Brain areas involved in interlimb coordination: a distributed network

Perturbations in action goal influence bimanual grasp posture planning

The authors examined the effects of perturbations in action goal on bimanual grasp posture planning. Sixteen participants simultaneously reached for 2 cylinders and placed either the left or the right end of the cylinders into targets. As soon as the participants began their reaching movements, a secondary stimulus was triggered, which indicated whether the intended action goal for the left or right hand had changed. Overall, the tendency for a single hand to select end-state comfort compliant grasp postures was higher for the nonperturbed condition compared to both the perturbed left and perturbed right conditions. Furthermore, participants were more likely to plan their movements to ensure end-state comfort for both hands during nonperturbed trials, than perturbed trials, especially object end-orientation conditions that required the adoption of at least one underhand grasp posture to satisfy bimanual end-state comfort. Results indicated that when the action goal of a single object was perturbed, participants attempted to reduce the cognitive costs associated with grasp posture replanning by maintaining the original grasp posture plan, and tolerating grasp postures that result in less controllable final postures.

The how and why of arm swing during human walking

Humans walk bipedally, and thus, it is unclear why they swing their arms. In this paper, we will review the mechanisms and functions of arm swinging in human gait. First, we discuss the potential advantages of having swinging arms. Second, we go into the detail on the debate whether arm swing is arising actively or passively, where we will conclude that while a large part of arm swinging is mechanically passive, there is an active contribution of muscles (i.e. an activity that is not merely caused by stretch reflexes). Third, we describe the possible function of the active muscular contribution to arm swinging in normal gait, and discuss the possibility that a Central Pattern Generator (CPG) generates this activity. Fourth, we discuss examples from pathological cases, in which arm swinging is affected. Moreover, using the ideas presented, we suggest ways in which arm swing may be used as a therapeutic aid. We conclude that (1) arm swing should be seen as an integral part of human bipedal gait, arising mostly from passive movements, which are stabilized by active muscle control, which mostly originates from locomotor circuits in the central nervous system (2) arm swinging during normal bipedal gait most likely serves to reduce energy expenditure and (3) arm swinging may be of therapeutic value.

Cortical processing of simultaneous hand and foot movements: evidence from event-related potentials

The motor processes involved in generating simultaneous hand and foot movements were studied by recording event-related potentials (ERPs) during reaction time tasks in which participants made hand and foot movements either alone or in combination with one another. In particular, we assessed whether the motor potentials generated during combined movements were simply superpositions of the potentials generated during the individual movements in isolation. ERPs generated during single-limb movements replicated previously observed motor potentials, and those generated during both the execution (Experiment 1) and preparation (Experiment 2) of combined movements showed some deviations from the predictions of the superposition hypothesis, suggesting the presence of neural interactions between the hand and foot movement systems during preparation and execution of these actions.

Seeing or moving in parallel: the premotor cortex does both during bimanual coordination, while the cerebellum monitors the behavioral instability of symmetric movements

The underlying neural mechanisms of a perceptual bias for in-phase bimanual coordination movements are not well understood. In the present study, we measured brain activity with functional magnetic resonance imaging in healthy subjects during a task, where subjects performed bimanual index finger adduction-abduction movements symmetrically or in parallel with real-time congruent or incongruent visual feedback of the movements. One network, consisting of bilateral superior and middle frontal gyrus and supplementary motor area (SMA), was more active when subjects performed parallel movements, whereas a different network, involving bilateral dorsal premotor cortex (PMd), primary motor cortex, and SMA, was more active when subjects viewed parallel movements while performing either symmetrical or parallel movements. Correlations between behavioral instability and brain activity were present in right lateral cerebellum during the symmetric movements. These findings suggest the presence of different error-monitoring mechanisms for symmetric and parallel movements. The results indicate that separate areas within PMd and SMA are responsible for both perception and performance of ongoing movements and that the cerebellum supports symmetric movements by monitoring deviations from the stable coordination pattern.

