The Cortical Physiology of Ipsilateral Limb Movements

Patterns of cortical thickness alterations in degenerative cervical myelopathy: associations with dexterity and gait dysfunctions

Degenerative cervical myelopathy (DCM) can lead to significant brain structural reorganization. The association between the cortical changes and specific motor symptoms in DCM has yet to be fully elucidated. We investigated the associations between cortical thickness changes with neurological symptoms, such as dexterity and gait abnormalities, in patients with DCM in a case-control study. A 3 Tesla MRI scanner was used to acquire high-resolution T1-weighted structural scans from 30 right-handed patients with DCM and 22 age-matched healthy controls. Pronounced cortical thinning was observed in DCM patients relative to healthy controls, particularly in the bilateral precentral and prefrontal gyri, left pars triangularis, left postcentral gyrus, right transverse temporal and visual cortices (P ≤ 0.04). Notably, cortical thickness in these regions showed strong correlations with objective motor deficits (P < 0.0001). Specifically, the prefrontal cortex, premotor area and supplementary motor area exhibited significant thickness reductions correlating with diminished dexterity (R2 = 0.33, P < 0.0007; R2 = 0.34, P = 0.005, respectively). Similarly, declines in gait function were associated with reduced cortical thickness in the visual motor and frontal eye field cortices (R2 = 0.39, P = 0.029, R2 = 0.33, P = 0.04, respectively). Interestingly, only the contralateral precuneus thickness was associated with the overall modified Japanese Orthopaedic Association (mJOA) scores (R2 = 0.29, P = 0.003). However, the upper extremity subscore of mJOA indicated an association with the visual cortex and the anterior prefrontal (R2 = 0.48, P = 0.002, R2 = 0.33, P = 0.0034, respectively). In conclusion, our findings reveal patterns of cortical changes correlating with motor deficits, highlighting the significance of combining objective clinical and brain imaging assessments for understanding motor network dysfunction in DCM.

Dichotic listening and interhemispheric integration after callosotomy: A systematic review

The right-ear advantage (REA) for recalling dichotically presented auditory-verbal stimuli has been traditionally linked to the dominance of the left cerebral hemisphere for speech processing. Early studies on patients with callosotomy additionally found that the removal of the corpus callosum leads to a complete extinction of the left ear, and consequently the today widely used models to explain the REA assume a central role of callosal axons for recalling the left-ear stimulus in dichotic listening. However, later dichotic-listening studies on callosotomy patients challenge this interpretation, as many patients appear to be able to recall left-ear stimuli well above chance level, albeit with reduced accuracy. The aim of the present systematic review was to identify possible experimental and patient variables that explain the inconsistences found regarding the effect of split-brain surgery on dichotic listening. For this purpose, a systematic literature search was conducted (databases: Pubmed, Web of Knowledge, EBSChost, and Ovid) to identify all empirical studies on patients with surgical section of the corpus callosum (complete or partial) that used a verbal dichotic-listening paradigm. This search yielded ks = 32 publications reporting patient data either on case or group level, and the data was analysed by comparing the case-level incidence of left-ear suppression, left-ear extinction, and right-ear enhancement narratively or statistically considering possible moderator variables (i.a., extent of the callosal surgery, stimulus material, response format, selective attention). The main finding was an increased incidence of left-ear suppression (odds ratio = 7.47, CI95%: [1.21; 83.49], exact p = .02) and right-ear enhancement (odds ratio = 21.61, CI95%: [4.40; 154.11], p < .01) when rhyming as compared with non-rhyming stimuli were used. Also, an increase in left-ear reports was apparent when a response by the right hemisphere was allowed (i.e., response with the left hand). While the present review is limited by the overall small number of cases and a lack of an appropriate control sample in most of the original studies, the findings nevertheless suggest an adjustment of the classical dichotic-listening models incorporating right-hemispheric processing abilities as well as the perceptual competition of the left- and right-ear stimuli for attention.

Macroscopic brain dynamics beyond contralateral primary motor cortex for movement prediction

This study investigates the complex relationship between upper limb movement direction and macroscopic neural signals in the brain, which is critical for understanding brain-computer interfaces (BCI). Conventional BCI research has primarily focused on a local area, such as the contralateral primary motor cortex (M1), relying on the population-based decoding method with microelectrode arrays. In contrast, macroscopic approaches such as electroencephalography (EEG) and magnetoencephalography (MEG) utilize numerous electrodes to cover broader brain regions. This study probes the potential differences in the mechanisms of microscopic and macroscopic methods. It is important to determine which neural activities effectively predict movements. To investigate this, we analyzed MEG data from nine right-handed participants while performing arm-reaching tasks. We employed dynamic statistical parametric mapping (dSPM) to estimate source activity and built a decoding model composed of long short-term memory (LSTM) and a multilayer perceptron to predict movement trajectories. This model achieved a high correlation coefficient of 0.79 between actual and predicted trajectories. Subsequently, we identified brain regions sensitive to predicting movement direction using the integrated gradients (IG) method, which assesses the predictive contribution of each source activity. The resulting salience map demonstrated a distribution without significant differences across motor-related regions, including M1. Predictions based solely on M1 activity yielded a correlation coefficient of 0.42, nearly half as effective as predictions incorporating all source activities. This suggests that upper limb movements are influenced by various factors such as movement coordination, planning, body and target position recognition, and control, beyond simple muscle activity. All of the activities are needed in the decoding model using macroscopic signals. Our findings also revealed that contralateral and ipsilateral hemispheres contribute equally to movement prediction, implying that BCIs could potentially benefit patients with brain damage in the contralateral hemisphere by utilizing brain signals from the ipsilateral hemisphere. In conclusion, this study demonstrates that macroscopic activity from large brain regions significantly contributes to predicting upper limb movement. Non-invasive BCI systems would require a comprehensive collection of neural signals from multiple brain regions.

The excitability of ipsilateral motor evoked potentials is not task-specific and spatially distinct from the contralateral motor hotspot

OBJECTIVE

The role of ipsilateral descending motor pathways in voluntary movement of humans is still a matter of debate, with partly contradictory results. The aim of our study therefore was to examine the excitability of ipsilateral motor evoked potentials (iMEPs) regarding site and the specificity for unilateral and bilateral elbow flexion extension tasks.

METHODS

MR-navigated transcranial magnetic stimulation mapping of the dominant hemisphere was performed in twenty healthy participants during tonic unilateral (iBB), bilateral homologous (bBB) or bilateral antagonistic elbow flexion-extension (iBB-cAE), the map center of gravity (CoG) and iMEP area from BB were obtained.

RESULTS

The map CoG of the ipsilateral BB was located more anterior-laterally than the hotspot of the contralateral BB within the primary motor cortex, with a significant difference in CoG in iBB and iBB-cAE, but not bBB compared to the hotspot for the contralateral BB (each p < 0.05). However, different tasks had no effect on the size of the iMEPs.

CONCLUSION

Our data demonstrated that excitability of ipsilateral and contralateral MEP differ spatially in a task-specific manner suggesting the involvement of different motor networks within the motor cortex.

Lateralized modulation of cortical beta power during human gait is related to arm swing

Human gait is a complex behavior requiring dynamic control of upper and lower extremities that is accompanied by cortical activity in multiple brain areas. We investigated the contribution of beta (15-30 Hz) and gamma (30-50 Hz) band electroencephalography (EEG) activity during specific phases of the gait cycle, comparing treadmill walking with and without arm swing. Modulations of spectral power in the beta band during early double support and swing phases source-localized to the sensorimotor cortex ipsilateral, but not contralateral, to the leading leg. The lateralization disappeared in the condition with constrained arms, together with an increase of activity in bilateral supplementary motor areas. By contrast, gamma band modulations that localized to the presumed leg area of sensorimotor cortex around the heel-strike events were unaffected by arm movement. Our findings demonstrate that arm swing is accompanied by considerable cortical activation that should not be neglected in gait-related neuroimaging studies.

Hemodynamic activity is not parsimoniously tuned to index-of-difficulty in movement with dual requirements on speed-accuracy

Background

Reaching movements are crucial for daily living and rehabilitation, for which Fitts' Law describes a speed-accuracy trade-off that movement time increases with task difficulty. This study aims to investigate whether cortical activation in motor-related areas is directly linked to task difficulty as defined by Fitts' Law. Understanding this relationship provides a physiological basis for parameter selection in therapeutic exercises.

Methods

Sixteen healthy subjects performed 2D reaching movements using a rehabilitation robot, with their cortical responses detected using functional near-infrared spectroscopy (fNIRS). Task difficulty was manipulated by varying target size and distance, resulting in 3 levels of index-of-difficulty (ID). Kinematic signals were recorded alongside cortical activity to assess the relationship among movement time, task difficulty, and cortical activation.

