Aging effects on the resting state motor network and interlimb coordination

Sensorimotor Impairment in Aging and Neurocognitive Disorders: Beat Synchronization and Adaptation to Tempo Changes

Background

Understanding the nature and extent of sensorimotor decline in aging individuals and those with neurocognitive disorders (NCD), such as Alzheimer's disease, is essential for designing effective music-based interventions. Our understanding of rhythmic functions remains incomplete, particularly in how aging and NCD affect sensorimotor synchronization and adaptation to tempo changes.

Objective

This study aimed to investigate how aging and NCD severity impact tapping to metronomes and music, with and without tempo changes.

Methods

Patients from a memory clinic participated in a tapping task, synchronizing with metronomic and musical sequences, some of which contained sudden tempo changes. After exclusions, 51 patients were included in the final analysis.

Results

Participants' Mini-Mental State Examination scores were associated with tapping consistency. Additionally, age negatively influenced consistency when synchronizing with a musical beat, whereas consistency remained stable across age when tapping with a metronome.

Conclusions

The results indicate that the initial decline of attention and working memory with age may impact perception and synchronization to a musical beat, whereas progressive NCD-related cognitive decline results in more widespread sensorimotor decline, affecting tapping irrespective of audio type. These findings underline the importance of customizing rhythm-based interventions to the needs of older adults and individuals with NCD, taking into consideration their cognitive as well as their rhythmic aptitudes.

Aging exerts a limited influence on the perception of self-generated and externally generated touch

Touch generated by our voluntary movements is attenuated both at the perceptual and neural levels compared with touch of the same intensity delivered to our body by another person or machine. This somatosensory attenuation phenomenon relies on the integration of somatosensory input and predictions about the somatosensory consequences of our actions. Previous studies have reported increased somatosensory attenuation in elderly people, proposing an overreliance on sensorimotor predictions to compensate for age-related declines in somatosensory perception; however, recent results have challenged this direct relationship. In a preregistered study, we used a force-discrimination task to assess whether aging increases somatosensory attenuation and whether this increase is explained by decreased somatosensory precision in elderly individuals. Although 94% of our sample (n = 108, 21-77 yr old) perceived their self-generated touches as weaker than externally generated touches of identical intensity (somatosensory attenuation) regardless of age, we did not find a significant increase in somatosensory attenuation in our elderly participants (65-77 yr old), but a trend when considering only the oldest subset (69-77 yr old). Moreover, we did not observe a significant age-related decline in somatosensory precision or a significant relationship of age with somatosensory attenuation. Together, our results suggest that aging exerts a limited influence on the perception of self-generated and externally generated touch and indicate a less direct relationship between somatosensory precision and attenuation in the elderly individuals than previously proposed.NEW & NOTEWORTHY Self-generated touch is attenuated compared with externally generated touch of identical intensity. This somatosensory attenuation has been previously shown to be increased in elderly participants, but it remains unclear whether it is related to age-related somatosensory decline. In our preregistered study, we observed a trend for increased somatosensory attenuation in our oldest participants (≥69 yr), but we found no evidence of an age-related decline in somatosensory function or a relationship of age with somatosensory attenuation.

Telomere length and brain imaging phenotypes in UK Biobank

Telomeres form protective caps at the ends of chromosomes, and their attrition is a marker of biological aging. Short telomeres are associated with an increased risk of neurological and psychiatric disorders including dementia. The mechanism underlying this risk is unclear, and may involve brain structure and function. However, the relationship between telomere length and neuroimaging markers is poorly characterized. Here we show that leucocyte telomere length (LTL) is associated with multi-modal MRI phenotypes in 31,661 UK Biobank participants. Longer LTL is associated with: i) larger global and subcortical grey matter volumes including the hippocampus, ii) lower T1-weighted grey-white tissue contrast in sensory cortices, iii) white-matter microstructure measures in corpus callosum and association fibres, iv) lower volume of white matter hyperintensities, and v) lower basal ganglia iron. Longer LTL was protective against certain related clinical manifestations, namely all-cause dementia (HR 0.93, 95% CI: 0.91-0.96), but not stroke or Parkinson's disease. LTL is associated with multiple MRI endophenotypes of neurodegenerative disease, suggesting a pathway by which longer LTL may confer protective against dementia.

No evidence for a difference in lateralization and distinctiveness level of transcranial magnetic stimulation-derived cortical motor representations over the adult lifespan

This study aimed to investigate the presence and patterns of age-related differences in TMS-based measures of lateralization and distinctiveness of the cortical motor representations of two different hand muscles. In a sample of seventy-three right-handed healthy participants over the adult lifespan, the first dorsal interosseus (FDI) and abductor digiti minimi (ADM) cortical motor representations of both hemispheres were acquired using transcranial magnetic stimulation (TMS). In addition, dexterity and maximum force levels were measured. Lateralization quotients were calculated for homolog behavioral and TMS measures, whereas the distinctiveness between the FDI and ADM representation within one hemisphere was quantified by the center of gravity (CoG) distance and cosine similarity. The presence and patterns of age-related changes were examined using linear, polynomial, and piecewise linear regression. No age-related differences could be identified for the lateralization quotient of behavior or cortical motor representations of both intrinsic hand muscles. Furthermore, no evidence for a change in the distinctiveness of the FDI and ADM representation with advancing age was found. In conclusion this work showed that lateralization and distinctiveness of cortical motor representations, as determined by means of TMS-based measures, remain stable over the adult lifespan.

Network-specific differences in transient brain activity at rest are associated with age-related reductions in motor performance

Multiple functional changes occur in the brain with increasing age. Among those, older adults typically display more restricted fluctuations of brain activity, both during resting-state and task execution. These altered dynamic patterns have been linked to reduced task performance across multiple behavioral domains. Windowed functional connectivity, which is typically employed in the study of connectivity dynamics, however, might not be able to properly characterize moment-to-moment variations of individual networks. In the present study, we used innovation-driven co-activation patterns (ICAP) to overcome this limitation and investigate the length (duration) and frequency (innovation) in which various brain networks emerged across the adult lifespan (N= 92) during a resting-state period. We identified a link between increasing age and a tendency to engage brain areas with distinct functional associations simultaneously as a single network. The emergence of isolated and spatially well-defined visual, motor, frontoparietal, and posterior networks decreased with increased age. This reduction in dynamics of specialized networks mediated age-related performance decreases (i.e., increases in interlimb interference) in a bimanual motor task. Altogether, our findings demonstrated that older compared to younger adults tend to activate fewer network configurations, which include multiple functionally distinct brain areas. The reduction in independent emergence of functionally well-defined and task-relevant networks may reflect an expression of brain dedifferentiation and is likely associated with functional modulatory deficits, negatively impacting motor behavior.

