Asymmetric control mechanisms of bimanual coordination: an application of directed connectivity analysis to kinematic and functional MRI data

Robotic assessment of bilateral and unilateral upper limb functions in adults with cerebral palsy

BACKGROUND

Children with unilateral cerebral palsy (CP) exhibit motor impairments predominantly on one side of the body, while also having ipsilesional and bilateral impairments. These impairments are known to persist through adulthood, but their extent have not been described in adults with CP. This study's aim is to characterize bilateral and unilateral upper limbs impairments in adults with CP.

METHODS

Nineteen adults with CP (34.3 years old ± 11.5) performed three robotic assessments in the Kinarm Exoskeleton Lab, including two bilateral tasks (Object Hit [asymmetric independent goals task] and Ball on Bar [symmetric common goal task]) and one unilateral task (Visually Guided Reaching, performed with the more affected arm [MA] and less affected arm [LA]). Individual results were compared to sex, age and handedness matched normative data, describing the proportion of participants exhibiting impairments in each task-specific variable (e.g., Hand speed), each performance category (e.g., Feedforward control) and in global task performance. Associations were assessed using Spearman correlation coefficients between: 1: the results of the MA and LA of each limb in the unilateral task; and 2: the results of each limb in the unilateral vs. the bilateral tasks.

RESULTS

The majority of participants exhibited impairments in bilateral tasks (84%). The bilateral performance categories (i.e., Bimanual) identifying bilateral coordination impairments were impaired in the majority of participants (Object Hit: 57.8%; Ball on Bar: 31.6%). Most of the participants were impaired when performing a unilateral task with their MA arm (63%) and a smaller proportion with their LA arm (31%). The Feedforward control was the unilateral performance category showing the highest proportion of impaired participants while displaying the strongest relationship between the MA and LA arms impairments (rs = 0.93). Feedback control was the unilateral performance category most often associated with impairments in bilateral tasks (6 out of 8 performance categories).

CONCLUSIONS

Adults with CP experienced more impairment in bilateral tasks while still having substantial impairments in unilateral tasks. They frequently display Feedforward control impairments combined with a higher reliance on Feedback control during both bilateral and unilateral tasks, leading to poorer motor performance.

The effect of inherent and incidental constraints on bimanual force control in simulated Martian gravity

The ability to coordinate actions between the limbs is important for many operationally relevant tasks associated with space exploration. A future milestone in space exploration is sending humans to Mars. Therefore, an experiment was designed to examine the influence of inherent and incidental constraints on the stability characteristics associated with the bimanual control of force in simulated Martian gravity. A head-up tilt (HUT)/head-down tilt (HDT) paradigm was used to simulate gravity on Mars (22.3° HUT). Right limb dominant participants (N = 11) were required to rhythmically coordinate patterns of isometric forces in 1:1 in-phase and 1:2 multifrequency patterns by exerting force with their right and left limbs. Lissajous displays were provided to guide task performance. Participants performed 14 twenty-second practice trials at 90° HUT (Earth). Following a 30-min rest period, participants performed 2 test trials for each coordination pattern in both Earth and Mars conditions. Performance during the test trials were compared. Results indicated very effective temporal performance of the goal coordination tasks in both gravity conditions. However, results indicated differences associated with the production of force between Earth and Mars. In general, participants produced less force in simulated Martian gravity than in the Earth condition. In addition, force production was more harmonic in Martian gravity than Earth gravity for both limbs, indicating that less force distortions (adjustments, hesitations, and/or perturbations) occurred in the Mars condition than in the Earth condition. The force coherence analysis indicated significantly higher coherence in the 1:1 task than in the 1:2 task for all force frequency bands, with the highest level of coherence in the 1-4 Hz frequency band for both gravity conditions. High coherence in the 1-4 Hz frequency band is associated with a common neural drive that activates the two arms simultaneously and is consistent with the requirements of the two tasks. The results also support the notion that neural crosstalk stabilizes the performance of the 1:1 in-phase task. In addition, significantly higher coherence in the 8-12 Hz frequency bands were observed for the Earth condition than the Mars condition. Force coherence in the 8-12 Hz bands is associated with the processing of sensorimotor information, suggesting that participants were better at integrating visual, proprioceptive, and/or tactile feedback in Earth than for the Mars condition. Overall, the results indicate less neural interference in Martian gravity; however, participants appear to be more effective at using the Lissajous displays to guide performance under Earth's gravity.

The impact of lesion side on bilateral upper limb coordination after stroke

BACKGROUND

A stroke frequently results in impaired performance of activities of daily life. Many of these are highly dependent on effective coordination between the two arms. In the context of bimanual movements, cyclic rhythmical bilateral arm coordination patterns can be classified into two fundamental modes: in-phase (bilateral homologous muscles contract simultaneously) and anti-phase (bilateral muscles contract alternately) movements. We aimed to investigate how patients with left (LHS) and right (RHS) hemispheric stroke are differentially affected in both individual-limb control and inter-limb coordination during bilateral movements.

METHODS

We used kinematic measurements to assess bilateral coordination abilities of 18 chronic hemiparetic stroke patients (9 LHS; 9 RHS) and 18 age- and sex-matched controls. Using KINARM upper-limb exoskeleton system, we examined individual-limb control by quantifying trajectory variability in each hand and inter-limb coordination by computing the phase synchronization between hands during anti- and in-phase movements.

RESULTS

RHS patients exhibited greater impairment in individual- and inter-limb control during anti-phase movements, whilst LHS patients showed greater impairment in individual-limb control during in-phase movements alone. However, LHS patients further showed a swap in hand dominance during in-phase movements.

CONCLUSIONS

The current study used individual-limb and inter-limb kinematic profiles and showed that bilateral movements are differently impaired in patients with left vs. right hemispheric strokes. Our results demonstrate that both fundamental bilateral coordination modes are differently controlled in both hemispheres using a lesion model approach. From a clinical perspective, we suggest that lesion side should be taken into account for more individually targeted bilateral coordination training strategies.

TRIAL REGISTRATION

the current experiment is not a health care intervention study.

