Intermanual interactions during initiation and production of rhythmic and discrete movements in individuals lacking a corpus callosum

A Reflection on Motor Overflow, Mirror Phenomena, Synkinesia and Entrainment

In patients with movement disorders, voluntary movements can sometimes be accompanied by unintentional muscle contractions in other body regions. In this review, we discuss clinical and pathophysiological aspects of several motor phenomena including mirror movements, dystonic overflow, synkinesia, entrainment and mirror dystonia, focusing on their similarities and differences. These phenomena share some common clinical and pathophysiological features, which often leads to confusion in their definition. However, they differ in several aspects, such as the body part showing the undesired movement, the type of this movement (identical or not to the intentional movement), the underlying neurological condition, and the role of primary motor areas, descending pathways and inhibitory circuits involved, suggesting that these are distinct phenomena. We summarize the main features of these fascinating clinical signs aiming to improve the clinical recognition and standardize the terminology in research studies. We also suggest that the term "mirror dystonia" may be not appropriate to describe this peculiar phenomenon which may be closer to dystonic overflow rather than to the classical mirror movements.

Development of Adapted Guitar to Improve Motor Function After Stroke: Feasibility Study in Young Adults

Recent research indicates that music-supported therapies may offer unique benefits for rehabilitation of motor function after stroke. We designed an adapted guitar and training task aimed to improve coordination between rhythmic and discrete movements because individuals recovering from stroke have greater difficulty performing discrete vs. rhythmic movements. In this paper, we report a feasibility study on training to play this adapted guitar in healthy young adults. Subjects (N = 10) practiced two rhythmic strumming patterns over three consecutive days using their non-dominant hand guided by an audiovisual metronome (60 bpm). They were also instructed to press a foot pedal while maintaining the strumming movement. Elbow and wrist kinematics were estimated using wireless inertial measurement units. Results showed positive mean asynchrony between strum onsets and metronome onsets, and a decrease in the standard deviation of mean asynchrony over practice. In early practice, participants slowed the strumming movement when they pressed the foot pedal, but this interference decreased on days two and three. Smoothness of the elbow movement during the strum phase, which includes the contact with the strings, increased over practice, while smoothness of the return phase did not change over practice. The predominant joint coordination pattern used for the strum phase consisted of elbow extension coupled with elbow pronation, wrist extension, and ulnar deviation. We discuss how these results fit into current music-based rehabilitation literature and outline directions for future applications of this music-supported intervention.

Response biases: the influence of the contralateral limb and head position

Two experiments were designed to determine response biases resulting from production of force in the contralateral limb and head position. Participants were required to react with one limb while tracking a sinewave template by generating a pattern of force defined by the sinewave with the contralateral limb or watching a cursor move through the sinewave. In Experiment 1, participants had to react with their right or left limb while their head was in a neutral position. In Experiment 2, participants had to react with their left limb while their head was turned 60° to the left or right. A color change of the waveform signaled participants to produce an isometric contraction with the reacting limb. Reaction time was calculated as the time interval between the color change of the waveform and the initiation of the response. The results indicated mean reaction time for the left limb was significantly influenced by force production in the right limb. During left limb reactions, reaction time was faster for trials in which both limbs initiated force simultaneously as compared to trials in which the left limb initiated force while the right limb was producing force. Mean reaction time for the right limb was not influenced by force production in the contralateral limb. The results are consistent with the notion that crosstalk can influence the time required to react to stimuli but this influence occurs at the point of force initiation and is asymmetric in nature with the dominant limb exerting a stronger influence on the non-dominant limb than vice versa. However, we did not find a similar effect for head position via the tonic neck response.