Brain Structural and Functional Connectivity: A Review of Combined Works of Diffusion Magnetic Resonance Imaging and Electro-Encephalography

Implications of structural connections within and between brain regions for their functional counterpart are timely points of discussion. White matter microstructural organization and functional activity can be assessed in unison. At first glance, however, the corresponding findings appear variable, both in the healthy brain and in numerous neuro-pathologies. To identify consistent associations between structural and functional connectivity and possible impacts for the clinic, we reviewed the literature of combined recordings of electro-encephalography (EEG) and diffusion-based magnetic resonance imaging (MRI). It appears that the strength of event-related EEG activity increases with increased integrity of structural connectivity, while latency drops. This agrees with a simple mechanistic perspective: the nature of microstructural white matter influences the transfer of activity. The EEG, however, is often assessed for its spectral content. Spectral power shows associations with structural connectivity that can be negative or positive often dependent on the frequencies under study. Functional connectivity shows even more variations, which are difficult to rank. This might be caused by the diversity of paradigms being investigated, from sleep and resting state to cognitive and motor tasks, from healthy participants to patients. More challenging, though, is the potential dependency of findings on the kind of analysis applied. While this does not diminish the principal capacity of EEG and diffusion-based MRI co-registration, it highlights the urgency to standardize especially EEG analysis.

Cortical Engagement Metrics During Reactive Balance Are Associated With Distinct Aspects of Balance Behavior in Older Adults

Heightened reliance on the cerebral cortex for postural stability with aging is well-known, yet the cortical mechanisms for balance control, particularly in relation to balance function, remain unclear. Here we aimed to investigate motor cortical activity in relation to the level of balance challenge presented during reactive balance recovery and identify circuit-specific interactions between motor cortex and prefrontal or somatosensory regions in relation to metrics of balance function that predict fall risk. Using electroencephalography, we assessed motor cortical beta power, and beta coherence during balance reactions to perturbations in older adults. We found that individuals with greater motor cortical beta power evoked following standing balance perturbations demonstrated lower general clinical balance function. Individual older adults demonstrated a wide range of cortical responses during balance reactions at the same perturbation magnitude, showing no group-level change in prefrontal- or somatosensory-motor coherence in response to perturbations. However, older adults with the highest prefrontal-motor coherence during the post-perturbation, but not pre-perturbation, period showed greater cognitive dual-task interference (DTI) and elicited stepping reactions at lower perturbation magnitudes. Our results support motor cortical beta activity as a potential biomarker for individual level of balance challenge and implicate prefrontal-motor cortical networks in distinct aspects of balance control involving response inhibition of reactive stepping in older adults. Cortical network activity during balance may provide a neural target for precision-medicine efforts aimed at fall prevention with aging.

Cognition and action: a latent variable approach to study contributions of executive functions to motor control in older adults

Aging is associated with profound alterations in motor control that may be exacerbated by age-related executive functioning decline. Executive functions span multiple facets including inhibition (suppressing unwanted response tendencies), shifting (switching between cognitive operations), and updating (managing working memory content). However, comprehensive studies regarding the contributions of single facets of executive functioning to movement control in older adults are still lacking. A battery of nine neuropsychological tasks was administered to n = 92 older adults in order to derive latent factors for inhibition, shifting, and updating by structural equation modeling. A bimanual task was used to assess complex motor control. A sample of n = 26 young adults served as a control group to verify age-related performance differences. In older adults, structural equation models revealed that performance on the most challenging condition of the complex motor task was best predicted by the updating factor and by general executive functioning performance. These data suggest a central role for working memory updating in complex motor performance and contribute to our understanding of how individual differences in executive functioning relate to movement control in older adults.

High-Order Interdependencies in the Aging Brain

Background: Brain interdependencies can be studied from either a structural/anatomical perspective ("structural connectivity") or by considering statistical interdependencies ("functional connectivity" [FC]). Interestingly, while structural connectivity is by definition pairwise (white-matter fibers project from one region to another), FC is not. However, most FC analyses only focus on pairwise statistics and they neglect higher order interactions. A promising tool to study high-order interdependencies is the recently proposed O-Information, which can quantify the intrinsic statistical synergy and the redundancy in groups of three or more interacting variables. Methods: We analyzed functional magnetic resonance imaging (fMRI) data obtained at rest from 164 healthy subjects with ages ranging in 10 to 80 years and used O-Information to investigate how high-order statistical interdependencies are affected by age. Results: Older participants (from 60 to 80 years old) exhibited a higher predominance of redundant dependencies compared with younger participants, an effect that seems to be pervasive as it is evident for all orders of interaction. In addition, while there is strong heterogeneity across brain regions, we found a "redundancy core" constituted by the prefrontal and motor cortices in which redundancy was evident at all the interaction orders studied. Discussion: High-order interdependencies in fMRI data reveal a dominant redundancy in functions such as working memory, executive, and motor functions. Our methodology can be used for a broad range of applications, and the corresponding code is freely available.

TDCS effects on pointing task learning in young and old adults

Skill increase in motor performance can be defined as explicitly measuring task success but also via more implicit measures of movement kinematics. Even though these measures are often related, there is evidence that they represent distinct concepts of learning. In the present study, the effect of multiple tDCS-sessions on both explicit and implicit measures of learning are investigated in a pointing task in 30 young adults (YA) between 27.07 ± 3.8 years and 30 old adults (OA) between 67.97 years ± 5.3 years. We hypothesized, that OA would show slower explicit skill learning indicated by higher movement times/lower accuracy and slower implicit learning indicated by higher spatial variability but profit more from anodal tDCS compared with YA. We found age-related differences in movement time but not in accuracy or spatial variability. TDCS did not skill learning facilitate learning neither in explicit nor implicit parameters. However, contrary to our hypotheses, we found tDCS-associated higher accuracy only in YA but not in spatial variability. Taken together, our data shows limited overlapping of tDCS effects in explicit and implicit skill parameters. Furthermore, it supports the assumption that tDCS is capable of producing a performance-enhancing brain state at least for explicit skill acquisition.

