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Tamir-Ostrover H, Hassin-Baer S, Fay-Karmon T, Friedman J. Quantifying Changes in Dexterity as a Result of Piano Training in People with Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2024; 24:3318. [PMID: 38894110 PMCID: PMC11174779 DOI: 10.3390/s24113318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/01/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024]
Abstract
People with Parkinson's disease often show deficits in dexterity, which, in turn, can lead to limitations in performing activities of daily life. Previous studies have suggested that training in playing the piano may improve or prevent a decline in dexterity in this population. In this pilot study, we tested three participants on a six-week, custom, piano-based training protocol, and quantified dexterity before and after the intervention using a sensor-enabled version of the nine-hole peg test, the box and block test, a test of finger synergies using unidimensional force sensors, and the Quantitative Digitography test using a digital piano, as well as selected relevant items from the motor parts of the MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the Parkinson's Disease Questionnaire (PDQ-39) quality of life questionnaire. The participants showed improved dexterity following the training program in several of the measures used. This pilot study proposes measures that can track changes in dexterity as a result of practice in people with Parkinson's disease and describes a potential protocol that needs to be tested in a larger cohort.
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Affiliation(s)
- Hila Tamir-Ostrover
- Department of Physical Therapy, Faculty of Medical & Health Sciences, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Sharon Hassin-Baer
- Movement Disorders Institute and Department of Neurology, Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan 5262000, Israel; (S.H.-B.); (T.F.-K.)
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Tsvia Fay-Karmon
- Movement Disorders Institute and Department of Neurology, Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan 5262000, Israel; (S.H.-B.); (T.F.-K.)
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Jason Friedman
- Department of Physical Therapy, Faculty of Medical & Health Sciences, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel;
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
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Abolins V, Ormanis J, Latash ML. Unintentional drifts in performance during one-hand and two-hand finger force production. Exp Brain Res 2023; 241:699-712. [PMID: 36690719 DOI: 10.1007/s00221-023-06559-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/16/2023] [Indexed: 01/25/2023]
Abstract
We explored the phenomena of force drifts and unintentional finger force production (enslaving), and their dependence on visual feedback. Predictions have been drawn based on the theory of control with spatial referent coordinates for condition with feedback on instructed (master) finger force, enslaved finger force, and total force for one-hand and two-hand tasks. Subjects produced force under the different feedback conditions without their knowledge. No feedback condition was also used for the one-hand tasks. Overall, feedback of master finger force led to an increase in the enslaved force, feedback on the slave finger force led to a drop in the master force, feedback on the total force led to balanced drifts in the master force down and enslaved force up, and under the no-feedback condition, master and total force drifted down with large variability in the enslaved force drifts. The patterns were the same in both hands in the two-hand tasks when feedback was provided on the forces of one hand only (without subject's knowledge). The index of enslaving always drifted toward higher values. We interpret the findings as reflecting three main factors: drifts in the referent coordinates toward actual finger coordinates, spread of cortical excitation over representations of the fingers, and robust sharing of referent coordinates between the two hands in bimanual tasks. The large consistent drifts in enslaving toward higher values have to be considered in studies of multi-finger synergies.
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Affiliation(s)
- Valters Abolins
- Cyber-Physical Systems Laboratory, Institute of Electronics and Computer Science, Dzerbenes Iela 14, Riga, 1006, Latvia.
| | - Juris Ormanis
- Cyber-Physical Systems Laboratory, Institute of Electronics and Computer Science, Dzerbenes Iela 14, Riga, 1006, Latvia
| | - Mark L Latash
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA.
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de Freitas PB, Freitas SMSF, Prado-Rico JM, Lewis MM, Du G, Yanosky JD, Huang X, Latash ML. Synergic control in asymptomatic welders during multi-finger force exertion and load releasing while standing. Neurotoxicology 2022; 93:324-336. [PMID: 36309163 PMCID: PMC10398836 DOI: 10.1016/j.neuro.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022]
Abstract
Motor synergies, i.e., neural mechanisms that organize multiple motor elements to ensure stability of actions, are affected by several neurological condition. Asymptomatic welders showed impaired synergy controlling the stability of multi-finger action compared to non-welders and this impairment was associated with microstructural damage in the globus pallidus. We further explored the effect of welding-related metal exposure on multi-finger synergy and extended our investigation to posture-stabilizing synergy during a standing task. Occupational, MRI, and performance-stabilizing synergies during multi-finger accurate force production and load releasing while standing were obtained from 29 welders and 19 age- and sex-matched controls. R2* and R1 relaxation rate values were used to estimate brain iron and manganese content, respectively, and diffusion tensor imaging was used to reflect brain microstructural integrity. Associations of brain MRI (caudate, putamen, globus pallidus, and red nucleus), and motor synergy were explored by group status. The results revealed that welders had higher R2* values in the caudate (p = 0.03), putamen (p = 0.01), and red nucleus (p = 0.08, trend) than controls. No group effect was revealed on multi-finger synergy index during steady-state phase of action (ΔVZss). Compared to controls, welders exhibited lower ΔVZss (-0.106 ± 0.084 vs. 0.160 ± 0.092, p = 0.04) and variance that did not affect the performance variable (VUCM, 0.022 ± 0.003 vs. 0.038 ± 0.007, p = 0.03) in the load releasing, postural task. The postural synergy index, ΔVZss, was associated negatively with higher R2* in the red nucleus in welders (r = -0.44, p = 0.03), but not in controls. These results suggest that the synergy index in the load releasing during a standing task may reflect welding-related neurotoxicity in workers with chronic metals exposure. This finding may have important clinical and occupational health implications.