Bimanual motor coordination controlled by cooperative interactions in intrinsic and extrinsic coordinates

Although strong motor coordination in intrinsic muscle coordinates has frequently been reported for bimanual movements, coordination in extrinsic visual coordinates is also crucial in various bimanual tasks. To explore the bimanual coordination mechanisms in terms of the frame of reference, here we characterized implicit bilateral interactions in visuomotor tasks. Visual perturbations (finger-cursor gain change) were applied while participants performed a rhythmic tracking task with both index fingers under an in-phase or anti-phase relationship in extrinsic coordinates. When they corrected the right finger's amplitude, the left finger's amplitude unintentionally also changed [motor interference (MI)], despite the instruction to keep its amplitude constant. Notably, we observed two specificities: one was large MI and low relative-phase variability (PV) under the intrinsic in-phase condition, and the other was large MI and high PV under the extrinsic in-phase condition. Additionally, using a multiple-interaction model, we successfully decomposed MI into intrinsic components caused by motor correction and extrinsic components caused by visual-cursor mismatch of the right finger's movements. This analysis revealed that the central nervous system facilitates MI by combining intrinsic and extrinsic components in the condition with in-phases in both intrinsic and extrinsic coordinates, and that under-additivity of the effects is explained by the brain's preference for the intrinsic interaction over extrinsic interaction. In contrast, the PV was significantly correlated with the intrinsic component, suggesting that the intrinsic interaction dominantly contributed to bimanual movement stabilization. The inconsistent features of MI and PV suggest that the central nervous system regulates multiple levels of bilateral interactions for various bimanual tasks.

Symmetrical and asymmetrical influences on force production in 1:2 and 2:1 bimanual force coordination tasks

Results from a recent experiment (Kennedy et al. in Exp Brain Res 233:181-195, 2015) indicated consistent and identifiable distortion of the left limb forces that could be attributable to the production of right limb forces during a multi-frequency bimanual force task. However, distortions in the forces produced by the right limb that could be attributable to the production of force in the left limb were not observed. The present experiment was designed to replicate this finding and determine whether the influence of force produced by one limb on the contralateral limb is the result of the limb assigned the faster frequency on the limb performing the slower frequency or a bias associated with limb dominance. Participants (N = 10) were required to rhythmically coordinate a pattern of isometric forces in a 1:1, 1:2, or 2:1 coordination pattern. The 1:2 task required the right limb to perform the faster rhythm, while the 2:1 task required the left limb to perform the faster rhythm. The 1:1 task was used as a control. Participants performed 13 practice trials and 1 test trial per task. Lissajous displays were provided to guide performance. If the limb assigned the faster frequency was responsible for the distortions observed in the contralateral limb, it was hypothesized that distortions would only be observed in the force trace of the limb producing the slower pattern of force. If a bias associated with limb dominance was responsible for the distortions observed in the contralateral limb, it was hypothesized that in right-limb-dominant participants the right limb would influence the left limb, regardless of limb assignment. Replicating the results of the previous experiment, only distortions in the left limb were observed in the 1:2 coordination task that could be attributed to the production of force by the right limb. However, identifiable distortions were observed in the force produced by both the left and right limb in the 2:1 coordination task. Observed distortions in the left limb, when assigned the faster rhythm indicated that the source of interference is not limited to limb assignment but also a function of limb dominance.

Effect of auditory constraints on motor performance depends on stage of recovery post-stroke

In order to develop evidence-based rehabilitation protocols post-stroke, one must first reconcile the vast heterogeneity in the post-stroke population and develop protocols to facilitate motor learning in the various subgroups. The main purpose of this study is to show that auditory constraints interact with the stage of recovery post-stroke to influence motor learning. We characterized the stages of upper limb recovery using task-based kinematic measures in 20 subjects with chronic hemiparesis. We used a bimanual wrist extension task, performed with a custom-made wrist trainer, to facilitate learning of wrist extension in the paretic hand under four auditory conditions: (1) without auditory cueing; (2) to non-musical happy sounds; (3) to self-selected music; and (4) to a metronome beat set at a comfortable tempo. Two bimanual trials (15 s each) were followed by one unimanual trial with the paretic hand over six cycles under each condition. Clinical metrics, wrist and arm kinematics, and electromyographic activity were recorded. Hierarchical cluster analysis with the Mahalanobis metric based on baseline speed and extent of wrist movement stratified subjects into three distinct groups, which reflected their stage of recovery: spastic paresis, spastic co-contraction, and minimal paresis. In spastic paresis, the metronome beat increased wrist extension, but also increased muscle co-activation across the wrist. In contrast, in spastic co-contraction, no auditory stimulation increased wrist extension and reduced co-activation. In minimal paresis, wrist extension did not improve under any condition. The results suggest that auditory task constraints interact with stage of recovery during motor learning after stroke, perhaps due to recruitment of distinct neural substrates over the course of recovery. The findings advance our understanding of the mechanisms of progression of motor recovery and lay the foundation for personalized treatment algorithms post-stroke.