Arm movements can increase leg muscle activity during submaximal recumbent stepping in neurologically intact individuals

Facilitation of leg muscle activity by active arm movements during locomotor tasks could be beneficial during gait rehabilitation after spinal cord injury. The present study explored the effects of arm movements on leg muscle activity during submaximal recumbent stepping. Healthy subjects exercised on a recumbent stepping machine both with and without arm movements. Activity of five leg muscles was recorded and compared for stepping with and without arm movements. To determine which arm movements are optimal for leg muscle facilitation, subjects were instructed to step with 1) mechanically coupled vs. decoupled arm and leg movements, 2) synchronous vs. asynchronous arm movements, and 3) at 50 vs. 70 RPM. Leg muscle activity was increased by active arm movements in all muscles, except the vastus lateralis muscle. Activity of other extensors (soleus, medial gastrocnemius, and biceps femoris) was primarily increased during the extension phase, whereas activity of flexors (tibialis anterior) was also increased during the flexion phase. Facilitation was more or less consistent for both frequencies and for synchronous and asynchronous movements. For coupled arm movements, facilitation tended to be diminished or absent. The observed facilitation in the present study is probably of neuromuscular rather than biomechanical origin, since the arms are probably hardly involved in postural control or weight-bearing during recumbent stepping. Further studies in patients should explore the possibility to integrate neuromuscular facilitation in rehabilitation programs.

Can quantum probability help analyze the behavior of functional brain networks?

Pothos & Busemeyer (P&B) argue how key concepts of quantum probability, for example, order/context, interference, superposition, and entanglement, can be used in cognitive modeling. Here, we suggest that these concepts can be extended to analyze neurophysiological measurements of cognitive tasks in humans, especially in functional neuroimaging investigations of large-scale brain networks.

Relationship of neonatal cerebral blood flow velocity asymmetry with early motor, cognitive and language development in term infants

The objective of this study was to examine the relationships of Doppler cerebral blood flow velocity (CBFV) asymmetry measures with developmental outcomes in term infants. Doppler CBFV parameters (peak systolic velocity [PSV] and mean velocity [MV]) of the bilateral middle cerebral arteries of 52 healthy term infants were prospectively examined on postnatal days 1-5, and then their motor, cognitive and language development was evaluated with the Bayley Scales of Infant and Toddler Development, Third Edition, at 6, 12, 18 and 24 months of age. The left CBFV asymmetry measure (PSV or MV) was calculated by subtracting the right-side value from the left-side value. Left CBFV asymmetry measures were significantly positively related to motor scores at 6 (r = 0.3-0.32, p < 0.05) and 12 (r = 0.35, p < 0.05) months of age, but were not related to cognitive or language outcome. Thus, the leftward hemodynamic status of the middle cerebral arteries, as measured by cranial Doppler ultrasound in the neonatal period, predicts early motor outcome in term infants.

Ipsilateral wrist-ankle movements in the sagittal plane encoded in extrinsic reference frame

When performing oscillatory movements of two joints in the sagittal plane, there is a directional constraint for performing such movements. Previous studies could not distinguish whether the directional constraint reflected movement direction encoded in the extrinsic (outside the body) reference frame or in the intrinsic (the participants' torso/head) reference frame since participants performed coordinated movements in a sitting position where the torso/head was stationary relative to the external world. In order to discern the reference frame in the present study, participants performed paced oscillatory movements of the ipsilateral wrist and ankle in the sagittal plane in a standing position so that the torso/head moved relative to the external world. The coordinated movements were performed in one of two modes of coordination, moving the hand upward concomitant with either ankle plantarflexion or ankle dorsiflexion. The same directional mode relative to extrinsic space was more stable and accurate as compared with the opposite directional mode. When forearm position was changed from the pronated position to the supinated position, similar results were obtained, indicating that the results were independent of a particular coupling of muscles. These findings suggest that the directional constraint on ipsilateral joints movements in the sagittal plane reflects movement direction encoded in the extrinsic reference frame.

Coordination between the fore- and hindlimbs is bidirectional, asymmetrically organized, and flexible during quadrupedal locomotion in the intact adult cat

