1
|
Rueda Parra S, Perry JC, Wolbrecht ET, Gupta D. Neural correlates of bilateral proprioception and adaptation with training. PLoS One 2024; 19:e0299873. [PMID: 38489319 PMCID: PMC10942095 DOI: 10.1371/journal.pone.0299873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/14/2024] [Indexed: 03/17/2024] Open
Abstract
Bilateral proprioception includes the ability to sense the position and motion of one hand relative to the other, without looking. This sensory ability allows us to perform daily activities seamlessly, and its impairment is observed in various neurological disorders such as cerebral palsy and stroke. It can undergo experience-dependent plasticity, as seen in trained piano players. If its neural correlates were better understood, it would provide a useful assay and target for neurorehabilitation for people with impaired proprioception. We designed a non-invasive electroencephalography-based paradigm to assess the neural features relevant to proprioception, especially focusing on bilateral proprioception, i.e., assessing the limb distance from the body with the other limb. We compared it with a movement-only task, with and without the visibility of the target hand. Additionally, we explored proprioceptive accuracy during the tasks. We tested eleven Controls and nine Skilled musicians to assess whether sensorimotor event-related spectral perturbations in μ (8-12Hz) and low-β (12-18Hz) rhythms differ in people with musical instrument training, which intrinsically involves a bilateral proprioceptive component, or when new sensor modalities are added to the task. The Skilled group showed significantly reduced μ and low-β suppression in bilateral tasks compared to movement-only, a significative difference relative to Controls. This may be explained by reduced top-down control due to intensive training, despite this, proprioceptive errors were not smaller for this group. Target visibility significantly reduced proprioceptive error in Controls, while no change was observed in the Skilled group. During visual tasks, Controls exhibited significant μ and low-β power reversals, with significant differences relative to proprioceptive-only tasks compared to the Skilled group-possibly due to reduced uncertainty and top-down control. These results provide support for sensorimotor μ and low-β suppression as potential neuromarkers for assessing proprioceptive ability. The identification of these features is significant as they could be used to quantify altered proprioceptive neural processing in skill and movement disorders. This in turn can be useful as an assay for pre and post sensory-motor intervention research.
Collapse
Affiliation(s)
- Sebastian Rueda Parra
- Department of Electrical Engineering, University of Idaho, Moscow, Idaho, United States of America
- Stratton Veterans Affairs Medical Center, Albany, New York
| | - Joel C. Perry
- Department of Mechanical Engineering, University of Idaho, Moscow, Idaho, United States of America
| | - Eric T. Wolbrecht
- Department of Mechanical Engineering, University of Idaho, Moscow, Idaho, United States of America
| | - Disha Gupta
- Stratton Veterans Affairs Medical Center, Albany, New York
- Department of Electrical and Computer Engineering, University at Albany, State University of New York, Albany, New York, United States of America
| |
Collapse
|
2
|
Kenzie JM, Rajashekar D, Goodyear BG, Dukelow SP. Resting state functional connectivity associated with impaired proprioception post-stroke. Hum Brain Mapp 2024; 45:e26541. [PMID: 38053448 PMCID: PMC10789217 DOI: 10.1002/hbm.26541] [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: 08/31/2022] [Revised: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
Deficits in proprioception, the knowledge of limb position and movement in the absence of vision, occur in ~50% of all strokes; however, our lack of knowledge of the neurological mechanisms of these deficits diminishes the effectiveness of rehabilitation and prolongs recovery. We performed resting-state functional magnetic resonance imaging (fMRI) on stroke patients to determine functional brain networks that exhibited changes in connectivity in association with proprioception deficits determined by a Kinarm robotic exoskeleton assessment. Thirty stroke participants were assessed for proprioceptive impairments using a Kinarm robot and underwent resting-state fMRI at 1 month post-stroke. Age-matched healthy control (n = 30) fMRI data were also examined and compared to stroke data in terms of the functional connectivity of brain regions associated with proprioception. Stroke patients exhibited reduced connectivity of the supplementary motor area and the supramarginal gyrus, relative to controls. Functional connectivity of these regions plus primary somatosensory cortex and parietal opercular area was significantly associated with proprioceptive function. The parietal lobe of the lesioned hemisphere is a significant node for proprioception after stroke. Assessment of functional connectivity of this region after stroke may assist with prognostication of recovery. This study also provides potential targets for therapeutic neurostimulation to aid in stroke recovery.