Motor Skill Learning-Induced Functional Plasticity in the Primary Somatosensory Cortex: A Comparison Between Young and Older Adults

While in young adults (YAs) the underlying neural mechanisms of motor learning are well-studied, studies on the involvement of the somatosensory system during motor skill learning in older adults (OAs) remain sparse. Therefore, the aim of the present study was to investigate motor learning-induced neuroplasticity in the primary somatosensory cortex (S1) in YAs and OAs. Somatosensory evoked potentials (SEPs) were used to quantify somatosensory activation prior and immediately after motor skill learning in 20 right-handed healthy YAs (age range: 19–35 years) and OAs (age range: 57–76 years). Participants underwent a single session of a 30-min co-contraction task of the abductor pollicis brevis (APB) and deltoid muscle. To assess the effect of motor learning, muscle onset asynchrony (MOA) between the onsets of the contractions of both muscles was measured using electromyography monitoring. In both groups, MOA shortened significantly during motor learning, with YAs showing bigger reductions. No changes were found in SEP amplitudes after motor learning in both groups. However, a correlation analysis revealed an association between baseline SEP amplitudes of the N20/P25 and N30 SEP component and the motor learning slope in YAs such that higher amplitudes are related to higher learning. Hence, the present findings suggest that SEP amplitudes might serve as a predictor of individual motor learning success, at least in YAs. Additionally, our results suggest that OAs are still capable of learning complex motor tasks, showing the importance of motor training in higher age to remain an active part of our society as a prevention for care dependency.

Functional brain changes in the elderly for the perception of hand movements: A greater impairment occurs in proprioception than touch

Unlike age-related brain changes linked to motor activity, neural alterations related to self-motion perception remain unknown. Using fMRI data, we investigated age-related changes in the central processing of somatosensory information by inducing illusions of right-hand rotations with specific proprioceptive and tactile stimulation. Functional connectivity during resting-state (rs-FC) was also compared between younger and older participants. Results showed common sensorimotor activations in younger and older adults during proprioceptive and tactile illusions, but less deactivation in various right frontal regions and the precuneus were found in the elderly. Older participants exhibited a less-lateralized pattern of activity across the primary sensorimotor cortices (SM1) in the proprioceptive condition only. This alteration of the interhemispheric balance correlated with declining individual performance in illusion velocity perception from a proprioceptive, but not a tactile, origin. By combining task-related data, rs-FC and behavioral performance, this study provided consistent results showing that hand movement perception was altered in the elderly, with a more pronounced deterioration of the proprioceptive system, likely due to the breakdown of inhibitory processes with aging. Nevertheless, older people could benefit from an increase in internetwork connectivity to overcome this kinesthetic decline.

Characterization of Young and Old Adult Brains: An EEG Functional Connectivity Analysis

Brain connectivity studies have reported that functional networks change with older age. We aim to (1) investigate whether electroencephalography (EEG) data can be used to distinguish between individual functional networks of young and old adults; and (2) identify the functional connections that contribute to this classification. Two eyes-open resting-state EEG recording sessions with 64 electrodes for each of 22 younger adults (19-37 years) and 22 older adults (63-85 years) were conducted. For each session, imaginary coherence matrices in delta, theta, alpha, beta and gamma bands were computed. A range of machine learning classification methods were utilized to distinguish younger and older adult brains. A support vector machine (SVM) classifier was 93% accurate in classifying the brains by age group. We report decreased functional connectivity with older age in delta, theta, alpha and gamma bands, and increased connectivity with older age in beta band. Most connections involving frontal, temporal, and parietal electrodes, and more than half of connections involving occipital electrodes, showed decreased connectivity with older age. Slightly less than half of the connections involving central electrodes showed increased connectivity with older age. Functional connections showing decreased strength with older age were not significantly different in electrode-to-electrode distance than those that increased with older age. Most of the connections used by the classifier to distinguish participants by age group belonged to the alpha band. Findings suggest a decrease in connectivity in key networks and frequency bands associated with attention and awareness, and an increase in connectivity of the sensorimotor functional networks with aging during a resting state.

Induced Suppression of the Left Dorsolateral Prefrontal Cortex Favorably Changes Interhemispheric Communication During Bimanual Coordination in Older Adults-A Neuronavigated rTMS Study

Recent transcranial magnetic stimulation (TMS) research indicated that the ability of the dorsolateral prefrontal cortex (DLPFC) to disinhibit the contralateral primary motor cortex (M1) during motor preparation is an important predictor for bimanual motor performance in both young and older healthy adults. However, this DLPFC-M1 disinhibition is reduced in older adults. Here, we transiently suppressed left DLPFC using repetitive TMS (rTMS) during a cyclical bimanual task and investigated the effect of left DLPFC suppression: (1) on the projection from left DLPFC to the contralateral M1; and (2) on motor performance in 21 young (mean age ± SD = 21.57 ± 1.83) and 20 older (mean age ± SD = 69.05 ± 4.48) healthy adults. As predicted, without rTMS, older adults showed compromised DLPFC-M1 disinhibition as compared to younger adults and less preparatory DLPFC-M1 disinhibition was related to less accurate performance, irrespective of age. Notably, rTMS-induced DLPFC suppression restored DLPFC-M1 disinhibition in older adults and improved performance accuracy right after the local suppression in both age groups. However, the rTMS-induced gain in disinhibition was not correlated with the gain in performance. In sum, this novel rTMS approach advanced our mechanistic understanding of how left DLPFC regulates right M1 and allowed us to establish the causal role of left DLPFC in bimanual coordination.

Effectiveness of bimanual coordination tasks performance in improving coordination skills and cognitive functions in elderly

Background

The purpose of the study was to determine the impact of the performance of bimanual coordination tasks with specific characteristics on the changes in quality of coordination, musculoskeletal load of the upper limbs and cognitive functions.