The power of multivariate approach in identifying EEG correlates of interlimb coupling

Interlimb coupling refers to the interaction between movements of one limb and movements of other limbs. Understanding mechanisms underlying this effect is important to real life because it reflects the level of interdependence between the limbs that plays a role in daily activities including tool use, cooking, or playing musical instruments. Interlimb coupling involves multiple brain regions working together, including coordination of neural activity in sensory and motor regions across the two hemispheres. Traditional neuroscience research took a univariate approach to identify neural features that correspond to behavioural coupling measures. Yet, this approach reduces the complexity of the neural activity during interlimb tasks to one value. In this brief research report, we argue that identifying neural correlates of interlimb coupling would benefit from a multivariate approach in which full patterns from multiple sources are used to predict behavioural coupling. We demonstrate the feasibility of this approach in an exploratory EEG study where participants (n = 10) completed 240 trials of a well-established drawing paradigm that involves interlimb coupling. Using artificial neural network (ANN), we show that multivariate representation of the EEG signal significantly captures the interlimb coupling during bimanual drawing whereas univariate analyses failed to identify such correlates. Our findings demonstrate that analysing distributed patterns of multiple EEG channels is more sensitive than single-value techniques in uncovering subtle differences between multiple neural signals. Using such techniques can improve identification of neural correlates of complex motor behaviours.

Dynamic involvement of premotor and supplementary motor areas in bimanual pinch force control

Many activities of daily living require quick shifts between symmetric and asymmetric bimanual actions. Bimanual motor control has been mostly studied during continuous repetitive tasks, while little research has been carried out in experimental settings requiring dynamic changes in motor output generated by both hands. Here, we performed functional magnetic resonance imaging (MRI) while healthy volunteers performed a visually guided, bimanual pinch force task. This enabled us to map functional activity and connectivity of premotor and motor areas during bimanual pinch force control in different task contexts, requiring mirror-symmetric or inverse-asymmetric changes in discrete pinch force exerted with the right and left hand. The bilateral dorsal premotor cortex showed increased activity and effective coupling to the ipsilateral supplementary motor area (SMA) in the inverse-asymmetric context compared to the mirror-symmetric context of bimanual pinch force control while the SMA showed increased negative coupling to visual areas. Task-related activity of a cluster in the left caudal SMA also scaled positively with the degree of synchronous initiation of bilateral pinch force adjustments, irrespectively of the task context. The results suggest that the dorsal premotor cortex mediates increasing complexity of bimanual coordination by increasing coupling to the SMA while SMA provides feedback about motor actions to the sensory system.

The influence of distal and proximal muscle activation on neural crosstalk

Previous research has indicated that neural crosstalk is asymmetric, with the dominant effector exerting a stronger influence on the non-dominant effector than vice versa. Recently, it has been hypothesized that this influence is more substantial for proximal than distal effectors. The current investigation was designed to determine the effects of distal ((First Dorsal Interosseous (FDI)) and proximal (triceps brachii (TBI)) muscle activation on neural crosstalk. Twelve right-limb dominant participants (mean age = 21.9) were required to rhythmically coordinate a 1:2 pattern of isometric force guided by Lissajous displays. Participants performed 10, 30 s trials with both distal and proximal effectors. Coherence between the two effector groups were calculated using EMG-EMG wavelet coherence. The results indicated that participants could effectively coordinate the goal coordination pattern regardless of the effectors used. However, spatiotemporal performance was more accurate when performing the task with distal than proximal effectors. Force distortion, quantified by harmonicity, indicated that more perturbations occurred in the non-dominant effector than in the dominant effector. The results also indicated significantly lower harmonicity for the non-dominant proximal effector compared to the distal effectors. The current results support the notion that neural crosstalk is asymmetric in nature and is greater for proximal than distal effectors. Additionally, the EMG-EMG coherence results indicated significant neural crosstalk was occurring in the Alpha bands (5-13 Hz), with higher values observed in the proximal condition. Significant coherence in the Alpha bands suggest that the influence of neural crosstalk is occurring at a subcortical level.

The correlations between kinematic profiles and cerebral hemodynamics suggest changes of motor coordination in single and bilateral finger movement

Objective

The correlation between the performance of coordination movement and brain activity is still not fully understood. The current study aimed to identify activated brain regions and brain network connectivity changes for several coordinated finger movements with different difficulty levels and to correlate the brain hemodynamics and connectivity with kinematic performance.

Methods

Twenty-one right-dominant-handed subjects were recruited and asked to complete circular motions of single and bilateral fingers in the same direction (in-phase, IP) and in opposite directions (anti-phase, AP) on a plane. Kinematic data including radius and angular velocity at each task and synchronized blood oxygen concentration data using functional near-infrared spectroscopy (fNIRS) were recorded covering six brain regions including the prefrontal cortex, motor cortex, and occipital lobes. A general linear model was used to locate activated brain regions, and changes compared with baseline in blood oxygen concentration were used to evaluate the degree of brain region activation. Small-world properties, clustering coefficients, and efficiency were used to measure information interaction in brain activity during the movement.

Result

It was found that the radius error of the dominant hand was significantly lower than that of the non-dominant hand (p < 0.001) in both clockwise and counterclockwise movements. The fNIRS results confirmed that the contralateral brain region was activated during single finger movement and the dominant motor area was activated in IP movement, while both motor areas were activated simultaneously in AP movement. The Δhbo were weakly correlated with radius errors (p = 0.002). Brain information interaction in IP movement was significantly larger than that from AP movement in the brain network (p < 0.02) in the right prefrontal cortex. Brain activity in the right motor cortex reduces motor performance (p < 0.001), while the right prefrontal cortex region promotes it (p < 0.05).

Conclusion

Our results suggest there was a significant correlation between motion performance and brain activation level, as well as between motion deviation and brain functional connectivity. The findings may provide a basis for further exploration of the operation of complex brain networks.

Left hemisphere dominance for bilateral kinematic encoding in the human brain

Neurophysiological studies in humans and nonhuman primates have revealed movement representations in both the contralateral and ipsilateral hemispheres. Inspired by clinical observations, we ask if this bilateral representation differs for the left and right hemispheres. Electrocorticography was recorded in human participants during an instructed-delay reaching task, with movements produced with either the contralateral or ipsilateral arm. Using a cross-validated kinematic encoding model, we found stronger bilateral encoding in the left hemisphere, an effect that was present during preparation and was amplified during execution. Consistent with this asymmetry, we also observed better across-arm generalization in the left hemisphere, indicating similar neural representations for right and left arm movements. Notably, these left hemisphere electrodes were centered over premotor and parietal regions. The more extensive bilateral encoding in the left hemisphere adds a new perspective to the pervasive neuropsychological finding that the left hemisphere plays a dominant role in praxis.

