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Postoperative isolated lower extremity supplementary motor area syndrome: case report and review of the literature. Childs Nerv Syst 2020; 36:189-195. [PMID: 31705188 DOI: 10.1007/s00381-019-04362-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/30/2019] [Indexed: 10/25/2022]
Abstract
The supplementary motor area (SMA) syndrome is characterized by transient weakness and akinesia contralateral to the side of the affected hemisphere. The underlying pathology of the syndrome is not fully understood but is thought to be related to lesions in the SMA, residing principally in the mesial superior frontal gyrus (Broadmann's area 6c). Although the SMA syndrome a well-characterized clinical entity, we report herein, to our knowledge, the first case of isolated lower extremity SMA syndrome in the literature. This case highlights the importance of considering this rare clinical entity in the context of new or worsening postoperative neurologic deficits. Moreover, early studies did not support somatotopic organization of the SMA as in the primary motor cortex; emerging evidence suggests that delicate somatotopic representation may underlie distinct presentations like that reported in the present case.
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Increased Sensorimotor Cortex Activation With Decreased Motor Performance During Functional Upper Extremity Tasks Poststroke. J Neurol Phys Ther 2019; 43:141-150. [PMID: 31136449 DOI: 10.1097/npt.0000000000000277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Current literature has focused on identifying neuroplastic changes associated with stroke through tasks and in positions that are not representative of functional rehabilitation. Emerging technologies such as functional near-infrared spectroscopy (fNIRS) provide new methods of expanding the area of neuroplasticity within rehabilitation. This study determined the differences in sensorimotor cortex activation during unrestrained reaching and gripping after stroke. METHODS Eleven individuals with chronic stroke and 11 neurologically healthy individuals completed reaching and gripping tasks under 3 conditions using their (1) stronger, (2) weaker, and (3) both arms together. Performance and sensorimotor cortex activation using fNIRS were collected. Group and arm differences were calculated using mixed analysis of covariance (covariate: age). Pairwise comparisons were used for post hoc analyses. Partial Pearson correlations between performance and activation were assessed for each task, group, and hemisphere. RESULTS Larger sensorimotor activations in the ipsilesional hemisphere were found for the stroke compared with healthy group for reaching and gripping conditions despite poorer performance. Significant correlations were observed between gripping performance (with the weaker arm and both arms simultaneously) and sensorimotor activation for the stroke group only. DISCUSSION AND CONCLUSIONS Stroke leads to significantly larger sensorimotor activation during functional reaching and gripping despite poorer performance. This may indicate an increased sense of effort, decreased efficiency, or increased difficulty after stroke. fNIRS can be used for assessing differences in brain activation during movements in functional positions after stroke. This can be a promising tool for investigating possible neuroplastic changes associated with functional rehabilitation interventions in the stroke population.Video Abstract available for more insights from the authors (see Video Abstract, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A269).
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Isa T. The Brain Is Needed to Cure Spinal Cord Injury. Trends Neurosci 2017; 40:625-636. [PMID: 28893422 DOI: 10.1016/j.tins.2017.08.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 08/11/2017] [Accepted: 08/15/2017] [Indexed: 12/19/2022]
Abstract
Damage to corticospinal fibers in the cervical spinal cord is known to impair dexterous hand movements. However, accumulating evidence has shown that precision grip can recover considerably through rehabilitative training. Recent multidisciplinary studies have revealed that, at the spinal level, this recovery is possible due to an indirect neural pathway through propriospinal neurons (PNs), which relay cortical commands to hand motoneurons. Although this indirect spinal pathway is heavily involved in recovery, its role is dwarfed by a simultaneous large-scale network reorganization spanning motor-related cortices and mesolimbic structures. This large-scale network reorganization is key to the regulation of recovery and future therapeutic strategies will need to take into account the involvement of these supraspinal centers in addition to the known role of the spinal cord.
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Affiliation(s)
- Tadashi Isa
- Department of Neuroscience, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan.
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4
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Muraskin J, Sherwin J, Lieberman G, Garcia JO, Verstynen T, Vettel JM, Sajda P. Fusing multiple neuroimaging modalities to assess group differences in perception-action coupling. PROCEEDINGS OF THE IEEE. INSTITUTE OF ELECTRICAL AND ELECTRONICS ENGINEERS 2017; 105:83-100. [PMID: 28713174 PMCID: PMC5509353 DOI: 10.1109/jproc.2016.2574702] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In the last few decades, non-invasive neuroimaging has revealed macro-scale brain dynamics that underlie perception, cognition and action. Advances in non-invasive neuroimaging target two capabilities; 1) increased spatial and temporal resolution of measured neural activity, and 2) innovative methodologies to extract brain-behavior relationships from evolving neuroimaging technology. We target the second. Our novel methodology integrated three neuroimaging methodologies and elucidated expertise-dependent differences in functional (fused EEG-fMRI) and structural (dMRI) brain networks for a perception-action coupling task. A set of baseball players and controls performed a Go/No-Go task designed to mimic the situation of hitting a baseball. In the functional analysis, our novel fusion methodology identifies 50ms windows with predictive EEG neural correlates of expertise and fuses these temporal windows with fMRI activity in a whole-brain 2mm voxel analysis, revealing time-localized correlations of expertise at a spatial scale of millimeters. The spatiotemporal cascade of brain activity reflecting expertise differences begins as early as 200ms after the pitch starts and lasting up to 700ms afterwards. Network differences are spatially localized to include motor and visual processing areas, providing evidence for differences in perception-action coupling between the groups. Furthermore, an analysis of structural connectivity revealed that the players have significantly more connections between cerebellar and left frontal/motor regions, and many of the functional activation differences between the groups are located within structurally defined network modules that differentiate expertise. In short, our novel method illustrates how multimodal neuroimaging can provide specific macro-scale insights into the functional and structural correlates of expertise development.
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Affiliation(s)
- Jordan Muraskin
- Columbia University, Department of Biomedical Engineering, New York, NY, USA
| | - Jason Sherwin
- Columbia University, Department of Biomedical Engineering, New York, NY, USA
| | - Gregory Lieberman
- U.S. Army Research Laboratory, Human Research and Engineering Directorate, Aberdeen Proving Ground, MD, USA. He is also with University of Pennsylvania, Department of Bioengineering, Philadelphia, PA, USA
| | - Javier O Garcia
- U.S. Army Research Laboratory, Human Research and Engineering Directorate, Aberdeen Proving Ground, MD, USA
| | - Timothy Verstynen
- Carnegie Mellon University, Department of Psychology, Pittsburgh, PA, USA
| | - Jean M Vettel
- U.S. Army Research Laboratory, Human Research and Engineering Directorate, Aberdeen Proving Ground, MD, USA. He is also with University of Pennsylvania, Department of Bioengineering, Philadelphia, PA, USA and also with University of California, Santa Barbara, Department of Psychological & Brain Sciences, Santa Barbara, CA, USA
| | - Paul Sajda
- Columbia University, Department of Biomedical Engineering, New York, NY, USA
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Muraskin J, Dodhia S, Lieberman G, Garcia JO, Verstynen T, Vettel JM, Sherwin J, Sajda P. Brain dynamics of post-task resting state are influenced by expertise: Insights from baseball players. Hum Brain Mapp 2016; 37:4454-4471. [PMID: 27448098 PMCID: PMC5113676 DOI: 10.1002/hbm.23321] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 07/07/2016] [Accepted: 07/08/2016] [Indexed: 11/11/2022] Open
Abstract
Post‐task resting state dynamics can be viewed as a task‐driven state where behavioral performance is improved through endogenous, non‐explicit learning. Tasks that have intrinsic value for individuals are hypothesized to produce post‐task resting state dynamics that promote learning. We measured simultaneous fMRI/EEG and DTI in Division‐1 collegiate baseball players and compared to a group of controls, examining differences in both functional and structural connectivity. Participants performed a surrogate baseball pitch Go/No‐Go task before a resting state scan, and we compared post‐task resting state connectivity using a seed‐based analysis from the supplementary motor area (SMA), an area whose activity discriminated players and controls in our previous results using this task. Although both groups were equally trained on the task, the experts showed differential activity in their post‐task resting state consistent with motor learning. Specifically, we found (1) differences in bilateral SMA–L Insula functional connectivity between experts and controls that may reflect group differences in motor learning, (2) differences in BOLD‐alpha oscillation correlations between groups suggests variability in modulatory attention in the post‐task state, and (3) group differences between BOLD‐beta oscillations that may indicate cognitive processing of motor inhibition. Structural connectivity analysis identified group differences in portions of the functionally derived network, suggesting that functional differences may also partially arise from variability in the underlying white matter pathways. Generally, we find that brain dynamics in the post‐task resting state differ as a function of subject expertise and potentially result from differences in both functional and structural connectivity. Hum Brain Mapp 37:4454–4471, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Jordan Muraskin