Methods and findings

A group of 26 people aged 60–67 years performed 6 sessions of bimanual coordination training. Each session included set of tasks that varied depending on the shape in which the cursor moved, the coordination mode (in-phase, anti-phase, complex) and the tracking mode (imposed or freely chosen speed). Performance was assessed by: Error, Variability and Execution. The load of upper limb muscles was expressed with the value of the normalized EMG amplitude. Cognitive functions were evaluated using the Vienna Test System. The Variability and Error values obtained during the sixth training session decreased by more than 50% of the initial values. Tasks with freely chosen speed showed changes from 15% to 34% for Error and from 45% to 50% for Variability. For tasks with imposed speed and coordination mode anti-phase or complex it was between 51% and 58% for Error and between 58% and 68% for Variability. Statistically significant differences between load during the sixth training session compared to the first session occurred in three out of four muscles and were between 9% to 39%. There were statistically significant differences in motor time and no differences in variables describing attention and working memory.

Conclusions

Coordination mode is meaningful for improving coordination skills; tasks in the anti-phase and complex are recommended. Tracking mode also plays a role, tasks with an imposed cursor movement speed have greater potential to improve coordination skills than tasks with freely chosen. Improved control skills resulted in the reduction of upper limb musculoskeletal load. It can be assumed that an increase in coordination skills with the use of appropriate training can help to reduce musculoskeletal load.

Reduced Modulation of Task-Related Connectivity Mediates Age-Related Declines in Bimanual Performance

Aging is accompanied by marked changes in motor behavior and its neural correlates. At the behavioral level, age-related declines in motor performance manifest, for example, as a reduced capacity to inhibit interference between hands during bimanual movements, particularly when task complexity increases. At the neural level, aging is associated with reduced differentiation between distinct functional systems. Functional connectivity (FC) dedifferentiation is characterized by more homogeneous connectivity patterns across various tasks or task conditions, reflecting a reduced ability of the aging adult to modulate brain activity according to changing task demands. It is currently unknown, however, how whole-brain dedifferentiation interacts with increasing task complexity. In the present study, we investigated age- and task-related FC in a group of 96 human adults across a wide age range (19.9-74.5 years of age) during the performance of a bimanual coordination task of varying complexity. Our findings indicated stronger task complexity-related differentiation between visuomotor- and nonvisuomotor-related networks, though modulation capability decreased with increasing age. Decreased FC modulation mediated larger complexity-related increases in between-hand interference, reflective of worse bimanual coordination. Thus, the ability to maintain high motor performance levels in older adults is related to the capability to properly segregate and modulate functional networks.

Fiber-specific variations in anterior transcallosal white matter structure contribute to age-related differences in motor performance

Age-related differences in bimanual motor performance have been extensively documented, but their underlying neural mechanisms remain less clear. Studies applying diffusion MRI in the aging population have revealed evidence for age-related white matter variations in the corpus callosum (CC) which are related to bimanual motor performance. However, the diffusion tensor model used in those studies is confounded by partial volume effects in voxels with complex fiber geometries which are present in up to 90% of white matter voxels, including the bilateral projections of the CC. A recently developed whole-brain analysis framework, known as fixel-based analysis (FBA), enables comprehensive statistical analyses of white matter quantitative measures in the presence of such complex fiber geometries. To investigate the contribution of age-related fiber-specific white matter variations to age-related differences in bimanual performance, a cross-sectional lifespan sample of healthy human adults (N ​= ​95; 20-75 years of age) performed a bimanual tracking task. Furthermore, diffusion MRI data were acquired and the FBA metrics associated with fiber density, cross-section, and combined fiber density and cross-section were estimated. Whole-brain FBA revealed significant negative associations between age and fiber density, cross-section, and combined metrics of multiple white matter tracts, including the bilateral projections of the CC, indicative of white matter micro- and macrostructural degradation with age. More importantly, mediation analyses demonstrated that age-related variations in the combined (fiber density and cross-section) metric of the genu, but not splenium, of the CC contributed to the observed age-related differences in bimanual coordination performance. These findings highlight the contribution of variations in interhemispheric communication between prefrontal (non-motor) cortices to age-related differences in motor performance.

Impaired motor skills and atypical functional connectivity of the sensorimotor system in 40- to 65-year-old adults with autism spectrum disorders

Impairments in fine and gross motor function, coordination, and balance in early development are common in autism spectrum disorders (ASDs). It is unclear whether these deficits persist into adulthood and whether they may be exacerbated by additional motor problems that often emerge in typical aging. We assessed motor skills and used resting-state functional magnetic resonance imaging to study intrinsic functional connectivity of the sensorimotor network in 40- to 65-year-old adults with ASDs (n = 17) and typically developing matched adults (n = 19). Adults with ASDs scored significantly lower on assessments of motor skills compared with an age-matched group of typical control adults. In addition, functional connectivity of the sensorimotor system was reduced and the pattern of connectivity was more heterogeneous in adults with ASDs. A negative correlation between functional connectivity of the motor system and motor skills, however, was only found in the typical control group. Findings suggest behavioral impairment and atypical brain organization of the motor system in middle-age adults with ASDs, accompanied by pronounced heterogeneity.

Age-Related Declines in Motor Performance are Associated With Decreased Segregation of Large-Scale Resting State Brain Networks

Aging is typically associated with substantial declines in motor functioning as well as robust changes in the functional organization of brain networks. Previous research has investigated the link between these 2 age-varying factors but examinations were predominantly limited to the functional organization within motor-related brain networks. Little is known about the relationship between age-related behavioral impairments and changes in functional organization at the whole brain (i.e., multiple network) level. This knowledge gap is surprising given that the decreased segregation of brain networks (i.e., increased internetwork connectivity) can be considered a hallmark of the aging process. Accordingly, we investigated the association between declines in motor performance across the adult lifespan (20-75 years) and age-related modulations of functional connectivity within and between resting state networks. Results indicated that stronger internetwork resting state connectivity observed as a function of age was significantly related to worse motor performance. Moreover, performance had a significantly stronger association with the strength of internetwork as compared with intranetwork connectivity, including connectivity within motor networks. These findings suggest that age-related declines in motor performance may be attributed to a breakdown in the functional organization of large-scale brain networks rather than simply age-related connectivity changes within motor-related networks.