The Influence of Altered-Gravity on Bimanual Coordination: Retention and Transfer

Many of the activities associated with spaceflight require individuals to coordinate actions between the limbs (e.g., controlling a rover, landing a spacecraft). However, research investigating the influence of gravity on bimanual coordination has been limited. The current experiment was designed to determine an individual's ability to adapt to altered-gravity when performing a complex bimanual force coordination task, and to identify constraints that influence coordination dynamics in altered-gravity. A tilt table was used to simulate gravity on Earth [90° head-up tilt (HUT)] and microgravity [6° head-down tilt (HDT)]. Right limb dominant participants (N = 12) were required to produce 1:1 in-phase and 1:2 multi-frequency force patterns. Lissajous information was provided to guide performance. Participants performed 14, 20 s trials at 90° HUT (Earth). Following a 30-min rest period, participants performed, for each coordination pattern, two retention trials (Earth) followed by two transfer trials in simulated microgravity (6° HDT). Results indicated that participants were able to transfer their training performance during the Earth condition to the microgravity condition with no additional training. No differences between gravity conditions for measures associated with timing (interpeak interval ratio, phase angle slope ratio) were observed. However, despite the effective timing of the force pulses, there were differences in measures associated with force production (peak force, STD of peak force mean force). The results of this study suggest that Lissajous displays may help counteract manual control decrements observed during microgravity. Future work should continue to explore constraints that can facilitate or interfere with bimanual control performance in altered-gravity environments.

Bilateral Interference in Motor Performance in Homologous vs. Non-homologous Proximal and Distal Effectors

Performance of bimanual motor actions requires coordinated and integrated bilateral communication, but in some bimanual tasks, neural interactions and crosstalk might cause bilateral interference. The level of interference probably depends on the proportions of bilateral interneurons connecting homologous areas of the motor cortex in the two hemispheres. The neuromuscular system for proximal muscles has a higher number of bilateral interneurons connecting homologous areas of the motor cortex compared to distal muscles. Based on the differences in neurophysiological organization for proximal vs. distal effectors in the upper extremities, the purpose of the present experiment was to evaluate how the level of bilateral interference depends on whether the bilateral interference task is performed with homologous or non-homologous effectors as the primary task. Fourteen participants first performed a unilateral primary motor task with the dominant arm with (1) proximal and (2) distal controlled joysticks. Performance in the unilateral condition with the dominant arm was compared to the same effector’s performance when two different bilateral interference tasks were performed simultaneously with the non-dominant arm. The two different bilateral interference tasks were subdivided into (1) homologous and (2) non-homologous effectors. The results showed a significant decrease in performance for both proximal and distal controlled joysticks, and this effect was independent of whether the bilateral interference tasks were introduced with homologous or non-homologous effectors. The overall performance decrease as a result of bilateral interference was larger for proximal compared to distal controlled joysticks. Furthermore, a proximal bilateral interference caused a larger performance decrement independent of whether the primary motor task was controlled by a proximal or distal joystick. A novel finding was that the distal joystick performance equally interfered with either homologous (distal bilateral interference) or non-homologous (proximal bilateral interference) interference tasks performed simultaneously. The results indicate that the proximal–distal distinction is an important organismic constraint on motor control and for understanding bilateral communication and interference in general and, in particular, how bilateral interference caused by homologous vs. non-homologous effectors impacts motor performance for proximal and distal effectors. The results seem to map neuroanatomical and neurophysiological differences for these effectors.

The effect of inherent and incidental constraints on bimanual and social coordination

The current investigation was designed to examine the influence of inherent and incidental constraints on the stability characteristics associated with bimanual and social coordination. Individual participants (N = 9) and pairs of participants (N = 18, 9 pairs) were required to rhythmically coordinate patterns of isometric forces in 1:1 in-phase and 1:2 multi-frequency patterns by exerting force with their right and left limbs. Lissajous information was provided to guide performance. Participants performed 13 practice trials and 1 test trial per pattern. On the test trial, muscle activity from the triceps brachii muscles of each arm was recorded. EMG-EMG coherence between the two EMG signals was calculated using wavelet coherence. The behavioral data indicated that individual participants performed the 1:1 in-phase pattern more accurately and with less variability than paired participants. The EMG coherence analysis indicated significantly higher coherence for individual participants than for the paired participants during the 1:1 in-phase pattern, whereas no differences were observed between groups for the 1:2 coordination pattern. The results of the current investigation support the notion that neural crosstalk can stabilize 1:1 in-phase coordination when contralateral and ipsilateral signals are integrated via the neuromuscular linkage between two effectors.

Alpha and beta neural oscillations differentially reflect age-related differences in bilateral coordination

Bilateral in-phase (IP) and anti-phase (AP) movements represent two fundamental modes of bilateral coordination that are essential for daily living. Although previous studies have shown that aging is behaviorally associated with decline in bilateral coordination, especially in AP movements, the underlying neural mechanisms remain unclear. Here, we use kinematic measurements and electroencephalography to compare motor performance of young and older adults executing bilateral IP and AP hand movements. On the behavioral level, inter-limb synchronization was reduced during AP movements compared to IP and this reduction was stronger in the older adults. On the neural level, we found interactions between group and condition for task-related power change in different frequency bands. The interaction was driven by smaller alpha power decreases over the non-dominant cortical motor area in young adults during IP movements and larger beta power decreases over the midline region in older adults during AP movements. In addition, the decrease in inter-limb synchronization during AP movements was predicted by stronger directional connectivity in the beta-band: an effect more pronounced in older adults. Our results therefore show that age-related differences in the two bilateral coordination modes are reflected on the neural level by differences in alpha and beta oscillatory power as well as interhemispheric directional connectivity.

