Comparison of different methods to identify and quantify balance control

Is the stabilization of quiet upright stance in humans driven by synchronized modulations of the activity of medial and lateral gastrocnemius muscles?

A matrix of 120 electromyogram (EMG) electrodes (8 rows and 15 columns) was used to investigate individual activation patterns of the medial (MG) and lateral gastrocnemius (LG) muscles during forward sways of the body in human quiet stance. This matrix was positioned on the right calf of eight subjects after identification of the MG and LG contours with ultrasound scanning. Gray-scale images were generated with the maxima and minima of the cross-correlation function between the envelope of each EMG signal and the body center of pressure (CoP) for individual forward sways. These images were automatically segmented to reduce the data set into representative and local values of EMG-CoP cross-correlation for each muscle. On average, modulations in EMG amplitude preceded the onset of forward sways with a variable timing, with both gastrocnemius muscles being similarly and synchronously modulated in 193 out of 236 sways. Variations in the timing of activation between muscles were less frequent, although consistent across subjects and significantly correlated with changes in the direction and velocity of body sways. Interestingly, the time shift between EMG and CoP traces sometimes varied consistently along different channels of the same column of electrodes, either in proximal-to-distal or distal-to-proximal direction. The variable EMG-CoP cross-correlation delay was not congruent with the delay expected for the propagation of surface potentials along muscle fibers. Comparison of surface EMGs with intramuscular EMGs recorded from six subjects demonstrated that surface potentials provide high spatial selectivity, thus supporting the notion of selective activation of motor units during quiet standing. Hence, the stabilization of the quiet standing posture likely relies on flexible rather than stereotyped mechanisms of control.

A rigorous model of reflex function indicates that position and force feedback are flexibly tuned to position and force tasks

This study aims to quantify the separate contributions of muscle force feedback, muscle spindle activity and co-contraction to the performance of voluntary tasks ("reduce the influence of perturbations on maintained force or position"). Most human motion control studies either isolate only one contributor, or assume that relevant reflexive feedback pathways during voluntary disturbance rejection tasks originate mainly from the muscle spindle. Human ankle-control experiments were performed, using three task instructions and three perturbation characteristics to evoke a wide range of responses to force perturbations. During position tasks, subjects (n = 10) resisted the perturbations, becoming more stiff than when being relaxed (i.e., the relax task). During force tasks, subjects were instructed to minimize force changes and actively gave way to imposed forces, thus becoming more compliant than during relax tasks. Subsequently, linear physiological models were fitted to the experimental data. Inhibitory, as well as excitatory force feedback, was needed to account for the full range of measured experimental behaviors. In conclusion, force feedback plays an important role in the studied motion control tasks (excitatory during position tasks and inhibitory during force tasks), implying that spindle-mediated feedback is not the only significant adaptive system that contributes to the maintenance of posture or force.

Ankle-foot orthoses in stroke: effects on functional balance, weight-bearing asymmetry and the contribution of each lower limb to balance control

BACKGROUND

Ankle-foot orthoses are often provided to improve walking in stroke patients, although the evidence of effects on walking and balance control is still inconsistent. This could be caused by a lack of insight into the influence of orthoses on the underlying impairments. These impairments can be assessed with dual plate posturography to determine the relative contribution of each lower limb to balance control and weight-bearing. This study examined the effects of ankle-foot orthoses on functional balance, static and dynamic weight-bearing asymmetry and dynamic balance control of the paretic and non-paretic lower limbs.

METHODS

Twenty stroke subjects (time since stroke 5-127 months) completed the study. Subjects were assessed with and without ankle-foot orthosis. Functional balance was assessed using the Berg Balance Scale, Timed Up & Go test, Timed Balance Test, 10-m walking test and Functional Ambulation Categories. Weight-bearing asymmetry and dynamic balance control were assessed with force plates on a movable platform.

FINDINGS

No significant effects of ankle-foot orthoses were found for weight-bearing asymmetry and dynamic balance control, but significant differences in favour of ankle-foot orthosis use were found for most functional tests.

INTERPRETATION

Although ankle-foot orthoses had no effect on weight-bearing asymmetry or dynamic balance contribution of the paretic lower limb, functional tests were performed significantly better with orthoses. Apparently, improvements at functional level cannot be readily attributed to a greater contribution of the paretic lower limb to weight-bearing or balance control. This finding suggests that ankle-foot orthoses influence compensatory mechanisms.