Results

Our results showed that movement time increased with ID by 0.2974s/bit across all subjects (conditional r2 = 0.6434, p < 0.0001), and all subjects showed individual trends conforming Fitts' Law (all p < 0.001). Neither activation in BA4 nor in BA6 showed a significant correlation with ID (p > 0.05), while both the target size and distance, as well as the interaction between them, showed a significant relationship with BA4 or BA6 activation (all p < 0.05).

Conclusion

This study found that although kinematic measures supported Fitts' Law, cortical activity in motor-related areas during reaching movements did not correlate directly with task difficulty as defined by Fitts' Law. Additional factors such as muscle activation may call for different cortical control even when difficulty was identical.

Bilateral intracortical inhibition during unilateral motor preparation and sequence learning

Motor sequence learning gradually quickens reaction time, suggesting that sequence learning alters motor preparation processes. Interestingly, evidence has shown that preparing sequence movements decreases short intracortical inhibition (SICI) in the contralateral motor cortex (M1), but also that sequence learning alters motor preparation processes in both the contralateral and ipsilateral M1s. Therefore, one possibility is that sequence learning alters the SICI decreases occurring during motor preparation in bilateral M1s. To examine this, two novel hypotheses were tested: unilateral sequence preparation would decrease SICI in bilateral M1s, and sequence learning would alter such bilateral SICI responses. Paired-pulse transcranial magnetic stimulation was delivered over the contralateral and ipsilateral M1s to assess SICI in an index finger muscle during the preparation of sequences initiated by either the right index or little finger. In the absence of sequence learning, SICI decreased in both the contralateral and ipsilateral M1s during the preparation of sequences initiated by the right index finger, suggesting that SICI decreases in bilateral M1s during unilateral motor preparation. As sequence learning progressed, SICI decreased in the contralateral M1 whilst it increased in the ipsilateral M1. Moreover, these bilateral SICI responses were observed at the onset of motor preparation, suggesting that sequence learning altered baseline SICI levels rather than the SICI decreases occurring during motor preparation per se. Altogether, these results suggest that SICI responses in bilateral M1s reflect two motor processes: an acute decrease of inhibition during motor preparation, and a cooperative but bidirectional shift of baseline inhibition levels as sequence learning progresses.

Contribution of the subthalamic nucleus to motor, cognitive and limbic processes: an electrophysiological and stimulation study in monkeys

Deep brain stimulation of the subthalamic nucleus (STN) has become the gold standard surgical treatment for Parkinson's disease and is being investigated for obsessive compulsive disorders. Even if the role of the STN in the behavior is well documented, its organization and especially its division into several functional territories is still debated. A better characterization of these territories and a better knowledge of the impact of stimulation would address this issue. We aimed to find specific electrophysiological markers of motor, cognitive and limbic functions within the STN and to specifically modulate these components. Two healthy non-human primates (Macaca fascicularis) performed a behavioral task allowing the assessment of motor, cognitive and limbic reward-related behavioral components. During the task, four contacts in the STN allowed recordings and stimulations, using low frequency stimulation (LFS) and high frequency stimulation (HFS). Specific electrophysiological functional markers were found in the STN with beta band activity for the motor component of behavior, theta band activity for the cognitive component, and, gamma and theta activity bands for the limbic component. For both monkeys, dorsolateral HFS and LFS of the STN significantly modulated motor performances, whereas only ventromedial HFS modulated cognitive performances. Our results validated the functional overlap of dorsal motor and ventral cognitive subthalamic territories, and, provide information that tends toward a diffuse limbic territory sensitive to the reward within the STN.

Aging alters functional connectivity of motor theta networks during sensorimotor reactions

OBJECTIVE

Both cognitive and primary motor networks alter with advancing age in humans. The networks activated in response to external environmental stimuli supported by theta oscillations remain less well explored. The present study aimed to characterize the effects of aging on the functional connectivity of response-related theta networks during sensorimotor tasks.

METHODS

Electroencephalographic signals were recorded in young and middle-to-older age adults during three tasks performed in two modalities, auditory and visual: a simple reaction task, a Go-NoGo task, and a choice-reaction task. Response-related theta oscillations were computed. The phase-locking value (PLV) was used to analyze the spatial synchronization of primary motor and motor control theta networks.

RESULTS

Performance was overall preserved in older adults. Independently of the task, aging was associated with reorganized connectivity of the contra-lateral primary motor cortex. In younger adults, it was synchronized with motor control regions (intra-hemispheric premotor/frontal and medial frontal). In older adults, it was only synchronized with intra-hemispheric sensorimotor regions.

CONCLUSIONS

Motor theta networks of older adults manifest a functional decoupling between the response-generating motor cortex and motor control regions, which was not modulated by task variables. The overall preserved performance in older adults suggests that the increased connectivity within the sensorimotor network is associated with an excessive reliance on sensorimotor feedback during movement execution compensating for a deficient cognitive regulation of motor regions during sensorimotor reactions.

SIGNIFICANCE

New evidence is provided for the reorganization of motor networks during sensorimotor reactions already at the transition from middle to old age.

Multiscale Canonical Coherence for Functional Corticomuscular Coupling Analysis

Functional corticomuscular coupling (FCMC) probes multi-level information communication in the sensorimotor system. The canonical Coherence (caCOH) method has been leveraged to measure the FCMC between two multivariate signals within the single scale. In this paper, we propose the concept of multiscale canonical Coherence (MS-caCOH) to disentangle complex multi-layer information and extract coupling features in multivariate spaces from multiple scales. Then, we verified the reliability and effectiveness of MS-caCOH on two types of data sets, i.e., a synthetic multivariate data set and a real-world multivariate data set. Our simulation results showed that compared with caCOH, MS-caCOH enhanced coupling detection and achieved lower pattern recovery errors at multiple frequency scales. Further analysis on experimental data demonstrated that the proposed MS-caCOH method could also capture detailed multiscale spatial-frequency characteristics. This study leverages the multiscale analysis framework and multivariate method to give a new insight into corticomuscular coupling analysis.

Hemiplegic shoulder pain affects ipsilesional aiming movements after stroke: a cross-sectional study

BACKGROUND

Hemiplegic shoulder pain (HSP) is common after stroke. The pain perception may exacerbate changes in the motor behavior of the ipsi-lesional upper limb, contributing to the functional decline of an individual's motor performance.

OBJECTIVE

This study evaluates the influence of pain perception on the aiming movements performed with the ipsilesional upper limb in individuals with unilateral chronic stroke.

METHODS

A cross-sectional study was conducted with 41 participants divided into three groups: 1) stroke with contralesional shoulder pain ≥ 3 by the Visual Numerical Pain Scale (SPSG; n = 13); 2) stroke no shoulder pain (nSPSG; n = 14); and 3) healthy control (CTG; n = 14) matched by sex and age. Individuals with stroke were matched for the severity of sensorimotor impairment by the Fugl-Meyer upper limb subscale and the injured hemisphere side. Stroke groups performed aiming movements with the ipsilesional upper limb and the CTG with the corresponding limb using a pen tip on the sensitive surface of a digitizing tablet. Performance across groups was compared by one-way analysis of variance, considering the time since injury as a covariate. The planning and execution variables of the movement trajectory were analyzed, and the significance was set at 5%.

RESULTS

Trajectories of the SPSG were slower (p = .010; η2 = 0.22), were less smooth (p = .002; η2 = 0.30), had more directional error (p = .002; η2 = 0.28), and were less accurate (p = .034; η2 = 0.17) than the CTG. The nSPSG and CTG showed similar performance.

CONCLUSIONS

The perception of pain impairs aiming movements performed with the ipsilesional upper limb in individuals with unilateral chronic stroke.

Betz cells of the primary motor cortex

Betz cells, named in honor of Volodymyr Betz (1834-1894), who described them as "giant pyramids" in the primary motor cortex of primates and other mammalian species, are layer V extratelencephalic projection (ETP) neurons that directly innervate α-motoneurons of the brainstem and spinal cord. Despite their large volume and circumferential dendritic architecture, to date, no single molecular criterion has been established that unequivocally distinguishes adult Betz cells from other layer V ETP neurons. In primates, transcriptional signatures suggest the presence of at least two ETP neuron clusters that contain mature Betz cells; these are characterized by an abundance of axon guidance and oxidative phosphorylation transcripts. How neurodevelopmental programs drive the distinct positional and morphological features of Betz cells in humans remains unknown. Betz cells display a distinct biphasic firing pattern involving early cessation of firing followed by delayed sustained acceleration in spike frequency and magnitude. Few cell type-specific transcripts and electrophysiological characteristics are conserved between rodent layer V ETP neurons of the motor cortex and primate Betz cells. This has implications for the modeling of disorders that affect the motor cortex in humans, such as amyotrophic lateral sclerosis (ALS). Perhaps vulnerability to ALS is linked to the evolution of neural networks for fine motor control reflected in the distinct morphomolecular architecture of the human motor cortex, including Betz cells. Here, we discuss histological, molecular, and functional data concerning the position of Betz cells in the emerging taxonomy of neurons across diverse species and their role in neurological disorders.