Motor control characteristics of upper limbs in response to assistive forces during bilateral tasks

Most research on power assist suits (PASs) that concerned PAS-human interactions has used human physical reactions as criteria to evaluate the mechanical function, however, with minimal emphasis on human reactions in response to PASs. In this study, we focused on the physiological responses of the upper limbs including muscle activity of the biceps brachii and the triceps brachii, co-activation, force steadiness (CV) and rated perceived exertion (RPE) to various patterns of bilateral assistive force, such as unilateral assistance (L0% & R67% [% = percentage of workload force, L = left arm, R = right arm], L67% & R0%, L0% & R33%, L33% & R0%), symmetrical (L0% & R0%, L33% & R33%, L67% & R67%) and asymmetrical bilateral assistance (L33% & R67%, L67% & R33%), during bilateral isometric force-matching tasks. The results showed a similar muscular response of the two arms to bilateral assistive conditions, and the muscle activity of the arm that was being observed decreased only when the assistive force that applied on itself increased, indicating that both arms may have adopted similar but independent motor control mechanisms to acclimate to the bilateral assistive forces. Comparison between the two unilateral assistances (L0% & R33% and L33% & R0%) and the two asymmetrical bilateral assistances (L33% & R67%, L67% & R33%) showed no significant differences in muscular responses, CV and RPE, indicating that bilateral assistances with bilateral interchanged assistive levels may be equally effective regardless of which arm the higher assistive force is applied to. Comparison between unilateral and symmetrical assistive conditions that have similar overall workloads (L67% & R0%, L33% & R33%, L0% & R67%) showed a lower CV and RPE score at symmetrical assistance compared with unilateral assistance, suggesting that assisting both arms with the same level simultaneously improves task performances compared with applying the assistive force to only one arm.

Musical mirror-symmetrical movement tasks: comparison of rhythm versus melody-playing

Bimanual mirror-symmetrical movement (MSM) is relatively easy to control movement. Different MSM tasks may have different activations and interhemispheric interactions. The purpose of this study is to compare anatomo-physiological features such as hemispheric activations and dominance of two different MSMs, namely melody-playing and rhythm. We examined functional MRI (fMRI) recordings in a group of fifteen right-handed pianists performing two separate tasks: bimanual rhythm and bimanual melody-playing on two different keyboards with standard key order for right hand and reversed for left hand, which allows homolog fingers' movements. Activations and laterality indices on fMRI were examined. The results show that significant cerebellar activations (especially in anterior cerebellum) in both groups. Significant primary sensorimotor cortical activations are observed in the melody-playing group. While there are also bilaterally symmetric activations, and laterality indices suggest overall lateralization towards the left hemisphere in both groups. Activations in the left fronto-parietal cortex, left putamen and left thalamus in conjunction with right cerebellar activations suggest that the left cortico-thalamo-cerebellar loop may be a dominant loop. Dynamic causal modeling (DCM) indicates the presence of causal influences from the left to the right cerebral cortex. In conclusion, melody-playing with bimanual MSM is a complex in-phase task and may help activate the bilateral cortical areas, and left hemisphere is dominant according to laterality indices and DCM results. On the other hand, bimanual rhythm is a simpler in-phase task and may help activate subcortical areas, which might be independent of the voluntary cortical task.

Accessing interpersonal and intrapersonal coordination dynamics

Both intrapersonal and interpersonal coordination dynamics have traditionally been investigated using relative phase patterns of in-phase (ϕ = 0°) and/or anti-phase (ϕ = 180°). Numerous investigations have demonstrated that coordination tasks that require other relative phase patterns (e.g., 90°) are difficult or near impossible to perform without extended practice. Recent findings, however, have demonstrated that an individual can produce a wide range of intrapersonal bimanual patterns within a few minutes of practice when provided integrated feedback. The present experiment was designed to directly compare intra- and interpersonal coordination performance and variability when provided Lissajous feedback or pacing metronome. Single participants (N = 12) and pairs of participants (N = 24, 12 pairs) were required to produce relative phase patterns between 0° and 180° in 30° increments using either pacing metronomes or Lissajous displays. The Lissajous displays involved a goal template and a cursor providing integrated feedback regarding the position of the two effectors. The results indicated both single and pairs of participants could effectively produce a large range of coordination patterns that typically act as repellers after only 6 min of practice when provided integrated feedback. However, single participants performed the in-phase coordination pattern more accurately and with less variability than paired participants, regardless of the feedback condition. These results suggest an advantage for intrapersonal coordination when performing in-phase coordination, possibly due to the stabilizing effect occurring via the neuro-muscular linkage between effectors.

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.

Bilateral Contralaterally Controlled Functional Electrical Stimulation Reveals New Insights Into the Interhemispheric Competition Model in Chronic Stroke

Background. Upper-limb chronic stroke hemiplegia was once thought to persist because of disproportionate amounts of inhibition imposed from the contralesional on the ipsilesional hemisphere. Thus, one rehabilitation strategy involves discouraging engagement of the contralesional hemisphere by only engaging the impaired upper limb with intensive unilateral activities. However, this premise has recently been debated and has been shown to be task specific and/or apply only to a subset of the stroke population. Bilateral rehabilitation, conversely, engages both hemispheres and has been shown to benefit motor recovery. To determine what neurophysiological strategies bilateral therapies may engage, we compared the effects of a bilateral and unilateral based therapy using transcranial magnetic stimulation. Methods. We adopted a peripheral electrical stimulation paradigm where participants received 1 session of bilateral contralaterally controlled functional electrical stimulation (CCFES) and 1 session of unilateral cyclic neuromuscular electrical stimulation (cNMES) in a repeated-measures design. In all, 15 chronic stroke participants with a wide range of motor impairments (upper extremity Fugl-Meyer score: 15 [severe] to 63 [mild]) underwent single 1-hour sessions of CCFES and cNMES. We measured whether CCFES and cNMES produced different effects on interhemispheric inhibition (IHI) to the ipsilesional hemisphere, ipsilesional corticospinal output, and ipsilateral corticospinal output originating from the contralesional hemisphere. Results. CCFES reduced IHI and maintained ipsilesional output when compared with cNMES. We found no effect on ipsilateral output for either condition. Finally, the less-impaired participants demonstrated a greater increase in ipsilesional output following CCFES. Conclusions. Our results suggest that bilateral therapies are capable of alleviating inhibition on the ipsilesional hemisphere and enhancing output to the paretic limb.

Kinematic profiles suggest differential control processes involved in bilateral in-phase and anti-phase movements

In-phase and anti-phase movements represent two basic coordination modes with different characteristics: during in-phase movements, bilateral homologous muscle groups contract synchronously, whereas during anti-phase movements, they contract in an alternating fashion. Previous studies suggested that in-phase movements represent a more stable and preferential bilateral movement template in humans. The current experiment aims at confirming and extending this notion by introducing new empirical measures of spatiotemporal dynamics during performance of a bilateral circle drawing task in an augmented-reality environment. First, we found that anti-phase compared to in-phase movements were performed with higher radial variability, a result that was mainly driven by the non-dominant hand. Second, the coupling of both limbs was higher during in-phase movements, corroborated by a lower inter-limb phase difference and higher inter-limb synchronization. Importantly, the movement acceleration profile between bilateral hands followed an in-phase relationship during in-phase movements, while no specific relationship was found in anti-phase condition. These spatiotemporal relationships between hands support the hypothesis that differential neural processes govern both bilateral coordination modes and suggest that both limbs are controlled more independently during anti-phase movements, while bilateral in-phase movements are elicited by a common neural generator.