Stiffness and damping in postural control increase with age

Upright balance is believed to be maintained through active and passive mechanisms, both of which have been shown to be impacted by aging. A compensatory balance response often observed in older adults is increased co-contraction, which is generally assumed to enhance stability by increasing joint stiffness. We investigated the effect of aging on standing balance by fitting body sway data to a previously developed postural control model that includes active and passive stiffness and damping parameters. Ten young (24 +/- 3 years) and seven older (75 +/- 5 years) adults were exposed during eyes-closed stance to perturbations consisting of lateral pseudorandom floor tilts. A least-square fit of the measured body sway data to the postural control model found significantly larger active stiffness and damping model parameters in the older adults. These differences remained significant even after normalizing to account for different body sizes between the young and older adult groups. An age effect was also found for the normalized passive stiffness, but not for the normalized passive damping parameter. This concurrent increase in active stiffness and damping was shown to be more stabilizing than an increase in stiffness alone, as assessed by oscillations in the postural control model impulse response.

Comparison of human and humanoid robot control of upright stance

There is considerable recent interest in developing humanoid robots. An important substrate for many motor actions in both humans and biped robots is the ability to maintain a statically or dynamically stable posture. Given the success of the human design, one would expect there are lessons to be learned in formulating a postural control mechanism for robots. In this study we limit ourselves to considering the problem of maintaining upright stance. Human stance control is compared to a suggested method for robot stance control called zero moment point (ZMP) compensation. Results from experimental and modeling studies suggest there are two important subsystems that account for the low- and mid-frequency (DC to approximately 1Hz) dynamic characteristics of human stance control. These subsystems are (1) a "sensory integration" mechanism whereby orientation information from multiple sensory systems encoding body kinematics (i.e. position, velocity) is flexibly combined to provide an overall estimate of body orientation while allowing adjustments (sensory re-weighting) that compensate for changing environmental conditions and (2) an "effort control" mechanism that uses kinetic-related (i.e., force-related) sensory information to reduce the mean deviation of body orientation from upright. Functionally, ZMP compensation is directly analogous to how humans appear to use kinetic feedback to modify the main sensory integration feedback loop controlling body orientation. However, a flexible sensory integration mechanism is missing from robot control leaving the robot vulnerable to instability in conditions where humans are able to maintain stance. We suggest the addition of a simple form of sensory integration to improve robot stance control. We also investigate how the biological constraint of feedback time delay influences the human stance control design. The human system may serve as a guide for improved robot control, but should not be directly copied because the constraints on robot and human control are different.

Vestibular humanoid postural control

Many of our motor activities require stabilization against external disturbances. This especially applies to biped stance since it is inherently unstable. Disturbance compensation is mainly reactive, depending on sensory inputs and real-time sensor fusion. In humans, the vestibular system plays a major role. When there is no visual space reference, vestibular-loss clearly impairs stance stability. Most humanoid robots do not use a vestibular system, but stabilize upright body posture by means of center of pressure (COP) control. We here suggest using in addition a vestibular sensor and present a biologically inspired vestibular sensor along with a human-inspired stance control mechanism. We proceed in two steps. First, in an introductory review part, we report on relevant human sensors and their role in stance control, focusing on own models of transmitter fusion in the vestibular sensor and sensor fusion in stance control. In a second, experimental part, the models are used to construct an artificial vestibular system and to embed it into the stance control of a humanoid. The robot's performance is investigated using tilts of the support surface. The results are compared to those of humans. Functional significance of the vestibular sensor is highlighted by comparing vestibular-able with vestibular-loss states in robot and humans. We show that a kinematic body-space sensory feedback (vestibular) is advantageous over a kinetic one (force cues) for dynamic body-space balancing. Our embodiment of human sensorimotor control principles into a robot is more than just bionics. It inspired our biological work (neurorobotics: 'learning by building', proof of principle, and more). We envisage a future clinical use in the form of hardware-in-the-loop simulations of neurological symptoms for improving diagnosis and therapy and designing medical assistive devices.