Psychomotor slowing in schizophrenia is associated with cortical thinning of primary motor cortex: A three cohort structural magnetic resonance imaging study

Psychomotor slowing (PS) is characterized by slowed movements and lower activity levels. PS is frequently observed in schizophrenia (SZ) and distressing because it impairs performance of everyday tasks and social activities. Studying brain topography contributing to PS in SZ can help to understand the underlying neurobiological mechanisms as well as help to develop more effective treatments that specifically target affected brain areas. Here, we conducted structural magnetic resonance imaging (sMRI) of three independent cohorts of right-handed SZ patients (SZ#1: n = 72, SZ#2: n = 37, SZ#3: n = 25) and age, gender and education matched healthy controls (HC) (HC#1: n = 40, HC#2: n = 37, HC#3: n = 38). PS severity in the three SZ cohorts was determined using the Positive and Negative Syndrome Scale (PANSS) item #G7 (motor retardation) and Trail-Making-Test B (TMT-B). FreeSurfer v7.2 was used for automated parcellation and segmentation of cortical and subcortical regions. SZ#1 patients showed reduced cortical thickness in right precentral gyrus (M1; p = 0.04; Benjamini-Hochberg [BH] corr.). In SZ#1, cortical thinning in right M1 was associated with PANSS item #G7 (p = 0.04; BH corr.) and TMT-B performance (p = 0.002; BH corr.). In SZ#1, we found a significant correlation between PANSS item #G7 and TMT-B (p = 0.005, ρ=0.326). In conclusion, PANSS G#7 and TMT-B might have a surrogate value for predicting PS in SZ. Cortical thinning of M1 rather than alterations of subcortical structures may point towards cortical pathomechanism underlying PS in SZ.

Effects of rTMS combined with rPMS on stroke patients with arm paralysis after contralateral seventh cervical nerve transfer: a case-series

OBJECTIVE

We conducted this study to evaluate the effect of rTMS combined with rPMS on stroke patients with arm paralysis after CSCNTS.

METHODS

A case-series of four stroke patients with arm paralysis, ages ranging from 39 to 51 years, that underwent CSCNTS was conducted. Patients were treated with 10 HZ rTMS on the contralesional primary motor cortex combined with 20 HZ rPMS on groups of elbow and wrist muscles for 15 days.

RESULTS

The muscle tone of elbow flexor muscle (EFM), elbow extensor muscle (EEM), wrist flexor muscle (WFM) and flexor digitorum (FD) reduced immediately after operation followed by increasing gradually. After rehabilitation, the muscle tone of EEM and EFM reduced by 14% and 11%, respectively. There was a 13% and 45% change ratio in WFM and FD. The numeric rating scale (mean = 5.75 ± 1.71) was significantly lower (mean = 3.25 ± 1.90, t = 8.66, p = .00). Grip and pinch strength (mean = 23.65 ± 4.91; mean = 4.9 ± 0.59) were significantly higher (mean = 34.63 ± 5.23, t = -61.07, p = .00; mean = 7.1 ± 0.73, t = -13.91, p = .00).

CONCLUSIONS

The rehabilitation of stroke patients with arm paralysis after CSCNTS is a long, complicated process which includes great change of neuropathic pain, muscle tone, and muscle strength. In order to enhance the neural connection between the contralesional hemisphere and the hemiplegic limb, alleviate postoperative complications, as well as accelerate the rehabilitation process, we can consider to use rTMS combined with rPMS.

Biological and environmental factors may affect children's executive function through motor and sensorimotor development: Preterm birth and cerebral palsy

Disruptive biological and environmental factors may undermine the development of children's motor and sensorimotor skills. Since the development of cognitive skills, including executive function, is grounded in early motor and sensorimotor experiences, early delays or impairments in motor and sensorimotor processing often trigger dynamic developmental cascades that lead to suboptimal executive function outcomes. The purpose of this perspective paper is to link early differences in motor/sensorimotor processing to the development of executive function in children born preterm or with cerebral palsy. Uncovering such links in clinical populations would improve our understanding of developmental pathways and key motor and sensorimotor skills that are antecedent and foundational for the development of executive function. This knowledge will allow the refinement of early interventions targeting motor and sensorimotor skills with the goal of proactively improving executive function outcomes in at-risk populations.

Longitudinal optogenetic mapping reveals enhanced motor control by the contralesional cortex after traumatic brain injury in mice

Traumatic brain injury (TBI) is a significant cause of human disability, and understanding its spontaneous recovery pattern after injury is critical for potential treatments. However, studies on the function of the contralesional cortex after TBI have mostly focused on acute-phase changes, and long-term dynamic changes in the control of the affected limb by the contralesional cortex are less understood. To unravel long-term adaptations in the contralesional cortex, we developed a mouse model of TBI and used longitudinal optogenetic motor mapping to observe the function of contralesional corticospinal neurons (CSNs) projecting to the unilateral seventh cervical (C7) segment of the spinal cord. We injected a retrograde adeno-associated virus (AAV) expressing channelrhodopsin-2 to optogenetically stimulate and map the functional connections of the motor-sensory cortex. We validated the effectiveness of transcranial optogenetic stimulation for functional mapping and observed a general increase in the control of the affected limb by the contralesional cortex over time. Using retrograde labeling techniques, we showed that TBI does not affect the distribution of C7-CSNs but alters their function, and the labeled CSNs are concentrated in the caudal and rostral forelimb areas. Our findings provide new insights into harnessing contralesional cortical plasticity to improve treatment for affected limbs. This study sheds light on the long-term adaptations in the contralesional cortex after TBI, paving the way for potential clinical applications of optogenetic stimulation to improve motor control and rehabilitation outcomes.

Don't plan, just do it: Cognitive and sensorimotor contributions to manual dexterity

Manual dexterity is referred to as the skill to perform fine motor movements and it has been assumed to be associated to the cognitive domain, as well as the sensorimotor one. In this work, we investigated with functional near-infrared spectroscopy the cortical activations elicited by the execution of the 9-HPT, i.e., a standard test evaluating manual dexterity in which nine pegs were taken, placed into and then removed from nine holes on a board as quickly as possible. For comparison, we proposed a new active control task mainly involving the sensorimotor domain, in which the pegs must be placed and removed using the same single hole (1-HPT). Behaviorally, we found two distinct groups based on the difference between the execution time of the 9-HPT and the 1-HPT (ΔHPT). Cortical areas belonging to the network controlling reaching and grasping movements were active in both groups; however, participants showing a large ΔHPT presented significantly higher activation in prefrontal cortical areas (right BA10 and BA11) during 9-HPT and 1-HPT performance with respect to the participants with a small ΔHPT, who showed a deactivation in BA10. Unexpectedly, we observed a significant linear relationship between ΔHPT and right BA10 activity. This suggested that participants performing the 9-HPT more slowly than the 1-HPT recruited prefrontal areas implicitly exploiting the cognitive skills of planning, perhaps in search of a motor strategy to solve the test activating attentional and cognitive control processes, but this resulted not efficient and instead increased the time to accomplish a manual dexterity task.

A New Compound-Limbs Paradigm: Integrating Upper-Limb Swing Improves Lower-Limb Stepping Intention Decoding From EEG

Brain-computer interface (BCI) systems based on spontaneous electroencephalography (EEG) hold the promise to implement human voluntary control of lower-extremity powered exoskeletons. However, current EEG-BCI paradigms do not consider the cooperation of upper and lower limbs during walking, which is inconsistent with natural human stepping patterns. To deal with this problem, this study proposed a stepping-matched human EEG-BCI paradigm that involved actions of both unilateral lower and contralateral upper limbs (also referred to as compound-limbs movement). Experiments were conducted in motor execution (ME) and motor imagery (MI) conditions to validate the feasibility. Common spatial pattern (CSP) proposed subject-specific CSP (SSCSP), and filter-bank CSP (FBCSP) methods were applied for feature extraction, respectively. The best average classification results based on SSCSP indicated that the accuracies of compound-limbs paradigms in ME and MI conditions achieved 89.02% ± 12.84% and 73.70% ± 12.47%, respectively. Although they were 2.03% and 5.68% lower than those of the single-upper-limb mode that does not match human stepping patterns, they were 24.30% and 11.02% higher than those of the single-lower-limb mode. These findings indicated that the proposed compound-limbs EEG-BCI paradigm is feasible for decoding human stepping intention and thus provides a potential way for natural human control of walking assistance devices.