Effects of aging on finger movements in multiple sclerosis

BACKGROUND

People with multiple sclerosis (PwMS) report impaired hand movements and coordination. With an engineered glove we demonstrated altered finger movements in PwMS; increasing age resulted in decreased performance in healthy subjects (normative data). This study aims at investigating aging effects on finger motor performance in PwMS, in relation to disease duration and Expanded Disability Status Scale (EDSS).

METHODS

Ninety-six PwMS performed repetitive finger opposition movements with the dominant hand and both hands at maximal velocity or metronome-paced. Performance was compared with the norms, and correlation coefficients between finger motor parameters, age, disease duration and EDSS were calculated.

RESULTS

The majority of subjects was outside of the normal range according to age and probability increased with level of disability. Age significantly correlated with the glove parameters (r ranged in absolute value between 0.22-0.31; p-value in the range 0.002-0.049). Older subjects with lower disability showed worse performance than younger (p = 0.044 and 0.02), whilst younger subjects with higher disability performed similarly to older (p = 0.72 and 0.49).

CONCLUSION

Finger motor performance assessment provides important hints about upper limb disability, which should be evaluated in relation to age, disease duration and EDSS.

Sensorimotor cortex neurometabolite levels as correlate of motor performance in normal aging: evidence from a 1H-MRS study

Aging is associated with gradual alterations in the neurochemical characteristics of the brain, which can be assessed in-vivo with proton-magnetic resonance spectroscopy (¹H-MRS). However, the impact of these age-related neurochemical changes on functional motor behavior is still poorly understood. Here, we address this knowledge gap and specifically focus on the neurochemical integrity of the left sensorimotor cortex (SM1) and the occipital lobe (OCC), as both regions are main nodes of the visuomotor network underlying bimanual control. ¹H-MRS data and performance on a set of bimanual tasks were collected from a lifespan (20-75 years) sample of 86 healthy adults. Results indicated that aging was accompanied by decreased levels of N-acetylaspartate (NAA), glutamate-glutamine (Glx), creatine ​+ ​phosphocreatine (Cr) and myo-inositol (mI) in both regions, and decreased Choline (Cho) in the OCC region. Lower NAA and Glx levels in the SM1 and lower NAA levels in the OCC were related to poorer performance on a visuomotor bimanual coordination task, suggesting that NAA could serve as a potential biomarker for the integrity of the motor system supporting bimanual control. In addition, lower NAA, Glx, and mI levels in the SM1 were found to be correlates of poorer dexterous performance on a bimanual dexterity task. These findings highlight the role for ¹H-MRS to study neurochemical correlates of motor performance across the adult lifespan.

Age-related differences in network flexibility and segregation at rest and during motor performance

Brain networks undergo widespread changes in older age. A large body of knowledge gathered about those changes evidenced an increase of functional connectivity between brain networks. Previous work focused mainly on cortical networks during the resting state. Subcortical structures, however, are of critical importance during the performance of motor tasks. In this study, we investigated age-related changes in cortical, striatal and cerebellar functional connectivity at rest and its modulation by motor task execution. To that end, functional MRI from twenty-five young (mean age 21.5 years) and eighteen older adults (mean age 68.6 years) were analysed during rest and while performing a bimanual tracking task practiced over a two-week period. We found that inter-network connectivity among cortical structures was more positive in older adults both during rest and task performance. Functional connectivity within striatal structures decreased with age during rest and task execution. Network flexibility, the changes in network composition from rest to task, was also reduced in older adults, but only in networks with an age-related increase in connectivity. Finally, flexibility of areas in the prefrontal cortex were associated with lower error scores during task execution, especially in older adults. In conclusion, our findings indicate an age-related reduction in the ability to suppress irrelevant network communication, leading to less segregated and less flexible cortical networks. At the same time, striatal connectivity is impaired in older adults, while cerebellar connectivity shows heterogeneous age-related effects during rest and task execution. Future research is needed to clarify how cortical and subcortical connectivity changes relate to one another.

A combined diffusion-weighted and electroencephalography study on age-related differences in connectivity in the motor network during bimanual performance

We studied the relationship between age-related differences in inter- and intra-hemispheric structural and functional connectivity in the bilateral motor network. Our focus was on the correlation between connectivity and declined motor performance in older adults. Structural and functional connectivity were estimated using diffusion weighted imaging and resting-state electro-encephalography, respectively. A total of 48 young and older healthy participants were measured. In addition, motor performances were assessed using bimanual coordination tasks. To pre-select regions-of-interest (ROIs), a neural model was adopted that accounts for intra-hemispheric functional connectivity between dorsal premotor area (PMd) and primary motor cortex (M1) and inter-hemispheric connections between left and right M1 (M1_L and M1_R ). Functional connectivity was determined via the weighted phase-lag index (wPLI) in the source-reconstructed beta activity during rest. We quantified structural connectivity using kurtosis anisotropy (KA) values of tracts derived from diffusion tensor-based fiber tractography between the aforementioned areas. In the group of older adults, wPLI values between M1_L -M1_R were negatively associated with the quality of bimanual motor performance. The additional association between wPLI values of PMd_L --M1_L and PMd_R -M1_L supports that functional connectivity with the left hemisphere mediated (bimanual) motor control in older adults. The correlational analysis between the selected structural and functional connections revealed a strong association between wPLI values in the left intra-hemispheric PMd_L -M1_L pathway and KA values in M1_L -M1_R and PMd_R -M1_L pathways in the group of older adults. This suggests that weaker structural connections in older adults correlate with stronger functional connectivity and, hence, poorer motor performance.

GABA levels and measures of intracortical and interhemispheric excitability in healthy young and older adults: an MRS-TMS study

Edited magnetic resonance spectroscopy (MRS) and transcranial magnetic stimulation (TMS) have often been used to study the integrity of the GABAergic neurotransmission system in healthy aging. To investigate whether the measurement outcomes obtained with these 2 techniques are associated with each other in older human adults, gamma-aminobutyric acid (GABA) levels in the left sensorimotor cortex were assessed with edited MRS in 28 older (63-74 years) and 28 young adults (19-34 years). TMS at rest was then used to measure intracortical inhibition (short-interval intracortical inhibition/long-interval intracortical inhibition), intracortical facilitation, interhemispheric inhibition from left to right primary motor cortex (M1) and recruitment curves of left and right M1. Our observations showed that short-interval intracortical inhibition and long-interval intracortical inhibition in the left M1 were reduced in older adults, while GABA levels did not significantly differ between age groups. Furthermore, MRS-assessed GABA within left sensorimotor cortex was not correlated with TMS-assessed cortical excitability or inhibition. These observations suggest that healthy aging gives rise to altered inhibition at the postsynaptic receptor level, which does not seem to be associated with MRS-assessed GABA+ levels.