Despite the obvious importance of inter-girdle coordination for quadrupedal locomotion in terrestrial mammals, its organization remains poorly understood. Here, we evaluated cycle and phase durations, as well as footfall patterns of four intact adult cats trained to walk on a transverse split-belt treadmill that could independently control fore- and hindlimb speed. When the hindlimbs walked at faster speeds than the forelimbs, an equal rhythm was always maintained between the fore- and hindlimbs, even at the highest fore-hindlimb speed ratio of 1:3 (0.4:1.2 m/s). The locomotor pattern adjusted through changes in both hindlimb stance and swing phase durations, whereas only the forelimb stance phase was affected. In such conditions, when fore- and hindlimb values were compared to those obtained at matched speeds during tied-belt walking (i.e. predicted values based on treadmill speed), hindlimb cycle, stance and swing durations were consistently longer than predicted. On the other hand, forelimb cycle and stance durations were shorter than predicted but only at the highest split-belt speed ratios. Forelimb swing durations were as predicted based on front-belt speed. The sequence of footfall pattern when hindlimb speed was faster was identical to tied-belt walking. In stark contrast, when the forelimbs walked at slightly faster speeds than the hindlimbs, the rhythm between the fore- and hindlimbs broke down. In such conditions, the locomotor pattern was adjusted through changes in stance and swing phase durations in both the fore- and hindlimbs. When the rhythm between the fore- and hindlimbs broke down, hindlimb cycle and phase durations were similar to predicted values, whereas forelimb values were shorter than predicted. Moreover, several additional sequences of footfall patterns were observed. Therefore, the results clearly demonstrate the existence of a bidirectional, asymmetric, and flexible control of inter-girdle coordination during quadrupedal locomotion in the intact adult cat.

Ipsilateral synkinesia involves the supplementary motor area

The supplementary motor area coordinates movements. Synkinesia is a rare disorder in which an involuntary movement occurs coordinated with a voluntary movement. Here, we test the hypothesis that the supplementary motor area is involved in involuntary coordination of movement. We collected functional magnetic resonance imaging (fMRI) data from two patients with ipsilateral hand-foot synkinesia and two control participants while they performed rhythmic tasks. In synkinesia patients, both the supplementary motor area and the foot motor cortex were significantly activated during the hand motor task. This pattern was not seen in controls. Our findings suggest that the supplementary motor area plays a central role in involuntary coordination observed in synkinesia, and provides insight into how the supplementary motor area orchestrates movements.

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.

Resting-state functional connectivity of the vermal and hemispheric subregions of the cerebellum with both the cerebral cortical networks and subcortical structures

The human cerebellum is a heterogeneous structure, and the pattern of resting-state functional connectivity (rsFC) of each subregion has not yet been fully characterized. We aimed to systematically investigate rsFC pattern of each cerebellar subregion in 228 healthy young adults. Voxel-based analysis revealed that several subregions showed similar rsFC patterns, reflecting functional integration; however, different subregions displayed distinct rsFC patterns, representing functional segregation. The same vermal and hemispheric subregions showed either different patterns or different strengths of rsFCs with the cerebrum, and different subregions of lobules VII and VIII displayed different rsFC patterns. Region of interest (ROI)-based analyses also confirmed these findings. Specifically, strong rsFCs were found: between lobules I-VI and vermal VIIb-IX and the visual network; between hemispheric VI, VIIb, VIIIa and the auditory network; between lobules I-VI, VIII and the sensorimotor network; between lobule IX, vermal VIIIb and the default-mode network; between lobule Crus I, hemispheric Crus II and the fronto-parietal network; between hemispheric VIIb, VIII and the task-positive network; between hemispheric VI, VIIb, VIII and the salience network; between most cerebellar subregions and the thalamus; between lobules V, VIIb and the midbrain red nucleus; between hemispheric Crus I, Crus II, vermal VIIIb, IX and the caudate nucleus; between lobules V, VI, VIIb, VIIIa and the pallidum and putamen; and between lobules I-V, hemispheric VIII, IX and the hippocampus and amygdala. These results confirm the existence of both functional integration and segregation among cerebellar subregions and largely improve our understanding of the functional organization of the human cerebellum.

Analysis of ground reaction force and electromyographic activity of the gastrocnemius muscle during double support

Mechanisms associated with energy expenditure during gait have been extensively researched and studied. According to the double-inverted pendulum model energy expenditure is higher during double support, as lower limbs need to work to redirect the centre of mass velocity. This study looks into how the ground reaction force of one limb affects the muscle activity required by the medial gastrocnemius of the contralateral limb during step-to-step transition. Thirty-five subjects were monitored as to the medial gastrocnemius electromyographic activity of one limb and the ground reaction force of the contralateral limb during double support. After determination of the Pearson correlation coefficient (r), a moderate correlation was observed between the medial gastrocnemius electromyographic activity of the dominant leg and the vertical (Fz) and anteroposterior (Fy) components of ground reaction force of the non-dominant leg (r = 0.797, p < 0.0001; r = –0.807, p < 0.0001). A weak and moderate correlation was observed between the medial gastrocnemius electromyographic activity of the non-dominant leg and the Fz and Fy of the dominant leg, respectively (r = 0.442, p = 0.018; r = –0.684 p < 0.0001). The results obtained suggest that during double support, ground reaction force is associated with the electromyographic activity of the contralateral medial gastrocnemius and that there is an increased dependence between the ground reaction force of the non-dominant leg and the electromyographic activity of the dominant medial gastrocnemius.