Increased interhemispheric functional connectivity during non-dominant hand movement in right-handed subjects

Hand preference is one of the behavioral expressions of lateralization in the brain. Previous fMRI studies showed the activation in several regions including the motor cortex and the cerebellum during single-hand movement. However, functional connectivity related to hand preference has not been investigated. Here, we used the generalized psychophysiological interaction (gPPI) approach to investigate the alteration of functional connectivity during single-hand movement from the resting state in right-hand subjects. The functional connectivity in interhemispheric motor-related regions including the supplementary motor area, the precentral gyrus, and the cerebellum was significantly increased during non-dominant hand movement, while functional connectivity was not increased during dominant hand movement. The general linear model (GLM) showed activation in contralateral supplementary motor area, contralateral precentral gyrus, and ipsilateral cerebellum during right- or left-hand movement. These results indicate that a combination of GLM and gPPI analysis can detect the lateralization of hand preference more clearly.

Modulation of ipsilateral motor evoked potentials during bimanual coordination tasks

Introduction

Ipsilateral motor evoked potentials (iMEPs) are difficult to obtain in distal upper limb muscles of healthy participants but give a direct insight into the role of ipsilateral motor control.

Methods

We tested a new high-intensity double pulse transcranial magnetic stimulation (TMS) protocol to elicit iMEPs in wrist extensor and flexor muscles during four different bimanual movements (cooperative-asymmetric, cooperative-symmetric, non-cooperative-asymmetric and non-cooperative-symmetric) in 16 participants.

Results

Nine participants showed an iMEP in the wrist extensor in at least 20% of the trials in each of the conditions and were classified as iMEP+ participants. iMEP persistence was greater for cooperative (50.5 ± 28.8%) compared to non-cooperative (31.6 ± 22.1%) tasks but did not differ between asymmetric and symmetric tasks. Area and amplitude of iMEPs were also increased during cooperative (area = 5.41 ± 3.4 mV × ms; amplitude = 1.60 ± 1.09 mV) compared to non-cooperative (area = 3.89 ± 2.0 mV × ms; amplitude = 1.12 ± 0.56 mV) tasks and unaffected by task-symmetry.

Discussion

The upregulation of iMEPs during common-goal cooperative tasks shows a functional relevance of ipsilateral motor control in bimanual movements. The paired-pulse TMS protocol is a reliable method to elicit iMEPs in healthy participants and can give new information about neural control of upper limb movements. With this work we contribute to the research field in two main aspects. First, we describe a reliable method to elicit ipsilateral motor evoked potentials in healthy participants which will be useful in further advancing research in the area of upper limb movements. Second, we add new insight into the motor control of bimanual movements. We were able to show an upregulation of bilateral control represented by increased ipsilateral motor evoked potentials in cooperative, object-oriented movements compared to separate bimanual tasks. This result might also have an impact on neurorehabilitation after stroke.

The role of ipsilateral motor network in upper limb movement

The execution of voluntary movements is primarily governed by the cerebral hemisphere contralateral to the moving limb. Previous research indicates that the ipsilateral motor network, comprising the primary motor cortex (M1), supplementary motor area (SMA), and premotor cortex (PM), plays a crucial role in the planning and execution of limb movements. However, the precise functions of this network and its interplay in different task contexts have yet to be fully understood. Twenty healthy right-handed participants (10 females, mean age 26.1 ± 4.6 years) underwent functional MRI scans while performing biceps brachii representations such as bilateral, unilateral flexion, and bilateral flexion-extension. Ipsilateral motor evoked potentials (iMEPs) were obtained from the identical set of participants in a prior study using transcranial magnetic stimulation (TMS) targeting M1 while employing the same motor tasks. The voxel time series was extracted based on the region of interest (M1, SMA, ventral PM and dorsal PM). Directed functinal connectivity was derived from the extracted time series using time-resolved partial directed coherence. We found increased connectivity from left-PMv to both sides M1, as well as right-PMv to both sides SMA, in unilateral flexion compared to bilateral flexion. Connectivity from left M1 to left-PMv, and left-SMA to right-PMd, also increased in both unilateral flexion and bilateral flexion-extension compared to bilateral flexion. However, connectivity between PMv and right-M1 to left-PMd decreased during bilateral flexion-extension compared to unilateral flexion. Additionally, during bilateral flexion-extension, the connectivity from right-M1 to right-SMA had a negative relationship with the area ratio of iMEP in the dominant side. Our results provide corroborating evidence for prior research suggesting that the ipsilateral motor network is implicated in the voluntary movements and underscores its involvement in cognitive processes such as movement planning and coordination. Moreover, ipsilateral connectivity from M1 to SMA on the dominant side can modulate the degree of ipsilateral M1 activation during bilateral antagonistic contraction.

Representation and decoding of bilateral arm motor imagery using unilateral cerebral LFP signals

Introduction

In the field of upper limb brain computer interfaces (BCIs), the research focusing on bilateral decoding mostly based on the neural signals from two cerebral hemispheres. In addition, most studies used spikes for decoding. Here we examined the representation and decoding of different laterality and regions arm motor imagery in unilateral motor cortex based on local field potentials (LFPs).

Methods

The LFP signals were recorded from a 96-channel Utah microelectrode array implanted in the left primary motor cortex of a paralyzed participant. There were 7 kinds of tasks: rest, left, right and bilateral elbow and wrist flexion. We performed time-frequency analysis on the LFP signals and analyzed the representation and decoding of different tasks using the power and energy of different frequency bands.

Results

The frequency range of <8 Hz and >38 Hz showed power enhancement, whereas 8-38 Hz showed power suppression in spectrograms while performing motor imagery. There were significant differences in average energy between tasks. What's more, the movement region and laterality were represented in two dimensions by demixed principal component analysis. The 135-300 Hz band signal had the highest decoding accuracy among all frequency bands and the contralateral and bilateral signals had more similar single-channel power activation patterns and larger signal correlation than contralateral and ipsilateral signals, bilateral and ipsilateral signals.

Discussion

The results showed that unilateral LFP signals had different representations for bilateral motor imagery on the average energy of the full array and single-channel power levels, and different tasks could be decoded. These proved the feasibility of multilateral BCI based on the unilateral LFP signal to broaden the application of BCI technology.

Clinical trial registration

https://www.chictr.org.cn/showproj.aspx?proj=130829, identifier ChiCTR2100050705.

Neural Substrates for Hand and Shoulder Movement in Healthy Adults: A Functional near Infrared Spectroscopy Study

Characterization of cortical activation patterns during movements in healthy adults may help our understanding of how the injured brain works. Upper limb motor tasks are commonly used to assess impaired motor function and to predict recovery in individuals with neurological disorders such as stroke. This study aimed to explore cortical activation patterns associated with movements of the hand and shoulder using functional near-infrared spectroscopy (fNIRS) and to demonstrate the potential of this technology to distinguish cerebral activation between distal and proximal movements. Twenty healthy, right-handed participants were recruited. Two 10-s motor tasks (right-hand opening-closing and right shoulder abduction-adduction) were performed in a sitting position at a rate of 0.5 Hz in a block paradigm. We measured the variations in oxyhemoglobin (HbO₂) and deoxyhemoglobin (HbR) concentrations. fNIRS was performed with a 24-channel system (Brite 24®; Artinis) that covered most motor control brain regions bilaterally. Activation was mostly contralateral for both hand and shoulder movements. Activation was more lateral for hand movements and more medial for shoulder movements, as predicted by the classical homunculus representation. Both HbO₂ and HbR concentrations varied with the activity. Our results showed that fNIRS can distinguish patterns of cortical activity in upper limb movements under ecological conditions. These results suggest that fNIRS can be used to measure spontaneous motor recovery and rehabilitation-induced recovery after brain injury. The trial was restropectively registered on January 20, 2023: NCT05691777 (clinicaltrial.gov).

Feasibility of using fNIRS to explore motor-related regional haemodynamic signal changes in patients with sensorimotor impairment and healthy controls: A pilot study

BACKGROUND

While functional near-infrared spectroscopy (fNIRS) can provide insight into cortical brain activity during motor tasks in healthy and diseased populations, the feasibility of using fNIRS to assess haemoglobin-evoked responses to reanimated upper limb motor function in patients with tetraplegia remains unknown.