Age-Dependent Modulations of Resting State Connectivity Following Motor Practice

Recent work in young adults has demonstrated that motor learning can modulate resting state functional connectivity. However, evidence for older adults is scarce. Here, we investigated whether learning a bimanual tracking task modulates resting state functional connectivity of both inter- and intra-hemispheric regions differentially in young and older individuals, and whether this has behavioral relevance. Both age groups learned a set of complex bimanual tracking task variants over a 2-week training period. Resting-state and task-related functional magnetic resonance imaging scans were collected before and after training. Our analyses revealed that both young and older adults reached considerable performance gains. Older adults even obtained larger training-induced improvements relative to baseline, but their overall performance levels were lower than in young adults. Short-term practice resulted in a modulation of resting state functional connectivity, leading to connectivity increases in young adults, but connectivity decreases in older adults. This pattern of age differences occurred for both inter- and intra-hemispheric connections related to the motor network. Additionally, long-term training-induced increases were observed in intra-hemispheric connectivity in the right hemisphere across both age groups. Overall, at the individual level, the long-term changes in inter-hemispheric connectivity correlated with training-induced motor improvement. Our findings confirm that short-term task practice shapes spontaneous brain activity differentially in young and older individuals. Importantly, the association between changes in resting state functional connectivity and improvements in motor performance at the individual level may be indicative of how training shapes the short-term functional reorganization of the resting state motor network for improvement of behavioral performance.

Network connectivity of motor control in the ageing brain

Older individuals typically display stronger regional brain activity than younger subjects during motor performance. However, knowledge regarding age-related changes of motor network interactions between brain regions remains scarce. We here investigated the impact of ageing on the interaction of cortical areas during movement selection and initiation using dynamic causal modelling (DCM). We found that age-related psychomotor slowing was accompanied by increases in both regional activity and effective connectivity, especially for ‘core’ motor coupling targeting primary motor cortex (M1). Interestingly, younger participants within the older group showed strongest connectivity targeting M1, which steadily decreased with advancing age. Conversely, prefrontal influences on the motor system increased with advancing age, and were inversely correlated with reduced parietal influences and core motor coupling. Interestingly, higher net coupling within the prefrontal-premotor-M1 axis predicted faster psychomotor speed in ageing. Hence, as opposed to a uniform age-related decline, our findings are compatible with the idea of different age-related compensatory mechanisms, with an important role of the prefrontal cortex compensating for reduced coupling within the core motor network.

•

Enhanced motor network activity and connectivity in ageing

•

Parietal-premotor and premotor-M1 coupling decreases with advancing age.

•

Prefrontal influences on the motor system increase with advancing age.

•

Prefrontal cortex compensates for age-related decline in other motor connections.

•

Prefrontal-premotor-M1 coupling predicts psychomotor speed in ageing.

Quantitative assessment of finger motor performance: Normative data

Background

Finger opposition movements are the basis of many daily living activities and are essential in general for manipulating objects; an engineered glove quantitatively assessing motor performance during sequences of finger opposition movements has been shown to be useful to provide reliable measures of finger motor impairment, even subtle, in subjects affected by neurological diseases. However, the obtained behavioral parameters lack published reference values.

Objective

To determine mean values for different motor behavioral parameters describing the strategy adopted by healthy people in performing repeated sequences of finger opposition movements, examining associations with gender and age.

Methods

Normative values for finger motor performance parameters were obtained on a sample of 255 healthy volunteers executing sequences of finger-to-thumb opposition movements, stratified by gender and over a wide range of ages. Touch duration, inter-tapping interval, movement rate, correct sequences (%), movements in advance compared with a metronome (%) and inter-hand interval were assessed.

Results

Increasing age resulted in decreased movement speed, advance movements with respect to a cue, correctness of sequences, and bimanual coordination.

No significant performance differences were found between male and female subjects except for the duration of the finger touch, the interval between two successive touches and their ratio.

Conclusions

We report age- and gender-specific normal mean values and ranges for different parameters objectively describing the performance of finger opposition movement sequences, which may serve as useful references for clinicians to identify possible deficits in subjects affected by diseases altering fine hand motor skills.

Two hands, one brain, and aging

Many activities of daily living require moving both hands in an organized manner in space and time. Therefore, understanding the impact of aging on bimanual coordination is essential for prolonging functional independence and well-being in older adults. Here we investigated the behavioral and neural determinants of bimanual coordination in aging. The studies surveyed in this review reveal that aging is associated with cortical hyper-activity (but also subcortical hypo-activity) during performance of bimanual tasks. In addition to changes in activation in local areas, the interaction between distributed brain areas also exhibits age-related effects, i.e., functional connectivity is increased in the resting brain as well as during task performance. The mechanisms and triggers underlying these functional activation and connectivity changes remain to be investigated. This requires further research investment into the detailed study of interactions between brain structure, function and connectivity. This will also provide the foundation for interventional research programs towards preservation of brain health and behavioral performance by maximizing neuroplasticity potential in older adults.

Early Age-Related Functional Connectivity Decline in High-Order Cognitive Networks

As the world ages, it becomes urgent to unravel the mechanisms underlying brain aging and find ways of intervening with them. While for decades cognitive aging has been related to localized brain changes, growing attention is now being paid to alterations in distributed brain networks. Functional connectivity magnetic resonance imaging (fcMRI) has become a particularly useful tool to explore large-scale brain networks; yet, the temporal course of connectivity lifetime changes has not been established. Here, an extensive cross-sectional sample (21-85 years old, N = 887) from a public fcMRI database was used to characterize adult lifespan connectivity dynamics within and between seven brain networks: the default mode, salience, dorsal attention, fronto-parietal control, auditory, visual and motor networks. The entire cohort was divided into young (21-40 years, mean ± SD: 25.5 ± 4.8, n = 543); middle-aged (41-60 years, 50.6 ± 5.4, n = 238); and old (61 years and above, 69.0 ± 6.3, n = 106) subgroups. Correlation matrices as well as a mixed model analysis of covariance indicated that within high-order cognitive networks a considerable connectivity decline is already evident by middle adulthood. In contrast, a motor network shows increased connectivity in middle adulthood and a subsequent decline. Additionally, alterations in inter-network interactions are noticeable primarily in the transition between young and middle adulthood. These results provide evidence that aging-related neural changes start early in adult life.