Interactions between brain structure and behavior: the corpus callosum and bimanual coordination

Bimanual coordination skills are required for countless everyday activities, such as typing, preparing food, and driving. The corpus callosum (CC) is the major collection of white matter bundles connecting both hemispheres that enables the coordination between the two sides of the body. Principal evidence for this brain-behavior relationship in humans was first provided by research on callosotomy patients, showing that sectioning (parts of) the CC affected interactions between both hands directly. Later, new noninvasive in vivo imaging techniques, such as diffusion tensor imaging, have energized the study of the link between microstructural properties of the CC and bimanual performance in normal volunteers. Here we discuss the principal factors (such as age, pathology and training) that mediate the relationship between specific bimanual functions and distinct anatomical CC subdivisions. More specifically, the question is whether different bimanual task characteristics can be mapped onto functionally distinct CC subregions. We review the current status of this mapping endeavor, and propose future perspectives to inspire research on this unique link between brain structure and behavior.

Learning to never forget-time scales and specificity of long-term memory of a motor skill

Despite anecdotal reports that humans retain acquired motor skills for many years, if not a lifetime, long-term memory of motor skills has received little attention. While numerous neuroimaging studies showed practice-induced cortical plasticity, the behavioral correlates, what is retained and also what is forgotten, are little understood. This longitudinal case study on four subjects presents detailed kinematic analyses of humans practicing a bimanual polyrhythmic task over 2 months with retention tests after 6 months and, for two subjects, after 8 years. Results showed that individuals not only retained the task, but also reproduced their individual "style" of performance, even after 8 years. During practice, variables such as the two hands' frequency ratio and relative phase, changed at different rates, indicative of multiple time scales of neural processes. Frequency leakage across hands, reflecting intermanual crosstalk, attenuated at a significantly slower rate and was the only variable not maintained after 8 years. Complementing recent findings on neuroplasticity in gray and white matter, our study presents new behavioral evidence that highlights the multi-scale process of practice-induced changes and its remarkable persistence. Results suggest that motor memory may comprise not only higher-level task variables but also individual kinematic signatures.

When kinesthesia becomes visual: a theoretical justification for executing motor tasks in visual space

Several experimental studies in the literature have shown that even when performing purely kinesthetic tasks, such as reaching for a kinesthetically felt target with a hidden hand, the brain reconstructs a visual representation of the movement. In our previous studies, however, we did not observe any role of a visual representation of the movement in a purely kinesthetic task. This apparent contradiction could be related to a fundamental difference between the studied tasks. In our study subjects used the same hand to both feel the target and to perform the movement, whereas in most other studies, pointing to a kinesthetic target consisted of pointing with one hand to the finger of the other, or to some other body part. We hypothesize, therefore, that it is the necessity of performing inter-limb transformations that induces a visual representation of purely kinesthetic tasks. To test this hypothesis we asked subjects to perform the same purely kinesthetic task in two conditions: INTRA and INTER. In the former they used the right hand to both perceive the target and to reproduce its orientation. In the latter, subjects perceived the target with the left hand and responded with the right. To quantify the use of a visual representation of the movement we measured deviations induced by an imperceptible conflict that was generated between visual and kinesthetic reference frames. Our hypothesis was confirmed by the observed deviations of responses due to the conflict in the INTER, but not in the INTRA, condition. To reconcile these observations with recent theories of sensori-motor integration based on maximum likelihood estimation, we propose here a new model formulation that explicitly considers the effects of covariance between sensory signals that are directly available and internal representations that are ‘reconstructed’ from those inputs through sensori-motor transformations.

