stroke-based analysing program. The mean number of inversions in velocity (NIV) per stroke was used to quantify the mode of motor control during each PET scan. A NIV of 1 indicates fast open-loop processing, whereas an increase in NIV reflects a shift towards slow closed-loop processing of handwriting. Foci in the left primary sensorimotor cortex, the right lateral premotor cortex, the left anterior parietal cortex, the left anterior putamen, the left rostral supplementary motor area and the right precuneus showed a graded increase in functional activation with the mean NIV per stroke, suggesting that this set of brain regions is particularly involved in the processing of slow closed-loop writing movements. No area showed a negative relationship between rCBF and the mean NIV per stroke, suggesting that fast open-loop handwriting is achieved by an optimized cooperation of the manual sensorimotor network rather than by a selective activation of a distinct network component.

Functional magnetic resonance imaging of the primary motor cortex in humans: response to increased functional demands

Functional magnetic resonance imaging (fMRI) studies have been performed on 20 right handed volunteers at 1.5 Tesla using echo planar imaging (EPI) protocol. Index finger tapping invoked localized activation in the primary motor area. Consistent and highly reproducible activation in the primary motor area was observed in six different sessions of a volunteer over a period of one month. Increased tapping rate resulted in increase in the blood oxygenation level dependent (BOLD) signal intensity as well as the volume/area of activation (pixels) in the contralateral primary motor area up to tapping rate of 120 taps/min (2 Hz), beyond which it saturates. Activation in supplementary motor area was also observed. The obtained results are correlated to increased functional demands.

Atypical patterns of cerebral motor activation in autism: a functional magnetic resonance study

BACKGROUND

Early neurodevelopmental pathogenesis in autism potentially affects emerging functional maps, but little imaging evidence is available.

METHODS

We studied eight male autistic and eight matched normal subjects, using functional magnetic resonance imaging during visually paced finger movement, compared to a control condition (visual stimulation in the absence of motor response).

RESULTS

Groupwise analyses showed activation in contralateral perirolandic cortex, basal ganglia, and thalamus, bilateral supplementary motor area, and ipsilateral cerebellum for both groups. However, activations were less pronounced in the autism group. Direct group comparisons demonstrated greater activation in perirolandic and supplementary motor areas in the control group and greater activation (or reduced deactivation) in posterior and prefrontal cortices in the autism group. Intraindividual analyses further showed that strongest activations were consistently located along the contralateral central sulcus in control subjects but occurred in locations differing from individual to individual in the autism group.

CONCLUSIONS

Our findings, though based on a rather small sample, suggest abnormal individual variability of functional maps and less distinct regional activation/deactivation patterns in autism. The observations may relate to known motor impairments in autism and are compatible with the general hypothesis of disturbances of functional differentiation in the autistic cerebrum.

Differential contributions of motor cortex, basal ganglia, and cerebellum to speech motor control: effects of syllable repetition rate evaluated by fMRI

In order to delineate the neuroanatomical correlates of speech motor control, functional magnetic resonance imaging was performed during silent repetitions of the syllable "ta" at three different rates (2.5, 4.0, and 5.5 Hz). Spatial extent and magnitude of hemodynamic responses at the level of the motor cortex showed a positive correlation to production frequencies. As concerns the basal ganglia, the lower rates (2.5 and 4.0 Hz) gave rise to higher magnitudes of activation within the left putamen as compared to the 5.5 Hz condition. In contrast, cerebellar responses were rather restricted to fast performance (4.0 and 5.5 Hz) and exhibited a shift in caudal direction during 5.5 as compared to 4.0 Hz. These findings corroborate the suggestion of a differential impact of various cortical and subcortical areas on speech motor control.

Event-related potentials as a function of movement parameter variations during motor imagery and isometric action

Neuroimaging and electrophysiological studies have shown that executed action and motor imagery activate common neuronal substrates, leading to the hypothesis that movement preparation and motor imagery are functionally equivalent processes. This study further tested the functional equivalence hypothesis by determining whether electrocortical patterns associated with variations in motor control parameters are similar during imagined and executed actions. Event-related potentials (ERPs) were recorded from the supplementary motor/premotor area (SMA/PMA; FCz site) and primary motor area (M1; C3, C4 sites) during an executed and an imagined, cued, discrete isometric contraction task while target force (TF; low, moderate) and rate of force development (RFD; slow, rapid) were varied. For M1, the correlation of ERPs between moderate- and low force-executions was near zero and N2 amplitude was greater for moderate than low force executions, indicating that M1 activity is related to TF. Rapid executions were greater in amplitude and longer in latency than slow executions and the ERPs for rapid- and slow-executions were negatively correlated, indicating that M1 activity is also related to RFD. There were no differences in N2 amplitude and a zero correlation between execution and imagined actions of similar TF and RFD, indicating that neither TF or RFD are represented in M1 activity during imagery. For SMA/PMA, there was a moderate correlation between moderate- and low force-executions and larger N2 amplitude for moderate- than for low force-executions, indicating that TF may be related to SMA/PMA electrocortical activity. ERP patterns were uncorrelated between rapid- and slow-execution at FCz, but N2 amplitude was the same, making it unclear whether the RFD parameter is represented in FCz activity. The correlational and N2 amplitude analyses demonstrate that patterns of electrocortical activity at SMA/PMA are nearly isomorphic during executed and imagined actions as TF and RFD are varied. These results provide evidence that patterns of electrocortical activity associated with variations in the parameters of executed action are similar during motor imagery at SMA/PMA but not at M1.