- Department of Biomedical Engineering, Columbia University, New York, New York
| | - Sonam Dodhia
- Department of Biomedical Engineering, Columbia University, New York, New York
| | - Gregory Lieberman
- U.S. Army Research Laboratory, Human Research and Engineering Directorate, Aberdeen Proving Ground, Aberdeen, Maryland.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Javier O Garcia
- U.S. Army Research Laboratory, Human Research and Engineering Directorate, Aberdeen Proving Ground, Aberdeen, Maryland
| | - Timothy Verstynen
- Department of Psychology and Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Jean M Vettel
- U.S. Army Research Laboratory, Human Research and Engineering Directorate, Aberdeen Proving Ground, Aberdeen, Maryland.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Psychological & Brain Sciences, University of California, Santa Barbara, California
| | - Jason Sherwin
- Department of Biomedical Engineering, Columbia University, New York, New York
| | - Paul Sajda
- Department of Biomedical Engineering, Columbia University, New York, New York
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Abstract
Motor cortical organization has commonly been conceived as somatotopically ordered, with single body parts controlled from individual patches of cortical tissue. An opposing viewpoint suggests that motor cortex has a distnbuted, adaptive, and dynamic organi zation that underlies movement planning, performance, adaptation, and learning. Con verging evidence from anatomic, neurophysiologic, and functional neuroimaging sources indicates that the arm area of motor cortical areas in monkeys and humans has multiple, interconnected sites that ostensibly contribute to controlling various parts of the arm. These representations can exhibit rapid and sometimes enduring modifications following injury, changes in somatic sensory input, and motor learning. Activity-dependent changes in the intrinsic motor cortical network of horizontal and vertical connections coupled with ascending thalamic and corticocortical inputs could provide a substrate for dynamic mod ulation of motor cortex functional representations. NEUROSCIENTIST 3:158-165, 1997
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Dancause N. Plasticity in the motor network following primary motor cortex lesion. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 782:61-86. [PMID: 23296481 DOI: 10.1007/978-1-4614-5465-6_4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- Numa Dancause
- Groupe de Recherche sur le Système Nerveux Central (GRSNC), Département de Physiologie, Pavillon Paul-G-Desmarais, Université de Montréal, 2960, Chemin de la Tour, bureau 4138, H3T 1J4, Montréal, Québec, Canada,
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Longitudinal Assessment of Motor Recovery of Contralateral Hand after Basal Ganglia Infarction Using Functional Magnetic Resonance Imaging. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7403795. [PMID: 27069924 PMCID: PMC4812188 DOI: 10.1155/2016/7403795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 02/08/2016] [Accepted: 02/17/2016] [Indexed: 11/17/2022]
Abstract
We used functional fMRI to study the brain activation during active finger movements at different time points during the recovery phase following basal ganglia infarction. Four hemiplegic patients with basal ganglia infarction were serially evaluated at different time points spanning the acute and chronic phase using fMRI. To evaluate motor recovery, the patients were asked to perform functional tasks arranged in a block design manner with their hand. On follow-up (chronic phase), three patients achieved significant recovery of motor function of affected limbs. Activation of bilateral sensorimotor cortex (SMC) was observed in two of these patients, while activation of cerebellum was observed in all patients. No remarkable recovery of motor function was noted in one patient with left basal ganglia infarction. In this patient, the activation domain was located in SMC of both sides in acute phase and in ipsilateral SMC in chronic phase. Contralateral SMC appears to be involved in the functional rehabilitation following basal ganglia infarction. The cerebellum may act as an intermediary during functional recovery following basal ganglia infarction. The activation domain associated with active finger movement may be bilateral in acute phase; one patient was ipsilateral in the chronic stage.
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Evidence for a role of the reticulospinal system in recovery of skilled reaching after cortical stroke: initial results from a model of ischemic cortical injury. Exp Brain Res 2015; 233:3231-51. [PMID: 26231990 DOI: 10.1007/s00221-015-4390-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 07/13/2015] [Indexed: 12/25/2022]
Abstract
The purposes of this pilot study were to create a model of focal cortical ischemia in Macaca fascicularis and to explore contributions of the reticulospinal system in recovery of reaching. Endothelin-1 was used to create a focal lesion in the shoulder/elbow representation of left primary motor cortex (M1) of two adult female macaques. Repetitive microstimulation was used to map upper limb motor outputs from right and left cortical motor areas and from the pontomedullary reticular formation (PMRF). In subject 1 with a small lesion and spontaneous recovery, reaching was mildly impaired. Changes were evident in the shoulder/elbow representations of both the lesioned and contralesional M1, and there appeared to be fewer than expected upper limb responses from the left (ipsilesional) PMRF. In subject 2 with a substantial lesion, reaching was severely impaired immediately after the lesion. After 12 weeks of intensive rehabilitative training, reach performance recovered to near-baseline levels, but movement times remained about 50% slower. Surprisingly, the shoulder/elbow representation in the lesioned M1 remained completely absent after recovery, and there was a little change in the contralesional M1. There was a definite difference in motor output patterns for left versus right PMRF for this subject, with an increase in right arm responses from right PMRF and a paucity of left arm responses from left PMRF. The results are consistent with increased reliance on PMRF motor outputs for recovery of voluntary upper limb motor control after significant cortical ischemic injury.
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Bajaj S, Butler AJ, Drake D, Dhamala M. Functional organization and restoration of the brain motor-execution network after stroke and rehabilitation. Front Hum Neurosci 2015; 9:173. [PMID: 25870557 PMCID: PMC4378298 DOI: 10.3389/fnhum.2015.00173] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/12/2015] [Indexed: 12/18/2022] Open
Abstract
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.
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Affiliation(s)
- Sahil Bajaj
- Department of Physics and Astronomy, Georgia State University Atlanta, GA, USA
| | - Andrew J Butler
- Department of Physical Therapy, Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University Atlanta, GA, USA ; Department of Veteran's Affairs, Atlanta Rehabilitation Research and Development Center of Excellence Decatur, GA, USA ; Neuroscience Institute, Joint Center for Advanced Brain Imaging, Center for Behavioral Neuroscience, Georgia State University Atlanta, GA, USA
| | - Daniel Drake
- Department of Physical Therapy, Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University Atlanta, GA, USA
| | - Mukesh Dhamala
- Department of Physics and Astronomy, Georgia State University Atlanta, GA, USA ; Neuroscience Institute, Joint Center for Advanced Brain Imaging, Center for Behavioral Neuroscience, Georgia State University Atlanta, GA, USA
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Morecraft RJ, Ge J, Stilwell-Morecraft KS, McNeal DW, Hynes SM, Pizzimenti MA, Rotella DL, Darling WG. Vulnerability of the medial frontal corticospinal projection accompanies combined lateral frontal and parietal cortex injury in rhesus monkey. J Comp Neurol 2014; 523:669-97. [PMID: 25349147 DOI: 10.1002/cne.23703] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 11/09/2022]
Abstract
Concurrent damage to the lateral frontal and parietal cortex is common following middle cerebral artery infarction, leading to upper extremity paresis, paresthesia, and sensory loss. Motor recovery is often poor, and the mechanisms that support or impede this process are unclear. Since the medial wall of the cerebral hemisphere is commonly spared following stroke, we investigated the spontaneous long-term (6 and 12 month) effects of lateral frontoparietal injury (F2P2 lesion) on the terminal distribution of the corticospinal projection (CSP) from intact, ipsilesional supplementary motor cortex (M2) at spinal levels C5 to T1. Isolated injury to the frontoparietal arm/hand region resulted in a significant loss of contralateral corticospinal boutons from M2 compared with controls. Specifically, reductions occurred in the medial and lateral parts of lamina VII and the dorsal quadrants of lamina IX. There were no statistical differences in the ipsilateral CSP. Contrary to isolated lateral frontal motor injury (F2 lesion), which results in substantial increases in contralateral M2 labeling in laminae VII and IX (McNeal et al. [2010] J. Comp. Neurol. 518:586-621), the added effect of adjacent parietal cortex injury to the frontal motor lesion (F2P2 lesion) not only impedes a favorable compensatory neuroplastic response but results in a substantial loss of M2 CSP terminals. This dramatic reversal of the CSP response suggests a critical trophic role for cortical somatosensory influence on spared ipsilesional frontal corticospinal projections, and that restoration of a favorable compensatory response will require therapeutic intervention.