Age-related changes in bilateral upper extremity coordination

Although evidence exists that changes in sensorimotor function occur with aging, changes in the bilateral coordination of the upper extremities is less understood. Here, we review the behavioral and neural evidence of declines in bilateral coordination as well as the implications these deficits have on function and physical rehabilitation. We begin with an introduction to the two major forms of bilateral coordination, symmetric and non-symmetric and their sub-groupings. After discussing the motor performance changes with age in symmetric tasks, we address age-related changes in motor lateralization that may affect the bilateral coordination of non-symmetric coordination. This is followed by a discussion of the contributions of cognitive, sensory, and cortical changes with age that influence and underlie bilateral motor performance. Finally, age-related changes in motor learning of bilateral movements are also considered. In general, most age related changes are found in complex symmetric movements but, surprisingly, there is a dearth of information about changes in the more challenging and ubiquitous non-symmetric bilateral movements. Future investigations should focus on broadening the understanding of age-related changes in complex, functionally relevant bilateral movements, such that the real-world implications of these changes may be derived.

Age-Related Changes in Frontal Network Structural and Functional Connectivity in Relation to Bimanual Movement Control

Changes in both brain structure and neurophysiological function regulating homotopic as well as heterotopic interhemispheric interactions (IHIs) are assumed to be responsible for the bimanual performance deficits in older adults. However, how the structural and functional networks regulating bimanual performance decline in older adults, as well as the interplay between brain structure and function remain largely unclear. Using a dual-site transcranial magnetic stimulation paradigm, we examined the age-related changes in the interhemispheric effects from the dorsolateral prefrontal cortex and dorsal premotor cortex onto the contralateral primary motor cortex (M1) during the preparation of a complex bimanual coordination task in human. Structural properties of these interactions were assessed with diffusion-based fiber tractography. Compared with young adults, older adults showed performance declines in the more difficult bimanual conditions, less optimal brain white matter (WM) microstructure, and a decreased ability to regulate the interaction between dorsolateral prefrontal cortex and M1. Importantly, we found that WM microstructure, neurophysiological function, and bimanual performance were interrelated in older adults, whereas only the task-related changes in IHI predicted bimanual performance in young adults. These results reflect unique interactions between structure and function in the aging brain, such that declines in WM microstructural organization likely lead to dysfunctional regulation of IHI, ultimately accounting for bimanual performance deficits.

SIGNIFICANCE STATEMENT

The structural and functional changes in the aging brain are associated with a decline in movement control, compromising functional independence. We used MRI and noninvasive brain stimulation techniques to investigate white matter microstructural organization and neurophysiological function in the aging brain, in relation to bimanual movement control. We found that less optimal brain microstructural organization and task-related modulations in neurophysiological function resulted in poor bimanual performance in older adults. By interrelating brain structure, neurophysiological function, and behavior, the current study provides a comprehensive picture of biological alterations in the aging brain that underlie declines in bimanual performance.

Mild cognitive impairment affects motor control and skill learning

Mild cognitive impairment (MCI) is a transitional phase between normal cognitive aging and dementia. As the world population is aging rapidly, more MCI patients will be identified, posing significant problems to society. Normal aging is associated with cognitive and motor decline, and MCI brings additional impairments. Compared to healthy older adults, MCI patients show poorer motor control in a variety of tasks. Efficient motor control and skill learning are essential for occupational and leisure purposes; degradation of motor behaviors in MCI patients often adversely affects their health and quality of life. In this article, we first define MCI and describe its pathology and neural correlates. After this, we review cognitive changes and motor control and skill learning in normal aging. This section is followed by a discussion of MCI-related degradation of motor behaviors. Finally, we propose that multicomponent interventions targeting both cognitive and motor domains can improve MCI patients’ motor functions. Future research directions are also raised.

The Exercising Brain: Changes in Functional Connectivity Induced by an Integrated Multimodal Cognitive and Whole-Body Coordination Training

This study investigated the impact of “life kinetik” training on brain plasticity in terms of an increased functional connectivity during resting-state functional magnetic resonance imaging (rs-fMRI). The training is an integrated multimodal training that combines motor and cognitive aspects and challenges the brain by introducing new and unfamiliar coordinative tasks. Twenty-one subjects completed at least 11 one-hour-per-week “life kinetik” training sessions in 13 weeks as well as before and after rs-fMRI scans. Additionally, 11 control subjects with 2 rs-fMRI scans were included. The CONN toolbox was used to conduct several seed-to-voxel analyses. We searched for functional connectivity increases between brain regions expected to be involved in the exercises. Connections to brain regions representing parts of the default mode network, such as medial frontal cortex and posterior cingulate cortex, did not change. Significant connectivity alterations occurred between the visual cortex and parts of the superior parietal area (BA7). Premotor area and cingulate gyrus were also affected. We can conclude that the constant challenge of unfamiliar combinations of coordination tasks, combined with visual perception and working memory demands, seems to induce brain plasticity expressed in enhanced connectivity strength of brain regions due to coactivation.