Muscle weakness and lack of reflex gain adaptation predominate during post-stroke posture control of the wrist

Background

Instead of hyper-reflexia as sole paradigm, post-stroke movement disorders are currently considered the result of a complex interplay between neuronal and muscular properties, modified by level of activity. We used a closed loop system identification technique to quantify individual contributors to wrist joint stiffness during an active posture task.

Methods

Continuous random torque perturbations applied to the wrist joint by a haptic manipulator had to be resisted maximally. Reflex provoking conditions were applied i.e. additional viscous loads and reduced perturbation signal bandwidth. Linear system identification and neuromuscular modeling were used to separate joint stiffness into the intrinsic resistance of the muscles including co-contraction and the reflex mediated contribution.

Results

Compared to an age and sex matched control group, patients showed an overall 50% drop in intrinsic elasticity while their reflexive contribution did not respond to provoking conditions. Patients showed an increased mechanical stability compared to control subjects.

Conclusion

Post stroke, we found active posture tasking to be dominated by: 1) muscle weakness and 2) lack of reflex adaptation. This adds to existing doubts on reflex blocking therapy as the sole paradigm to improve active task performance and draws attention to muscle strength and power recovery and the role of the inability to modulate reflexes in post stroke movement disorders.

A model of postural control in quiet standing: robust compensation of delay-induced instability using intermittent activation of feedback control

The main purpose of this study is to compare two different feedback controllers for the stabilization of quiet standing in humans, taking into account that the intrinsic ankle stiffness is insufficient and that there is a large delay inducing instability in the feedback loop: 1) a standard linear, continuous-time PD controller and 2) an intermittent PD controller characterized by a switching function defined in the phase plane, with or without a dead zone around the nominal equilibrium state. The stability analysis of the first controller is carried out by using the standard tools of linear control systems, whereas the analysis of the intermittent controllers is based on the use of Poincaré maps defined in the phase plane. When the PD-control is off, the dynamics of the system is characterized by a saddle-like equilibrium, with a stable and an unstable manifold. The switching function of the intermittent controller is implemented in such a way that PD-control is 'off' when the state vector is near the stable manifold of the saddle and is 'on' otherwise. A theoretical analysis and a related simulation study show that the intermittent control model is much more robust than the standard model because the size of the region in the parameter space of the feedback control gains (P vs. D) that characterizes stable behavior is much larger in the latter case than in the former one. Moreover, the intermittent controller can use feedback parameters that are much smaller than the standard model. Typical sway patterns generated by the intermittent controller are the result of an alternation between slow motion along the stable manifold of the saddle, when the PD-control is off, and spiral motion away from the upright equilibrium determined by the activation of the PD-control with low feedback gains. Remarkably, overall dynamic stability can be achieved by combining in a smart way two unstable regimes: a saddle and an unstable spiral. The intermittent controller exploits the stabilizing effect of one part of the saddle, letting the system evolve by alone when it slides on or near the stable manifold; when the state vector enters the strongly unstable part of the saddle it switches on a mild feedback which is not supposed to impose a strict stable regime but rather to mitigate the impending fall. The presence of a dead zone in the intermittent controller does not alter the stability properties but improves the similarity with biological sway patterns. The two types of controllers are also compared in the frequency domain by considering the power spectral density (PSD) of the sway sequences generated by the models with additive noise. Different from the standard continuous model, whose PSD function is similar to an over-damped second order system without a resonance, the intermittent control model is capable to exhibit the two power law scaling regimes that are typical of physiological sway movements in humans.

Optimal motor control may mask sensory dynamics

Properties of neural controllers for closed-loop sensorimotor behavior can be inferred with system identification. Under the standard paradigm, the closed-loop system is perturbed (input), measurements are taken (output), and the relationship between input and output reveals features of the system under study. Here we show that under common assumptions made about such systems (e.g. the system implements optimal control with a penalty on mechanical, but not sensory, states) important aspects of the neural controller (its zeros mask the modes of the sensors) remain hidden from standard system identification techniques. Only by perturbing or measuring the closed-loop system "between" the sensor and the control can these features be exposed with closed-loop system identification methods; while uncommon, there exist noninvasive techniques such as galvanic vestibular stimulation that perturb between sensor and controller in this way.