Collapse
Affiliation(s)
- Jeffrey M. Kenzie
- Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada
- Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health ServicesCalgaryAlbertaCanada
| | - Deepthi Rajashekar
- Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada
| | - Bradley G. Goodyear
- Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada
- Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health ServicesCalgaryAlbertaCanada
- Department of RadiologyUniversity of CalgaryCalgaryAlbertaCanada
- Hotchkiss Brain InstituteUniversity of CalgaryCalgaryAlbertaCanada
| | - Sean P. Dukelow
- Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada
- Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health ServicesCalgaryAlbertaCanada
| |
Collapse
|
3
|
Ma T, Xu X, Li M, Li Y, Wang Y, Li Q, Xue X, Tao W, Hua Y. Cortical Activation During Single-Legged Stance in Patients With Chronic Ankle Instability. J Athl Train 2023; 58:927-933. [PMID: 36827609 PMCID: PMC10784888 DOI: 10.4085/1062-6050-0363.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
CONTEXT Chronic ankle instability (CAI) has been considered a neurophysiological condition, with dysfunctional somatosensory and motor system excitability. However, few researchers have explored the changes in cortical activation during balance tasks of patients with CAI. OBJECTIVE To compare the cortical activity during single-legged stance among CAI, copers, and uninjured control participants and to compare dynamic balance across groups. DESIGN Cross-sectional study. SETTING Biomechanics laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 22 participants with CAI (median [interquartile range]; age = 34.5 [11.0] years, height = 170.0 [15.8] cm, mass = 67.0 [16.2] kg), 17 copers (age = 27.0 [14.0] years, height = 170.0 [9.5] cm, mass = 66.5 [16.5] kg), and 21 uninjured control participants (age = 25.0 [10.5] years, height = 170.0 [11.0] cm, mass = 64.0 [16.5] kg). MAIN OUTCOME MEASURE(S) Participants performed single-legged stance while cortical activation was tested with functional near-infrared spectroscopy. The peak oxyhemoglobin response of the activated cortex was calculated and compared across groups. The Y-Balance test outcomes and patient-reported outcomes were assessed and compared across groups. RESULTS The CAI group had worse Y-balance test and patient-reported outcomes than the coper and uninjured control groups. Differences in the peak oxyhemoglobin response were observed for the primary somatosensory cortex (S1; F2,57 = 4.347, P = .017, ηp2 = 0.132) and superior temporal gyrus (STG; F2,57 = 4.548, P = .015, ηp2 = 0.138). Specifically, copers demonstrated greater activation in S1 and STG than the CAI (d = 0.73, P = .034, and d = 0.69, P = .043, respectively) and uninjured control (d = 0.77, P = .036, and d = 0.88, P = .022, respectively) groups. No differences were found in the cortical activation between CAI and uninjured control participants. CONCLUSIONS Copers displayed greater cortical activation in S1 and STG than CAI and uninjured control participants. Greater activation in S1 and STG suggested a better ability to perceive somatosensory stimuli and may represent a compensatory mechanism that allows copers to maintain good functional ability after the initial severe ankle sprain.
Collapse
Affiliation(s)
- Tengjia Ma
- Department of Joint and Sports Medicine, The Second Hospital of Dalian Medical University, Liaoning, China
| | - Xiaoyun Xu
- School of Kinesiology, Shanghai University of Sport, China
| | - Moxin Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yunxia Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yiran Wang
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianru Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiao’ao Xue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Weichu Tao
- School of Kinesiology, Shanghai University of Sport, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
4
|
Seo HG, Yun SJ, Farrens A, Johnson C, Reinkensmeyer DJ. A Systematic Review of the Learning Dynamics of Proprioception Training: Specificity, Acquisition, Retention, and Transfer. Neurorehabil Neural Repair 2023; 37:744-757. [PMID: 37864458 PMCID: PMC10847967 DOI: 10.1177/15459683231207354] [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] [Indexed: 10/22/2023]
Abstract
OBJECTIVE We aimed to identify key aspects of the learning dynamics of proprioception training including: 1) specificity to the training type, 2) acquisition of proprioceptive skills, 3) retention of learning effects, and 4) transfer to different proprioceptive skills. METHODS We performed a systematic literature search using the database (MEDLINE, EMBASE, Cochrane Library, and PEDro). The inclusion criteria required adult participants who underwent any training program that could enhance proprioceptive function, and at least 1 quantitative assessment of proprioception before and after the intervention. We analyzed within-group changes to quantify the effectiveness of an intervention. RESULTS In total, 106 studies with 343 participant-outcome groups were included. Proprioception-specific training resulted in large effect sizes with a mean improvement of 23.4 to 42.6%, nonspecific training resulted in medium effect sizes with 12.3 to 22% improvement, and no training resulted in small effect sizes with 5.0 to 8.9% improvement. Single-session training exhibited significant proprioceptive improvement immediately (10 studies). For training interventions with a midway evaluation (4 studies), trained groups improved by approximately 70% of their final value at the midway point. Proprioceptive improvements were largely maintained at a delayed follow-up of at least 1 week (12 studies). Finally, improvements in 1 assessment were significantly correlated with improvements in another assessment (10 studies). CONCLUSIONS Proprioceptive learning appears to exhibit several features similar to motor learning, including specificity to the training type, 2 time constant learning curves, good retention, and improvements that are correlated between different assessments, suggesting a possible, common mechanism for the transfer of training.