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Affiliation(s)
- Paulo B de Freitas
- Interdisciplinary Graduate Program in Health Science, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil
| | - Sandra M S F Freitas
- Graduate Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Janina M Prado-Rico
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
| | - Mechelle M Lewis
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA; Department of Pharmacology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
| | - Guangwei Du
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
| | - Jeff D Yanosky
- Department of Public Health Science, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Xuemei Huang
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA; Department of Pharmacology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA; Radiology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA; Department of Neurosurgery, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA; Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA.
| | - Mark L Latash
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA.
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Madarshahian S, Latash ML. Effects of hand muscle function and dominance on intra-muscle synergies. Hum Mov Sci 2022; 82:102936. [PMID: 35217391 DOI: 10.1016/j.humov.2022.102936] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/09/2022] [Accepted: 02/13/2022] [Indexed: 11/04/2022]
Abstract
The goal of the study was to explore the effects of hand dominance and muscle function (prime mover vs. supporting muscle) on recently discovered intra-muscle synergies as potential windows into their neural origin. Healthy right-handed subjects performed accurate cyclical force production tasks while pressing with the middle phalanges and distal phalanges of the fingers of the dominant and non-dominant hand. Surface electromyography was used to identify individual motor unit action potentials in two muscles, flexor digitorum superficialis (FDS) and extensor digitorum communis (EDC). Stable motor unit groups (MU-modes) were defined in each muscle and in both muscles together. The composition of the MU-modes allowed linking them to the reciprocal and co-activation command. Force-stabilizing synergies were quantified in each hand and during force production at both sites using the framework of the uncontrolled manifold hypothesis. Force-stabilizing synergies were seen in the spaces of MU-modes from FDS and EDC separately, but not of MU-modes defined for both muscles together. Synergy indices were similar for both hands and both sites of force application. In contrast, force-stabilizing synergies in the space of finger forces were present in the non-dominant hand and absent in the dominant hand. The data suggest existence of distributed mechanisms of synergic control. Finger force synergies are likely to reflect functioning of subcortical loops involving the basal ganglia and cerebellum, while MU-mode synergies are likely to reflect spinal circuitry. Studies of both force-based and motor-unit-based synergies may be clinically valuable for distinguishing effects of spinal and supraspinal disorders.
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Affiliation(s)
- Shirin Madarshahian
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA
| | - Mark L Latash
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA.
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Latash ML, Yamagata M. Recent Advances in the Neural Control of Movements: Lessons for Functional Recovery. Phys Ther Res 2021; 25:1-11. [PMID: 35582118 PMCID: PMC9095426 DOI: 10.1298/ptr.r0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/12/2021] [Indexed: 09/05/2023]
Abstract
We review the current views on the control and coordination of movements following the traditions set by Nikolai Bernstein. In particular, we focus on the theory of neural control of effectors - from motor units to individual muscles, to joints, limbs, and to the whole body - with spatial referent coordinates organized into a hierarchy with multiple few-to-many mappings. Further, we discuss synergies ensuring stability of natural human movements within the uncontrolled manifold hypothesis. Synergies are organized within the neural control hierarchy based on the principle of motor abundance. Movement disorders are discussed as consequences of an inability to use the whole range of changes in referent coordinates (as in spasticity) and an inability to ensure controlled stability of salient variables as reflected in indices of multi-element synergies and their adjustments in preparation to actions (as in brain disorders, including Parkinson's disease, multiple-system atrophy, and stroke). At the end of the review, we discuss possible implications of this theoretical approach to peripheral disorders and their rehabilitations using, as an example, osteoarthritis. In particular, "joint stiffening" is viewed as a maladaptive strategy, which can compromise stability of salient variables during walking.