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Affiliation(s)
- R J Morecraft
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota, 57069
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12
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Morecraft RJ, Stilwell-Morecraft KS, Solon-Cline KM, Ge J, Darling WG. Cortical innervation of the hypoglossal nucleus in the non-human primate (Macaca mulatta). J Comp Neurol 2014; 522:3456-84. [PMID: 24752643 PMCID: PMC4139435 DOI: 10.1002/cne.23614] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 04/14/2014] [Accepted: 04/15/2014] [Indexed: 01/06/2023]
Abstract
The corticobulbar projection to the hypoglossal nucleus was studied from the frontal, parietal, cingulate, and insular cortices in the rhesus monkey by using high-resolution anterograde tracers and stereology. The hypoglossal nucleus received bilateral input from the face/head region of the primary (M1), ventrolateral pre- (LPMCv), supplementary (M2), rostral cingulate (M3), and caudal cingulate (M4) motor cortices. Additional bilateral corticohypoglossal projections were found from the dorsolateral premotor cortex (LPMCd), ventrolateral proisocortical motor area (ProM), ventrolateral primary somatosensory cortex (S1), rostral insula, and pregenual region of the anterior cingulate gyrus (areas 24/32). Dense terminal projections arose from the ventral region of M1, and moderate projections from LPMCv and rostral part of M2, with considerably fewer hypoglossal projections arising from the other cortical regions. These findings demonstrate that extensive regions of the non-human primate cerebral cortex innervate the hypoglossal nucleus. The widespread and bilateral nature of this corticobulbar connection suggests recovery of tongue movement after cortical injury that compromises a subset of these areas, may occur from spared corticohypoglossal projection areas located on the lateral, as well as medial surfaces of both hemispheres. Since functional imaging studies have shown that homologous cortical areas are activated in humans during tongue movement tasks, these corticobulbar projections may exist in the human brain.
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Affiliation(s)
- Robert J. Morecraft
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota 57069
| | - Kimberly S. Stilwell-Morecraft
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota 57069
| | - Kathryn M. Solon-Cline
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota 57069
| | - Jizhi Ge
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota 57069
| | - Warren G. Darling
- Department of Health and Human Physiology, Motor Control Laboratories, The University of Iowa, Iowa City, Iowa 52242
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Heiferman DM, Ackerman PD, Hayward DM, Primeau MJ, Anderson DE, Prabhu VC. Bilateral supplementary motor area syndrome causing akinetic mutism following parasagittal meningioma resection. ACTA ACUST UNITED AC 2014. [DOI: 10.7243/2052-6946-2-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Lazaridou A, Astrakas L, Mintzopoulos D, Khanchiceh A, Singhal A, Moskowitz M, Rosen B, Tzika A. fMRI as a molecular imaging procedure for the functional reorganization of motor systems in chronic stroke. Mol Med Rep 2013; 8:775-9. [PMID: 23900349 PMCID: PMC3782530 DOI: 10.3892/mmr.2013.1603] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 03/20/2013] [Indexed: 01/12/2023] Open
Abstract
Previous brain imaging studies suggest that stroke alters functional connectivity in motor execution networks. Moreover, current understanding of brain plasticity has led to new approaches in stroke rehabilitation. Recent studies showed a significant role of effective coupling of neuronal activity in the SMA (supplementary motor area) and M1 (primary motor cortex) network for motor outcome in patients after stroke. After a subcortical stroke, functional magnetic resonance imaging (fMRI) during movement reveals cortical reorganization that is associated with the recovery of function. The aim of the present study was to explore connectivity alterations within the motor-related areas combining motor fMRI with a novel MR-compatible hand-induced robotic device (MR_CHIROD) training. Patients completed training at home and underwent serial MR evaluation at baseline and after 8 weeks of training. Training at home consisted of squeezing a gel exercise ball with the paretic hand at ~75% of maximum strength for 1 h/day, 3 days/week. The fMRI analysis revealed alterations in M1, SMA, PMC (premotor cortex) and Cer (cerebellum) in both stroke patients and healthy controls after the training. Findings of the present study suggest that enhancement of SMA activity could benefit M1 dysfunction in stroke survivors. These results also indicate that connectivity alterations between motor areas might assist the counterbalance of a functionally abnormal M1 in chronic stroke survivors and possibly other patients with motor dysfunction.
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Affiliation(s)
- Asimina Lazaridou
- NMR Surgical Laboratory, Massachusetts General Hospital and Shriners Burn Institute, Harvard Medical School, Boston, MA, USA
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15
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Knikou M. Functional reorganization of soleus H-reflex modulation during stepping after robotic-assisted step training in people with complete and incomplete spinal cord injury. Exp Brain Res 2013; 228:279-96. [PMID: 23708757 DOI: 10.1007/s00221-013-3560-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 05/02/2013] [Indexed: 12/14/2022]
Abstract
Body weight-supported (BWS) robotic-assisted step training on a motorized treadmill is utilized with the aim to improve walking ability in people after damage to the spinal cord. However, the potential for reorganization of the injured human spinal neuronal circuitry with this intervention is not known. The objectives of this study were to determine changes in the soleus H-reflex modulation pattern and activation profiles of leg muscles during stepping after BWS robotic-assisted step training in people with chronic spinal cord injury (SCI). Fourteen people who had chronic clinically complete, motor complete, and motor incomplete SCI received an average of 45 training sessions, 5 days per week, 1 h per day. The soleus H-reflex was evoked and recorded via conventional methods at similar BWS levels and treadmill speeds before and after training. After BWS robotic-assisted step training, the soleus H-reflex was depressed at late stance, stance-to-swing transition, and swing phase initiation, allowing a smooth transition from stance to swing. The soleus H-reflex remained depressed at early and mid-swing phases of the step cycle promoting a reciprocal activation of ankle flexors and extensors. The spinal reflex circuitry reorganization was, however, more complex, with the soleus H-reflex from the right leg being modulated either in a similar or in an opposite manner to that observed in the left leg at a given phase of the step cycle after training. Last, BWS robotic-assisted step training changed the amplitude and onset of muscle activity during stepping, decreased the step duration, and improved the gait speed. BWS robotic-assisted step training reorganized spinal locomotor neuronal networks promoting a functional amplitude modulation of the soleus H-reflex and thus step progression. These findings support that spinal neuronal networks of persons with clinically complete, motor complete, or motor incomplete SCI have the potential to undergo an endogenous-mediated reorganization, and improve spinal reflex function and walking function with BWS robotic-assisted step training.
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Affiliation(s)
- Maria Knikou
- Electrophysiological Analysis of Gait and Posture Laboratory, Sensory Motor Performance Program, Rehabilitation Institute of Chicago, 345 East Superior Street, Suite 1406, Chicago, IL 60611, USA.
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Kasasbeh AS, Yarbrough CK, Limbrick DD, Steger-May K, Leach JL, Mangano FT, Smyth MD. Characterization of the supplementary motor area syndrome and seizure outcome after medial frontal lobe resections in pediatric epilepsy surgery. Neurosurgery 2012; 70:1152-68; discussion 1168. [PMID: 22067422 DOI: 10.1227/neu.0b013e31823f6001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In adults, resection of the medial frontal lobe has been shown to result in supplementary motor area (SMA) syndrome, a disorder characterized by transient motor impairment. Studies examining the development of SMA syndrome in children, however, are wanting. OBJECTIVE To characterize the development of SMA syndrome and to analyze seizure outcomes after surgery in the medial frontal lobe for medically intractable epilepsy. METHODS Thirty-nine patients with medically intractable epilepsy who underwent surgery in the medial frontal lobe were reviewed retrospectively. The progression of neurological impairment and seizure outcome after surgery was recorded, and the extent of cortex resected was analyzed. RESULTS After resection in the region of the SMA, 23 patients (59%) developed postoperative neurological impairment; 17 (74%) were identified as SMA syndrome. No neurological impairment was found after surgery in 16 patients (41%). Six patients (15%) experienced permanent neurological impairment. The majority of patients (82%) who developed SMA syndrome had resolution of their symptoms by 1 month postoperatively. Preoperative magnetic resonance imaging finding of lesional cases was associated with a significantly decreased likelihood of developing SMA syndrome (P = .02). Seizure outcome was favorable after surgery in most patients. CONCLUSION Surgery for medically intractable epilepsy in the region of the medial frontal cortex is effective and associated with reversible neurological impairment in children. All patients had resolution of their SMA syndrome by 6 months postoperatively.
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Affiliation(s)
- Aimen S Kasasbeh
- Department of Neuroscience, University of Arizona, Tucson, Arizona 85719, USA.
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Pennycott A, Wyss D, Vallery H, Klamroth-Marganska V, Riener R. Towards more effective robotic gait training for stroke rehabilitation: a review. J Neuroeng Rehabil 2012; 9:65. [PMID: 22953989 PMCID: PMC3481425 DOI: 10.1186/1743-0003-9-65] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 08/29/2012] [Indexed: 01/19/2023] Open
Abstract
Background Stroke is the most common cause of disability in the developed world and can severely degrade walking function. Robot-driven gait therapy can provide assistance to patients during training and offers a number of advantages over other forms of therapy. These potential benefits do not, however, seem to have been fully realised as of yet in clinical practice. Objectives This review determines ways in which robot-driven gait technology could be improved in order to achieve better outcomes in gait rehabilitation. Methods The literature on gait impairments caused by stroke is reviewed, followed by research detailing the different pathways to recovery. The outcomes of clinical trials investigating robot-driven gait therapy are then examined. Finally, an analysis of the literature focused on the technical features of the robot-based devices is presented. This review thus combines both clinical and technical aspects in order to determine the routes by which robot-driven gait therapy could be further developed. Conclusions Active subject participation in robot-driven gait therapy is vital to many of the potential recovery pathways and is therefore an important feature of gait training. Higher levels of subject participation and challenge could be promoted through designs with a high emphasis on robotic transparency and sufficient degrees of freedom to allow other aspects of gait such as balance to be incorporated.