Collapse
Affiliation(s)
- Han Gil Seo
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Mechanical and Aerospace Engineering, University of California at Irvine, California, USA
| | - Seo Jung Yun
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Human System Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Andria Farrens
- Department of Mechanical and Aerospace Engineering, University of California at Irvine, California, USA
| | - Christopher Johnson
- Department of Biomedical Engineering, University of California at Irvine, California, USA
| | - David J. Reinkensmeyer
- Department of Mechanical and Aerospace Engineering, University of California at Irvine, California, USA
- Department of Biomedical Engineering, University of California at Irvine, California, USA
- Department of Anatomy and Neurobiology, University of California at Irvine, California, USA
- Department of Physical Medicine and Rehabilitation, University of California at Irvine, California, USA
| |
Collapse
|
5
|
Lin Y, Jiang Z, Zhan G, Su H, Kang X, Jia J. Brain network characteristics between subacute and chronic stroke survivors in active, imagery, passive movement task: a pilot study. Front Neurol 2023; 14:1143955. [PMID: 37538258 PMCID: PMC10395333 DOI: 10.3389/fneur.2023.1143955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/27/2023] [Indexed: 08/05/2023] Open
Abstract
Background The activation patterns and functional network characteristics between stroke survivors and healthy individuals based on resting-or task-state neuroimaging and neurophysiological techniques have been extensively explored. However, the discrepancy between stroke patients at different recovery stages remains unclear. Objective To investigate the changes in brain connectivity and network topology between subacute and chronic patients, and hope to provide a basis for rehabilitation strategies at different stages after stroke. Methods Fifteen stroke survivors were assigned to the subacute group (SG, N = 9) and chronic group (CG, N = 6). They were asked to perform hand grasping under active, passive, and MI conditions when recording EEG. The Fugl-Meyer Assessment Upper Extremity subscale (FMA_UE), modified Ashworth Scale (MAS), Manual Muscle Test (MMT), grip and pinch strength, modified Barthel Index (MBI), and Berg Balance Scale (BBS) were measured. Results Functional connectivity analyses showed significant interactions on frontal, parietal and occipital lobes connections in each frequency band, particularly in the delta band. The coupling strength of premotor cortex, M1, S1 and several connections linked to frontal, parietal, and occipital lobes in subacute subjects were lower than in chronic subjects in low alpha, high alpha, low beta, and high beta bands. Nodal clustering coefficient (CC) analyses revealed that the CC in chronic subjects was higher than in subacute subjects in the ipsilesional S1 and occipital area, contralesional dorsolateral prefrontal cortex and parietal area. Characteristic path length (CPL) analyses showed that CPL in subacute subjects was lower than in chronic subjects in low beta, high beta, and gamma bands. There were no significant differences between subacute and chronic subjects for small-world property. Conclusion Subacute stroke survivors were characterized by higher transfer efficiency of the entire brain network and weak local nodal effects. Transfer efficiency was reduced, the local nodal role was strengthened, and more neural resources needed to be mobilized to perform motor tasks for chronic survivors. Overall, these results may help to understand the remodeling pattern of the brain network for different post-stroke stages on task conditions and the mechanism of spontaneous recovery.