Diffusion tensor imaging metrics of the corpus callosum in relation to bimanual coordination: effect of task complexity and sensory feedback

When manipulating objects with both hands, the corpus callosum (CC) is of paramount importance for interhemispheric information exchange. Hence, CC damage results in impaired bimanual performance. Here, healthy young adults performed a complex bimanual dial rotation task with or without augmented visual feedback and according to five interhand frequency ratios (1:1, 1:3, 2:3, 3:1, 3:2). The relation between bimanual task performance and microstructural properties of seven CC subregions (i.e., prefrontal, premotor/supplementary motor, primary motor, primary sensory, occipital, parietal, and temporal) was studied by means of diffusion tensor imaging (DTI). Findings revealed that bimanual coordination deteriorated in the absence as compared to the presence of augmented visual feedback. Simple frequency ratios (1:1) were performed better than the multifrequency ratios (non 1:1). Moreover, performance was more accurate when the preferred hand (1:3-2:3) as compared to the nonpreferred hand (3:1-3:2) moved faster and during noninteger (2:3-3:2) as compared to integer frequency ratios (1:3-3:1). DTI findings demonstrated that bimanual task performance in the absence of augmented visual feedback was significantly related to the microstructural properties of the primary motor and occipital region of the CC, suggesting that white matter microstructure is associated with the ability to perform bimanual coordination patterns in young adults.

Complete corpus callosum agenesis: can it be mild?

Corpus callosum agenesis is a relatively common brain malformation. It can be isolated or included in a complex alteration of brain (or sometimes even whole body) morphology. Etiology and pathogenetic mechanisms have been better understood in recent years due to the availability of more adequate animal models and the relevant progresses in developmental neurosciences. We present the case of a girl with a complete agenesis of the corpus callosum discovered at birth. She had mild learning difficulties, but reached satisfactory levels of autonomy after an individually tailored rehabilitative treatment. Her story is discussed in light of recent findings, which emphasize the possibility to exploit brain plasticity and the utility of an individually tailored approach, defined on the basis of a dialogue with the family and the patient.

Bimanual coordination and corpus callosum microstructure in young adults with traumatic brain injury: a diffusion tensor imaging study

Bimanual actions are ubiquitous in daily life. Many coordinated movements of the upper extremities rely on precise timing, which requires efficient interhemispheric communication via the corpus callosum (CC). As the CC in particular is known to be vulnerable to traumatic brain injury (TBI), furthering our understanding of its structure-function association is highly valuable for TBI diagnostics and prognosis. In this study, 21 young adults with TBI and 17 controls performed object manipulation tasks (insertion of pegs with both hands and bilateral daily life activities) and cognitive control tasks (i.e., switching maneuvers during spatially and temporally coupled bimanual circular motions). The structural organization of 7 specific subregions of the CC (prefrontal, premotor/supplementary motor, primary motor, primary sensory, parietal, temporal, and occipital) was subsequently investigated in these subjects with diffusion tensor imaging (DTI). Findings revealed that bimanual coordination was impaired in TBI patients as shown by elevated movement time values during daily life activities, a decreased number of peg insertions, and slower response times during the switching task. Furthermore, the DTI analysis demonstrated a significantly decreased fractional anisotropy and increased radial diffusivity in prefrontal, primary sensory, and parietal regions in TBI patients versus controls. Finally, multiple regression analyses showed evidence of the high specificity of callosal subregions accounting for the variance associated with performance of the different bimanual coordination tasks. Whereas disruption in commissural pathways between occipital areas played a role in performance on the clinical tests of bimanual coordination, deficits in the switching task were related to disrupted interhemispheric communication in prefrontal, sensory, and parietal regions. This study provides evidence that structural alterations of several subregional callosal fibers in adults with TBI are associated with differential behavioral manifestations of bimanual motor functioning.