Potential roles of force cues in human stance control

Human stance is inherently unstable. A small deviation from upright body orientation is enough to yield a gravitational component in the ankle joint torque, which tends to accelerate the body further away from upright ('gravitational torque'; magnitude is related to body-space lean angle). Therefore, to maintain a given body lean position, a corresponding compensatory torque must be generated. It is well known that subjects use kinematic sensory information on body-space lean from the vestibular system for this purpose. Less is known about kinetic cues from force/torque receptors. Previous work indicated that they are involved in compensating external contact forces such as a pull or push having impact on the body. In this study, we hypothesized that they play, in addition, a role when the vestibular estimate of the gravitational torque becomes erroneous. Reasons may be sudden changes in body mass, for instance by a load, or an impairment of the vestibular system. To test this hypothesis, we mimicked load effects on the gravitational torque in normal subjects and in patients with chronic bilateral vestibular loss (VL) with eyes closed. We added/subtracted extra torque to the gravitational torque by applying an external contact force (via cable winches and a body harness). The extra torque was referenced to body-space lean, using different proportionality factors. We investigated how it affected body-space lean responses that we evoked using sinusoidal tilts of the support surface (motion platform) with different amplitudes and frequencies (normals +/-1 degrees, +/-2 degrees, and +/-4 degrees at 0.05, 0.1, 0.2, and 0.4 Hz; patients +/-1 degrees and +/-2 degrees at 0.05 and 0.1 Hz). We found that added/subtracted extra torque scales the lean response in a systematic way, leading to increase/decrease in lean excursion. Expressing the responses in terms of gain and phase curves, we compared the experimental findings to predictions obtained from a recently published sensory feedback model. For the trials in which the extra torque tended to endanger stance control, predictions in normals were better when the model included force cues than without these cues. This supports our notion that force cues provide an automatic 'gravitational load compensation' upon changes in body mass in normals. The findings in the patients support our notion that the presumed force cue mechanism provides furthermore vestibular loss compensation. Patients showed a body-space stabilization that cannot be explained by ankle angle proprioception, but must involve graviception, most likely by force cues. Our findings suggest that force cues contribute considerably to the redundancy and robustness of the human stance control system.

The Dynamics of Postural Sway Cannot Be Captured Using a One-Segment Inverted Pendulum Model: A PCA on Segment Rotations During Unperturbed Stance

Research on unperturbed stance is largely based on a one-segment inverted pendulum model. Recently, an increasing number of studies report a contribution of other major joints to postural control. Therefore this study evaluates whether the conclusions originating from the research based on a one-segment model adequately capture postural sway during unperturbed stance. High-pass filtered kinematic data (cutoff frequency 1/30 Hz) obtained over 3 min of unperturbed stance were analyzed in different ways. Variance of joint angles was analyzed. Principal-component analysis (PCA) was performed on the variance of lower leg, upper leg, and head–arms–trunk (HAT) angles, as well as on lower leg and COM angle (the orientation of the line from ankle joint to center of mass). It was found that the variance in knee and hip joint angles did not differ from the variance found in the ankle angle. The first PCA component indicated that, generally, the upper leg and HAT segments move in the same direction as the lower leg with a somewhat larger amplitude. The first PCA component relating ankle angle variance and COM angle variance indicated that the ankle joint angle displacement gives a good estimate of the COM angle displacement. The second PCA component on the segment angles partly explains the apparent discrepancy between these findings because this component points to a countermovement of the HAT relative to the ankle joint angle. It is concluded that postural control during unperturbed stance should be analyzed in terms of a multiple inverted pendulum model.

Identification of the plant for upright stance in humans: multiple movement patterns from a single neural strategy

We determined properties of the plant during human upright stance using a closed-loop system identification method originally applied to human postural control by another group. To identify the plant, which was operationally defined as the mapping from muscle activation (rectified EMG signals) to body segment angles, we rotated the visual scene about the axis through the subject's ankles using a sum-of-sines stimulus signal. Because EMG signals from ankle muscles and from hip and lower trunk muscles showed similar responses to the visual perturbation across frequency, we combined EMG signals from all recorded muscles into a single plant input. Body kinematics were described by the trunk and leg angles in the sagittal plane. The phase responses of both angles to visual scene angle were similar at low frequencies and approached a difference of approximately 150 degrees at higher frequencies. Therefore we considered leg and trunk angles as separate plant outputs. We modeled the plant with a two-joint (ankle and hip) model of the body, a second-order low-pass filter from EMG activity to active joint torques, and intrinsic stiffness and damping at both joints. The results indicated that the in-phase (ankle) pattern was neurally generated, whereas the out-of-phase pattern was caused by plant dynamics. Thus a single neural strategy leads to multiple kinematic patterns. Moreover, estimated intrinsic stiffness in the model was insufficient to stabilize the plant.