Collapse
Affiliation(s)
- Yifang Lin
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Jing’an District Central Hospital, Shanghai, China
| | - Zewu Jiang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Gege Zhan
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Haolong Su
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - XiaoYang Kang
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Jing’an District Central Hospital, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| |
Collapse
|
6
|
Beyond the Dorsal Column Medial Lemniscus in Proprioception and Stroke: A White Matter Investigation. Brain Sci 2022; 12:brainsci12121651. [PMID: 36552111 PMCID: PMC9775186 DOI: 10.3390/brainsci12121651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/15/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
Proprioceptive deficits are common following stroke, yet the white matter involved in proprioception is poorly understood. Evidence suggests that multiple cortical regions are involved in proprioception, each connected by major white matter tracts, namely: Superior Longitudinal Fasciculus (branches I, II and III), Arcuate Fasciculus and Middle Longitudinal Fasciculus (SLF I, SLF II, SLF III, AF and MdLF respectively). However, direct evidence on the involvement of these tracts in proprioception is lacking. Diffusion imaging was used to investigate the proprioceptive role of the SLF I, SLF II, SLF III, AF and MdLF in 26 participants with stroke, and seven control participants without stroke. Proprioception was assessed using a robotic Arm Position Matching (APM) task, performed in a Kinarm Exoskeleton robotic device. Lesions impacting each tract resulted in worse APM task performance. Lower Fractional Anisotropy (FA) was also associated with poorer APM task performance for the SLF II, III, AF and MdLF. Finally, connectivity data surrounding the cortical regions connected by each tract accurately predicted APM task impairments post-stroke. This study highlights the importance of major cortico-cortical white matter tracts, particularly the SLF III and AF, for accurate proprioception after stroke. It advances our understanding of the white matter tracts responsible for proprioception.
Collapse
|
7
|
Proprioceptive Training with Visual Feedback Improves Upper Limb Function in Stroke Patients: A Pilot Study. Neural Plast 2022; 2022:1588090. [PMID: 35075359 PMCID: PMC8783730 DOI: 10.1155/2022/1588090] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/30/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022] Open
Abstract
Proprioceptive deficit is one of the common sensory impairments following stroke and has a negative impact on motor performance. However, evidence-based training procedures and cost-efficient training setups for patients with poststroke are still limited. We compared the effects of proprioceptive training versus nonspecific sensory stimulation on upper limb proprioception and motor function rehabilitation. In this multicenter, single-blind, randomized controlled trial, 40 participants with poststroke hemiparesis were enrolled from 3 hospitals in China. Participants were assigned randomly to receive proprioceptive training involving passive and active movements with visual feedback (proprioceptive training group [PG]; n = 20) or nonspecific sensory stimulation (control group [CG]; n = 20) 20 times in four weeks. Each session lasted 30 minutes. A clinical assessor blinded to group assignment evaluated patients before and after the intervention. The primary outcome was the change in the motor subscale of the Fugl-Meyer assessment for upper extremity (FMA-UE-M). Secondary outcomes were changes in box and block test (BBT), thumb localization test (TLT), the sensory subscale of the Fugl-Meyer assessment for upper extremity (FMA-UE-S), and Barthel Index (BI). The results showed that the mean change scores of FMA-UE were significantly greater in the PG than in the CG (p = 0.010 for FMA-UE-M, p = 0.033 for FMA-UE-S). The PG group was improved significantly in TLT (p = 0.010) and BBT (p = 0.027), while there was no significant improvement in TLT (p = 0.083) and BBT (p = 0.107) for the CG group. The results showed that proprioceptive training was effective in improving proprioception and motor function of the upper extremity in patients with poststroke. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR2000037808).
Collapse
|
8
|
van Kordelaar J, van de Ruit M, Solis-Escalante T, Aerden LAM, Meskers CGM, van Wegen EEH, Schouten AC, Kwakkel G, van der Helm FCT. The Cortical Response Evoked by Robotic Wrist Perturbations Reflects Level of Proprioceptive Impairment After Stroke. Front Hum Neurosci 2021; 15:695366. [PMID: 34858150 PMCID: PMC8631193 DOI: 10.3389/fnhum.2021.695366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Proprioception is important for regaining motor function in the paretic upper extremity after stroke. However, clinical assessments of proprioception are subjective and require verbal responses from the patient to applied proprioceptive stimuli. Cortical responses evoked by robotic wrist perturbations and measured by electroencephalography (EEG) may be an objective method to support current clinical assessments of proprioception. Objective: To establish whether evoked cortical responses reflect proprioceptive deficits as assessed by clinical scales and whether they predict upper extremity motor function at 26 weeks after stroke. Methods: Thirty-one patients with stroke were included. In week 1, 3, 5, 12, and 26 after stroke, the upper extremity sections of the Erasmus modified Nottingham Sensory Assessment (EmNSA-UE) and the Fugl-Meyer Motor Assessment (FM-UE) and the EEG responses (64 channels) to robotic wrist perturbations were measured. The extent to which proprioceptive input was conveyed to the affected hemisphere was estimated by the signal-to-noise ratio (SNR) of the evoked response. The relationships between SNR and EmNSA-UE as well as SNR and time after stroke were investigated using linear regression. Receiver-operating-characteristic curves were used to compare the predictive values of SNR and EmNSA-UE for predicting whether patients regained some selective motor control (FM-UE > 22) or whether they could only move their paretic upper extremity within basic limb synergies (FM-UE ≤ 22) at 26 weeks after stroke. Results: Patients (N = 7) with impaired proprioception (EmNSA-UE proprioception score < 8) had significantly smaller SNR than patients with unimpaired proprioception (N = 24) [EmNSA-UE proprioception score = 8, t(29) = 2.36, p = 0.03]. No significant effect of time after stroke on SNR was observed. Furthermore, there was no significant difference in the predictive value between EmNSA-UE and SNR for predicting motor function at 26 weeks after stroke. Conclusion: The SNR of the evoked cortical response does not significantly change as a function of time after stroke and differs between patients with clinically assessed impaired and unimpaired proprioception, suggesting that SNR reflects persistent damage to proprioceptive pathways. A similar predictive value with respect to EmNSA-UE suggests that SNR may be used as an objective predictor next to clinical sensory assessments for predicting motor function at 26 weeks after stroke.