Shared right-hemispheric representations of sensorimotor goals in dynamic task environments

Functional behaviour affords that we form goals to integrate sensory information about the world around us with suitable motor actions, such as when we plan to grab an object with a hand. However, much research has tested grasping in static scenarios where goals are pursued with repetitive movements, whereas dynamic contexts require goals to be pursued even when changes in the environment require a change in the actions to attain them. To study grasp goals in dynamic environments here, we employed a task where the goal remained the same but the execution of the movement changed; we primed participants to grasp objects either with their right or left hand, and occasionally they had to switch to grasping with both. Switch costs should be minimal if grasp goal representations were used continuously, for example, within the left dominant hemisphere. But remapped or re-computed goal representations should delay movements. We found that switching from right-hand grasping to bimanual grasping delayed reaction times but switching from left-hand grasping to bimanual grasping did not. Further, control experiments showed that the lateralized switch costs were not caused by asymmetric inhibition between hemispheres or switches between usual and unusual tasks. Our results show that the left hemisphere does not serve a general role of sensorimotor grasp goal representation. Instead, sensorimotor grasp goals appear to be represented at intermediate levels of abstraction, downstream from cognitive task representations, yet upstream from the control of the grasping effectors.

TMS Motor Thresholds Correlate With TDCS Electric Field Strengths in Hand Motor Area

Transcranial direct current stimulation (TDCS) modulates cortical activity and influences motor and cognitive functions in both healthy and clinical populations. However, there is large inter-individual variability in the responses to TDCS. Computational studies have suggested that inter-individual differences in cranial and brain anatomy may contribute to this variability via creating varying electric fields in the brain. This implies that the electric fields or their strength and orientation should be considered and incorporated when selecting the TDCS dose. Unfortunately, electric field modeling is difficult to perform; thus, a more-robust and practical method of estimating the strength of TDCS electric fields for experimental use is required. As recent studies have revealed a relationship between the sensitivity to TMS and motor cortical TDCS after-effects, the aim of the present study was to investigate whether the resting motor threshold (RMT), a simple measure of transcranial magnetic stimulation (TMS) sensitivity, would be useful for estimating TDCS electric field strengths in the hand area of primary motor cortex (M1). To achieve this, we measured the RMT in 28 subjects. We also obtained magnetic resonance images from each subject to build individual three-dimensional anatomic models, which were used in solving the TDCS and TMS electric fields using the finite element method (FEM). Then, we calculated the correlation between the measured RMT and the modeled TDCS electric fields. We found that the RMT correlated with the TDCS electric fields in hand M1 (R² = 0.58), but no obvious correlations were identified in regions outside M1. The found correlation was mainly due to a correlation between the TDCS and TMS electric fields, both of which were affected by individual's anatomic features. In conclusion, the RMT could provide a useful tool for estimating cortical electric fields for motor cortical TDCS.

Bimanual coordination: A missing piece of arm rehabilitation after stroke

Inability to use the arm in daily actions significantly lowers quality of life after stroke. Most contemporary post-stroke arm rehabilitation strategies that aspire to re-engage the weaker arm in functional activities have been greatly limited in their effectiveness. Most actions of daily life engage the two arms in a highly coordinated manner. In contrast, most rehabilitation approaches predominantly focus on restitution of the impairments and unilateral practice of the weaker hand alone. We present a perspective that this misalignment between real world requirements and intervention strategies may limit the transfer of unimanual capability to spontaneous arm use and functional recovery. We propose that if improving spontaneous engagement and use of the weaker arm in real life is the goal, arm rehabilitation research and treatment need to address the coordinated interaction between arms in targeted theory-guided interventions. Current narrow focus on unimanual deficits alone, difficulty in quantifying bimanual coordination in real-world actions and limited theory-guided focus on control and remediation of different coordination modes are some of the biggest obstacles to successful implementation of effective interventions to improve bimanual coordination in the real world. We present a theory-guided taxonomy of bimanual actions that will facilitate quantification of coordination for different real-world tasks and provide treatment targets for addressing coordination deficits. We then present evidence in the literature that points to bimanual coordination deficits in stroke survivors and demonstrate how current rehabilitation approaches are limited in their impact on bimanual coordination. Importantly, we suggest theory-based areas of future investigation that may assist quantification, identification of neural mechanisms and scientifically-based training/remediation approaches for bimanual coordination deficits post-stroke. Advancing the science and practice of arm rehabilitation to incorporate bimanual coordination will lead to a more complete functional recovery of the weaker arm, thus improving the effectiveness of rehabilitation interventions and augmenting quality of life after stroke.

Neural motor control differs between bimanual common-goal vs. bimanual dual-goal tasks

Coordinating bimanual movements is essential for everyday activities. Two common types of bimanual tasks are common goal, where two arms share a united goal, and dual goal, which involves independent goals for each arm. Here, we examine how the neural control mechanisms differ between these two types of bimanual tasks. Ten non-disabled individuals performed isometric force tasks of the elbow at 10% of their maximal voluntary force in both bimanual common and dual goals as well as unimanual conditions. Using transcranial magnetic stimulation, we concurrently examined the intracortical inhibitory modulation (short-interval intracortical inhibition, SICI) as well as the interlimb coordination strategies utilized between common- vs. dual-goal tasks. Results showed a reduction of SICI in both hemispheres during dual-goal compared to common-goal tasks (dominant hemisphere: P = 0.04, non-dominant hemisphere: P = 0.03) and unimanual tasks (dominant hemisphere: P = 0.001, non-dominant hemisphere: P = 0.001). For the common-goal task, a reduction of SICI was only seen in the dominant hemisphere compared to unimanual tasks (P = 0.03). Behaviorally, two interlimb coordination patterns were identified. For the common-goal task, both arms were organized into a cooperative "give and take" movement pattern. Control of the non-dominant arm affected stabilization of bimanual force (R² = 0.74, P = 0.001). In contrast, for the dual-goal task, both arms were coupled together in a positive fashion and neither arm affected stabilization of bimanual force (R² = 0.31, P = 0.1). The finding that intracortical inhibition and interlimb coordination patterns were different based on the goal conceptualization of bimanual tasks has implications for future research.