Modeling sensorimotor control of human upright stance

We model human postural control of upright stance during external disturbances and voluntary lean. Our focus is on how data from various sensors are combined to estimate these disturbances. Whereas most current engineering models of multisensory estimation rely on "internal observers" and complex processing, we compute our estimates by simple sensor fusion mechanisms, i.e., weighted sums of sensory signals combined with thresholds. We show with simulations that this simple device mimics human-like postural behavior in a wide range of situations and diseases. We have now embodied our mechanism in a biped humanoid robot to show that it works in the real world with complex, noisy, and imperfectly known sensors and effectors. On the other hand, we find that the more complex, internal-observer approach, when applied to bipedal posture, can also yield human-like behavior. We suggest that humans use both mechanisms: simple, fast sensor fusions with thresholding for automatic reactions (default mechanism), and more complex methods for voluntary movements. We suggest also that the fusion with thresholding mechanisms are optimized during phylogenesis but are mainly hardwired in any one organism, whereas sensorimotor learning and optimization is mainly a domain of the internal observers.

Application of a bi-planar postural stability model in children with cerebral palsy

This study presents initial results from a bi-planar model used to investigate the neurological factors affecting balance deficits in children with diplegic cerebral palsy (CP). The model uses an inverted pendulum to describe sway in both the anteroposterior (AP) and mediolateral (ML) planes. The study presents Center of Pressure (COP) data from 17 children diagnosed with spastic diplegic CP using two standard AMTI force plates. Sway metrics in the time and frequency domains in the AP and ML planes were calculated and compared to simulations produced by the model. The proposed bi-planar model successfully reproduced sway signals acquired from experimental (clinical) data.

Comparison of standing balance between female collegiate dancers and soccer players

STUDY DESIGN

This study was designed as a comparison study of two cohorts.

OBJECTIVES

The hypothesis of this study was that soccer players and dancers have different balance abilities and that these differences could be objectively measured using center of pressure measurements.

BACKGROUND

Center of pressure (COP) measurements are reproducible and have been validated in the literature for assessing standing balance. The literature does not provide sensitive enough techniques for discriminating between two groups of athletes with excellent standing balance.

METHODS AND MEASURES

A Matscan pressure mat (Tekscan, Boston, MA) was used to compare COP change variability between 32 female collegiate soccer players and 32 dancers. COP was used to calculate sway index, center acquisition time, sway path length and sway velocity as measures of standing balance.

RESULTS

The dancers had significantly better balance scores (p<0.05) in 5 of 20 balance tests. Results for the remaining 15 balance tests were not significantly different.

CONCLUSION

These data show that standing balance characteristics of dancers and soccer players can be objectively measured using COP data. Dancers have certain standing balance abilities that are better than those of soccer players. The COP measurements in this study can be used as a tool in future studies investigating standing balance in different groups of athletes.

Detecting asymmetries in balance control with system identification: first experimental results from Parkinson patients

Cognitive processes can influence balance in various ways, but not all changes in postural performance can easily be identified with the naked clinical eye. Various studies have shown that dynamic posturography is able to detect more subtle changes in balance control. For patients with Parkinson's disease (which is typically an asymmetric disease), changes in the symmetry of balance control might provide a sensitive measure of cognitive influences on balance. Here, we describe a new posturography technique that combines dynamic platform perturbations with system identification techniques to detect such asymmetries in balance control of two patients with Parkinson's disease. Results were compared to those of six healthy controls. Our pilot data show clear asymmetries in dynamic balance control, even though patients themselves were not aware of this and had no subjective problems with stability or standing. We also found asymmetries in weight bearing, but the asymmetries in dynamic balance contribution were larger. Finally, asymmetries in weight bearing and dynamic balance in patients were not tightly coupled as in healthy controls. Future studies could incorporate this approach when examining the influence of mental decline on postural regulation.