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Effects of Electroacupuncture at Head Points on the Function of Cerebral Motor Areas in Stroke Patients: A PET Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:902413. [PMID: 22956979 PMCID: PMC3432396 DOI: 10.1155/2012/902413] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 06/18/2012] [Indexed: 02/01/2023]
Abstract
Positron emission tomography (PET) is used to observe the cerebral
function widely and is a good method to explore the mechanism of
acupuncture treatment on the central nervous system. By using this
method, we observed the cerebral function of 6 patients suffering
from ischemic stroke after receiving EA treatment at Baihui(GV20)
and right Qubin(GB7). The results were: (1) the glucose metabolism
changed significantly on primary motor area (M1), premotor cortex
(PMC), and superior parietal louble (LPs) bilaterally, as well as
the Supplementary Motor Area (SMA) on the unaffected hemisphere
right after the first EA treatment. (2) The glucose metabolism on
bilateral M1 and LPs changed significantly after three weeks of
daily EA treatments. (3) The glucose metabolism on other areas
such as insula, putamen, and cerebellum changed significantly. It
demonstrated that EA at Qubin and Baihui couldactivate the
cerebral structures related to motor function on the bilateral
hemispheres.We concluded that EA was very helpful for the cerebral
motor plasticity after the ischemic stroke. Also based on this
study we assumed that the brain plasticity should be a network and
that acupuncture participated in some sections of this course.
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Hoyer EH, Celnik PA. Understanding and enhancing motor recovery after stroke using transcranial magnetic stimulation. Restor Neurol Neurosci 2012; 29:395-409. [PMID: 22124033 DOI: 10.3233/rnn-2011-0611] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Stroke is the leading cause of long-term disability. Understanding how people recover from stroke and other brain lesions remain one of the biggest conundrums in neuroscience. As a result, concerted efforts in recent years have focused on investigating the neurophysiological changes that occur in the brain after stroke, and in developing novel strategies to enhance motor recovery. In particular, transcranial magnetic stimulation (TMS) is a non-invasive tool that has been used to investigate the brain plasticity changes resulting from stroke and as a therapeutic modality to safely improve motor function. In this review, we discuss the contributions of TMS to understand how different motor areas, such as the ipsilesional hemisphere, secondary motor areas, and contralesional hemisphere are involved in motor recovery. We also consider recent studies using repetitive TMS (rTMS) in stroke patients to enhance upper extremity function. Although further studies are needed, these investigations provide an important starting point to understand the stimulation parameters and patient characteristics that may influence the optimal response to non-invasive brain stimulation. Future directions of rTMS are discussed in the context of post-stroke motor recovery.
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Affiliation(s)
- Erik H Hoyer
- Department of Physical Medicine and Rehabilitation, Johns Hopkins Medical Institution, Baltimore, MD 21287, USA
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Activation likelihood estimation meta-analysis of motor-related neural activity after stroke. Neuroimage 2012; 59:2771-82. [DOI: 10.1016/j.neuroimage.2011.10.023] [Citation(s) in RCA: 228] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 10/06/2011] [Accepted: 10/07/2011] [Indexed: 01/27/2023] Open
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Motor control of jaw movements: An fMRI study of parafunctional clench and grind behavior. Brain Res 2011; 1383:206-17. [DOI: 10.1016/j.brainres.2011.01.096] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2010] [Revised: 01/14/2011] [Accepted: 01/26/2011] [Indexed: 01/30/2023]
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Hummelsheim H, Amberger S, Mauritz K. The influence of EMG-initiated electrical muscle stimulation on motor recovery of the centrally paretic hand. Eur J Neurol 2011; 3:245-54. [DOI: 10.1111/j.1468-1331.1996.tb00430.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Central to the production of adaptive behavior is the ability to learn the temporal order of behavioral elements (e.g., A, B, C). Yet little is known about neural substrates of serial order in self-initiated behavioral sequences. The present study assessed the contributions of specific dorsal striatal regions to the acquisition of serial order in mice, using a two-action sequence task without instructive cues. Excitotoxic lesions of the sensorimotor (dorsolateral) striatum dramatically impaired the acquisition of a simple sequence; in contrast, lesions of the associative (dorsomedial) striatum had no significant effect. Neither lesion caused gross motor impairments or affected the learning of nonsequential actions. These results demonstrate for the first time a critical role of the sensorimotor striatum in the learning of serial order.
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Salimpoor VN, Chang C, Menon V. Neural basis of repetition priming during mathematical cognition: repetition suppression or repetition enhancement? J Cogn Neurosci 2010; 22:790-805. [PMID: 19366289 DOI: 10.1162/jocn.2009.21234] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We investigated the neural basis of repetition priming (RP) during mathematical cognition. Previous studies of RP have focused on repetition suppression as the basis of behavioral facilitation, primarily using word and object identification and classification tasks. More recently, researchers have suggested associative stimulus-response learning as an alternate model for behavioral facilitation. We examined the neural basis of RP during mathematical problem solving in the context of these two models of learning. Brain imaging and behavioral data were acquired from 39 adults during novel and repeated presentation of three-operand mathematical equations. Despite wide-spread decreases in activation during repeat, compared with novel trials, there was no direct relation between behavioral facilitation and the degree of repetition suppression in any brain region. Rather, RT improvements were directly correlated with repetition enhancement in the hippocampus and the posteromedial cortex [posterior cingulate cortex, precuneus, and retrosplenial cortex; Brodmann's areas (BAs) 23, 7, and 30, respectively], regions known to support memory formation and retrieval, and in the SMA (BA 6) and the dorsal midcingulate ("motor cingulate") cortex (BA 24d), regions known to be important for motor learning. Furthermore, improvements in RT were also correlated with increased functional connectivity of the hippocampus with both the SMA and the dorsal midcingulate cortex. Our findings provide novel support for the hypothesis that repetition enhancement and associated stimulus-response learning may facilitate behavioral performance during problem solving.
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Buma FE, Lindeman E, Ramsey NF, Kwakkel G. Review: Functional Neuroimaging Studies of Early Upper Limb Recovery After Stroke: A Systematic Review of the Literature. Neurorehabil Neural Repair 2010; 24:589-608. [DOI: 10.1177/1545968310364058] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Understanding mechanisms of recovery may result in new treatment strategies to improve motor outcome after stroke. Imaging techniques such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) allow changes in brain activity after stroke recovery to be identified. Objective. To systematically review serial imaging studies on recovery within 6 months poststroke, assess their methodological quality, and identify trends in the association between task-related brain activation patterns and functional upper limb recovery. Methods. A literature search was performed using Medline, PICARTA, and EMBASE databases. Studies were appraised using binary weighted methodological criteria for internal, statistical, and external validity. Results. Twenty-two of the 869 identified studies met the inclusion criteria. Studies showed methodological weaknesses with respect to controlling for task performance, selecting appropriate outcome measures, and adequate presentation and execution of statistical analysis. After stroke, motor task performance shows unilateral overactivation of motor and nonmotor areas, a posterior shift in activity in the primary motor cortex, and bilateral recruitment of associated motor and nonmotor areas. Concomitant with neurological recovery, overactivation appears to diminish longitudinally, but not in all patients. Conclusion . Despite methodological shortcomings and heterogeneity, trends can be discerned. However, statistically sound associations with recovery are not consistent. The challenges in future research will be, controlling for confounding factors, finding outcomes that specifically measure dexterity of the paretic limb, to control for the extent of white matter damage and changes in perfusion in order to establish the longitudinal construct validity of fMRI and PET with regard to upper limb recovery after stroke.
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Affiliation(s)
- Floor E. Buma
- University Medical Centre Utrecht, Utrecht, Netherlands,
| | | | | | - Gert Kwakkel
- University Medical Centre Utrecht, Utrecht, Netherlands, VU University Medical Centre, Amsterdam, Netherlands
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26
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Acuña C, Pardo-Vázquez JL, Leborán V. Decision-Making, Behavioral Supervision and Learning: An Executive Role for the Ventral Premotor Cortex? Neurotox Res 2010; 18:416-27. [DOI: 10.1007/s12640-010-9194-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Revised: 03/04/2010] [Accepted: 04/06/2010] [Indexed: 11/29/2022]
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27
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Reithler J, van Mier HI, Goebel R. Continuous motor sequence learning: cortical efficiency gains accompanied by striatal functional reorganization. Neuroimage 2010; 52:263-76. [PMID: 20362682 DOI: 10.1016/j.neuroimage.2010.03.073] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 03/25/2010] [Indexed: 11/19/2022] Open
Abstract
The acquisition and generation of action sequences constitute essential elements of purposeful human behavior. However, there is still considerable debate on how experience-driven changes related to skill learning are expressed at the neural systems level. The current functional magnetic resonance imaging (fMRI) study focused on changes in the neural representation of continuous movement sequences as learning evolved. Behavioral and neural manifestations of nonvisual motor practice were studied both within the time frame of a single scanning session, as well as after several days of extended practice. Based on detailed behavioral recordings which enabled the continuous characterization of the ongoing learning process at the single subject level, sequence-specific decreases in activation throughout a learning-related network of cortical areas were identified. Furthermore, the spatial layout of this cortical network remained largely unchanged after extensive practice, although further decreases in activation levels could be observed as learning progressed. In contrast, the posterior part of the left putamen showed increased activation levels when an extensively trained sequence needed to be recalled. Overall, these findings imply that continuous motor sequence learning is mainly associated with more efficient processing in a network of consistently recruited cortical areas, together with co-occurring activation pattern changes at the subcortical level.