Increasingly complex bimanual multi-frequency coordination patterns are equally easy to perform with on-line relative velocity feedback

An experiment was conducted to determine whether multi-frequency continuous bimanual circling movements of varying difficulty (1:2, 2:3, 3:4, and 4:5) could be effectively performed following relatively little practice when on-line continuous relative velocity feedback is provided. The between-subjects results indicate extremely effective bimanual multi-frequency performance for all coordination patterns with relatively stable and continuous movements of both limbs. The findings suggest that the previous performance effects using Lissajous feedback with reciprocal movement can be extended to circling movements using on-line relative velocity feedback. Contrary to the long-held position that these coordination patterns result in increasing difficulty, we failed to find systematic relative velocity error, variability, or bias differences between the participants performing the various multi-frequency coordination patterns. Indeed, coordination error, variability, and biases were remarkably low for each of the tasks. The results clearly indicate the ease with which participants are able to produce bimanual coordination patterns typically considered difficult if not impossible when salient visual information is provided that allows the participants to detect and correct their coordination errors.

Rhythmic arm swing enhances long latency facilitatory effect of transcranial magnetic stimulation on soleus motoneuron pool excitability

The purpose of this study was to investigate whether rhythmic arm swing modulates the long latency effect of transcranial magnetic stimulation (TMS) on soleus motoneuron pool excitability. Ten healthy humans rhythmically swung the left arm back and forth in a sitting position. The soleus H-reflex was evoked when the arm was in the backward swing phase. Conditioning TMS was delivered over the motor cortex 8 ms before the soleus H-reflex was evoked. The soleus H-reflex amplitude in both legs was depressed by the rhythmic arm swing. In contrast, rhythmic arm swing enhanced the facilitatory effect of conditioning TMS over the motor cortex contralateral to the arm swing side on the soleus H-reflex ipsilateral to the arm swing side. This finding indicates that rhythmic arm swing enhances some polysynaptic facilitatory pathways from the motor cortex contralateral to the arm swing side to the soleus motoneuron pool ipsilateral to the arm swing side.

Altered resting-state effective connectivity of fronto-parietal motor control systems on the primary motor network following stroke

Previous brain imaging work suggests that stroke alters the effective connectivity (the influence neural regions exert upon each other) of motor execution networks. The present study examines the intrinsic effective connectivity of top-down motor control in stroke survivors (n=13) relative to healthy participants (n=12). Stroke survivors exhibited significant deficits in motor function, as assessed by the Fugl-Meyer Motor Assessment. We used structural equation modeling (SEM) of resting-state fMRI data to investigate the relationship between motor deficits and the intrinsic effective connectivity between brain regions involved in motor control and motor execution. An exploratory adaptation of SEM determined the optimal model of motor execution effective connectivity in healthy participants, and confirmatory SEM assessed stroke survivors' fit to that model. We observed alterations in spontaneous resting-state effective connectivity from fronto-parietal guidance systems to the motor network in stroke survivors. More specifically, diminished connectivity was found in connections from the superior parietal cortex to primary motor cortex and supplementary motor cortex. Furthermore, the paths demonstrated large individual variance in stroke survivors but less variance in healthy participants. These findings suggest that characterizing the deficits in resting-state connectivity of top-down processes in stroke survivors may help optimize cognitive and physical rehabilitation therapies by individually targeting specific neural pathway.

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

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

The learning of 90° continuous relative phase with and without Lissajous feedback: external and internally generated bimanual coordination

Results from recent experiments (e.g., Kovacs, Buchanan, & Shea, 2009a-b, 2010a,b) suggest that when salient visual information is presented using Lissajous plots bimanual coordination patterns typically thought to be very difficult to perform without extensive practice can be performed with remarkably low relative phase error and variability with 5min or less of practice. However, when this feedback is removed, performance deteriorates. The purpose of the present experiment was to determine if reducing the frequency of feedback presentation will decrease the participant's reliance on the feedback and will facilitate the development of an internal representation capable of sustaining performance when the Lissajous feedback is withdrawn. The results demonstrated that reduced frequency Lissajous feedback results in very effective bimanual coordination performance on tests with Lissajous feedback available and when feedback is withdrawn. Taken together the present experiments add to the growing literature that supports the notion that salient perceptual information can override some aspects of the system's intrinsic dynamics typically linked to motor output control. Additionally, the present results suggest that the learning of both externally and internally driven bimanual coordination is facilitated by providing reduced frequency Lissajous feedback.