Pharmacological Characterization of the Muscarinic Agonist (3R,4R)-3-(3-Hexylsulfanyl-pyrazin-2-yloxy)-1-aza-bicyclo[2.2.1]heptane (WAY-132983) in in Vitro and in Vivo Models of Chronic Pain

Here, we have investigated the in vitro pharmacology of a muscarinic agonist, (3R,4R)-3-(3-hexylsulfanyl-pyrazin-2-yloxy)-1-aza-bicyclo[2.2.1]heptane (WAY-132983), and we demonstrated its activity in several models of pain. WAY-132983 had a similar affinity for the five muscarinic receptors (9.4-29.0 nM); however, in calcium mobilization studies it demonstrated moderate selectivity for M(1) (IC(50) = 6.6 nM; E(max) = 65% of 10 muM carbachol-stimulation) over the M(3) (IC(50) = 23 nM; E(max) = 41%) and M(5) receptors (IC(50) = 300 nM; E(max) = 18%). WAY-132983 also activated the M(4) receptor, fully inhibiting forskolin-induced increase in cAMP levels (IC(50) = 10.5 nM); at the M(2) receptor its potency was reduced by 5-fold (IC(50) = 49.8 nM). In vivo, WAY-132983 demonstrated good systemic bioavailability and high brain penetration (>20-fold over plasma levels). In addition, WAY-1329823 produced potent and efficacious antihyperalgesic and antiallodynic effects in rodent models of chemical irritant, chronic inflammatory, neuropathic, and incisional pain. It is noteworthy that efficacy in these models was observed at doses that did not produce analgesia or ataxia. Furthermore, a series of antagonist studies demonstrated that the in vivo activity of WAY-132983 is mediated through activation of muscarinic receptors primarily through the M(4) receptor. The data presented herein suggest that muscarinic agonists, such as WAY-132983, may have a broad therapeutic efficacy for the treatment of pain.

Postural responses evoked by platform pertubations are dominated by continuous feedback

Is human balance control dominated by time invariant continuous feedback mechanisms or do noncontinuous mechanisms play a significant role like intermittent control? The goal of this paper is to quantify how much of the postural responses evoked by pseudorandom external periodic perturbations can be explained by continuous time invariant feedback control. Nine healthy subjects participated in this study. Center of mass and ankle torque responses were elicited by periodic platform perturbations in forward-backward directions containing energy in the 0.06- to 4.5-Hz frequency band. Subjects had their eyes open (EO) or eyes closed (EC). Responses were decomposed into a periodic component and a remnant (stochastic) component using spectral analysis. It is concluded that periodic responses can explain most of the evoked responses, although the remnant power spectral densities (PSDs) were significant especially for slow responses (<0.2 Hz) and largest for EC. The found remnant PSD did depend on the sensory condition but not on the platform perturbation amplitude. The ratio of the body sway and ankle torque remnant PSD reflects the body dynamics. Both findings are consistent with the idea that estimation of body orientation is part of a continuous feedback loop and that (stochastic) estimation errors increase when one source of sensory information is removed. The findings are not consistent with the idea that discrete or discontinuous intermittent feedback mechanisms significantly shape postural responses.

Differential and synergistic effects of selective norepinephrine and serotonin reuptake inhibitors in rodent models of pain

There is increasing recognition that norepinephrine (NE) and serotonin (5-HT) reuptake inhibitors (NRIs and SRIs) are efficacious in treating some types of pain. To date, studies have not systematically evaluated the relative activity at the NE and/or 5-HT transporter required for maximal efficacy in rodent pain models. Known selective NE and 5-HT reuptake inhibitors reboxetine, desipramine, fluoxetine, and paroxetine were evaluated in both in vitro and in vivo assays. Using the spinal nerve ligation model of neuropathic pain, the compounds differentially reversed tactile allodynia. Evaluation of a broader spectrum of reuptake inhibitors in the para-phenylquinone (PPQ)-induced abdominal constriction model, a model of acute visceral pain, demonstrated that both the SRIs and the NRIs significantly blocked abdominal constrictions. However, the magnitude of this effect was greater following treatment with compounds having greater affinity for NRI compared with SRI affinity. In addition, isobolographic analyses indicated significant synergistic effects for all combinations of desipramine and fluoxetine in the PPQ model of visceral pain. Collectively, the present results support the hypothesis that compounds with greater NRI activity should be more effective for the treatment of pain than compounds having only SRI activity, and this hypothesis is also supported by clinical data. These studies also suggest that the potency and effectiveness of NRIs might be enhanced by the presence of 5-HT activity.