Collapse
Affiliation(s)
- Joost van Kordelaar
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
| | - Mark van de Ruit
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
| | - Teodoro Solis-Escalante
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands.,Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Leo A M Aerden
- Department of Neurology, Reinier de Graaf Hospital, Delft, Netherlands
| | - Carel G M Meskers
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Erwin E H van Wegen
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Alfred C Schouten
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands.,Department of Biomedical Engineering, University of Twente, Enschede, Netherlands
| | - Gert Kwakkel
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Frans C T van der Helm
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
| |
Collapse
|
9
|
Chilvers MJ, Hawe RL, Scott SH, Dukelow SP. Investigating the neuroanatomy underlying proprioception using a stroke model. J Neurol Sci 2021; 430:120029. [PMID: 34695704 DOI: 10.1016/j.jns.2021.120029] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 09/08/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022]
Abstract
Neuroanatomical investigations have associated cortical areas, beyond Primary Somatosensory Cortex (S1), with impaired proprioception. Cortical regions have included temporoparietal (TP) regions (supramarginal gyrus, superior temporal gyrus, Heschl's gyrus) and insula. Previous approaches have struggled to account for concurrent damage across multiple brain regions. Here, we used a targeted lesion analysis approach to examine the impact of specific combinations of cortical and sub-cortical lesions and quantified the prevalence of proprioceptive impairments when different regions are damaged or spared. Seventy-seven individuals with stroke (49 male; 28 female) were identified meeting prespecified lesion criteria based on MRI/CT imaging: 1) TP lesions without S1, 2) TP lesions with S1, 3) isolated S1 lesions, 4) isolated insula lesions, and 5) lesions not impacting these regions (other regions group). Initially, participants meeting these criteria (1-4) were grouped together into right or left lesion groups and compared to each other, and the other regions group (5), on a robotic Arm Position Matching (APM) task and a Kinesthesia (KIN) task. We then examined the behaviour of individuals that met each specific criteria (groups 1-5). Proprioceptive impairments were more prevalent following right hemisphere lesions than left hemisphere lesions. The extent of damage to TP regions correlated with performance on both robotic tasks. Even without concurrent S1 lesions, TP and insular lesions were associated with impairments on the APM and KIN tasks. Finally, lesions not impacting these regions were much less likely to result in impairments. This study highlights the critical importance of TP and insular regions for accurate proprioception. SIGNIFICANCE STATEMENT: This work advances our understanding of the neuroanatomy of human proprioception. We validate the importance of regions, beyond the dorsal column medial lemniscal pathway and S1, for proprioception. Further, we provide additional evidence of the importance of the right hemisphere for human proprioception. Improved knowledge on the neuroanatomy of proprioception is crucial for advancing therapeutic approaches which target individuals with proprioceptive impairments following neurological injury or with neurological disorders.
