Lack of interlimb transfer following visuomotor adaptation in a person with congenital mirror movements

Corpus Callosum-Mediated Interhemispheric Interactions in Cervical Spondylotic Myelopathy

PURPOSE

The corpus callosum is crucial for interhemispheric interactions in the motor control of limb functions. Human and animal studies suggested spinal cord pathologies may induce cortical reorganization in sensorimotor areas. We investigate participation of the corpus callosum in executions of a simple motor task in patients with cervical spondylotic myelopathy (CSM) using transcranial magnetic stimulation.

METHODS

Twenty patients with CSM with various MRI grades of severity of cord compression were compared with 19 normal controls. Ipsilateral silent period, contralateral silent period, central motor conduction time, and transcallosal conduction time (TCT) were determined.

RESULTS

In both upper and lower limbs, TCTs were significantly increased for patients with CSM than normal controls ( p < 0.001 for all), without side-to-side differences. Ipsilateral silent period and contralateral silent period durations were significantly increased bilaterally for upper limbs in comparison to controls ( p < 0.01 for all), without side-to-side differences. There were no significant correlations of TCT with central motor conduction time nor severity of CSM for both upper and lower limbs ( p > 0.05 for all) bilaterally.

CONCLUSIONS

Previous transcranial magnetic stimulation studies show increased motor cortex excitability in CSM; hence, increased TCTs observed bilaterally may be a compensatory mechanism for effective unidirectional and uniplanar execution of muscle activation in the distal limb muscles. Lack of correlation of TCTs with severity of CSM or central motor conduction time may be in keeping with a preexistent role of the corpus callosum as a predominantly inhibitory pathway for counteracting redundant movements resulting from increased motor cortex excitability occurring after spinal cord lesions.

Memory decay and generalization following distinct motor learning mechanisms

Motor skill learning is considered to arise out of contributions from multiple learning mechanisms, including error-based learning (EBL), use-dependent learning (UDL), and reinforcement learning (RL). These learning mechanisms exhibit dissociable roles and engage different neural circuits during skill acquisition. However, it remains largely unknown how a newly formed motor memory acquired through each learning mechanism decays over time and whether distinct learning mechanisms produce different generalization patterns. Here, we used variants of reaching paradigms that dissociated these learning mechanisms to examine the time course of memory decay following each learning and the generalization patterns of each learning. We found that motor memories acquired through these learning mechanisms decayed as a function of time. Notably, 15 min, 6 h, and 24 h after acquisition, the memory of EBL decayed much greater than that of RL. The memory acquired through UDL faded away within a few minutes. Motor memories formed through EBL and RL for given movement directions generalized to untrained movement directions, with the generalization of EBL being greater than that of RL. In contrast, motor memory of UDL could not generalize to untrained movement directions. These results suggest that distinct learning mechanisms exhibit different patterns of memory decay and generalization.NEW & NOTEWORTHY Motor skill learning is likely to involve error-based learning, use-dependent plasticity, and operant reinforcement. Here, we showed that these dissociable learning mechanisms exhibited distinct patterns of memory decay and generalization. With a better understanding of the characteristics of these learning mechanisms, it becomes possible to regulate each learning process separately to improve neurological rehabilitation.

Facilitative effects of use-dependent learning on interlimb transfer of visuomotor adaptation in a person with congenital mirror movements

It has been shown that use-dependent learning can facilitate interlimb transfer of motor learning in neurologically intact individuals. However, it is unknown whether it can also facilitate interlimb transfer in individuals with neurological impairment. In this case study, we examined the effect of use-dependent learning on interlimb transfer of visuomotor adaptation in a person with congenital mirror movements, DB, who showed no interlimb transfer in our previous studies (Bao, Morgan, Lei, & Wang, 2020; Javidialsaadi, & Wang, 2021). DB first performed reaching movements with the right arm repeatedly while adapting to a visuomotor rotation condition with the left arm (training session), and then adapted to the same rotation condition with the right arm (transfer session). DB's right arm performance in the transfer session was significantly better than that observed in our previous studies, indicating interlimb transfer of visuomotor adaptation. The percentage of transfer was over 90%, which is similar to that observed in healthy young adults previously. These findings suggest that interlimb transfer of visuomotor adaptation can occur by involving model-based learning, which is effector independent, and/or use-dependent (or model-free) learning, which is effector specific; and also that the relative contribution of use-dependent learning to interlimb transfer of visuomotor adaptation can be as large as that of model-based learning.

Interlimb Transfer of Reach Adaptation Does Not Require an Intact Corpus Callosum: Evidence from Patients with Callosal Lesions and Agenesis

Generalization of sensorimotor adaptation across limbs, known as interlimb transfer, is a well-demonstrated phenomenon in humans, yet the underlying neural mechanisms remain unclear. Theoretical models suggest that interlimb transfer is mediated by interhemispheric transfer of information via the corpus callosum. We thus hypothesized that lesions of the corpus callosum, especially to its midbody connecting motor, supplementary motor, and premotor areas of the two cerebral hemispheres, would impair interlimb transfer of sensorimotor adaptation. To test this hypothesis, we recruited three patients: two rare stroke patients with recent, extensive callosal lesions including the midbody and one patient with complete agenesis. A prismatic adaptation paradigm involving unconstrained arm reaching movements was designed to assess interlimb transfer from the prism-exposed dominant arm (DA) to the unexposed non-dominant arm (NDA) for each participant. Baseline results showed that spatial performance of each patient did not significantly differ from controls, for both limbs. Further, each patient adapted to the prismatic perturbation, with no significant difference in error reduction compared with controls. Crucially, interlimb transfer was found in each patient. The absolute magnitude of each patient’s transfer did not significantly differ from controls. These findings show that sensorimotor adaptation can transfer across limbs despite extensive lesions or complete absence of the corpus callosum. Therefore, callosal pathways connecting homologous motor, premotor, and supplementary motor areas are not necessary for interlimb transfer of prismatic reach adaptation. Such interlimb transfer could be mediated by transcallosal splenium pathways (connecting parietal, temporal and visual areas), ipsilateral cortico-spinal pathways or subcortical structures such as the cerebellum.

Lack of interlimb transfer following visuomotor adaptation in a person with congenital mirror movements despite the awareness of the visuomotor perturbation

There is a controversy regarding whether visuomotor adaptation heavily involves both implicit and explicit learning processes or not. Likewise, another controversy exists regarding whether interlimb transfer of visuomotor adaptation is related to explicit processes or not. To address the latter issue, we examined interlimb transfer of visuomotor adaptation in an individual with congenital mirror movements, 'DB'. DB has been tested previously using an experimental paradigm in which neurologically intact individuals demonstrated substantial transfer. DB, however, showed no transfer due to impaired interhemispheric communications. In that study, DB was unaware of the visuomotor perturbation. Here, we informed him of the perturbation prior to the experiment to determine whether providing the information would increase interlimb transfer. DB first adapted to a visuomotor rotation with the left arm, then with the right arm during reaching movements. Data from the present study were compared against those from our previous study. Results indicate no transfer across the arms despite the fact that he was aware of the perturbation. Considering overall findings in the literature, we suggest that interlimb transfer does not depend on one's awareness, although its extent can increase when individuals rely on cognitive strategies to deal with perturbations (c.f., Werner et al., 2019).