Cannabinoid (CB1) receptor activation inhibits trigeminovascular neurons

Migraine is a common and disabling neurological disorder that involves activation or the perception of activation of the trigeminovascular system. Cannabinoid (CB) receptors are present in brain and have been suggested to be antinociceptive. Here we determined the effect of cannabinoid receptor activation on neurons with trigeminovascular nociceptive input in the rat. Neurons in the trigeminocervical complex (TCC) were studied using extracellular electrophysiological techniques. Responses to both dural electrical stimulation and cutaneous facial receptive field activation of the ophthalmic division of the trigeminal nerve and the effect of cannabinoid agonists and antagonists were studied. Nonselective CB receptor activation with R(+)-[2,3-dihydro-5-methyl-3-[(morpholinyl)methyl]pyrrolo[1,2, 3-de]-1,4-benzoxazin-yl]-(1-naphthalenyl) (WIN55,212; 1 mg kg(-1)) inhibited neuronal responses to A-(by 52%) and C-fiber (by 44%) afferents, an effect blocked by the CB(1) receptor antagonist SR141716 [N-(piperidin-1-yl)-5-(4-chlorophenyl)-1-(2,4-dichlorophenyl)-4-methyl-1H-pyrazole-3-carboxamide; 3 mg kg(-1)] but not the CB2 receptor antagonist AM630 (6-iodopravadoline; 3 mg kg(-1)). Anandamide (10 mg kg(-1)) was able to inhibit both A- and C-fiber-elicited TCC firing, only after transient receptor potential vanilloid 1 receptor inhibition. Activation of cannabinoid receptors had no effect on cutaneous receptive fields when recorded from TCC neurons. The data show that manipulation of CB1 receptors can affect the responses of trigeminal neurons with A- and C-fiber inputs from the dura mater. This may be a direct effect on neurons in the TCC itself or an effect in discrete areas of the brain that innervate these neurons. The data suggest that CB receptors may have therapeutic potential in migraine, cluster headache, or other primary headaches, although the potential hazards of psychoactive side effects that accompany cannabinoid treatments may be complex to overcome.

The frequency of human, manual adjustments in balancing an inverted pendulum is constrained by intrinsic physiological factors

While standing naturally and when manually or pedally balancing an equivalent inverted pendulum, the load sways slowly (characteristic unidirectional duration approximately 1 s) and the controller, calf muscles or hand, makes more frequent adjustments (characteristic unidirectional duration 400 ms). Here we test the hypothesis that these durations reflect load properties rather than some intrinsic property of the human neuromuscular system. Using a specialized set-up mechanically analogous to real standing, subjects manually balanced inverted pendulums with different moments of inertia through a compliant spring representing the Achilles tendon. The spring bias was controlled by a sensitive joystick via a servo motor and accurate visual feedback was provided on an oscilloscope. As moment of inertia decreased, inverted pendulum sway size increased and it became difficult to sustain successful balance. The mean duration of unidirectional balance adjustments did not change. Moreover, the mean duration of unidirectional inverted pendulum sway reduced only slightly, remaining around 1 s. The simplest explanation is that balance was maintained by a process of manual adjustments intrinsically limited to a mean frequency of two to three unidirectional adjustments per second corresponding to intermittent control observed in manual tracking experiments. Consequently the inverted pendulum sway duration, mechanically related to the bias duration, reflects an intrinsic constraint of the neuromuscular control system. Given the similar durations of sway and muscle adjustments observed in real standing, we postulate that the characteristic duration of unidirectional standing sway reflects intrinsic intermittent control rather than the inertial properties of the body.