Impact of Handedness Consistency on Bimanual and Unimanual Continuous Movements

Bimanual coordination is an essential human function requiring efficient interhemispheric communication to produce coordinated movements. Previous research suggests a "bimanual advantage" phenomenon, where completing synchronized bimanual tasks results in less variability than unimanual tasks. Additionally, of hand dominance has been shown to influence coordinated performance. The present study examined the bimanual advantage in individuals with consistent and inconsistent handedness. It was predicted that participants with consistent handedness would not display a bimanual advantage unlike those with inconsistent handedness. Fifty-six young adults completed a finger-tapping paradigm in five conditions: unimanual tapping with either left or right hand, in-phase bimanual tapping, and out-of phase bimanual tapping led by either left or right hand. Results were not consistent with the hypothesis that participants with consistent handedness displayed the "bimanual advantage". However, the "bimanual advantage" was not evident for the inconsistent handers when the temporal consistency was measured with either the left or right hand only. Overall, the "bimanual advantage" may be dependent upon consistency of hand preference, as well as the direction of hand dominance.

Manual action verbs modulate the grip force of each hand in unimanual or symmetrical bimanual tasks

Manual action verbs modulate the right-hand grip force in right-handed subjects. However, to our knowledge, no studies demonstrate the ability to accomplish this modulation during bimanual tasks nor describe their effect on left-hand behavior in unimanual and bimanual tasks. Using load cells and word playlists, we evaluated the occurrence of grip force modulation by manual action verbs in unimanual and symmetrical bimanual tasks across the three auditory processing phases. We found a significant grip force increase for all conditions compared to baseline, indicating the occurrence of modulation. When compared to each other, the grip force variation from baseline for the three phases of both hands in the symmetrical bimanual task was not different from the right-hand in the unimanual task. The left-hand grip force showed a lower amplitude for auditory phases 1 and 2 when compared to the other conditions. The right-hand grip force modulation became significant from baseline at 220 ms after the word onset in the unimanual task. This moment occurred earlier for both hands in bimanual task (160 ms for the right-hand and 180 for the left-hand). It occurred later for the left-hand in unimanual task (320 ms). We discuss the hypothesis that Broca's area and Broca's homologue area likely control the left-hand modulation in a unilateral or a bilateral fashion. These results provide new evidence for understanding the linguistic function processing in both hemispheres.

Age-related changes in bilateral upper extremity coordination

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

Goal conceptualization and symmetry of arm movements affect bimanual coordination in individuals after stroke

Coordination during goal-directed movements emerges from an interaction of task and individual constraints. It is not known how individuals with unilateral stroke and age-matched controls coordinate their arms when performing symmetric and asymmetric movements to accomplish common task goals compared to independent task goals. Eleven individuals with chronic stroke and ten age-matched controls executed a bimanual task under virtual conditions that allowed systematic manipulation of symmetry and goal conditions. Spatial and temporal bimanual coordination was characterized using the cross-correlation coefficients and time lag between the tangential velocities between the two hands. While task conditions had little effect on coordination of control participants, individuals with stroke were less coordinated in space and time during common-goal bimanual actions employing asymmetric arm movements. Further, patients demonstrated lesser contribution of their paretic arm compared to their non-paretic arm during common-goal conditions. These findings indicate that conceptualization of task goals (common vs. independent) and symmetry of arm movements influence coordination and contribution of the two hands during bimanual tasks in patients with stroke.

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.

Tailoring Brain Stimulation to the Nature of Rehabilitative Therapies in Stroke: A Conceptual Framework Based on their Unique Mechanisms of Recovery

Despite showing early promise, several recent clinical trials of noninvasive brain stimulation (NIBS) failed to augment rehabilitative outcomes of the paretic upper limb. This article addresses why pairing NIBS with unilateral approaches is weakly generalizable to patients in all ranges of impairments. The article also addresses whether alternate therapies are better suited for the more impaired patients, where they may be more feasible and offer neurophysiologic advantages not offered with unilateral therapies. The article concludes by providing insight on how to create NIBS paradigms that are tailored to distinctly augment the effects of therapies across patients with varying degrees of impairment.

Bimanual force control: cooperation and interference?

Three experiments were designed to determine the level of cooperation or interference observed from the forces generated in one limb on the forces exhibited by the contralateral limb when one or both limbs were producing a constant force (Experiment 1), one limb was producing a dynamic force while the other limb was producing a constant force (Experiment 2), and both limbs were producing dynamic force patterns (Experiment 3). The results for both Experiments 1 and 2 showed relatively strong positive time series cross correlations between the left and right limb forces indicating increases or decreases in the forces generated by one limb resulted in corresponding changes in the forces produced by the homologous muscles of the contralateral limb. Experiment 3 required participants to coordinate 1:1 and 1:2 rhythmical bimanual force production tasks when provided Lissajous feedback. The results indicated very effective performance of both bimanual coordination patterns. However, identifiable influences of right limb forces on the left limb force time series were observed in the 1:2 coordination pattern but not in the 1:1 pattern. The results of all three experiments support the notion that neural crosstalk is partially responsible for the stabilities and instabilities associated with bimanual coordination.

Bimanual force variability and chronic stroke: asymmetrical hand control

The purpose of this study was to investigate force variability generated by both the paretic and non-paretic hands during bimanual force control. Nine chronic stroke individuals and nine age-matched individuals with no stroke history performed a force control task with both hands simultaneously. The task involved extending the wrist and fingers at 5%, 25%, and 50% of maximum voluntary contraction. Bimanual and unimanual force variability during bimanual force control was determined by calculating the coefficient of variation. Analyses revealed two main findings: (a) greater bimanual force variability in the stroke group than the control group and (b) increased force variability by the paretic hands during bimanual force control in comparison to the non-paretic hands at the 5% and 25% force production conditions. A primary conclusion is that post stroke bimanual force variability is asymmetrical between hands.