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Affiliation(s)
- Joel Reithler
- Cognitive Neuroscience Department, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
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28
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McNeal DW, Darling WG, Ge J, Stilwell-Morecraft KS, Solon KM, Hynes SM, Pizzimenti MA, Rotella DL, Vanadurongvan T, Morecraft RJ. Selective long-term reorganization of the corticospinal projection from the supplementary motor cortex following recovery from lateral motor cortex injury. J Comp Neurol 2010; 518:586-621. [PMID: 20034062 DOI: 10.1002/cne.22218] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Brain injury affecting the frontal motor cortex or its descending axons often causes contralateral upper extremity paresis. Although recovery is variable, the underlying mechanisms supporting favorable motor recovery remain unclear. Because the medial wall of the cerebral hemisphere is often spared following brain injury and recent functional neuroimaging studies in patients indicate a potential role for this brain region in the recovery process, we investigated the long-term effects of isolated lateral frontal motor cortical injury on the corticospinal projection (CSP) from intact, ipsilesional supplementary motor cortex (M2). After injury to the arm region of the primary motor (M1) and lateral premotor (LPMC) cortices, upper extremity recovery is accompanied by terminal axon plasticity in the contralateral CSP but not the ipsilateral CSP from M2. Furthermore, significant contralateral plasticity occurs only in lamina VII and dorsally within lamina IX. Thus, selective intraspinal sprouting transpires in regions containing interneurons, flexor-related motor neurons, and motor neurons supplying intrinsic hand muscles, which all play important roles in mediating reaching and digit movements. After recovery, subsequent injury of M2 leads to reemergence of hand motor deficits. Considering the importance of the CSP in humans and the common occurrence of lateral frontal cortex injury, these findings suggest that spared supplementary motor cortex may serve as an important therapeutic target that should be considered when designing acute and long-term postinjury patient intervention strategies aimed to enhance the motor recovery process following lateral cortical trauma.
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30
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Katiuscia S, Franco C, Federico D, Davide M, Sergio D, Giuliano G. Reorganization and enhanced functional connectivity of motor areas in repetitive ankle movements after training in locomotor attention. Brain Res 2009; 1297:124-34. [DOI: 10.1016/j.brainres.2009.08.049] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2008] [Revised: 08/13/2009] [Accepted: 08/14/2009] [Indexed: 11/26/2022]
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31
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Ring A, Rajandran H, Harvey A, Ghosh S. Changes in electrical thresholds for evoking movements from the cat cerebral cortex following lesions of the sensori-motor area. Somatosens Mot Res 2009; 21:117-36. [PMID: 15370092 DOI: 10.1080/08990220410001721275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We evaluated motor maps in the cerebral cortex and motor performance in cats before and after lesions of the forelimb representation in the primary motor area. After the lesion there was a reduction in the use of the affected forelimb and loss of accuracy in prehension tasks using the forelimb; some recovery occurred during the mapping study. Electrode tracts and lesion sites were located in cytoarchitectonically identified cortical areas 4gamma, 4delta, 6aalpha, 6agamma, 3a. The lesions were mainly in area 4gamma. In the lesioned hemisphere there were many points around the lesion site (in areas 4gamma and 3a) from which movements could not be evoked. In some areas distant from the lesion site (e.g. area 6agamma) the mean thresholds for evoking forelimb movements were significantly elevated. Mean thresholds for evoking hindlimb and facial movements were not different from before. In the contralateral hemisphere mean thresholds for evoking forelimb, but not hindlimb or facial movements, were significantly elevated in several sensorimotor areas (area 4gamma, 6agamma and 3a). Mean thresholds for evoking forelimb movements appeared to progressively increase during the time of study. Minimal currents required to evoke forelimb movements from the cerebral cortex increase (possibly progressively) following a lesion of the forelimb representation in the primary motor area, affecting many interconnected motor areas in the hemispheres ipsilateral and contralateral to the lesioned site. This increase in thresholds may play a role in the changes in cortical control of the affected and contralateral limbs following brain lesions and explain the increased sense of effort required to produce movements.
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Affiliation(s)
- A Ring
- Centre for Neuromuscular & Neurological Disorders, University of Western Australia, Perth, WA 6009, Australia
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32
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Abstract
During the last decades, transcranial magnetic stimulation (TMS) has been used as a noninvasive method to investigate motor cortical reorganization and neuroplasticity in humans after stroke. An increasing number of studies in the field of motor control have used TMS to gain an understanding of the different aspects of stroke cortical physiology and motor recovery. This review addresses the effects of corticospinal tract (CST) lesions in humans and nonhuman primates on the functional organization of the motor system. We review information on the physiological mechanisms by which the CST contributes to normal motor control and to central nervous system reorganization following stroke when the CST is injured as measured using TMS. Insight into these physiological mechanisms has led to the development of scientifically sound interventional proposals in the field of neurorehabilitation.
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Affiliation(s)
- Monica A Perez
- Department of Physical Medicine and Rehabilitation, Center for the Neural Basis of Cognition, University of Pittsburgh, Pennsylvania, USA
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33
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Hatanaka N, Tokuno H, Nambu A, Takada M. Transdural doppler ultrasonography monitors cerebral blood flow changes in relation to motor tasks. Cereb Cortex 2009; 19:820-31. [PMID: 18660498 DOI: 10.1093/cercor/bhn129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Monitoring changes in cerebral blood flow in association with neuronal activity has widely been used to evaluate various brain functions. However, current techniques do not directly measure blood flow changes in specified blood vessels. The present study identified arterioles within the cerebral cortex by echoencephalography and color Doppler imaging, and then measured blood flow velocity (BFV) changes in pulsed-wave Doppler mode. We applied this "transdural Doppler ultrasonography (TDD)" to examine BFV changes in the cortical motor-related areas of monkeys during the performance of unimanual (right or left) and bimanual key-press tasks. BFV in the primary motor cortex (MI) was increased in response to contralateral movement. In each of the unimanual and bimanual tasks, bimodal BFV increases related to both the instruction signal and the movement were observed in the supplementary motor area (SMA). Such BFV changes in the SMA were prominent during the early stage of task training and gradually decreased with improvements in task performance, leaving those in the MI unchanged. Moreover, BFV changes in the SMA depended on task difficulty. The present results indicate that TDD is useful for evaluating regional brain functions.
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Affiliation(s)
- Nobuhiko Hatanaka
- Tokyo Metropolitan Institute for Neuroscience, Tokyo Metropolitan Organization for Medical Research, Fuchu, Japan.
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34
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Paz R, Vaadia E. Learning from learning: what can visuomotor adaptations tell us about the neuronal representation of movement? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2009; 629:221-42. [PMID: 19227502 DOI: 10.1007/978-0-387-77064-2_11] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The use of sensorimotor adaptation and learning paradigms in psychophyical and electrophysiological experiments can help to shed light on two fundamental questions. First, what are the computations that control sensorimotor behavior and, second, what are the neuronal mechanisms and representations underlying newly learned sensorimotor skills? We describe experiments that combined behavioral and electrophysioloigcal techniques and discuss implication of the results to three main questions: How do neuronal primitives of representation affect performance and learning? Do pre-motor and primary motor cortices form a hierarchy of computation, with different roles during learning and motor performance? How do these different cortical areas and the representations of movement change during the different stages of learning and memory formation?
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Affiliation(s)
- Rony Paz
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel.