Design of a torque-controlled manipulator to analyse the admittance of the wrist joint

This paper describes the design of a torque-controlled manipulator to identify the dynamics of the wrist joint. With torque disturbances, the subject can actively control the joint angle, giving a natural task. The application of a hybrid haptic controller guarantees linearity over a large bandwidth and adjustable virtual dynamics. The haptic controller has a bandwidth of 50 Hz, meaning that the virtual dynamics are realistically felt at up to 50 Hz. To let the subject 'feel' the torque, disturbances as well as possible the apparent, or virtual, dynamics of the device must be small. The minimal apparent inertia of the device is 1.6 g m(2), which is of the same order as for a normal wrist, and the minimal damping and stiffness are negligible. To judge the accuracy of the manipulator, loads of known physical properties were attached and their parameters were quantified. The parameters of the loads were estimated with a maximum error of 5%. As the eigenfrequency of a (co)-contracted human wrist is approximately 15 Hz, the 50-Hz bandwidth of the haptic device is sufficient to measure all relevant dynamics of the human wrist. With this device, the dynamics of the human wrist joint can be measured under varying virtual dynamics, as well as the effect of neurological dysfunction on human motor control, for example.

Combined sagittal and coronal plane postural stability model

We present a preliminary study of combined anterior posterior (AP) and medial lateral (ML) sway assuming a classic inverted pendulum with included subtalar movement. Based on a feedback control posture model in the sagittal plane as presented by Maurer and Peterka, we have investigated parameters needed to model ML sway components. Center of pressure (COP) data was collected from a population of 8 normal adults (age 18 to 30 years) using a dual AMTI force plate system. Fourteen different sway metrics were calculated. The collected data was successfully compared to numerous simulations of the model where model parameters were varied and the goal was to reproduce both AP and ML components.

Multisensory control of human upright stance

The interaction of different orientation senses contributing to posture control is not well understood. We therefore performed experiments in which we measured the postural responses of normal subjects and vestibular loss patients during perturbation of their stance. Subjects stood on a motion platform with their eyes closed and auditory cues masked. The perturbing stimuli consisted of either platform tilts or external torque produced by force-controlled pull of the subjects' body on a stationary platform. Furthermore, we presented trials in which these two stimuli were applied when the platform was body-sway referenced (i.e., coupled 1:1 to body position, by which ankle joint proprioceptive feedback is essentially removed). We analyzed subjects' postural responses, i.e., the excursions of their center of mass (COM) and center of pressure (COP), using a systems analysis approach. We found gain and phase of the responses to vary as a function of stimulus frequency and in relation to the absence versus presence of vestibular and proprioceptive cues. In addition, gain depended on stimulus amplitude, reflecting a non-linearity in the control. The experimental results were compared to simulation results obtained from an 'inverted pendulum' model of posture control. In the model, sensor fusion mechanisms yield internal estimates of the external stimuli, i.e., of the external torque (pull), the platform tilt and gravity. These estimates are derived from three sensor systems: ankle proprioceptors, vestibular sensors and plantar pressure sensors (somatosensory graviceptors). They are fed as global set point signals into a local control loop of the ankle joints, which is based on proprioceptive negative feedback. This local loop stabilizes the body-on-foot support, while the set point signals upgrade the loop into a body-in-space control. Amplitude non-linearity was implemented in the model in the form of central threshold mechanisms. In model simulations that combined sensor fusion and thresholds, an automatic context-specific sensory re-weighting across stimulus conditions occurred. Model parameters were identified using an optimization procedure. Results suggested that in the sway-referenced condition normal subjects altered their postural strategy by strongly weighting feedback from plantar somatosensory force sensors. Taking this strategy change into account, the model's simulation results well paralleled all experimental results across all conditions tested.

Cross-correlation between EMG and center of gravity during quiet stance: theory and simulations

Several signal processing tools have been employed in the experimental study of the postural control system in humans. Among them, the cross-correlation function has been used to analyze the time relationship between signals such as the electromyogram and the horizontal projection of the center of gravity. The common finding is that the electromyogram precedes the biomechanical signal, a result that has been interpreted in different ways, for example, the existence of feedforward control or the preponderance of a velocity feedback. It is shown here, analytically and by simulation, that the cross-correlation function is dependent in a complicated way on system parameters and on noise spectra. Results similar to those found experimentally, e.g., electromyogram preceding the biomechanical signal may be obtained in a postural control model without any feedforward control and without any velocity feedback. Therefore, correct interpretations of experimentally obtained cross-correlation functions may require additional information about the system. The results extend to other biomedical applications where two signals from a closed loop system are cross-correlated.