Effects of the motor cortical quadripulse transcranial magnetic stimulation (QPS) on the contralateral motor cortex and interhemispheric interactions

Corpus callosum connects the bilateral primary motor cortices (M1s) and plays an important role in motor control. Using the paired-pulse transcranial magnetic stimulation (TMS) paradigm, we can measure interhemispheric inhibition (IHI) and interhemispheric facilitation (IHF) as indexes of the interhemispheric interactions in humans. We investigated how quadripulse transcranial magnetic stimulation (QPS), one form of repetitive TMS (rTMS), on M1 affects the contralateral M1 and the interhemispheric interactions. QPS is able to induce bidirectional plastic changes in M1 depending on the interstimulus intervals (ISIs) of TMS pulses: long-term potentiation (LTP)-like effect by QPS-5 protocol, and long-term depression-like effect by QPS-50, whose numbers indicate the ISI (ms). Twelve healthy subjects were enrolled. We applied QPS over the left M1 and recorded several parameters before and 30 min after QPS. QPS-5, which increased motor-evoked potentials (MEPs) induced by left M1 activation, also increased MEPs induced by right M1 activation. Meanwhile, QPS-50, which decreased MEPs elicited by left M1 activation, did not induce any significant changes in MEPs elicited by right M1 activation. None of the resting motor threshold, active motor threshold, short-interval intracortical inhibition, long-interval intracortical inhibition, intracortical facilitation, and short-interval intracortical inhibition in right M1 were affected by QPS. IHI and IHF from left to right M1 significantly increased after left M1 QPS-5. The degree of left first dorsal interosseous MEP amplitude change by QPS-5 significantly correlated with the degree of IHF change. We suppose that the LTP-like effect on the contralateral M1 may be produced by some interhemispheric interactions through the corpus callosum.

Bimanual coupling paradigm as an effective tool to investigate productive behaviors in motor and body awareness impairments

When humans move simultaneously both hands strong coupling effects arise and neither of the two hands is able to perform independent actions. It has been suggested that such motor constraints are tightly linked to action representation rather than to movement execution. Hence, bimanual tasks can represent an ideal experimental tool to investigate internal motor representations in those neurological conditions in which the movement of one hand is impaired. Indeed, any effect on the “moving” (healthy) hand would be caused by the constraints imposed by the ongoing motor program of the ‘impaired’ hand. Here, we review recent studies that successfully utilized the above-mentioned paradigms to investigate some types of productive motor behaviors in stroke patients. Specifically, bimanual tasks have been employed in left hemiplegic patients who report illusory movements of their contralesional limbs (anosognosia for hemiplegia). They have also been administered to patients affected by a specific monothematic delusion of body ownership, namely the belief that another person’s arm and his/her voluntary action belong to them. In summary, the reviewed studies show that bimanual tasks are a simple and valuable experimental method apt to reveal information about the motor programs of a paralyzed limb. Therefore, it can be used to objectively examine the cognitive processes underpinning motor programming in patients with different delusions of motor behavior. Additionally, it also sheds light on the mechanisms subserving bimanual coordination in the intact brain suggesting that action representation might be sufficient to produce these effects.

Drawing lines while imagining circles: Neural basis of the bimanual coupling effect during motor execution and motor imagery

When people simultaneously draw lines with one hand and circles with the other hand, both trajectories tend to assume an oval shape, showing that hand motor programs interact (the so-called "bimanual coupling effect"). The aim of the present study was to investigate how motor parameters (drawing trajectories) and the related brain activity vary during bimanual movements both in real execution and in motor imagery tasks. In the 'Real' modality, subjects performed right hand movements (lines) and, simultaneously, Congruent (lines) or Non-congruent (circles) left hand movements. In the 'Imagery' modality, subjects performed only right hand movements (lines) and, simultaneously, imagined Congruent (lines) or Non-congruent (circles) left hand movements. Behavioral results showed a similar interference of both the real and the imagined circles on the actually executed lines, suggesting that the coupling effect also pertains to motor imagery. Neuroimaging results showed that a prefrontal-parietal network, mostly involving the pre-Supplementary Motor Area (pre-SMA) and the posterior parietal cortex (PPC), was significantly more active in Non-congruent than in Congruent conditions, irrespective of task (Real or Imagery). The data also confirmed specific roles of the right superior parietal lobe (SPL) in mediating spatial interference, and of the left PPC in motor imagery. Collectively, these findings suggest that real and imagined Non-congruent movements activate common circuits related to the intentional and predictive operation generating bimanual coupling, in which the pre-SMA and the PPC play a crucial role.

Reacting while moving: influence of right limb movement on left limb reaction

An experiment was designed to determine whether the activation of a muscle group (flexors or extensors) used to produce an ongoing movement of one limb influenced the reaction time and associated initiation of elbow flexion or extension movements of the contralateral limb. Right-handed participants in the bimanual groups were asked to produce a pattern of flexion/extension movements defined by a sine wave (period = 2 s, amplitude = 16°) with the right limb. While performing the right limb movement, participants were instructed that they were to react as quickly as possible by making a flexion or extension movement with their left limb when the cursor they were using to track the sine wave changed color. Participants in the unimanual groups performed the left limb reaction time task but were not asked to make right limb movements. The reaction time stimulus occurred once in each trial and was presented at one of six locations on one of the six cycles comprising the sinusoidal waveform. Participants performed 7 blocks of 6 test trials. Reaction time was calculated as the time interval between the color change of the cursor and the initiation of the response with the left limb. Movement time was calculated as the interval of time between the initiation of the response and the left limb cursor crossing the upper or lower boundary line. Mean reaction of the left limb was significantly influenced by the concurrent type of movement (flexion/extension) of the right limb. Reaction times were shorter on trials in which both limbs were initiating movement with homologous muscles as compared to trials in which the limbs were initiating movement with non-homologous muscles. No differences were detected when the stimuli were presented during the ballistic phase of the right limb movement, and no differences at any position were detected for the unimanual groups. This result is consistent with the notion that neural crosstalk can influence the time required to react to a stimulus but this influence occurs when contralateral muscles are activated.

Enriched childhood experiences moderate age-related motor and cognitive decline

Aging is associated with deterioration of skilled manual movement. Specifically, aging corresponds with increased reaction time, greater movement duration, segmentation of movement, increased movement variability, and reduced ability to adapt to external forces and inhibit previously learned sequences. Moreover, it is thought that decreased lateralization of neural function in older adults may point to increased neural recruitment as a compensatory response to deterioration of key frontal and intra-hemispheric networks, particularly of callosal structures. However, factors that mediate age-related motor decline are not well understood. Here we show that music training in childhood is associated with reduced age-related decline of bimanual and unimanual motor skills in a MIDI keyboard motor learning task. Compared to older adults without music training, older adults with more than a year of music training demonstrated proficient bimanual and unimanual movement, evidenced by enhanced speed and decreased movement errors. Further, this group demonstrated significantly better implicit learning in the weather prediction task, a non-motor task. The performance of older adults with music training in those tasks was comparable to young adults. Older adults, however, displayed greater verbal ability compared to young adults irrespective of a past history of music training. Our results indicate that music training early in life may reduce age-associated decline of neural motor and cognitive networks.