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Affiliation(s)
- Mark L Latash
- Department of Kinesiology, The Pennsylvania State University, USA
| | - Momoko Yamagata
- Department of Human Development, Graduate School of Human Development and Environment, Kobe University, Japan
- Department of Physical Therapy, Human Health Science, Graduate School of Medicine, Kyoto University, Japan
- Research Fellow of the Japan Society for the Promotion of Science, Japan
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Latash ML. One more time about motor (and non-motor) synergies. Exp Brain Res 2021; 239:2951-2967. [PMID: 34383080 DOI: 10.1007/s00221-021-06188-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 08/03/2021] [Indexed: 11/28/2022]
Abstract
We revisit the concept of synergy based on the recently translated classical book by Nikolai Bernstein (On the construction of movements, Medgiz, Moscow 1947; Latash, Bernstein's Construction of Movements, Routledge, Abingdon 2020b) and progress in understanding the physics and neurophysiology of biological action. Two aspects of synergies are described: organizing elements into stable groups (modes) and ensuring dynamical stability of salient performance variables. The ability of the central nervous system to attenuate synergies in preparation for a quick action-anticipatory synergy adjustments-is emphasized. Recent studies have demonstrated synergies at the level of hypothetical control variables associated with spatial referent coordinates for effectors. Overall, the concept of synergies fits naturally the hierarchical scheme of control with referent coordinates with an important role played by back-coupling loops within the central nervous system and from peripheral sensory endings. Further, we review studies showing non-trivial changes in synergies with development, aging, fatigue, practice, and a variety of neurological disorders. Two aspects of impaired synergic control-impaired stability and impaired agility-are introduced. The recent generalization of the concept of synergies for non-motor domains, including perception, is discussed. We end the review with a list of unresolved and troubling issues.
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Affiliation(s)
- Mark L Latash
- Department of Kinesiology, Rec.Hall-268N, The Pennsylvania State University, University Park, PA, 16802, USA.
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Freitas SMSF, de Freitas PB, Falaki A, Corson T, Lewis MM, Huang X, Latash ML. Synergic control of action in levodopa-naïve Parkinson's disease patients: II. Multi-muscle synergies stabilizing vertical posture. Exp Brain Res 2020; 238:2931-2945. [PMID: 33068173 PMCID: PMC7644647 DOI: 10.1007/s00221-020-05947-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/06/2020] [Indexed: 01/07/2023]
Abstract
Postural instability is a major disabling feature in Parkinson's disease (PD). We quantified the organization of leg and trunk muscles into synergies stabilizing the center of pressure (COP) coordinate within the uncontrolled manifold hypothesis in levodopa-naïve patients with PD and age-matched control subjects. The main hypothesis was that changes in the synergic control of posture are present early in the PD process even before levodopa exposure. Eleven levodopa-naïve patients with PD and 11 healthy controls performed whole-body cyclical voluntary sway tasks and a self-initiated load-release task during standing on a force plate. Surface electromyographic activity in 13 muscles on the right side of the body was analyzed to identify muscle groups with parallel scaling of activation levels (M-modes). Data were collected both before ("off-drug") and approximately 60 min after the first dose of 25/100 carbidopa/levodopa ("on-drug"). COP-stabilizing synergies were quantified for the load-release task. Levodopa-naïve patients with PD showed no COP-stabilizing synergy "off-drug", whereas controls showed posture-stabilizing multi-M-mode synergy. "On-drug", patients with PD demonstrated a significant increase in the synergy index. There were no significant drug effects on the M-mode composition, anticipatory postural adjustments, indices of motor equivalence, or indices of COP variability. The results suggest that levodopa-naïve patients with PD already show impaired posture-stabilizing multi-muscle synergies that may be used as promising behavioral biomarkers for emerging postural disorders in PD. Moreover, levodopa modified synergy metrics differently in these levodopa-naïve patients compared to a previous study of patients on chronic antiparkinsonian medications (Falaki et al. in J Electromyogr Kinesiol 33:20-26, 2017a), suggesting different neurocircuitry involvement.
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Affiliation(s)
- Sandra M S F Freitas
- Graduate Program in Physical Therapy, City University of São Paulo, São Paulo, SP, Brazil
- Department of Kinesiology, The Pennsylvania State University, Rec.Hall-267, University Park, PA, 16802, USA
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
| | - Paulo B de Freitas
- Department of Kinesiology, The Pennsylvania State University, Rec.Hall-267, University Park, PA, 16802, USA
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
- Interdisciplinary Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo, SP, Brazil
| | - Ali Falaki
- Department of Physiology, University of Montreal, Montreal, QC, Canada
| | - Tyler Corson
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
| | - Mechelle M Lewis
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
- Department of Pharmacology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
| | - Xuemei Huang
- Department of Kinesiology, The Pennsylvania State University, Rec.Hall-267, University Park, PA, 16802, USA
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
- Department of Pharmacology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
- Department of Radiology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
- Department of Neurosurgery, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
| | - Mark L Latash
- Department of Kinesiology, The Pennsylvania State University, Rec.Hall-267, University Park, PA, 16802, USA.
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