The insular lobe: physiopathological and surgical considerations

OBJECTIVE

Surgery of the insula represents a technical challenge, because of the proximity of the internal capsule to the lenticulostriate arteries and the lack of certainty concerning its functionality. Using intraoperative direct cerebral stimulation, combined with neuronavigation, the authors operated on 12 insular gliomas. On the basis of this experience, the physiopathological and surgical implications are discussed.

METHODS

A low-grade insular glioma, revealed by seizures, was diagnosed in 12 right-handed patients with a normal neurological status. Preoperative magnetic resonance imaging showed that, according to Yasargil's classification system, three patients harbored Type 3 lesions and nine patients had Type 5 lesions (10 tumors on the right side and 2 on the left dominant side). All patients underwent surgery using direct cerebral stimulation, under general anesthesia in nine patients (motor mapping) and under local anesthesia in three patients (sensorimotor and language mapping). Ultrasonography and/or neuronavigation was used in all cases. Preoperative angio-computed tomographic scanning showed the lenticulostriate arteries in two patients.

RESULTS

The internal capsule was systematically detected, and the language areas were identified within the left insula in the awake patients. The lenticulostriate arteries were seen in two patients. Seven patients presented an immediate postoperative deficit; six of them recovered completely within 3 months. Four resections were total, six were subtotal, and two were partial (left insula).

CONCLUSION

The use of intraoperative direct cerebral stimulation and neuronavigation allows surgery of the insula with minimization of the risk of sequelae, but its use is still limited with regard to the dominant hemisphere, owing to the essential role of this structure in language.

Variability in fMRI: an examination of intersession differences

The results from a single functional magnetic resonance imaging session are typically reported as indicative of the subject's functional neuroanatomy. Underlying this interpretation is the implicit assumption that there are no responses specific to that particular session, i.e., that the potential variability of response between sessions is negligible. The present study sought to examine this assumption empirically. A total of 99 sessions, comprising 33 repeats of simple motor, visual, and cognitive paradigms, were collected over a period of 2 months on a single male subject. For each paradigm, the inclusion of session-by-condition interactions explained a significant amount of error variance (P < 0.05 corrected for multiple comparisons) over a model assuming a common activation magnitude across all sessions. However, many of those voxels displaying significant session-by-condition interactions were not seen in a multisession fixed-effects analysis of the same data set; i.e., they were not activated on average across all sessions. Most voxels that were both significantly variable and activated on average across all sessions did not survive a random-effects analysis (modeling between-session variance). We interpret our results as demonstrating that correct inference about subject responses to activation tasks can be derived through the use of a statistical model which accounts for both within- and between-session variance, combined with an appropriately large session sample size. If researchers have access to only a single session from a single subject, erroneous conclusions are a possibility, in that responses specific to this single session may be claimed to be typical responses for this subject.

Self-initiated versus externally triggered movements. II. The effect of movement predictability on regional cerebral blood flow

Event-related potential studies in man suggest a role for the supplementary motor area (SMA) in movement preparation, particularly when movements are internally generated. In a previous study combining PET with recording of movement-related cortical potentials, we found similar SMA activation and early pre-movement negativity during self-initiated and predictably paced index finger extensions. Early pre-movement negativity was absent when finger movements were paced by unpredictable cues. We postulated that preparation preceding self-initiated and predictably cued movements was responsible for equivalent levels of SMA activation in these two conditions. To test this, we have performed further studies on six normal volunteers with H2(15)O-PET. Twelve measurements of regional cerebral blood flow were made in each subject under three conditions: rest; self-initiated right index finger extension at a variable rate of once every 2-7 s; and finger extension triggered by pacing tones at unpredictable intervals (at a rate yoked to the self-initiated movements). Activation associated with these conditions was compared using analysis of covariance and t statistics. Compared with rest, unpredictably cued movements activated the contralateral primary sensorimotor cortex, caudal SMA and contralateral putamen. Self-initiated movements additionally activated rostral SMA, adjacent anterior cingulate cortex and bilateral dorsolateral prefrontal cortex (DLPFC). Direct comparison of the two motor tasks confirmed significantly greater activation of these areas and of caudal SMA in the self-initiated condition. These results, combined with our previous data, suggest that rostral SMA plays a primary role in movement preparation while caudal SMA is a motor executive area. In this experiment and in our earlier study, DLPFC was activated only during the self-initiated task, in which decisions were required about the timing of movements.