OBJECTIVE

The primary objective of this pilot study is to determine the feasibility of using fNIRS to assess cortical signal intensity changes during upper limb motor tasks in individuals with surgically restored grip functions. The secondary objectives are: 1) to collect pilot data on individuals with tetraplegia to determine any trends in the cortical signal intensity changes as measured by fNIRS and 2) to compare cortical signal intensity changes in affected individuals versus age-appropriate healthy volunteers. Specifically, patients presented with tetraplegia, a type of paralysis resulting from a cervical spinal cord injury causing loss of movement and sensation in both lower and upper limbs. All patients have their grip functions restored by surgical tendon transfer, a procedure which constitutes a unique, focused stimulus for brain plasticity.

METHOD

fNIRS is used to assess changes in cortical signal intensity during the performance of two motor tasks (isometric elbow and thumb flexion). Six individuals with tetraplegia and six healthy controls participate in the study. A block paradigm is utilized to assess contralateral and ipsilateral haemodynamic responses in the premotor cortex (PMC) and primary motor cortex (M1). We assess the amplitude of the optical signal and spatial features during the paradigms. The accuracy of channel locations is maximized through 3D digitizations of channel locations and co-registering these locations to template atlas brains. A general linear model approach, with short-separation regression, is used to extract haemodynamic response functions at the individual and group levels.

RESULTS

Peak oxyhaemoglobin (oxy-Hb) changes in PMC appear to be particularly bilateral in nature in the tetraplegia group during both pinch and elbow trials whereas for controls, a bilateral PMC response is not especially evident. In M1 / primary sensory cortex (S1), the oxy-Hb responses to the pinch task are mainly contralateral in both groups, while for the elbow flexion task, lateralization is not particularly clear.

CONCLUSIONS

This pilot study shows that the experimental setup is feasible for assessing brain activation using fNIRS during volitional upper limb motor tasks in individuals with surgically restored grip functions. Cortical signal changes in brain regions associated with upper extremity sensorimotor processing appear to be larger and more bilateral in nature in the tetraplegia group than in the control group. The bilateral hemispheric response in the tetraplegia group may reflect a signature of adaptive brain plasticity mechanisms. Larger studies than this one are needed to confirm these findings and draw reliable conclusions.

Aged Patients With Severe Small Vessel Disease Exhibit Poor Bimanual Coordination During the Anti-Phase Horizontal Line Drawing Task

The present study explores whether SVD affects bimanual coordination, which is easier to detect than by conventional, MRI-based methods. We tested nine severe SVD patients, eight non-severe (i.e., moderate or mild) SVD patients, eleven healthy age-matched controls, and eight young adults. They were grouped according to Fazekas scale and by age. Participants performed horizontal line drawings with both hands simultaneously on two pen tablets. The movements consisted of rhythmic patterns where participants used both hands to draw horizontal lines in anti-phase on two pen tablets. Each participant underwent a series of neuropsychiatric assessments. Results showed that SVD patients exhibited in each hand smaller horizontal movement amplitudes with variability larger compared to the healthy age-matched controls. Only movement amplitudes appeared to decrease significantly with severity of SVD. Interestingly, we found no relevant differences between the age-matched, elderly controls and the young controls. Therefore, this effect appeared indicative of SVD. The variability of the lines orthogonal to the horizontal lines of the left, non-dominant hand differed only between the severe SVD group and the other groups. Furthermore, partial correlations demonstrated that the mean horizontal movement amplitude of the left hand was positively associated with the clock drawing test score, and the inter-manual asynchrony of the horizontal movements was positively associated with the Trail Making Test-B time. These results indicated that SVD patients show poor bimanual coordination, as reflected by spatial features such as movement amplitudes and variabilities, and abnormal bimanual coordination was associated with executive dysfunction.

Parietofrontal oscillations show hand-specific interactions with top-down movement plans

To generate a hand-specific reach plan, the brain must integrate hand-specific signals with the desired movement strategy. Although various neurophysiology/imaging studies have investigated hand-target interactions in simple reach-to-target tasks, the whole brain timing and distribution of this process remain unclear, especially for more complex, instruction-dependent motor strategies. Previously, we showed that a pro/anti pointing instruction influences magnetoencephalographic (MEG) signals in frontal cortex that then propagate recurrently through parietal cortex (Blohm G, Alikhanian H, Gaetz W, Goltz HC, DeSouza JF, Cheyne DO, Crawford JD. NeuroImage 197: 306-319, 2019). Here, we contrasted left versus right hand pointing in the same task to investigate 1) which cortical regions of interest show hand specificity and 2) which of those areas interact with the instructed motor plan. Eight bilateral areas, the parietooccipital junction (POJ), superior parietooccipital cortex (SPOC), supramarginal gyrus (SMG), medial/anterior interparietal sulcus (mIPS/aIPS), primary somatosensory/motor cortex (S1/M1), and dorsal premotor cortex (PMd), showed hand-specific changes in beta band power, with four of these (M1, S1, SMG, aIPS) showing robust activation before movement onset. M1, SMG, SPOC, and aIPS showed significant interactions between contralateral hand specificity and the instructed motor plan but not with bottom-up target signals. Separate hand/motor signals emerged relatively early and lasted through execution, whereas hand-motor interactions only occurred close to movement onset. Taken together with our previous results, these findings show that instruction-dependent motor plans emerge in frontal cortex and interact recurrently with hand-specific parietofrontal signals before movement onset to produce hand-specific motor behaviors.NEW & NOTEWORTHY The brain must generate different motor signals depending on which hand is used. The distribution and timing of hand use/instructed motor plan integration are not understood at the whole brain level. Using MEG we show that different action planning subnetworks code for hand usage and integrating hand use into a hand-specific motor plan. The timing indicates that frontal cortex first creates a general motor plan and then integrates hand specificity to produce a hand-specific motor plan.

Restoring After Central Nervous System Injuries: Neural Mechanisms and Translational Applications of Motor Recovery

Central nervous system (CNS) injuries, including stroke, traumatic brain injury, and spinal cord injury, are leading causes of long-term disability. It is estimated that more than half of the survivors of severe unilateral injury are unable to use the denervated limb. Previous studies have focused on neuroprotective interventions in the affected hemisphere to limit brain lesions and neurorepair measures to promote recovery. However, the ability to increase plasticity in the injured brain is restricted and difficult to improve. Therefore, over several decades, researchers have been prompted to enhance the compensation by the unaffected hemisphere. Animal experiments have revealed that regrowth of ipsilateral descending fibers from the unaffected hemisphere to denervated motor neurons plays a significant role in the restoration of motor function. In addition, several clinical treatments have been designed to restore ipsilateral motor control, including brain stimulation, nerve transfer surgery, and brain–computer interface systems. Here, we comprehensively review the neural mechanisms as well as translational applications of ipsilateral motor control upon rehabilitation after CNS injuries.

Crossing nerve transfer drives sensory input-dependent plasticity for motor recovery after brain injury

Restoring limb movements after central nervous system injury remains a substantial challenge. Recent studies proved that crossing nerve transfer surgery could rebuild physiological connectivity between the contralesional cortex and the paralyzed arm to compensate for the lost function after brain injury. However, the neural mechanism by which this surgery mediates motor recovery remains still unclear. Here, using a clinical mouse model, we showed that this surgery can restore skilled forelimb function in adult mice with unilateral cortical lesion by inducing cortical remapping and promoting corticospinal tract sprouting. After reestablishing the ipsilateral descending pathway, resecting of the artificially rebuilt peripheral nerve did not affect motor improvements. Furthermore, retaining the sensory afferent, but not the motor efferent, of the transferred nerve was sufficient for inducing brain remapping and facilitating motor restoration. Thus, our results demonstrate that surgically rebuilt sensory input triggers neural plasticity for accelerating motor recovery, which provides an approach for treating central nervous system injuries.

Biomechanical assessment of the ipsilesional upper limb in post-stroke patients during multi-joint reaching tasks: A quantitative study

In hemiplegic patients with stroke, investigating the ipsilesional limb may shed light on the upper limb motor control, impairments and mechanisms of functional recovery. Usually investigation of motor impairment and rehabilitative interventions in patients are performed only based on the contralesional limb. Previous studies found that also the ipsilesional limb presents motor deficits, mostly evaluated with clinical scales which could lack of sensibility. To quantitatively evaluate the performance of the ipsilesional limb in patient with stroke, we conducted an observational study in which 49 hemiplegic patients were enrolled, divided in subgroups based on the severity of impairment of the contralesional limb, and assessed with a kinematic, dynamic and motor control evaluation protocol on their ipsilesional upper limb during reaching movements. Measurements were repeated in the acute and subacute phases and compared to healthy controls. Our results showed that the ipsilesional limb presented lower kinematic and dynamic performances with respect to the healthy controls. Patients performed the movements slower and with a reduced range of motion, indicating a difficulty in controlling the motion of the arm. The energy and the power outputs were lower in both shoulder and elbow joint with a high significance level, confirming the limitation found in kinematics. Moreover, we showed that motor deficits were higher in the acute phase with respect to the subacute one and we found higher significant differences in the group with a more severe contralesional limb impairment. Ipsilesional upper limb biomechanics adds significant and more sensible measures for assessments based on multi-joints dynamics, providing a better insight on the upper limb motor control after stroke. These results could have clinical implications while evaluating and treating ipsilesional and contralesional upper limb impairments and dysfunctions in patients with stroke.