Modeling constraints to redundancy in bimanual force coordination

This study investigated the interactive influence of organismic, environmental, and task constraints on the organization of redundant force coordination patterns and the hypothesis that each of the three categories of constraints is weighted based on their relative influence on coordination patterns and the realization of the task goal. In the bimanual isometric force experiment, the task constraint was manipulated via different coefficients imposed on the finger forces such that the weighted sum of the finger forces matched the target force. We examined three models of task constraints based on the criteria of task variance (minimum variance model) and efficiency of muscle force output (coefficient-independent and coefficient-dependent efficiency models). The environmental constraint was quantified by the perceived performance error, and the organismic constraint was quantified by the bilateral coupling effect (i.e., symmetric force production) between hands. The satisficing approach was used in the models to quantify the constraint weightings that reflect the interactive influence of different categories of constraints on force coordination. The findings showed that the coefficient-dependent efficiency model best predicted the redundant force coordination patterns across trials. However, the within-trial variability structure revealed that there was not a consistent coordination strategy in the online control of the individual trial. The experimental findings and model tests show that the force coordination patterns are adapted based on the principle of minimizing muscle force output that is coefficient dependent rather than on the principle of minimizing signal-dependent variance. Overall, the results support the proposition that redundant force coordination patterns are organized by the interactive influence of different categories of constraints.

Intrasurgical mapping of complex motor function in the superior frontal gyrus

A lesion to the superior frontal gyrus (SFG) has been associated with long-lasting deficits in complex motor functions. The aim of this study was to analyze the functional role of the SFG by means of electrical cortical stimulation. Direct intraoperative electrical stimulation was used in a group of 21 subjects with lesions within or close to the SFG while they performed three motor tasks that require high skills or bimanual synergy. The results were compared to functional magnetic resonance imaging (fMRI). Ninety-four of the 98 (94.9%) labels identified were located on the convexity surface of the SFG and only four (4.1%) labels were located on the middle surface of the SFG. Areas of blockage of the three tasks were identified in six of the 12 (50%) hemispheres with lesions that had infiltrated the SFG, compared to all 10 of the 10 hemispheres (100%) with lesions that spared the SFG. The difference between these two proportions was statistically significant (P=0.015). fMRI activation was mainly located on the medial aspect of the SFG. We show that the convexity surface of the SFG has an important role in bilateral control of complex movements and in bimanual coordination. The infiltration of the posterior part of the SFG by a lesion disturbs some of the complex hand motor functions, which may be assumed by the contralesional homologous area. Finally, the current study emphasizes the discrepancies between fMRI and intraoperative electrical stimulation maps in complex hand motor function.

Understanding higher level gait disturbances in mild dementia in order to improve rehabilitation: 'last in-first out'

Predicting and anticipating disturbances in higher level gait is particularly relevant for patients with dementia as higher level gait appears to be closely related to higher level cognitive functioning. A phenomenon that could contribute to the understanding and prediction of disturbances in higher level gait and gait-related motor activity in the various subtypes of dementia is paraphrased as 'last in-first out'. 'Last in-first out' refers to the principle that neural circuits that mature late in development are the most vulnerable to neurodegeneration. The strength of relating symptoms to the 'last in-first out' principle is that a future symptom can be predicted and anticipated in a therapeutic way, even if the disease process has not already started. Therefore, the aim of this review is to provide new strategies for rehabilitation of higher level gait disturbances in dementia based upon the 'last in-first out' principle. These new strategies emerge from five neural networks: the superior longitudinal fasciculus, the uncinate fasciculus, the fronto-cerebellar and fronto-striatal connections, and the cingulum.

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.

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.

Effects of an intensive, task-specific rehabilitation program for individuals with chronic stroke: a case series

PURPOSE

The purpose of this case series was to determine feasibility and evaluate changes in activity and participation outcomes in persons with chronic stroke after an intensive, task-specific rehabilitation program incorporating whole-body and client-centred interventions.

METHOD

Participants with chronic stroke (N = 12) who were ambulatory and had at least minimal arm/hand function were recruited. The program included whole-body goal-focused activities, gait training and strengthening exercises for 4 h, 5 days per week for 2 weeks. Daily educational sessions and a home activities program were also included. Activity-based measures including the Wolf motor function test, Berg balance scale, timed up and go test and 6-min walk test and participation-based measures including the Stroke Impact Scale and Canadian Occupational Performance Measure were collected at pre-test, immediate post-test and 5-month retention.