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35
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Eisner-Janowicz I, Barbay S, Hoover E, Stowe AM, Frost SB, Plautz EJ, Nudo RJ. Early and late changes in the distal forelimb representation of the supplementary motor area after injury to frontal motor areas in the squirrel monkey. J Neurophysiol 2008; 100:1498-512. [PMID: 18596180 DOI: 10.1152/jn.90447.2008] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Neuroimaging studies in stroke survivors have suggested that adaptive plasticity occurs following stroke. However, the complex temporal dynamics of neural reorganization after injury make the interpretation of functional imaging studies equivocal. In the present study in adult squirrel monkeys, intracortical microstimulation (ICMS) techniques were used to monitor changes in representational maps of the distal forelimb in the supplementary motor area (SMA) after a unilateral ischemic infarct of primary motor (M1) and premotor distal forelimb representations (DFLs). In each animal, ICMS maps were derived at early (3 wk) and late (13 wk) postinfarct stages. Lesions resulted in severe deficits in motor abilities on a reach and retrieval task. Limited behavioral recovery occurred and plateaued at 3 wk postinfarct. At both early and late postinfarct stages, distal forelimb movements could still be evoked by ICMS in SMA at low current levels. However, the size of the SMA DFL changed after the infarct. In particular, wrist-forearm representations enlarged significantly between early and late stages, attaining a size substantially larger than the preinfarct area. At the late postinfarct stage, the expansion in the SMA DFL area was directly proportional to the absolute size of the lesion. The motor performance scores were positively correlated to the absolute size of the SMA DFL at the late postinfarct stage. Together, these data suggest that, at least in squirrel monkeys, descending output from M1 and dorsal and ventral premotor cortices is not necessary for SMA representations to be maintained and that SMA motor output maps undergo delayed increases in representational area after damage to other motor areas. Finally, the role of SMA in recovery of function after such lesions remains unclear because behavioral recovery appears to precede neurophysiological map changes.
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Affiliation(s)
- Ines Eisner-Janowicz
- Department of Molecular and Integrative Physiology Department and Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas, USA
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Schaechter JD, Perdue KL. Enhanced cortical activation in the contralesional hemisphere of chronic stroke patients in response to motor skill challenge. Cereb Cortex 2007; 18:638-47. [PMID: 17602141 DOI: 10.1093/cercor/bhm096] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The brain processes involved in the restoration of motor skill after hemiparetic stroke are not fully understood. The current study compared cortical activity in chronic stroke patients who successfully recovered hand motor skill and normal control subjects during performance of kinematically matched unskilled and skilled hand movements using functional magnetic resonance imaging. We found that cortical activation during performance of the unskilled movement was increased in the patients relative to controls in the contralesional primary sensorimotor cortex. Performance of the skilled movement elicited increased activation in the patients relative to controls in the contralesional primary sensorimotor cortex, ventral premotor cortex, supplementary motor area/cingulate, and occipitoparietal cortex. Further, the activation change in the contralesional occipitoparietal cortex was greater in the patients relative to controls with the increase in motor skill challenge. Kinematic differences, mirror movements, and residual motor deficits did not account for the enhanced activation in the contralesional cortices in the patients. These results suggest that activation in the contralesional cortical network was enhanced as a function of motor skill challenge in stroke patients with good motor recovery. The findings of the current study suggest that successful recovery of motor skill after hemiparetic stroke involves participation of the contralesional cortical network.
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Affiliation(s)
- Judith D Schaechter
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA 02129, USA.
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37
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Abstract
Evidence supporting the plastic capacity of the adult cortex is abundant. Changes have been associated with exposure to enriched environments, learning, peripheral lesions and central lesions. The initial loss of function caused by a lesion is generally followed by a certain amount of recovery that is believed to be due, at least in part, to adaptive plasticity. In particular, the reorganization of cortical representational maps has been associated with improvement of performance. Therefore, areas undergoing such reorganization following lesions are generally assumed to participate in the recovery. We review evidence demonstrating the remodeling of representational maps of the forelimb in adult cortex and the structural plasticity that has been coupled with it. A particular emphasis is paid to non-human primate studies and stroke.
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Affiliation(s)
- Numa Dancause
- Department of Neurology, University of Rochester Medical Center, 601 Elmwood Ave, Box 673, Rochester, NY 14642, USA.
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Dancause N. Vicarious function of remote cortex following stroke: recent evidence from human and animal studies. Neuroscientist 2007; 12:489-99. [PMID: 17079515 DOI: 10.1177/1073858406292782] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Following a lesion, the adult central nervous system undergoes dramatic structural and physiological reorganization in diverse subcortical and cortical areas. Our knowledge of the events that parallel recovery within the tissue surrounding the lesion and other distant cortical areas has evolved greatly in the past few years. Particularly, recent efforts have increased our understanding of the potential implication of premotor areas in recovery from lesions disturbing the primary motor cortex (M1) and its corticospinal outputs. Because these areas share extensive connections with M1 and have direct access to the spinal cord through corticospinal projections, they are particularly well positioned to take over the role of M1 in a vicarious manner and thus compensate for the neuronal loss resulting from M1 lesions. The impressive postlesional reorganization known to occur in many areas of the CNS including the premotor cortex traditionally has been assumed to play a beneficial role in recovery. However, recent experiments suggest that in some cases, reorganization of distant cortical areas correlates with poor recovery, raising the concept of maladaptive vicarious process. This concept might be particularly critical in the development of new treatment approaches favoring postlesion plasticity and even more so for interventions targeting specific area(s). Here, the author reviews human and animal studies that show the plastic potential of the adult CNS after stroke, highlighting the vicarious role of the premotor cortex in the recovery of motor control.
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Affiliation(s)
- Numa Dancause
- Department of Neurology, University of Rochester, Rochester, NY 14642, USA.
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Diserens K, Perret N, Chatelain S, Bashir S, Ruegg D, Vuadens P, Vingerhoets F. The effect of repetitive arm cycling on post stroke spasticity and motor control. J Neurol Sci 2007; 253:18-24. [PMID: 17241642 DOI: 10.1016/j.jns.2006.10.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2006] [Revised: 10/03/2006] [Accepted: 10/29/2006] [Indexed: 10/23/2022]
Abstract
This study's aims were (1) to test whether training on an arm ergometer improves motor performance, and (2) to develop a technique to quantify individual muscle spasticity. Nine patients with a stabilized hemisyndrome (in average 22 months after ischemic stroke in the territory of middle cerebral artery) underwent a 3-week training on an arm ergometer, 5 days/week. The patients were tested one week before training, at training onset, at the end of training and 2 weeks after training. Spasticity was quantified by (1) the Ashworth Scale of the elbow flexors and extensors, (2) the maximum active extension of the biceps, and (3) the minimum torque on the lesioned side during arm cycling. The data were standardized, pooled and a 2-way ANOVA revealed a decrease of the spasticity by the training (p=0.076). Similarly muscle force was evaluated by the Rivermead Motorik Assessment, the Motricity Index and the cycling force, and the range of active movement as the sum of the angles at a maximum shoulder flexion, shoulder abduction, elbow flexion and elbow extension. The training increased the force (p<0.01) and also the range of motion (p<0.05) significantly. The patients confirmed the clinical relevance of the results. The spasticity index - the relation between the muscle activity modulation on the normal and lesioned side - was shown to be a useful tool in quantifying individual muscle spasticity. It was concluded that cycling on an arm ergometer is a useful tool for rehabilitation.
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Affiliation(s)
- K Diserens
- Department of Neurology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
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40
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Schieber MH. Chapter 2 Comparative anatomy and physiology of the corticospinal system. HANDBOOK OF CLINICAL NEUROLOGY 2007; 82:15-37. [PMID: 18808887 DOI: 10.1016/s0072-9752(07)80005-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The corticospinal tract provides the most direct pathway over which the cerebral cortex controls movement. In rodents and marsupials this influence is exerted largely upon interneurons in the dorsal horn of the spinal gray matter. However, ascending the phylogenetic scale through carnivores and primates, the number of corticospinal axons grows and corticospinal terminations shift progressively toward the interneurons of the intermediate zone and ventral horn, ultimately forming increasing numbers of synaptic terminations directly on the motoneurons themselves. Based on this phylogenetic trend, humans are believed to have more direct corticomotoneuronal synapses than any other species, consistent with observations that humans suffer more extensive loss of motility from lesions of the corticospinal tract than do other mammals. Beyond this phylogenetic trend, studies of the corticospinal system in animals have provided insight into the motor abnormalities that result from corticospinal lesions in humans. Corticospinal lesions impair many functionally related muscles and movements in parallel, both because of the divergent output from single corticomotoneuronal cells to multiple motoneuron pools, and because of the convergent input to different motoneuron pools from large, overlapping cortical territories. Furthermore, the weakness, slowness and inflexible, stereotyped movements that remain after corticospinal lesions reflect the loss of input to spinal interneurons and motoneurons from corticospinal neurons, the discharge frequency of which varies with the force, direction and speed of both gross and fine movements. That these deficits resulting from corticospinal lesions are more prominent in humans than in animals indicates, moreover, that animals make greater use of additional descending pathways to control movement. Animal studies have shown that although the bulk of the corticospinal tract arises from the primary motor cortex, this projection is not the only route via which the brain controls movement. Adjacent areas in the frontal and parietal lobes also contribute axons to the corticospinal tract, as well as having corticocortical connections with the motor cortex. Furthermore, the motor cortex and premotor cortex both project to the red nucleus and to the pontomedullary reticular formation, from which the rubrospinal and reticulospinal tracts arise. However, given the limitations on experimental studies in humans, comparative animal studies of the distributed descending system through which the brain controls movement continue to provide deeper understanding and insight into the deficits resulting from human corticospinal lesions, whether caused by stroke, tumor, multiple sclerosis, trauma or ALS.