A MEG compatible, interactive IR game paradigm for the study of visuomotor reach-to-target movements in young children and clinical populations: The Target-Touch Motor Task

BACKGROUND

The conventional focus on discrete finger movements (i.e., index finger flexion or button-box key presses) has been an effective method to study neuromotor control using magnetoencephalography (MEG). However, this approach is challenging for young children and not possible for some people with physical disability.

NEW METHOD

We have developed a novel, interactive MEG compatible reach-to-target task to investigate neuromotor function, specifically for use with young children. We used an infrared touch-screen frame to detect responses to targets presented using custom software. The game can be played using a conventional computer monitor or during MEG recordings via projector. We termed this game the Target-Touch Motor Task (TTMT).

RESULTS

We demonstrate that the TTMT is a feasible motor task for use with young children including children with physical impairments. TTMT response-to-target trial counts are also comparable to conventional methods. Artifacts from the touch screen, while present > 100 Hz, did not affect MEG source analysis in the beta band (14-30 Hz). MEG responses during TTMT game play reveal robust cortical activity from expected areas of motor cortex as typically observed following movements of the upper limb.

COMPARISON WITH EXISTING METHOD(S)

The TTMT paradigm allows participation by individuals with a broad range of motor abilities on a reach-to-target' functional task rather than conventional tasks focusing on discrete finger movements.

CONCLUSIONS

The TTMT is well suited for young children and successfully activates expected motor cortical areas. The TTMT opens-up new opportunities for the assessment of motor function across the lifespan, including for children with physical limitations.

Functional characterization of the fronto-parietal reaching and grasping network: reversible deactivation of M1 and areas 2, 5, and 7b in awake behaving monkeys

In the present investigation, we examined the role of different cortical fields in the fronto-parietal reaching and grasping network in awake, behaving macaque monkeys. This network is greatly expanded in primates compared to other mammals and coevolved with glabrous hands with opposable thumbs and the extraordinary dexterous behaviors employed by a number of primates, including humans. To examine this, we reversibly deactivated the primary motor area (M1), anterior parietal area 2, and posterior parietal areas 5L and 7b individually while monkeys were performing two types of reaching and grasping tasks. Reversible deactivation was accomplished with small microfluidic thermal regulators abutting specifically targeted cortical areas. Placement of these devices in the different cortical fields was confirmed post hoc in histologically processed tissue. Our results indicate that the different areas examined form a complex network of motor control that is overlapping. However, several consistent themes emerged that suggest the independent roles that motor cortex, area 2, area 7b, and area 5L play in the motor planning and execution of reaching and grasping movements. Area 5L is involved in the early stages and area 7b the later stages of a reaching and grasping movement, motor cortex is involved in all aspects of the execution of the movement, and area 2 provides proprioceptive feedback throughout the movement. We discuss our results in the context of previous studies that explored the fronto-parietal network, the overlapping (but also independent) functions of different nodes of this network, and the rapid compensatory plasticity of this network.NEW & NOTEWORTHY This is the first study to directly compare the results of cooling different portions of the fronto-parietal reaching and grasping network (motor cortex, anterior and posterior parietal cortex) in the same animals and the first to employ a complex, bimanual reaching and grasping task that is ethologically relevant. Whereas cooling area 7b or area 5L evoked deficits at distinct task phases, cooling M1 evoked a general set of deficits and cooling area 2 evoked proprioceptive deficits.

White matter tract disruption is associated with ipsilateral hand impairment in subacute stroke: a diffusion MRI study

PURPOSE

The ipsilateral hand (ILH) is impaired after unilateral stroke, but the underlying mechanisms remain unresolved. Based on the degeneracy theory of network connectivity that many connectivity patterns are functionally equivalent, we hypothesized that ILH impairment would result from the summation of microstructural white matter (WM) disruption in the motor network, with a task-related profile. We aimed to determine the WM disruption patterns associated with ILH impairment.

METHODS

This was a cross-sectional analysis of patients in the ISIS-HERMES Study with ILH and diffusion-MRI data collected 1 month post-stroke. Patients performed three tasks, the Purdue Pegboard Test (PPT), handgrip strength, and movement time. Fractional anisotropy (FA) derived from diffusion MRI was measured in 33 WM regions. We used linear regression models controlling for age, sex, and education to determine WM regions associated with ILH impairment.

RESULTS

PPT was impaired in 42%, grip in 59%, and movement time in 24% of 29 included patients (mean age, 51.9 ± 10.5 years; 21 men). PPT was predicted by ipsilesional corticospinal tract (i-CST) (B = 17.95; p = 0.002) and superior longitudinal Fasciculus (i-SLF) (B = 20.52; p = 0.008); handgrip by i-CST (B = 109.58; p = 0.016) and contralesional anterior corona radiata (B = 42.69; p = 0.039); and movement time by the corpus callosum (B =  - 1810.03; p = 0.003) i-SLF (B =  - 917.45; p = 0.015), contralesional pons-CST (B = 1744.31; p = 0.016), and i-corticoreticulospinal pathway (B =  - 380.54; p = 0.037).

CONCLUSION

ILH impairment was associated with WM disruption to a combination of ipsilateral and contralesional tracts with a pattern influenced by task-related processes, supporting the degeneracy theory. We propose to integrate ILH assessment in rehabilitation programs and treatment interventions such as neuromodulation.

Ipsilateral hand impairment predicts long-term outcome in patients with subacute stroke

BACKGROUND

Ipsilateral hand (ILH) impairment is documented following motor stroke, but its impact on long-term outcome remains unknown. We assessed ILH impairment in subacute stroke and tested whether ILH impairment predicted long-term outcome.

METHODS

We performed a longitudinal study in 209 consecutive patients with unilateral stroke and sensorimotor deficit at admission. ILH impairment was evaluated using Purdue Pegboard Test (PPT) and handgrip strength and defined as mild (z-score <-1) or moderate (z-score <-1.65). We used logistic regression (LR) to predict outcome assessed 9 (7-12) months post-stroke with the modified Rankin scale (mRS) categorized into good (mRS≤1) and poor outcome (mRS≥2). For internal validation, LR-bootstrapping, and cross-validation with Lasso and Random-Forest were performed.

RESULTS

ILH impairment assessed at 89.04 ±45.82 days post-stroke was moderate in 10.53% (95% CI, 6.7, 14.83) for PPT and 17.22% (95% CI, 11.96, 22.49) for grip, and mild in 21.05% (95% CI, 15.78, 26.79) for PPT and 35.89 (95% CI, 29.67, 42.58) for grip. Good outcome was predicted by ILH-PPT (B=1.03 [95% CI, 0.39, 3.31]), ILH-grip (B=1.16 [95% CI, 0.54, 3.53]), low NIHSS-discharge (B=-1.57, [95% CI, -4.0, -1.19]), and no depression (B=-0.62, [95% CI, -1.63, -0.43]), accounting for stroke delay (B=-0.011, [95% CI, -0.06, 0.01]). Model efficiency was 91.6% (AUC=0.977, 95%CI, 0.959, 0.996). Lasso and Random-Forest methods provided similar results, confirming the LR model robustness.

CONCLUSIONS

ILH impairment is frequent after motor stroke and predicts long-term outcome. We propose to integrate ILH impairment in rehabilitation programs to improve recovery and serve research interventions such as neuromodulation.

A brief review of motor imagery and bimanual coordination

Motor imagery is increasingly being used in clinical settings, such as in neurorehabilitation and brain computer interface (BCI). In stroke, patients lose upper limb function and must re-learn bimanual coordination skills necessary for the activities of daily living. Physiotherapists integrate motor imagery with physical rehabilitation to accelerate recovery. In BCIs, users are often asked to imagine a movement, often with sparse instructions. The EEG pattern that coincides with this cognitive task is captured, then used to execute an external command, such as operating a neuroprosthetic device. As such, BCIs are dependent on the efficient and reliable interpretation of motor imagery. While motor imagery improves patient outcome and informs BCI research, the cognitive and neurophysiological mechanisms which underlie it are not clear. Certain types of motor imagery techniques are more effective than others. For instance, focusing on kinesthetic cues and adopting a first-person perspective are more effective than focusing on visual cues and adopting a third-person perspective. As motor imagery becomes more dominant in neurorehabilitation and BCIs, it is important to elucidate what makes these techniques effective. The purpose of this review is to examine the research to date that focuses on both motor imagery and bimanual coordination. An assessment of current research on these two themes may serve as a useful platform for scientists and clinicians seeking to use motor imagery to help improve bimanual coordination, either through augmenting physical therapy or developing more effective BCIs.