RESULTS

The effect of the intervention on participation-based outcomes was much greater than on the activity-based outcomes. Minimal detectable differences in self-perceived participation were reported for most participants.

CONCLUSIONS

The intensive, task-specific intervention was a feasible program for these participants with stroke. Although minimal changes in activity-based outcomes were found, the participants perceived improvements in participation with personal goal-related activities that resulted in large effect sizes that were maintained for 5-months after the intervention.

Disruptions in functional network connectivity during alcohol intoxicated driving

BACKGROUND

Driving while under the influence of alcohol is a major public health problem whose neural basis is not well understood. In a recently published functional magnetic resonance imaging (fMRI) study (Meda et al., 2009), our group identified 5, independent critical driving-associated brain circuits whose inter-regional connectivity was disrupted by alcohol intoxication. However, the functional connectivity between these circuits has not yet been explored in order to determine how these networks communicate with each other during sober and alcohol-intoxicated states.

METHODS

In the current study, we explored such differences in connections between the above brain circuits and driving behavior, under the influence of alcohol versus placebo. Forty social drinkers who drove regularly underwent fMRI scans during virtual reality driving simulations following 2 alcohol doses, placebo and an individualized dose producing blood alcohol concentrations (BACs) of 0.10%.

RESULTS

At the active dose, we found specific disruptions of functional network connectivity between the frontal-temporal-basal ganglia and the cerebellar circuits. The temporal connectivity between these 2 circuits was found to be less correlated (p < 0.05) when driving under the influence of alcohol. This disconnection was also associated with an abnormal driving behavior (unstable motor vehicle steering).

CONCLUSIONS

Connections between frontal-temporal-basal ganglia and cerebellum have recently been explored; these may be responsible in part for maintaining normal motor behavior by integrating their overlapping motor control functions. These connections appear to be disrupted by alcohol intoxication, in turn associated with an explicit type of impaired driving behavior.

Bilateral limb phase relationship and its potential to alter muscle activity phasing during locomotion

It is well established that the sensorimotor state of one limb can influence another limb and therefore bilateral somatosensory inputs make an important contribution to interlimb coordination patterns. However, the relative contribution of interlimb pathways for modifying muscle activation patterns in terms of phasing is less clear. Here we studied adaptation of muscle activity phasing to the relative angular positions of limbs using a split-crank ergometer, where the cranks could be decoupled to allow different spatial angular position relationships. Twenty neurologically healthy individuals performed the specified pedaling tasks at different relative angular positions while surface electromyographic (EMG) signals were recorded bilaterally from eight lower extremity muscles. During each experiment, the relative angular crank positions were altered by increasing or decreasing their difference by randomly ordered increments of 30 degrees over the complete cycle [0 degrees (in phase pedaling); 30, 60, 90, 120, 150, and 180 degrees (standard pedaling); and 210, 240, 270, 300, and 330 degrees out of phase pedaling]. We found that manipulating the relative angular positions of limbs in a pedaling task caused muscle activity phasing changes that were either delayed or advanced, dependent on the relative spatial position of the two cranks and this relationship is well-explained by a sine curve. Further, we observed that the magnitude of phasing changes in biarticular muscles (like rectus femoris) was significantly greater than those of uniarticular muscles (like vastus medialis). These results are important because they provide new evidence that muscle phasing can be systematically influenced by interlimb pathways.

Human bipeds use quadrupedal coordination during locomotion

During evolution, the increased influence of a direct cortical-motoneuronal system in parallel with a more specialized hand function might have replaced phylogenetically older systems that organized locomotor movements. However, recent research indicates that interlimb coordination during human locomotion is organized in a way similar to that in the cat. During locomotion, corticospinal excitation of upper-limb motoneurons is mediated indirectly, via propriospinal neurons in the cervical spinal cord. This allows a task-dependent neuronal linkage of cervical and thoracolumbar propriospinal circuits controlling leg and arm movements during human locomotor activities. During obstacle avoidance steps, an anticipatory quadrupedal limb coordination is up-regulated, with an involvement of proximal arm muscles during the acquisition and performance of this precision locomotor task.