Collapse
Affiliation(s)
- Matthew J Chilvers
- Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada.
| | - Rachel L Hawe
- Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; School of Kinesiology, University of Minnesota, 1900 University Ave SE, Minneapolis, MN 55455, United States
| | - Stephen H Scott
- Department of Biomedical and Molecular Sciences, Centre for Neuroscience Studies, Queens University, Kingston, ON K7L 3N6, Canada
| | - Sean P Dukelow
- Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada.
| |
Collapse
|
10
|
Geva S, Schneider LM, Roberts S, Khan S, Gajardo-Vidal A, Lorca-Puls DL, Team P, Hope TMH, Green DW, Price CJ. Right cerebral motor areas that support accurate speech production following damage to cerebellar speech areas. NEUROIMAGE-CLINICAL 2021; 32:102820. [PMID: 34653836 PMCID: PMC8517928 DOI: 10.1016/j.nicl.2021.102820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/29/2022]
Abstract
Participants with damage to cerebellar speech regions were studied with fMRI. At the time of test, their speech production was accurate and precise. Their speech production activation was enhanced in right hemisphere motor regions. We provide hypotheses for targeting future fMRI and brain stimulation studies.
Specific regions of the cerebellum are activated when neurologically intact adults speak, and cerebellar damage can impair speech production early after stroke, but how the brain supports accurate speech production years after cerebellar damage remains unknown. We investigated this in patients with cerebellar lesions affecting regions that are normally recruited during speech production. Functional MRI activation in these patients, measured during various single word production tasks, was compared to that of neurologically intact controls, and patient controls with lesions that spared the cerebellar speech production regions. Our analyses revealed that, during a range of speech production tasks, patients with damage to cerebellar speech production regions had greater activation in the right dorsal premotor cortex (r-PMd) and right supplementary motor area (r-SMA) compared to neurologically intact controls. The loci of increased activation in cerebral motor speech areas motivate future studies to delineate the functional contributions of different parts of the speech production network, and test whether non-invasive stimulation to r-PMd and r-SMA facilitates speech recovery after cerebellar stroke.
Collapse
Affiliation(s)
- Sharon Geva
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3AR, United Kingdom.
| | - Letitia M Schneider
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3AR, United Kingdom; Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Universitätsring 1, 1010 Vienna, Austria
| | - Sophie Roberts
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3AR, United Kingdom.
| | - Shamima Khan
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3AR, United Kingdom.
| | - Andrea Gajardo-Vidal
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3AR, United Kingdom; Faculty of Health Sciences, Universidad del Desarrollo, Concepcion, Chile.
| | - Diego L Lorca-Puls
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3AR, United Kingdom; Department of Speech, Language and Hearing Sciences, Faculty of Medicine, Universidad de Concepcion, Concepcion, Chile.
| | - Ploras Team
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3AR, United Kingdom
| | - Thomas M H Hope
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3AR, United Kingdom.
| | - David W Green
- Department of Experimental Psychology, Faculty of Brain Sciences, University College London, London, United Kingdom.
| | - Cathy J Price
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3AR, United Kingdom.
| |
Collapse
|
11
|
Lai Y, Song Y, Huang P, Wang T, Wang L, Pan Y, Sun Q, Sun B, Zhang C, Li D. Subthalamic Stimulation for Camptocormia in Parkinson's Disease: Association of Volume of Tissue Activated and Structural Connectivity with Clinical Effectiveness. JOURNAL OF PARKINSONS DISEASE 2021; 11:199-210. [PMID: 33325395 PMCID: PMC7990421 DOI: 10.3233/jpd-202259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Deep brain stimulation of the subthalamic nucleus (STN-DBS) has been reported to be effective for camptocormia in Parkinson's disease (PD). However, the association between clinical effectiveness and the stimulated volumes or structural connectivity remains unexplored. OBJECTIVE To investigate the effectiveness of STN-DBS for treating camptocormia in PD and its association with volumes of tissue activated (VTA) and structural connectivity. METHODS We reviewed video recordings of patients who had undergone STN-DBS. The total and upper camptocormia (TCC and UCC) angles were measured to quantify changes in camptocormia. The Movement Disorders Society Unified Parkinson's Disease Rating Scale III (MDS-UPDRS III) was used to assess motor symptoms. Pre- and postoperative brain images were collected for modeling volume of VTA and structural connectivity using Lead-DBS software. RESULTS Participants included 36 patients with PD (8 with TCC-camptocormia and 2 with UCC-camptocormia) treated with bilateral STN-DBS. After surgery, patients showed a significant improvement in postural alignment at follow-up (mean follow-up duration: 6.0±2.2 months). In the entire sample, higher structural connectivity to the right supplementary motor area (SMA) and right lateral premotor cortex along the dorsal plane (PMd) was associated with larger postsurgical improvements in axial signs and TCC angles after stimulation was turned on. In patients diagnosed with camptocormia, larger improvement in camptocormia angles after STN-DBS was associated with a larger VTA overlap with STN (R = 0.75, p = 0.032). CONCLUSION This study suggests that both VTA overlap with STN and structural connectivity to cortical motor regions are associated with the effectiveness of STN-DBS for managing camptocormia in PD.