A Single Bout of High-Intensity Cardiovascular Exercise Does Not Enhance Motor Performance and Learning of a Visuomotor Force Modulation Task, but Triggers Ipsilateral Task-Related EEG Activity

Acute cardiovascular exercise (aCE) seems to be a promising strategy to improve motor performance and learning. However, results are heterogeneous, and the related neurophysiological mechanisms are not well understood. Oscillatory brain activitiy, such as task-related power (TRPow) in the alpha and beta frequencies, are known neural signatures of motor activity. Here, we tested the effects of aCE on motor performance and learning, along with corresponding modulations in EEG TRPow over the sensorimotor cortex. Forty-five right-handed participants (aged 18-34 years) practiced a visuomotor force-matching (FM) task after either high-intensity (HEG), low-intensity (LEG), or no exercise (control group, CG). Motor performance was assessed immediately, 15 min, 30 min, and 24 h after aCE/control. EEG was measured during the FM task. Results of frequentist and Bayesian statistics revealed that high- and low-intensity aCE had no effect at the behavioral level, adding to the previous mixed results. Interestingly, EEG analyses showed an effect of aCE on the ipsilateral sensorimotor cortex, with a stronger decrease in β-TRPow 15 min after exercise in both groups compared to the CG. Overall, aCE applied before motor practice increased ipsilateral sensorimotor activity, while motor learning was not affected; it remains to be seen whether aCE might affect motor learning in the long run.

Neural mechanisms mediating cross education: With additional considerations for the ageing brain

CALVERT, G.H.M., and CARSON, R.G. Neural mechanisms mediating cross education: With additional considerations for the ageing brain. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 2021. - Cross education (CE) is the process whereby a regimen of unilateral limb training engenders bilateral improvements in motor function. The contralateral gains thus derived may impart therapeutic benefits for patients with unilateral deficits arising from orthopaedic injury or stroke. Despite this prospective therapeutic utility, there is little consensus concerning its mechanistic basis. The precise means through which the neuroanatomical structures and cellular processes that mediate CE may be influenced by age-related neurodegeneration are also almost entirely unknown. Notwithstanding the increased incidence of unilateral impairment in later life, age-related variations in the expression of CE have been examined only infrequently. In this narrative review, we consider several mechanisms which may mediate the expression of CE with specific reference to the ageing CNS. We focus on the adaptive potential of cellular processes that are subserved by a specific set of neuroanatomical pathways including: the corticospinal tract, corticoreticulospinal projections, transcallosal fibres, and thalamocortical radiations. This analysis may inform the development of interventions that exploit the therapeutic utility of CE training in older persons.

Decoding attempted phantom hand movements from ipsilateral sensorimotor areas after amputation

Objective.The sensorimotor cortex is often selected as target in the development of a Brain-Computer Interface, as activation patterns from this region can be robustly decoded to discriminate between different movements the user executes. Up until recently, such BCIs were primarily based on activity in the contralateral hemisphere, where decoding movements still works even years after denervation. However, there is increasing evidence for a role of the sensorimotor cortex in controlling the ipsilateral body. The aim of this study is to investigate the effects of denervation on the movement representation on the ipsilateral sensorimotor cortex.Approach.Eight subjects with acquired above-elbow arm amputation and nine controls performed a task in which they made (or attempted to make with their phantom hand) six different gestures from the American Manual Alphabet. Brain activity was measured using 7T functional MRI, and a classifier was trained to discriminate between activation patterns on four different regions of interest (ROIs) on the ipsilateral sensorimotor cortex.Main results.Classification scores showed that decoding was possible and significantly better than chance level for both the phantom and intact hands from all ROIs. Decoding both the left (intact) and right (phantom) hand from the same hemisphere was also possible with above-chance level classification score.Significance.The possibility to decode both hands from the same hemisphere, even years after denervation, indicates that implantation of motor-electrodes for BCI control possibly need only cover a single hemisphere, making surgery less invasive, and increasing options for people with lateralized damage to motor cortex like after stroke.

Handedness Does Not Impact Inhibitory Control, but Movement Execution and Reactive Inhibition Are More under a Left-Hemisphere Control

The relationship between handedness, laterality, and inhibitory control is a valuable benchmark for testing the hypothesis of the right-hemispheric specialization of inhibition. According to this theory, and given that to stop a limb movement, it is sufficient to alter the activity of the contralateral hemisphere, then suppressing a left arm movement should be faster than suppressing a right-arm movement. This is because, in the latter case, inhibitory commands produced in the right hemisphere should be sent to the other hemisphere. Further, as lateralization of cognitive functions in left-handers is less pronounced than in right-handers, in the former, the inhibitory control should rely on both hemispheres. We tested these predictions on a medium-large sample of left- and right-handers (n = 52). Each participant completed two sessions of the reaching versions of the stop-signal task, one using the right arm and one using the left arm. We found that reactive and proactive inhibition do not differ according to handedness. However, we found a significant advantage of the right versus the left arm in canceling movements outright. By contrast, there were no differences in proactive inhibition. As we also found that participants performed movements faster with the right than with the left arm, we interpret our results in light of the dominant role of the left hemisphere in some aspects of motor control.

Ageing and the Ipsilateral M1 BOLD Response: A Connectivity Study

Young people exhibit a negative BOLD response in ipsilateral primary motor cortex (M1) when making unilateral movements, such as button presses. This negative BOLD response becomes more positive as people age. In this study, we investigated why this occurs, in terms of the underlying effective connectivity and haemodynamics. We applied dynamic causal modeling (DCM) to task fMRI data from 635 participants aged 18-88 from the Cam-CAN dataset, who performed a cued button pressing task with their right hand. We found that connectivity from contralateral supplementary motor area (SMA) and dorsal premotor cortex (PMd) to ipsilateral M1 became more positive with age, explaining 44% of the variability across people in ipsilateral M1 responses. In contrast, connectivity from contralateral M1 to ipsilateral M1 was weaker and did not correlate with individual differences in rM1 BOLD. Neurovascular and haemodynamic parameters in the model were not able to explain the age-related shift to positive BOLD. Our results add to a body of evidence implicating neural, rather than vascular factors as the predominant cause of negative BOLD-while emphasising the importance of inter-hemispheric connectivity. This study provides a foundation for investigating the clinical and lifestyle factors that determine the sign and amplitude of the M1 BOLD response in ageing, which could serve as a proxy for neural and vascular health, via the underlying neurovascular mechanisms.

Contralateral C7 Nerve Transfer for Stroke Recovery: New Frontier for Peripheral Nerve Surgery

Ischemic stroke remains a major cause of disability in the United States and worldwide. Following the large-scale implementation of stroke thrombectomy and the optimization of treatment protocols for acute stroke, the reduction in stroke-associated mortality has resulted in an increased proportion of stroke survivors, many of whom have moderate to severe disability. To date, the treatment of subacute and chronic stroke has remained a challenge. Several approaches, involving pharmacological interventions to promote neuroplasticity, brain stimulation strategies and rehabilitative interventions, are currently being explored at different stages of the translational spectrum, yet level 1 evidence is still limited. In a recent landmark study, surgical intervention using contralateral C7 nerve transfer, an approach used to treat brachial plexus injury, was implemented in patients with chronic stroke, demonstrating an added benefit to standard rehabilitation strategies, leading to improved motor performance and reduced spasticity. The procedure involved the transfer of the C7 nerve root and middle trunk from the uninjured extremity to the injured extremity using a short conduit that allows for faster regeneration and innervation of the injured upper extremity via the ipsilateral (contralesional) hemisphere. In this work, we review the rationale for using contralateral C7 nerve transfer in stroke, describe the surgical intervention with associated variations and limitations, and discuss the current evidence for the efficacy of this technique in ischemic stroke research.

Voluntary suppression of associated activity decreases force steadiness in the active hand

Unilateral muscle contractions are often accompanied by the activation of the ipsilateral hemisphere, producing associated activity (AA) in the contralateral homologous muscles. However, the functional role of AA is not fully understood. We determined the effects of voluntary suppression of AA in the first dorsal interosseous (FDI), on force steadiness during a constant force isometric contraction of the contralateral FDI. Participants (n = 17, 25.5 years) performed two trials of isometric FDI contractions as steadily as possible. In Trial 1, they did not receive feedback or explicit instructions for suppressing the AA in the contralateral homologous FDI. In Trial 2, participants received feedback and were asked to voluntarily suppress the AA in the contralateral nontarget FDI. During both trials, corticospinal excitability and motor cortical inhibition were measured. The results show that participants effectively suppressed the AA in the nontarget contralateral FDI (-71%), which correlated with reductions in corticospinal excitability (-57%), and the suppression was also accompanied by increases in inhibition (27%) in the ipsilateral motor cortex. The suppression of AA impaired force steadiness, but the decrease in force steadiness did not correlate with the magnitude of suppression. The results show that voluntary suppression of AA decreases force steadiness in the active hand. However, due to the lack of association between suppression and decreased steadiness, we interpret these data to mean that specific elements of the ipsilateral brain activation producing AA in younger adults are neither contributing nor detrimental to unilateral motor control during a steady isometric contraction.