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Takata K, Yamauchi H, Tatsuno H, Hashimoto K, Abo M. Is the ipsilateral cortex surrounding the lesion or the non-injured contralateral cortex important for motor recovery in rats with photochemically induced cortical lesions? Eur Neurol 2006; 56:106-12. [PMID: 16960450 DOI: 10.1159/000095700] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2005] [Accepted: 06/29/2006] [Indexed: 11/19/2022]
Abstract
PRIMARY OBJECTIVE To determine whether the ipsilateral cortex surrounding the lesion or the non-injured contralateral cortex is important for motor recovery after brain damage in the photochemically initiated thrombosis (PIT) model. RESEARCH DESIGN We induced PIT in the sensorimotor cortex in rats and examined the recovery of motor function using the beam-walking test. METHODS AND PROCEDURES In 24 rats, the right sensorimotor cortex was lesioned after 2 days of training for the beam-walking test (group 1). After 10 days, PIT was induced in the left sensorimotor cortex. Eight additional rats (group 2) received 2 days training in beam walking, then underwent the beam-walking test to evaluate function. After 10 days of testing, the left sensorimotor cortex was lesioned and recovery was monitored by the beam-walking test for 8 days. MAIN OUTCOMES AND RESULTS In group 1 animals, left hindlimb function caused by a right sensorimotor cortex lesion recovered within 10 days after the operation. Right hindlimb function caused by the left-side lesion recovered within 6 days. In group 2, right hindlimb function caused by induction of the left-side lesion after a total of 12 days of beam-walking training and testing recovered within 6 days as with the double PIT model. The training effect may be relevant to reorganization and neuromodulation. Motor recovery patterns did not indicate whether motor recovery was dependent on the ipsilateral cortex surrounding the lesion or the cortex of the contralateral side. CONCLUSION The results emphasize the need for selection of appropriate programs tailored to the area of cortical damage in order to enhance motor functional recovery in this model.
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Affiliation(s)
- Kotaro Takata
- Department of Rehabilitation Medicine, Jikei University School of Medicine, Tokyo, Japan
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Sacco K, Cauda F, Cerliani L, Mate D, Duca S, Geminiani GC. Motor imagery of walking following training in locomotor attention. The effect of ‘the tango lesson’. Neuroimage 2006; 32:1441-9. [PMID: 16861008 DOI: 10.1016/j.neuroimage.2006.05.018] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2006] [Revised: 04/12/2006] [Accepted: 05/02/2006] [Indexed: 11/13/2022] Open
Abstract
The hypothesis of this study is that focusing attention on walking motor schemes could modify sensorimotor activation of the brain. Indeed, gait is a learned automated process, mostly regulated by subcortical and spinal structures. We examined the functional changes in the activity of the cerebral areas involved in locomotor imagery tasks, before and after one week of training consisting of physical and mental practice. The aim of the training was to focus the subject's conscious attention on the movements involved in walking. In our training, subjects were asked to perform basic tango steps, which require specific ways of walking; each tango lesson ended with motor imagery training of the performed steps. The results show that training determines an expansion of active bilateral motor areas during locomotor imagery. This finding, together with a reduction of visuospatial activation in the posterior right brain, suggests a decreased role of visual imagery processes in the post-training period in favor of motor-kinesthetic ones.
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Affiliation(s)
- K Sacco
- Center for Cognitive Science and Department of Psychology, University of Turin, via Po 12, 10123 Turin, Italy.
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Carey LM, Abbott DF, Egan GF, O'Keefe GJ, Jackson GD, Bernhardt J, Donnan GA. Evolution of brain activation with good and poor motor recovery after stroke. Neurorehabil Neural Repair 2006; 20:24-41. [PMID: 16467276 DOI: 10.1177/1545968305283053] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To characterize the evolution of brain activation in stroke patients with variable motor recovery and quantify changes relative to healthy controls. METHODS Serial PET activation studies, using a simple finger-tapping task, and quantitative measures of motor performance were obtained in 9 patients (2-7 weeks poststroke and 6 months later) and compared with serial healthy volunteer data. RESULTS Patients with moderate impairment and good recovery (n = 5) activated the primary sensorimotor cortex (SM1) contralateral to the paretic hand moved, bilateral supplementary motor area (SMA), contralateral cingulate gyrus, and ipsilateral lateral premotor cortex. Activation in the bilateral SMA was greater at the initial study but reduced over time compared to healthy controls and poor recoverers. Patients with severe impairment and poor recovery (n =4) showed limited activation of contralateral SM1 and SMA at both studies and no significant change over time. A posterior shift in SM1 activation was evident in good and poor recoverers. CONCLUSIONS Activation of typical motor regions and recruitment of additional sites occur subacutely poststroke, with evolution to normal patterns in moderately impaired patients who recover well. In comparison, severely impaired, poor-recovery patients show persistent, reduced activation. Dynamic changes in SMA, differentially observed in good recoverers over 6 months, highlight its importance in recovery.
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Affiliation(s)
- Leeanne M Carey
- National Stroke Research Institute, Austin Health, Heidelberg West, Victoria, Australia, LaTrobe University, Bundoora, Victoria, Australia.
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Paz R, Natan C, Boraud T, Bergman H, Vaadia E. Emerging patterns of neuronal responses in supplementary and primary motor areas during sensorimotor adaptation. J Neurosci 2005; 25:10941-51. [PMID: 16306407 PMCID: PMC6725878 DOI: 10.1523/jneurosci.0164-05.2005] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2004] [Revised: 09/13/2005] [Accepted: 10/16/2005] [Indexed: 11/21/2022] Open
Abstract
Acquisition and retention of sensorimotor skills have been extensively investigated psychophysically, but little is known about the underlying neuronal mechanisms. Here we examine the evolution of neural activity associated with adaptation to new kinematic tasks in two cortical areas: the caudal supplementary motor area (SMA proper), and the primary motor cortex (MI). We investigate the hypothesis that adaptation starts at premotor areas, i.e., higher in the hierarchy of computation, until a stable representation is formed in primary areas. In accordance with previous studies, we found that adaptation can be characterized by two phases: an early phase that is accompanied by fast and substantial reduction of errors, followed by a late phase with slower and more moderate improvements in behavior. We used unsupervised clustering to separate the activity of the single cells into groups of cells with similar response patterns, under the assumption that each such subpopulation forms a functional unit. We specifically observed the number of clusters in each cortical area during early and late phases of the adaptation and found that the number of clusters is higher in the SMA during early phases of adaptation. In contrast, a higher number of clusters was observed in MI only during late phases. Our results suggest a new approach to analyze responses of large populations of neurons and use it to show a hierarchy of dynamic reorganization of functional groups during adaptation.
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Affiliation(s)
- Rony Paz
- Department of Physiology, Hadassah Medical School, The Hebrew University, Jerusalem 91120, Israel.
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Dum RP, Strick PL. Frontal lobe inputs to the digit representations of the motor areas on the lateral surface of the hemisphere. J Neurosci 2005; 25:1375-86. [PMID: 15703391 PMCID: PMC6726000 DOI: 10.1523/jneurosci.3902-04.2005] [Citation(s) in RCA: 389] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We examined the frontal lobe connections of the digit representations in the primary motor cortex (M1), the dorsal premotor area (PMd), and the ventral premotor area (PMv) of cebus monkeys. All of these digit representations lie on the lateral surface of the hemisphere. We used intracortical stimulation to identify the digit representations physiologically, and then we injected different tracers into two of the three cortical areas. This approach enabled us to compare the inputs to two digit representations in the same animal. We found that the densest inputs from the premotor areas to the digit representation in M1 originate from the PMd and the PMv. Both of these premotor areas contain a distinct digit representation, and the two digit representations are densely interconnected. Surprisingly, the projections from the digit representation in the supplementary motor area (SMA) to the PMd and PMv are stronger than the SMA projections to M1. The projections from other premotor areas to M1, the PMd, and the PMv are more modest. Of the three digit areas on the lateral surface, only the PMv receives dense input from the prefrontal cortex. Based on these results, we believe that M1, the PMd, and the PMv form a densely interconnected network of cortical areas that is concerned with the generation and control of hand movements. Overall, the laminar origins of neurons that interconnect the three cortical areas are typical of "lateral" interactions. Thus, from an anatomical perspective, this cortical network lacks a clear hierarchical organization.