Collapse
Affiliation(s)
- Yijie Lai
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunhai Song
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Neurosurgery, Shanghai Children's Medical Center Affiliated to the Medical School of Shanghai Jiaotong University, Shanghai, China
| | - Peng Huang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Wang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linbin Wang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yixin Pan
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingfang Sun
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bomin Sun
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chencheng Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dianyou Li
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
12
|
Lowrey CR, Blazevski B, Marnet JL, Bretzke H, Dukelow SP, Scott SH. Robotic tests for position sense and movement discrimination in the upper limb reveal that they each are highly reproducible but not correlated in healthy individuals. J Neuroeng Rehabil 2020; 17:103. [PMID: 32711540 PMCID: PMC7382092 DOI: 10.1186/s12984-020-00721-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 07/06/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Robotic technologies for neurological assessment provide sensitive, objective measures of behavioural impairments associated with injuries or disease such as stroke. Previous robotic tasks to assess proprioception typically involve single limbs or in some cases both limbs. The challenge with these approaches is that they often rely on intact motor function and/or working memory to remember/reproduce limb position, both of which can be impaired following stroke. Here, we examine the feasibility of a single-arm Movement Discrimination Threshold (MDT) task to assess proprioception by quantifying thresholds for sensing passive limb movement without vision. We use a staircase method to adjust movement magnitude based on subject performance throughout the task in order to reduce assessment time. We compare MDT task performance to our previously-designed Arm Position Matching (APM) task. Critically, we determine test-retest reliability of each task in the same population of healthy controls. METHOD Healthy participants (N = 21, age = 18-22 years) completed both tasks in the End-Point Kinarm robot. In the MDT task the robot moved the dominant arm left or right and participants indicated the direction moved. Movement displacement was systematically adjusted (decreased after correct answers, increased after incorrect) until the Discrimination Threshold was found. In the APM task, the robot moved the dominant arm and participants "mirror-matched" with the non-dominant arm. RESULTS Discrimination Threshold for direction of arm displacement in the MDT task ranged from 0.1-1.3 cm. Displacement Variability ranged from 0.11-0.71 cm. Test-retest reliability of Discrimination Threshold based on ICC confidence intervals was moderate to excellent (range, ICC = 0.78 [0.52-0.90]). Interestingly, ICC values for Discrimination Threshold increased to 0.90 [0.77-0.96] (good to excellent) when the number of trials was reduced to the first 50. Most APM parameters had ICC's above 0.80, (range, ICC = [0.86-0.88]) with the exception of variability (ICC = 0.30). Importantly, no parameters were significantly correlated across tasks as Spearman rank correlations across parameter-pairings ranged from - 0.27 to 0.30. CONCLUSIONS The MDT task is a feasible and reliable task, assessing movement discrimination threshold in ~ 17 min. Lack of correlation between the MDT and a position-matching task (APM) indicates that these tasks assess unique aspects of proprioception that are not strongly related in young, healthy individuals.
Collapse
Affiliation(s)
- Catherine R. Lowrey
- Laboratory of Integrative Motor Behaviour, Centre for Neuroscience Studies, Queen’s University, 18 Stuart St., Kingston, ON K7L 3N6 Canada
| | - Benett Blazevski
- Laboratory of Integrative Motor Behaviour, Centre for Neuroscience Studies, Queen’s University, 18 Stuart St., Kingston, ON K7L 3N6 Canada
| | - Jean-Luc Marnet
- BioEngineering and Innovation in Neuroscience, University Paris Descartes, Paris, France
| | - Helen Bretzke
- Laboratory of Integrative Motor Behaviour, Centre for Neuroscience Studies, Queen’s University, 18 Stuart St., Kingston, ON K7L 3N6 Canada
| | - Sean P. Dukelow
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta Canada
| | - Stephen H. Scott
- Laboratory of Integrative Motor Behaviour, Centre for Neuroscience Studies, Queen’s University, 18 Stuart St., Kingston, ON K7L 3N6 Canada
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON Canada
- Department of Medicine, Queen’s University, Kingston, ON Canada
| |
Collapse
|
13
|
Marini F, Zenzeri J, Pippo V, Morasso P, Campus C. Neural correlates of proprioceptive upper limb position matching. Hum Brain Mapp 2019; 40:4813-4826. [PMID: 31348604 PMCID: PMC6865654 DOI: 10.1002/hbm.24739] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/15/2019] [Accepted: 07/16/2019] [Indexed: 11/06/2022] Open
Abstract
Proprioceptive information allows humans to perform smooth coordinated movements by constantly updating one's mind with knowledge of the position of one's limbs in space. How this information is combined with other sensory modalities and centrally processed to form conscious perceptions of limb position remains relatively unknown. What has proven even more elusive is pinpointing the contribution of proprioception in cortical activity related to motion. This study addresses these gaps by examining electrocortical dynamics while participants performed an upper limb position matching task in two conditions, namely with proprioceptive feedback or with both visual and proprioceptive feedback. Specifically, we evaluated the reduction of the electroencephalographic power (desynchronization) in the μ frequency band (8-12 Hz), which is known to characterize the neural activation associated with motor control and behavior. We observed a stronger desynchronization in the left motor and somatosensory areas, contralateral to the moving limb while, parietal and occipital regions, identifying association and visual areas, respectively, exhibited a similar activation level in the two hemispheres. Pertaining to the influence of the two experimental conditions it affected only movement's offset, and precisely we found that when matching movements are performed relying only on proprioceptive information, a lower cortical activity is entailed. This effect was strongest in the visual and association areas, while there was a minor effect in the hand motor and somatosensory areas.