Frontal callosal disconnection syndromes

The interhemispheric connections of the cortical areas of the human brain are distributed within the corpus callosum according to a topographic order which is being studied in detail by novel imaging techniques. Total section of the corpus callosum is followed by a variety of interhemispheric disconnection symptoms each of which can be attributed to the interruption of fibers in a specific callosal sector. Disconnection symptoms deriving from posterior callosal sections, disconnecting parietal, temporal and occipital lobes across the midline, are more apparent than those following anterior callosal sections disconnecting the frontal lobes. In spite of the massive bulk of the frontal callosal connections in man, ascertained consequences of their interruption are limited to disorders of motor control, with particular regard to bimanual coordination. Technical advances in brain imaging and the design of appropriate tests are expected to reveal so far undetected deficits in the domain of executive and higher cognitive functions, resulting from callosal disconnection of the prefrontal cortices.

Corpus callosum agenesis and rehabilitative treatment

Corpus callosum agenesis is a relatively common brain malformation. It can be isolated or included in a complex alteration of brain (or sometimes even whole body) morphology. It has been associated with a number of neuropsychiatric disorders, from subtle neuropsychological deficits to Pervasive Developmental Disorders.

Etiology and pathogenetic mechanisms have been better understood in recent years, due to the availability of more adequate animal models and the relevant progresses in developmental neurosciences. These recent findings are reviewed (through a MedLine search including papers published in the last 5 years and most relevant previously published papers) in view of the potential impact on children's global functioning and on the possible rehabilitative treatment, with an emphasis on the possibility to exploit brain plasticity and on the use of the ICF-CY framework.

Neural integration of reaching and posture: interhemispheric spike correlations in cat motor cortex

To study the interlimb coordination of reaching and postural movements, chronically implanted microelectrodes were used to record single unit activity from the primary motor cortex (MI) of cats during performance of a trained reaching task. Recordings were made from both cerebral hemispheres to record neurons that modulated their activity during reaching (reach-related neurons) and supportive (posture-related neurons) movements of either forelimb. Evidence of temporal associations in the activities of simultaneously recorded reach- and posture-related neurons was evaluated using shuffle-corrected cross correlograms. The spike activity of approximately 34% of reach-related neurons was temporally correlated with the spike activity of simultaneously recorded posture-related neurons in the opposite motor cortex. Significant associations in the spike activity of neurons recorded from homotopic representational areas of the motor cortex in opposite hemispheres have not previously been reported. These interactions may have an important role in the coordination of opposite forelimbs during reaching movements and postural actions.

The coordination of movement: optimal feedback control and beyond

Optimal control theory and its more recent extension, optimal feedback control theory, provide valuable insights into the flexible and task-dependent control of movements. Here, we focus on the problem of coordination, defined as movements that involve multiple effectors (muscles, joints or limbs). Optimal control theory makes quantitative predictions concerning the distribution of work across multiple effectors. Optimal feedback control theory further predicts variation in feedback control with changes in task demands and the correlation structure between different effectors. We highlight two crucial areas of research, hierarchical control and the problem of movement initiation, that need to be developed for an optimal feedback control theory framework to characterise movement coordination more fully and to serve as a basis for studying the neural mechanisms involved in voluntary motor control.

A computational model for rhythmic and discrete movements in uni- and bimanual coordination

Current research on discrete and rhythmic movements differs in both experimental procedures and theory, despite the ubiquitous overlap between discrete and rhythmic components in everyday behaviors. Models of rhythmic movements usually use oscillatory systems mimicking central pattern generators (CPGs). In contrast, models of discrete movements often employ optimization principles, thereby reflecting the higher-level cortical resources involved in the generation of such movements. This letter proposes a unified model for the generation of both rhythmic and discrete movements. We show that a physiologically motivated model of a CPG can not only generate simple rhythmic movements with only a small set of parameters, but can also produce discrete movements if the CPG is fed with an exponentially decaying phasic input. We further show that a particular coupling between two of these units can reproduce main findings on in-phase and antiphase stability. Finally, we propose an integrated model of combined rhythmic and discrete movements for the two hands. These movement classes are sequentially addressed in this letter with increasing model complexity. The model variations are discussed in relation to the degree of recruitment of the higher-level cortical resources, necessary for such movements.