Switching between hands in a serial reaction time task: a comparison between young and old adults

Healthy aging is associated with a variety of functional and structural brain alterations. These age-related brain alterations have been assumed to negatively impact cognitive and motor performance. Especially important for the execution of everyday activities in older adults (OA) is the ability to perform movements that depend on both hands working together. However, bimanual coordination is typically deteriorated with increasing age. Hence, a deeper understanding of such age-related brain-behavior alterations might offer the opportunity to design future interventional studies in order to delay or even prevent the decline in cognitive and/or motor performance over the lifespan. Here, we examined to what extent the capability to acquire and maintain a novel bimanual motor skill is still preserved in healthy OA as compared to their younger peers (YA). For this purpose, we investigated performance of OA (n = 26) and YA (n = 26) in a bimanual serial reaction time task (B-SRTT), on two experimental sessions, separated by 1 week. We found that even though OA were generally slower in global response times, they showed preserved learning capabilities in the B-SRTT. However, sequence specific learning was more pronounced in YA as compared to OA. Furthermore, we found that switching between hands during B-SRTT learning trials resulted in increased response times (hand switch costs), a phenomenon that was more pronounced in OA. These hand switch costs were reduced in both groups over the time course of learning. More interestingly, there were no group differences in hand switch costs on the second training session. These results provide novel evidence that bimanual motor skill learning is capable of reducing age-related deficits in hand switch costs, a finding that might have important implications to prevent the age-related decline in sensorimotor function.

Functional organization and restoration of the brain motor-execution network after stroke and rehabilitation

Multiple cortical areas of the human brain motor system interact coherently in the low frequency range (<0.1 Hz), even in the absence of explicit tasks. Following stroke, cortical interactions are functionally disturbed. How these interactions are affected and how the functional organization is regained from rehabilitative treatments as people begin to recover motor behaviors has not been systematically studied. We recorded the intrinsic functional magnetic resonance imaging (fMRI) signals from 30 participants: 17 young healthy controls and 13 aged stroke survivors. Stroke participants underwent mental practice (MP) or both mental practice and physical therapy (MP+PT) within 14-51 days following stroke. We investigated the network activity of five core areas in the motor-execution network, consisting of the left primary motor area (LM1), the right primary motor area (RM1), the left pre-motor cortex (LPMC), the right pre-motor cortex (RPMC) and the supplementary motor area (SMA). We discovered that (i) the network activity dominated in the frequency range 0.06-0.08 Hz for all the regions, and for both able-bodied and stroke participants (ii) the causal information flow between the regions: LM1 and SMA, RPMC and SMA, RPMC and LM1, SMA and RM1, SMA and LPMC, was reduced significantly for stroke survivors (iii) the flow did not increase significantly after MP alone and (iv) the flow among the regions during MP+PT increased significantly. We also found that sensation and motor scores were significantly higher and correlated with directed functional connectivity measures when the stroke-survivors underwent MP+PT but not MP alone. The findings provide evidence that a combination of mental practice and physical therapy can be an effective means of treatment for stroke survivors to recover or regain the strength of motor behaviors, and that the spectra of causal information flow can be used as a reliable biomarker for evaluating rehabilitation in stroke survivors.

Resting-State Functional Connectivity of the Sensorimotor Network in Individuals with Nonspecific Low Back Pain and the Association with the Sit-to-Stand-to-Sit Task

Individuals with nonspecific low back pain (NSLBP) show a decreased sit-to-stand-to-sit (STSTS) performance. This dynamic sensorimotor task requires integration of sensory and motor information in the brain. Therefore, a better understanding of the underlying central mechanisms of impaired sensorimotor performance and the presence of NSLBP is needed. The aims of this study were to characterize differences in sensorimotor functional connectivity in individuals with NSLBP and to investigate whether the patterns of sensorimotor functional connectivity underlie the impaired STSTS performance. Seventeen individuals with NSLBP and 17 healthy controls were instructed to perform five consecutive STSTS movements as fast as possible. Based on the center of pressure displacement, the total duration of the STSTS task was determined. In addition, resting-state functional connectivity images were acquired and analyzed on a multivariate level using both functional connectivity density mapping and independent component analysis. Individuals with NSLBP needed significantly more time to perform the STSTS task compared to healthy controls. In addition, decreased resting-state functional connectivity of brain areas related to the integration of sensory and/or motor information was shown in the individuals with NSLBP. Moreover, the decreased functional connectivity at rest of the left precentral gyrus and lobule IV and V of the left cerebellum was associated with a longer duration of the STSTS task in both individuals with NSLBP and healthy controls. In summary, individuals with NSLBP showed a reorganization of the sensorimotor network at rest, and the functional connectivity of specific sensorimotor areas was associated with the performance of a dynamic sensorimotor task.

Subcortical volumetric changes across the adult lifespan: subregional thalamic atrophy accounts for age-related sensorimotor performance declines

Even though declines in sensorimotor performance during healthy aging have been documented extensively, its underlying neural mechanisms remain unclear. Here, we explored whether age-related subcortical atrophy plays a role in sensorimotor performance declines, and particularly during bimanual manipulative performance (Purdue Pegboard Test). The thalamus, putamen, caudate and pallidum of 91 participants across the adult lifespan (ages 20-79 years) were automatically segmented. In addition to studying age-related changes in the global volume of each subcortical structure, local deformations within these structures, indicative of subregional volume changes, were assessed by means of recently developed shape analyses. Results showed widespread age-related global and subregional atrophy, as well as some notable subregional expansion. Even though global atrophy failed to explain the observed performance declines with aging, shape analyses indicated that atrophy in left and right thalamic subregions, specifically subserving connectivity with the premotor, primary motor and somatosensory cortical areas, mediated the relation between aging and performance decline. It is concluded that subregional volume assessment by means of shape analyses offers a sensitive tool with high anatomical resolution in the search for specific age-related associations between brain structure and behavior.

Vision of the active limb impairs bimanual motor tracking in young and older adults

Despite the intensive investigation of bimanual coordination, it remains unclear how directing vision toward either limb influences performance, and whether this influence is affected by age. To examine these questions, we assessed the performance of young and older adults on a bimanual tracking task in which they matched motor-driven movements of their right hand (passive limb) with their left hand (active limb) according to in-phase and anti-phase patterns. Performance in six visual conditions involving central vision, and/or peripheral vision of the active and/or passive limb was compared to performance in a no vision condition. Results indicated that directing central vision to the active limb consistently impaired performance, with higher impairment in older than young adults. Conversely, directing central vision to the passive limb improved performance in young adults, but less consistently in older adults. In conditions involving central vision of one limb and peripheral vision of the other limb, similar effects were found to those for conditions involving central vision of one limb only. Peripheral vision alone resulted in similar or impaired performance compared to the no vision (NV) condition. These results indicate that the locus of visual attention is critical for bimanual motor control in young and older adults, with older adults being either more impaired or less able to benefit from a given visual condition.