Ipsilateral coordination at preferred rate: effects of age, body side and task complexity

Functional imaging studies have shown that elderly individuals activate widespread additional brain networks, compared to young subjects, when performing motor tasks. However, the parameters that effect this unique neural activation, including the spatial distribution of this activation across hemispheres, are still largely unknown. Here, we examined the effect of task complexity and body side on activation differences between older and younger adults while performing cyclical flexion-extension movements of the ipsilateral hand and foot. In particular, easy (isodirectional) and more difficult (non-isodirectional) coordination patterns were performed with either the left or right body side at a self-selected, comfortable rate. Even in the absence of imposed pacing the older group activated a larger brain network, suggestive of increased attentional deployment for monitoring the spatial relationships between the simultaneously moving segments and enhanced sensory processing and integration. Evidence of age-dependent underactivation was also found in contralateral M1, SMA and bilateral putamen, possibly reflecting a functional decline of the basal ganglia-mesial cortex pathway in the older group. An ANOVA model revealed significant main effects of task complexity and body side. However the interaction of these factors with age did not reach significance. Consequently, we conclude that under self-paced conditions, task complexity and body side did not have a modulatory effect on age-related brain activation.

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

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

The coordination of upper and lower limb movements during gait in healthy and stroke individuals

Human walking involves coordinated movements of all four limbs. The benefits of incorporating arm movements in gait rehabilitation are not known and difficult to investigate in patient populations with poor balance and reduced walking capacity. This study assessed the effect of supported (SUP) versus unsupported (UNSUP) arm movements on the coordination patterns present during walking in individuals with and without a stroke. Ten high functioning stroke subjects and 10 healthy subjects walked on a treadmill while swinging their arms naturally, and while holding onto handles that were either fixed in place or allowed to slide along horizontal handrails. Full-body kinematics were recorded, and arm-leg coordination was quantified using relative phase index, mean relative phase, and cross-correlation of hip and shoulder angle time series. No differences were observed in any measures of coordination between healthy and stroke subjects, indicating that the ability to coordinate arm and leg movements during walking remains preserved in high functioning stroke individuals. Coordination patterns were also unaffected by the use of sliding handrails, suggesting that this paradigm may be a suitable surrogate for natural arm movements if individuals are unable to walk without an external support. Stroke subjects were able to perform arm movements at a faster walking speed when using the handles than they were able to achieve without the handles, indicating that this paradigm may be useful in encouraging arm movements during gait rehabilitation.

Network activation during bimanual movements in humans

The coordination of movement between the upper limbs is a function highly distributed across the animal kingdom. How the central nervous system generates such bilateral, synchronous movements, and how this differs from the generation of unilateral movements, remain uncertain. Electrophysiologic and functional imaging studies support that the activity of many brain regions during bimanual and unimanual movement is quite similar. Thus, the same brain regions (and indeed the same neurons) respond similarly during unimanual and bimanual movements as measured by electrophysiological responses. How then are different motor behaviors generated? To address this question, we studied unimanual and bimanual movements using fMRI and constructed networks of activation using Structural Equation Modeling (SEM). Our results suggest that (1) the dominant hemisphere appears to initiate activity responsible for bimanual movement; (2) activation during bimanual movement does not reflect the sum of right and left unimanual activation; (3) production of unimanual movement involves a network that is distinct from, and not a mirror of, the network for contralateral unimanual movement; and (4) using SEM, it is possible to obtain robust group networks representative of a population and to identify individual networks which can be used to detect subtle differences both between subjects as well as within a single subject over time. In summary, these results highlight a differential role for the dominant and non-dominant hemispheres during bimanual movements, further elaborating the concept of handedness and dominance. This knowledge increases our understanding of cortical motor physiology in health and after neurological damage.

Reliable assessment of lower limb motor representations with fMRI: use of a novel MR compatible device for real-time monitoring of ankle, knee and hip torques

This study describes the use of a novel magnetic resonance imaging (MRI) compatible system capable of measuring isometric ankle, knee and hip joint torques in real-time during functional MRI (fMRI) testing in healthy volunteers. The motor representations of three isometric torques--ankle dorsiflexion, ankle plantarflexion and knee extension--were studied at two time points. The reliability of motor performance and fMRI-derived measures of brain activity across sessions was examined. Reproducible motor performance was observed for each of the tasks; torques of the requested amplitude, assisted by visual feedback, were generated at the relevant joint with good accuracy, both within and across the two sessions. Significant blood oxygen level dependent (BOLD) signal increases were observed in the left primary sensorimotor cortex (SM1) in the paracentral lobule and in secondary motor areas for all tasks. Within these areas there was substantial overlap of the motor representations though differential activation was observed in SM1, with greater activation of inferior paracentral lobule during knee extension than for either ankle task. Also, BOLD signal decreases were observed bilaterally within SM1 in the hand knob region for all tasks. No major session-related effects were identified at the group level. High intraclass correlation coefficients were observed for t-values of voxels in cortical motor areas for each contraction type for individuals, suggesting that fMRI-derived activity across time points was reliable. These findings support the use of this apparatus in serial studies of lower limb function.