Collapse
Affiliation(s)
- Francesca Marini
- Department of Robotics, Brain and Cognitive SciencesIstituto Italiano di TecnologiaGenoaItaly
| | - Jacopo Zenzeri
- Department of Robotics, Brain and Cognitive SciencesIstituto Italiano di TecnologiaGenoaItaly
| | - Valentina Pippo
- Department of Robotics, Brain and Cognitive SciencesIstituto Italiano di TecnologiaGenoaItaly
| | - Pietro Morasso
- Department of Robotics, Brain and Cognitive SciencesIstituto Italiano di TecnologiaGenoaItaly
| | - Claudio Campus
- U‐VIP Unit for Visually Impaired PeopleIstituto Italiano di TecnologiaGenoaItaly
| |
Collapse
|
14
|
Herter TM, Scott SH, Dukelow SP. Vision does not always help stroke survivors compensate for impaired limb position sense. J Neuroeng Rehabil 2019; 16:129. [PMID: 31666135 PMCID: PMC6822422 DOI: 10.1186/s12984-019-0596-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 09/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Position sense is commonly impaired after stroke. Traditional rehabilitation methods instruct patients to visualize their limbs to compensate for impaired position sense. OBJECTIVE Our goal was to evaluate how the use of vision influences impaired position sense. METHODS We examined 177 stroke survivors, an average of 12.7 days (+/- 10 days (SD)) post-stroke, and 133 neurologically-intact controls with a robotic assessment of position sense. The robot positioned one limb (affected) and subjects attempted to mirror-match the position using the opposite limb (unaffected). Subjects completed the test without, then with vision of their limbs. We examined three measures of position sense: variability (Var), contraction/expansion (C/E) and systematic shift (Shift). We classified stroke survivors as having full compensation if they performed the robotic task abnormally without vision but corrected performance within the range of normal with vision. Stroke survivors were deemed to have partial compensation if they performed the task outside the range of normal without and with vision, but improved significantly with vision. Those with absent compensation performed the task abnormally in both conditions and did not improve with vision. RESULTS Many stroke survivors demonstrated impaired position sense with vision occluded [Var: 116 (66%), C/E: 91 (51%), Shift: 52 (29%)]. Of those stroke survivors with impaired position sense, some exhibited full compensation with vision [Var: 23 (20%), C/E: 42 (46%), Shift: 32 (62%)], others showed partial compensation [Var: 37 (32%), C/E: 8 (9%), Shift: 3 (6%)] and many displayed absent compensation (Var: 56 (48%), C/E: 41 (45%), Shift: 17 (33%)]. Stroke survivors with an affected left arm, visuospatial neglect and/or visual field defects were less likely to compensate for impaired position sense using vision. CONCLUSIONS Our results indicate that vision does not help many stroke survivors compensate for impaired position sense, at least within the current paradigm. This contrasts with historical reports that vision helps compensate for proprioceptive loss following neurologic injuries.
Collapse
Affiliation(s)
- Troy M Herter
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Stephen H Scott
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
- Department of Anatomy and Cell Biology, Queen's University, Kingston, Ontario, Canada
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Sean P Dukelow
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
- Department of Clinical Neurosciences, University of Calgary, 1403 29th St NW, Foothills Medical Centre, South Tower-Room 905, Calgary, AB, T2N2T9, Canada.
| |
Collapse
|