Motor control and neural plasticity through interhemispheric interactions

The corpus callosum, which is the largest white matter structure in the human brain, connects the 2 cerebral hemispheres. It plays a crucial role in maintaining the independent processing of the hemispheres and in integrating information between both hemispheres. The functional integrity of interhemispheric interactions can be tested electrophysiologically in humans by using transcranial magnetic stimulation, electroencephalography, and functional magnetic resonance imaging. As a brain structural imaging, diffusion tensor imaging has revealed the microstructural connectivity underlying interhemispheric interactions. Sex, age, and motor training in addition to the size of the corpus callosum influence interhemispheric interactions. Several neurological disorders change hemispheric asymmetry directly by impairing the corpus callosum. Moreover, stroke lesions and unilateral peripheral impairments such as amputation alter interhemispheric interactions indirectly. Noninvasive brain stimulation changes the interhemispheric interactions between both motor cortices. Recently, these brain stimulation techniques were applied in the clinical rehabilitation of patients with stroke by ameliorating the deteriorated modulation of interhemispheric interactions. Here, we review the interhemispheric interactions and mechanisms underlying the pathogenesis of these interactions and propose rehabilitative approaches for appropriate cortical reorganization.

Spatiotemporal re-organization of large-scale neural assemblies underlies bimanual coordination

Bimanual coordination engages a distributed network of brain areas, the spatiotemporal organization of which has given rise to intense debates. Do bimanual movements require information processing in the same set of brain areas that are engaged by movements of the individual components (left and right hands)? Or is it necessary that other brain areas are recruited to help in the act of coordination? These two possibilities are often considered as mutually exclusive, with studies yielding support for one or the other depending on techniques and hypotheses. However, as yet there is no account of how the two views may work together dynamically. Using the method of Mode-Level Cognitive Subtraction (MLCS) on high density EEG recorded during unimanual and bimanual movements, we expose spatiotemporal reorganization of large-scale cortical networks during stable inphase and antiphase coordination and transitions between them. During execution of stable bimanual coordination patterns, neural dynamics were dominated by temporal modulation of unimanual networks. At instability and transition, there was evidence for recruitment of additional areas. Our study provides a framework to quantify large-scale network mechanisms underlying complex cognitive tasks often studied with macroscopic neurophysiological recordings.

Coordination of uncoupled bimanual movements by strictly timed interhemispheric connectivity

Independent use of both hands is characteristic of human action in daily life. By nature, however, in-phase bimanual movements, for example clapping, are easier to accomplish than anti-phase movements, for example playing the piano. It is commonly agreed that interhemispheric interactions play a central role in the coordination of bimanual movements. However, the spatial, temporal, and physiological properties of the interhemispheric signals that coordinate different modes of bimanual movements are still not completely understood. More precisely, do individual interhemispheric connectivity parameters have behavioral relevance for bimanual rapid anti-phase coordination? To address this question, we measured movement-related interhemispheric interactions, i.e., inhibition and facilitation, and correlated them with the performance during bimanual coordination. We found that movement-related facilitation from right premotor to left primary motor cortex (rPMd-lM1) predicted performance in anti-phase bimanual movements. It is of note that only fast facilitation during the preparatory period of a movement was associated with success in anti-phase movements. Modulation of right to left primary motor interaction (rM1-lM1) was not related to anti-phase but predicted bimanual in-phase and unimanual behavior. These data suggest that strictly timed modulation of interhemispheric rPMd-lM1 connectivity is essential for independent high-frequency use of both hands. The rM1-lM1 results indicate that adjustment of connectivity between homologous M1 may be important for the regulation of homologous muscle synergies.

Cross talk in implicit assignment of error information during bimanual visuomotor learning

When a neural movement controller, called an “internal model,” is adapted to a novel environment, the movement error needs to be appropriately associated with the controller. However, their association is not necessarily guaranteed for bimanual movements in which two controllers—one for each hand—result in two movement errors. Considering the implicit nature of the adaptation process, the movement error of one hand can be erroneously associated with the controller of the other hand. Here, we investigated this credit-assignment problem in bimanual movement by having participants perform bimanual, symmetric back-and-forth movements while displaying the position of the right hand only with a cursor. In the training session, the cursor position was gradually rotated clockwise, such that the participants were unaware of the rotation. The movement of the right hand gradually rotated counterclockwise as a consequence of adaptation. Although the participants knew that the cursor reflected the movement of the right hand, such gradual adaptation was also observed for the invisible left hand, especially when the cursor was presented on the left side of the display. Thus the movement error of the right hand was implicitly assigned to the left-hand controller. Such cross talk in credit assignment might influence motor adaptation performance, even when two cursors are presented; the adaptation was impaired when the rotations imposed on the cursors were opposite compared with when they were in the same direction. These results indicate the inherent presence of cross talk in the process of associating action with consequence in bimanual movement.

How the brain handles temporally uncoupled bimanual movements

Whereas the cerebral representation of bimanual spatial coordination has been subject to prior research, the networks mediating bimanual temporal coordination are still unclear. The present study used functional imaging to investigate cerebral networks mediating temporally uncoupled bimanual finger movements. Three bimanual tasks were designed for the execution of movements with different timing and amplitude, with same timing but different amplitude, and with same timing and amplitude. Functional magnetic resonance imaging results showed an increase of activation within right premotor and dorsolateral prefrontal, bilateral inferior parietal, basal ganglia, and cerebellum areas related to temporally uncoupled bilateral finger movements. Further analyses showed a decrease of connectivity between homologous primary hand motor regions. In contrast, there was an increase of connectivity between motor regions and anterior cingulate, premotor and posterior parietal regions during bimanual movements that were spatially or both temporally and spatially uncoupled, compared with bimanual movements that were both spatially and temporally coupled. These results demonstrate that the extent of bihemispheric coupling of M1 areas is related to the degree of temporal synchronization of bimanual finger movements. Furthermore, inferior parietal and premotor regions play a key role for the implementation not only of spatial but also of temporal movement parameters in bimanual coordination.