Obstacle stepping involves spinal anticipatory activity associated with quadrupedal limb coordination

Obstacle avoidance steps are associated with a facilitation of spinal reflexes in leg muscles. Here we have examined the involvement of both leg and arm muscles. Subjects walking with reduced vision on a treadmill were acoustically informed about an approaching obstacle and received feedback about task performance. Reflex responses evoked by tibial nerve stimulation were observed in all arm and leg muscles examined in this study. They were enhanced before the execution of obstacle avoidance compared with normal steps and showed an exponential adaptation in contralateral arm flexor muscles corresponding to the improvement of task performance. This enhancement was absent when the body was partially supported during the task. During the execution of obstacle steps, electromyographic activity in the arm muscles mimicked the preceding reflex behaviour with respect to enhancement and adaptation. Our results demonstrate an anticipatory quadrupedal limb coordination with an involvement of proximal arm muscles in the acquisition and performance of this precision locomotor task. This is presumably achieved by an up-regulated activity of coupled cervico-thoracal interneuronal circuits.

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.

Coordination constraints during bimanual versus unimanual performance conditions

Coordinated behaviour is prominent during daily life activities in various combinations and degrees of complexity. Here the influence of coordination constraints upon motor behaviour is evaluated by contrasting two-finger tapping (in-phase and anti-phase) during bimanual and unimanual conditions. Cortical dynamics was assessed by means of EEG coherence in the beta frequency band (13-30 Hz) and included intrahemispheric, interhemispheric and midline connectivity patterns. Results showed that intrahemispheric connectivity varied strongly in the different coordination tasks, with left hemisphere dominance for bimanual and right hand coordination versus right hemisphere dominance for left hand coordination. Interhemispheric connectivity was fairly similar across coordination tasks, except for the bimanual in-phase configuration that comprised the lowest coherence scores. Midline connectivity was equivalent across coordination tasks, with exception of the bimanual anti-phase assignment that was characterized with increased coherence scores. Across connectivity regions, the lowest coherence scores were obtained for bimanual and right hand coordination performed in the in-phase mode, underlining their basic mode of functioning. Furthermore by evaluating the coordination effort, estimated by the discrepancy between the coordination task and the sum of the individual components, an increased processing for intrahemispheric and midline connections was observed, but not for interhemispheric connections, which supports the general significance of interhemispheric communication for voluntary movement. Overall the current findings indicate a dynamic modulation of functional connectivity patterns according to the coordinative context. It suggests that brain regions within a motor network flexibly couple and decouple to implement the processing requirements associated with coordinated behaviour.

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.

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

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

Breakdown of inhibitory effects induced by foot motor imagery on hand motor area in lower-limb amputees

OBJECTIVE

Amputation of a limb induces plastic changes in motor cortex that modify the relationships between the missing limb and the remaining body part representations. We used motor imagery to explore the interactions between a missing lower limb and the hand/forearm cortical representations.

METHODS

Eight right leg amputees and nine healthy subjects participated in the study. Focal transcranial magnetic stimulation was used to map out the hand/forearm muscle maps at rest and during imagined ankle dorsiflexion and plantarflexion.

RESULTS

In healthy subjects, both motor imagery tasks strongly inhibited the map volume and contracted the map area of the hand muscles. By contrast, in amputees, imagined dorsiflexion and plantarflexion enhanced the map area and volume of the hand muscles. In the forearm muscle maps, both groups displayed a similar pattern of isodirectional coupling during both motor imagery tasks. Imagined dorsiflexion facilitated MEP amplitudes of the extensor and inhibited the flexor muscles of the upper limb. This pattern was reversed during imagined plantarflexion.

CONCLUSIONS

We argue that there exists an inhibitory relationship between the foot and hand motor cortices that ceases to exist after leg amputation.

SIGNIFICANCE

The understanding of these functional mechanisms may shed light on the motor network underlying interlimb coordination.