The functional neuroanatomy and long-term reproducibility of brain activation associated with a simple finger tapping task in older healthy volunteers: a serial PET study

We examined long-term reproducibility of the functional organization of the brain associated with a simple finger tapping movement using positron emission tomography (PET). Repeat measurements of regional cerebral blood flow were obtained in 10 individuals, ages 35 to 82 years (mean 52 years), at scanning sessions separated by 6 months. Although the functional neuroanatomy of hand movements has previously been investigated with PET by a number of groups, none has reported systematic investigation of the consistency of brain activation over an extended time. As expected, we found significant activation in the left precentral gyrus [Talairach coordinate (-32, -34, 52)], postcentral gyrus (-22, -48, 56), and supplementary motor area (SMA) (-2, -18, 52) at the initial study, consistent with previous studies in younger subjects. For the follow-up study we also found significant activation in the left precentral (-36, -28, 52) and postcentral (-28, -36, 52) gyri and in the SMA (2, -16, 56). Our group results demonstrate consistent anatomical location and extent of motor activation over time. More importantly, analysis of individuals confirmed the presence of consistent sites of activation in primary sensorimotor cortex and SMA over the 6-month interval in most subjects. A high degree of consistency in location of activation in the group, and within individuals, over time suggests that changes in loci of activation may be confidently monitored using the PET method. Evidence of individual differences in extent of activation over time highlights the need for caution when interpreting similar changes in patient studies.

FMRI and PET of self-paced finger movement: comparison of intersubject stereotaxic averaged data

We compared the intersubject-averaged functional anatomy of self-paced right index finger movement as revealed by (15)O water positron emission tomography (PET) and blood oxygen level-dependent functional magnetic resonance imaging (FMRI) at 1.5 T. Image data sets were acquired with both techniques on a group of eight subjects, spatially normalized in the stereotaxic space and subsequently processed in order to get identical smoothness and degrees of freedom. Intersubject-averaged PET and FMRI activation maps were found congruent in the left primary sensorimotor area (PSM), bilateral supplementary motor area, bilateral supra marginalis gyri, left operculum, left inferior parietal lobule, right middle frontal gyrus, and right cerebellum. In those regions the mean distance between PET and FMRI local maxima was 7.4 mm. FMRI detected additional activations in the right precentral gyrus, right rolandic operculum, right inferior parietal lobule, and bilateral insula, whereas PET demonstrated a higher detection sensitivity at the deep nuclei level. PET and FMRI percentage signal variations were found linearly related by a factor around 10, both within the PSM and across a set of distributed local extrema. However, in most cases, FMRI was more sensitive than PET, as assessed by t values. Finally the pattern of deactivations was markedly dissimilar between the two techniques, possibly due to differences in the "Rest" control task.

Linear coupling between cerebral blood flow and oxygen consumption in activated human cortex

The aim of this study was to test the hypothesis that, within a specific cortical unit, fractional changes in cerebral blood flow (CBF) and cerebral metabolic rate of oxygen consumption (CMR(O(2))) are coupled through an invariant relationship during physiological stimulation. This aim was achieved by simultaneously measuring relative changes in these quantities in human primary visual cortex (V1) during graded stimulation with patterns designed to selectively activate different populations of V1 neurons. Primary visual cortex was delineated individually in each subject by using phase-encoded retinotopic mapping. Flow-sensitive alternating inversion recovery MRI, in conjunction with blood oxygenation-sensitive MRI and hypercapnic calibration, was used to monitor CBF and CMR(O(2)). The stimuli used included (i) diffuse isoluminant chromatic displays; (ii) high spatial-frequency achromatic luminance gratings; and (iii) radial checkerboard patterns containing both color and luminance contrast modulated at different temporal rates. Perfusion responses to each pattern were graded by varying luminance and/or color modulation amplitudes. For all stimulus types, fractional changes in blood flow and oxygen uptake were found to be linearly coupled in a consistent ratio of approximately 2:1. The most potent stimulus produced CBF and CMR(O(2)) increases of 48 +/- 5% and 25 +/- 4%, respectively, with no evidence of a plateau for oxygen consumption. Estimation of aerobic ATP yields from the observed CMR(O(2)) increases and comparison with the maximum possible anaerobic ATP contribution indicate that elevated energy demands during brain activation are met largely through oxidative metabolism.