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Affiliation(s)
- Richard P Dum
- Center for the Neural Basis of Cognition and Department of Neurobiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA
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Hoshi E, Sawamura H, Tanji J. Neurons in the Rostral Cingulate Motor Area Monitor Multiple Phases of Visuomotor Behavior With Modest Parametric Selectivity. J Neurophysiol 2005; 94:640-56. [PMID: 15703223 DOI: 10.1152/jn.01201.2004] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We examined the cellular activity in the rostral cingulate motor area (CMAr) with respect to multiple behavioral factors that ranged from the retrieval and processing of associative visual signals to the planning and execution of instructed actions. We analyzed the neuronal activity in monkeys while they performed a behavioral task in which 2 visual instruction cues were given successively with an intervening delay. One cue instructed the location of the target to be reached; the other cue instructed which arm was to be used. After a second delay, the monkey received a motor-set cue to be prepared to initiate the motor task in accordance with instructions. Finally, after a go signal, the monkey reached for the instructed target with the instructed arm. We found that the activity of neurons in the CMAr changed profoundly throughout the behavioral task, which suggested that the CMAr participated in each of the behavioral processing steps. However, the neuronal activity was only modestly selective for the spatial location of the visual signal. We also found that selectivity for the instructional information delivered with the signals (target location and arm use) was modest. Furthermore, during the motor-set and movement periods, few CMAr neurons exhibited selectivity for such motor parameters as the location of the target or the arm to be used. The abundance and robustness of the neuronal activity within the CMAr that reflected each step of the behavioral task and the modest selectivity of the same cells for sensorimotor parameters are strikingly different from the preponderance of selectivity that we have observed in other frontal areas. Based on these results, we propose that the CMAr participates in monitoring individual behavioral events to keep track of the progress of required behavioral tasks. On the other hand, CMAr activity during motor planning may reflect the emergence of a general intention for action.
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Affiliation(s)
- Eiji Hoshi
- Department of Physiology, Tohoku University School of Medicine, Seiryo-cho 2-1, Aoba-ku, Sendai 980-8575, Japan
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Jaillard A, Martin CD, Garambois K, Lebas JF, Hommel M. Vicarious function within the human primary motor cortex? Brain 2005; 128:1122-38. [PMID: 15728652 DOI: 10.1093/brain/awh456] [Citation(s) in RCA: 181] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
While experimental studies in the monkey have shown that motor recovery after partial destruction of the hand motor cortex was based on adjacent motor reorganization, functional MRI (fMRI) studies with isolated primary motor cortical stroke have not yet been reported in humans. Based on experimental data, we designed a study to test if recovery after stroke within primary motor cortex (M1) was associated with reorganization within the surrounding motor cortex, i.e. the motor cortex was able to vicariate. Since motor recovery is time-dependent and might be inflected according to the tested task, the delay after stroke and two motor tasks were included in our design. We examined four patients with one ischaemic stroke limited to M1, and four sex- and age-matched healthy controls in a temporally balanced prospective longitudinal fMRI study over three sessions: <20 days, 4 months and 2 years after stroke. The paradigm included two motor tasks, finger tapping (FT) and finger extension (FE). Distinct patterns of motor activation were observed with time for FT and FE. At the first session, FT-related activation was lateralized in the ipsilateral hemisphere while FE-related activation was contralateral, involving bilateral cerebellar regions for both tasks. From 4 months, skilled motor recovery was associated with contralateral dorsal premotor and sensorimotor cortex and ipsilateral cerebellum motor-related activations, leading to lateralized motor patterns for both tasks. For the left recovered hand, FT and FE-related activations within M1 were more dorsal in patients than in controls. This dorsal shift progressively increased over 2 years, reflecting functional reorganization in the motor cortex adjacent to the lesion. In addition, patients showed a reverse representation of FT and FE within M1, corresponding to a greater dorsal shift for FT than for FE. This functional dissociation might reflect the structural subdivision of M1 with two distinct finger motor representations within M1. Recovery of FT, located within the lesioned depth of the rolandic sulcus in controls, might be related to the re-emergence of a new representation in the intact dorsal M1, while FE, located more dorsally, underwent minor reorganization. This is the first fMRI study of humans presenting with isolated M1 stroke comparable with experimental lesions in animals. Despite the small number of patients, our findings showing the re-emergence of a fingers motor task in the intact dorsal M1 instead of in ventral M1 are consistent with 'vicariation' models of stroke recovery.
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Affiliation(s)
- Assia Jaillard
- Département de Neurologie-Unité Neuro-vasculaire, Centre Hospitalier Universitaire de Grenoble, BP 217-38043 Grenoble Cedex 9, France E-mail:
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Tombari D, Loubinoux I, Pariente J, Gerdelat A, Albucher JF, Tardy J, Cassol E, Chollet F. A longitudinal fMRI study: in recovering and then in clinically stable sub-cortical stroke patients. Neuroimage 2004; 23:827-39. [PMID: 15528083 DOI: 10.1016/j.neuroimage.2004.07.058] [Citation(s) in RCA: 206] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2003] [Revised: 07/20/2004] [Accepted: 07/27/2004] [Indexed: 10/26/2022] Open
Abstract
The aim of this 1-year longitudinal fMRI study was to compare hand motor activation patterns between cerebrovascular paretic patients with a subcortical infarction and healthy elderly subjects and to evaluate the changes between the subacute phase and the chronic phase of recovery. We studied eight right-handed patients with pure motor hemiparesis due to a single ischemic infarct of the corticospinal tract. Each patient underwent a first fMRI (E1) 20 +/- 9 days after stroke, a second (E2) after 4 months and a third (E3) 12 months after stroke. During each fMRI session, the patients performed an active motor task consisting of audio-paced (1 Hz) finger flexion-extension of the paretic hand and underwent a passive motor task consisting of flexion-extension of the paretic hand performed by an examiner. Data were analyzed with SPM99 (random effect analyses). Patients had recovered at E2, were stable between E2 and E3, but still experienced a hand weakness. Displacement of activation maxima coordinates in patients compared to healthy subjects suggested an early reorganization within the SMA and a secondary reorganization within the ipsilesional S1M1 at E2. The main differences between patients and healthy subjects were (1) recruitment of the posterior part of the cingulate cortex and SMA, (2) a general hyperactivation (except in the deefferented primary motor cortex) and (3) an evolution in the S1M1 activation from an early (20 days after stroke) contralesional hyperactivation to a later (4 months after stroke) ipsilesional hyperactivation concomitant to recovery. Changes in activation were confirmed by the passive task that involved no effort and little attention. Despite clinical stability, changes in brain processing seemed to occur between E2 and E3 corresponding to a normalization of ipsilesional S1M1 activation, a decrease of bilateral cerebellar activation, and a progressive increase in SII-BA 40 activity suggesting evolving compensatory networks to sustain recovery.
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Affiliation(s)
- David Tombari
- INSERM U455, pavillon Riser, Hôpital Purpan, 31059 Toulouse, France
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Padoa-Schioppa C, Li CSR, Bizzi E. Neuronal activity in the supplementary motor area of monkeys adapting to a new dynamic environment. J Neurophysiol 2004; 91:449-73. [PMID: 12968016 DOI: 10.1152/jn.00876.2002] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To execute visually guided reaching movements, the central nervous system (CNS) must transform a desired hand trajectory (kinematics) into appropriate muscle-related commands (dynamics). It has been suggested that the CNS might face this challenging computation by using internal forward models for the dynamics. Previous work in humans found that new internal models can be acquired through experience. In a series of studies in monkeys, we investigated how neurons in the motor areas of the frontal lobe reflect the movement dynamics and how their activity changes when monkeys learn a new internal model. Here we describe the results for the supplementary motor area (SMA-proper, or SMA). In the experiments, monkeys executed visually guided reaching movements and adapted to an external perturbing force field. The experimental design allowed dissociating the neuronal activity related to movement dynamics from that related to movement kinematics. It also allowed dissociating the changes related to motor learning from the activity related to motor performance (kinematics and dynamics). We show that neurons in SMA reflect the movement dynamics individually and as a population, and that their activity undergoes a variety of plastic changes when monkeys adapt to a new dynamic environment.
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Affiliation(s)
- Camillo Padoa-Schioppa
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA.
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Obayashi S. Possible mechanism for transfer of motor skill learning: implication of the cerebellum. CEREBELLUM (LONDON, ENGLAND) 2004; 3:204-11. [PMID: 15686098 DOI: 10.1080/14734220410018977] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Transfer of learning takes place whenever our previous knowledge and skills affect the way in which new knowledge and skills are learned. The magnitude of transfer may depend on how prior memory is retrieved so that it may be relevant and usable in the present in terms of internal representation. This review highlights the power of neuroimaging techniques such as positron emission tomography (PET) to identify the underlying neuronal system of intermanual transfer by showing the asymmetry in the system for the same motor skill between hands. The review focuses on cerebellar cross-activation, cerebellar activation contralateral to the active hand, which would contribute to intermanual transfer of monkey tool-use learning, together with the fronto-parietal cortical circuit. Finally, this article proposes the relationship between the cerebellum and the possible mechanism underlying non-specific transfer that allows thinking in a flexible and productive manner.
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Affiliation(s)
- Shigeru Obayashi
- Brain Imaging Project, National Institute of Radiological Sciences, Chiba, Japan.
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