Effects of Gait Variations on Grip Force Coordination During Object Transport

In object transport during unimpeded locomotion, grip force is precisely timed and scaled to the regularly paced sinusoidal inertial force fluctuations. However, it is unknown whether this coupling is due to moment-to-moment predictions of upcoming inertial forces or a longer, generalized time estimate of regularly paced inertial forces generated during the normal gait cycle. Eight subjects transported a grip instrument during five walking conditions, four of which altered the gait cycle. The variations included changes in step length (taking a longer or shorter step) or stepping on and over a stable (predictable) or unstable (unpredictable support surface) obstacle within a series of baseline steps, which resulted in altered frequencies and magnitudes of the inertial forces exerted on the transported object. Except when stepping on the unstable obstacle, a tight temporal coupling between the grip and inertial forces was maintained across gait variations. Precision of this timing varied slightly within the time window for anticipatory grip force control possibly due to increased attention demands related to some of the step alterations. Furthermore, subjects anticipated variations in inertial force when the gait cycle was altered with increases or decreases in grip force, relative to the level of the inertial force peaks. Overall the maintenance of force coupling and scaling across predictable walking conditions suggests that the CNS is able to anticipate changes in inertial forces generated by gait variations and to efficiently predict the grip force needed to maintain object stability on a moment-to-moment basis.

Network activation during bimanual movements in humans

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

Callosal contributions to simultaneous bimanual finger movements

Corpus callosum (CC) is involved in the performance of bimanual motor tasks. We asked whether its functional role could be investigated by combining a motor behavioral study on bimanual movements in multiple sclerosis (MS) patients with a quantitative magnetic resonance diffusion tensor imaging (DTI) analysis of CC, which is shown to be damaged in this disease. MS patients and normal subjects were asked to perform sequences of bimanual finger opposition movements at different metronome rates; then we explored the structural integrity of CC by means of DTI. Significant differences in motor performance, mainly referred to timing accuracy, were observed between MS patients and control subjects. Bimanual motor coordination was impaired in MS patients as shown by the larger values of the interhand interval observed at all the tested metronome rates with respect to controls. Furthermore, DTI revealed a significant reduction of fractional anisotropy (FA), indicative of microstructural tissue damage, in the CC of MS patients. By correlating the mean FA values with the different motor behavior parameters, we found that the degree of damage in the anterior callosal portions mainly influences the bimanual coordination and, in particular, the movement phase preceding the finger touch. Finally, the described approach, which correlates quantitative measures of tissue damage obtained by advanced magnetic resonance imaging tools with appropriate behavioral measurements, may help the exploration of different aspects of motor performance impairment attributable to the disease.

On rhythmic and discrete movements: reflections, definitions and implications for motor control

At present, rhythmic and discrete movements are investigated by largely distinct research communities using different experimental paradigms and theoretical constructs. As these two classes of movements are tightly interlinked in everyday behavior, a common theoretical foundation spanning across these two types of movements would be valuable. Furthermore, it has been argued that these two movement types may constitute primitives for more complex behavior. The goal of this paper is to develop a rigorous taxonomic foundation that not only permits better communication between different research communities, but also helps in defining movement types in experimental design and thereby clarifies fundamental questions about primitives in motor control. We propose formal definitions for discrete and rhythmic movements, analyze some of their variants, and discuss the application of a smoothness measure to both types that enables quantification of discreteness and rhythmicity. Central to the definition of discrete movement is their separation by postures. Based on this intuitive definition, certain variants of rhythmic movement are indistinguishable from a sequence of discrete movements, reflecting an ongoing debate in the motor neuroscience literature. Conversely, there exist rhythmic movements that cannot be composed of a sequence of discrete movements. As such, this taxonomy may provide a language for studying more complex behaviors in a principled fashion.