Excitability of the Ipsilateral Primary Motor Cortex During Unilateral Goal-Directed Movement

Introduction

Previous transcranial magnetic stimulation (TMS) studies have revealed that the activity of the primary motor cortex ipsilateral to an active hand (ipsi-M1) plays an important role in motor control. The aim of this study was to investigate whether the ipsi-M1 excitability would be influenced by goal-directed movement and laterality during unilateral finger movements.

Method

Ten healthy right-handed subjects performed four finger tapping tasks with the index finger: (1) simple tapping (Tap) task, (2) Real-word task, (3) Pseudoword task, and (4) Visually guided tapping (VT) task. In the Tap task, the subject performed self-paced simple tapping on a touch screen. In the real-word task, the subject tapped letters displayed on the screen one by one to create a Real-word (e.g., apple). Because the action had a specific purpose (i.e., creating a word), this task was considered to be goal-directed as compared to the Tap task. In the Pseudoword task, the subject tapped the letters to create a pseudoword (e.g., gdiok) in the same manner as in the Real-word task; however, the word was less meaningful. In the VT task, the subject was required to touch a series of illuminated buttons. This task was considered to be less goal-directed than the Pseudoword task. The tasks were performed with the right and left hand, and a rest condition was added as control. Single- and paired-pulse TMS were applied to the ipsi-M1 to measure corticospinal excitability and short- and long-interval intracortical inhibition (SICI and LICI) in the resting first dorsal interosseous (FDI) muscle.

Results

We found the smaller SICI in the ipsi-M1 during the VT task compared with the resting condition. Further, both SICI and LICI were smaller in the right than in the left M1, regardless of the task conditions.

Discussion

We found that SICI in the ipsi-M1 is smaller during visual illumination-guided finger movement than during the resting condition. Our finding provides basic data for designing a rehabilitation program that modulates the M1 ipsilateral to the moving limb, for example, for post-stroke patients with severe hemiparesis.

Sensory stimulation enhances phantom limb perception and movement decoding

OBJECTIVE

A major challenge for controlling a prosthetic arm is communication between the device and the user's phantom limb. We show the ability to enhance phantom limb perception and improve movement decoding through targeted transcutaneous electrical nerve stimulation in individuals with an arm amputation.

APPROACH

Transcutaneous nerve stimulation experiments were performed with four participants with arm amputation to map phantom limb perception. We measured myoelectric signals during phantom hand movements before and after participants received sensory stimulation. Using electroencephalogram (EEG) monitoring, we measured the neural activity in sensorimotor regions during phantom movements and stimulation. In one participant, we also tracked sensory mapping over 2 years and movement decoding performance over 1 year.

MAIN RESULTS

Results show improvements in the participants' ability to perceive and move the phantom hand as a result of sensory stimulation, which leads to improved movement decoding. In the extended study with one participant, we found that sensory mapping remains stable over 2 years. Sensory stimulation improves within-day movement decoding while performance remains stable over 1 year. From the EEG, we observed cortical correlates of sensorimotor integration and increased motor-related neural activity as a result of enhanced phantom limb perception.

SIGNIFICANCE

This work demonstrates that phantom limb perception influences prosthesis control and can benefit from targeted nerve stimulation. These findings have implications for improving prosthesis usability and function due to a heightened sense of the phantom hand.

The Motor Cortex Has Independent Representations for Ipsilateral and Contralateral Arm Movements But Correlated Representations for Grasping

Motor commands for the arm and hand generally arise from the contralateral motor cortex, where most of the relevant corticospinal tract originates. However, the ipsilateral motor cortex shows activity related to arm movement despite the lack of direct connections. The extent to which the activity related to ipsilateral movement is independent from that related to contralateral movement is unclear based on conflicting conclusions in prior work. Here we investigate bilateral arm and hand movement tasks completed by two human subjects with intracortical microelectrode arrays implanted in the left hand and arm area of the motor cortex. Neural activity was recorded while they attempted to perform arm and hand movements in a virtual environment. This enabled us to quantify the strength and independence of motor cortical activity related to continuous movements of each arm. We also investigated the subjects' ability to control both arms through a brain-computer interface. Through a number of experiments, we found that ipsilateral arm movement was represented independently of, but more weakly than, contralateral arm movement. However, the representation of grasping was correlated between the two hands. This difference between hand and arm representation was unexpected and poses new questions about the different ways the motor cortex controls the hands and arms.

Cortical Activation During Shoulder and Finger Movements in Healthy Adults: A Functional Near-Infrared Spectroscopy (fNIRS) Study

Characterization of cortical activation patterns during movement of the upper extremity in healthy adults is helpful in understanding recovery mechanisms following neurological disorders. This study explores cortical activation patterns associated with movements of the shoulder and fingers in healthy adults using functional near-infrared spectroscopy (fNIRS). Twelve healthy right-handed participants were recruited. Two motor tasks (shoulder abduction and finger extension) with two different trial lengths (10 s and 20 s) were performed in a sitting position at a rate of 0.5 Hz. The hemodynamic response, as indicated by oxy-hemoglobin (HbO) and deoxy-hemoglobin (HbR), over both hemispheres was acquired using a 54-channel fNIRS system. We found a generalized bilateral cortical activation during both motor tasks with greater activation in the contralateral compared to the ipsilateral primary motor cortex. Particularly in the more medial part of the contralateral hemisphere, significant higher activation was found during the shoulder compared to finger movements. Furthermore, cortical activation patterns are affected not only by motor tasks but also by trial lengths. HbO is more sensitive to detect cortical activation during finger movements in longer trials, while HbR is a better surrogate to capture active areas during shoulder movement in shorter trials. Based on these findings, reporting both HbO and HbR is strongly recommended for future fNIRS studies, and trial lengths should be taken into account when designing experiments and explaining results. Our findings demonstrating distinct cortical activation patterns associated with shoulder and finger movements in healthy adults provide a foundation for future research to study recovery mechanisms following neurological disorders.

Beta-band power modulation in the human hippocampus during a reaching task

OBJECTIVE

Characterize the role of the beta-band (13-30 Hz) in the human hippocampus during the execution of voluntary movement.

APPROACH

We recorded electrophysiological activity in human hippocampus during a reach task using stereotactic electroencephalography (SEEG). SEEG has previously been utilized to study the theta band (3-8 Hz) in conflict processing and spatial navigation, but most studies of hippocampal activity during movement have used noninvasive measures such as fMRI. We analyzed modulation in the beta band (13-30 Hz), which is known to play a prominent role throughout the motor system including the cerebral cortex and basal ganglia. We conducted the classic 'center-out' direct-reach experiment with nine patients undergoing surgical treatment for medically refractory epilepsy.

MAIN RESULTS

In seven of the nine patients, power spectral analysis showed a statistically significant decrease in power within the beta band (13-30 Hz) during the response phase, compared to the fixation phase, of the center-out direct-reach task using the Wilcoxon signed-rank hypothesis test (p < 0.05).

SIGNIFICANCE

This finding is consistent with previous literature suggesting that the hippocampus may be involved in the execution of movement, and it is the first time that changes in beta-band power have been demonstrated in the hippocampus using human electrophysiology. Our findings suggest that beta-band modulation in the human hippocampus may play a role in the execution of voluntary movement.

Independent representations of ipsilateral and contralateral limbs in primary motor cortex

Several lines of research demonstrate that primary motor cortex (M1) is principally involved in controlling the contralateral side of the body. However, M1 activity has been correlated with both contralateral and ipsilateral limb movements. Why does ipsilaterally-related activity not cause contralateral motor output? To address this question, we trained monkeys to counter mechanical loads applied to their right and left limbs. We found >50% of M1 neurons had load-related activity for both limbs. Contralateral loads evoked changes in activity ~10ms sooner than ipsilateral loads. We also found corresponding population activities were distinct, with contralateral activity residing in a subspace that was orthogonal to the ipsilateral activity. Thus, neural responses for the contralateral limb can be extracted without interference from the activity for the ipsilateral limb, and vice versa. Our results show that M1 activity unrelated to downstream motor targets can be segregated from activity related to the downstream motor output.