Motor responses to sudden limb displacements in primates with specific CNS lesions and in human patients with motor system disorders

Precise cortical contributions to sensorimotor feedback control during reactive balance

The role of the cortex in shaping automatic whole-body motor behaviors such as walking and balance is poorly understood. Gait and balance are typically mediated through subcortical circuits, with the cortex becoming engaged as needed on an individual basis by task difficulty and complexity. However, we lack a mechanistic understanding of how increased cortical contribution to whole-body movements shapes motor output. Here we use reactive balance recovery as a paradigm to identify relationships between hierarchical control mechanisms and their engagement across balance tasks of increasing difficulty in young adults. We hypothesize that parallel sensorimotor feedback loops engaging subcortical and cortical circuits contribute to balance-correcting muscle activity, and that the involvement of cortical circuits increases with balance challenge. We decomposed balance-correcting muscle activity based on hypothesized subcortically- and cortically-mediated feedback components driven by similar sensory information, but with different loop delays. The initial balance-correcting muscle activity was engaged at all levels of balance difficulty. Its onset latency was consistent with subcortical sensorimotor loops observed in the lower limb. An even later, presumed, cortically-mediated burst of muscle activity became additionally engaged as balance task difficulty increased, at latencies consistent with longer transcortical sensorimotor loops. We further demonstrate that evoked cortical activity in central midline areas measured using electroencephalography (EEG) can be explained by a similar sensory transformation as muscle activity but at a delay consistent with its role in a transcortical loop driving later cortical contributions to balance-correcting muscle activity. These results demonstrate that a neuromechanical model of muscle activity can be used to infer cortical contributions to muscle activity without recording brain activity. Our model may provide a useful framework for evaluating changes in cortical contributions to balance that are associated with falls in older adults and in neurological disorders such as Parkinson's disease.

The benefit of knowledge: postural response modulation by foreknowledge of equilibrium perturbation in an upper limb task

For whole-body sway patterns, a compound motor response following an external stimulus may comprise reflexes, postural adjustments (anticipatory or compensatory), and voluntary muscular activity. Responses to equilibrium destabilization may depend on both motor set and a subject`s expectation of the disturbing stimulus. To disentangle these influences on lower limb responses, we studied a model in which subjects (n = 14) were suspended in the air, without foot support, and performed a fast unilateral wrist extension (WE) in response to a passive knee flexion (KF) delivered by a robot. To characterize the responses, electromyographic activity of rectus femoris and reactive leg torque was obtained bilaterally in a series of trials, with or without the requirement of WE (motor set), and/or beforehand information about the upcoming velocity of KF (subject`s expectation). Some fast-velocity trials resulted in StartReact responses, which were used to subclassify leg responses. When subjects were uninformed about the upcoming KF, large rectus femoris responses concurred with a postural reaction in conditions without motor task, and with both postural reaction and postural adjustment when WE was required. WE in response to a low-volume acoustic signal elicited no postural adjustments. When subjects were informed about KF velocity and had to perform WE, large rectus femoris responses corresponded to anticipatory postural adjustment rather than postural reaction. In conclusion, when subjects are suspended in the air and have to respond with WE, the prepared motor set includes anticipatory postural adjustments if KF velocity is known, and additional postural reactions if KF velocity is unknown.

A Cortical Mechanism Linking Saliency Detection and Motor Reactivity in Rhesus Monkeys

Sudden and surprising sensory events trigger neural processes that swiftly adjust behavior. To study the phylogenesis and the mechanism of this phenomenon, we trained two male rhesus monkeys to keep a cursor inside a visual target by exerting force on an isometric joystick. We examined the effect of surprising auditory stimuli on exerted force, scalp electroencephalographic (EEG) activity, and local field potentials (LFPs) recorded from the dorsolateral prefrontal cortex. Auditory stimuli elicited (1) a biphasic modulation of isometric force, a transient decrease followed by a corrective tonic increase, and (2) EEG and LFP deflections dominated by two large negative-positive waves (N70 and P130). The EEG potential was symmetrical and maximal at the scalp vertex, highly reminiscent of the human "vertex potential." Electrocortical potentials and force were tightly coupled: the P130 amplitude predicted the magnitude of the corrective force increase, particularly in the LFPs recorded from deep rather than superficial cortical layers. These results disclose a phylogenetically preserved corticomotor mechanism supporting adaptive behavior in response to salient sensory events.Significance Statement Survival in the natural world depends on an animal's capacity to adapt ongoing behavior to abrupt unexpected events. To study the neural mechanisms underlying this capacity, we trained monkeys to apply constant force on a joystick while we recorded their brain activity from the scalp and the prefrontal cortex contralateral to the hand holding the joystick. Unexpected auditory stimuli elicited a biphasic force modulation: a transient reduction followed by a corrective adjustment. The same stimuli also elicited EEG and LFP responses, dominated by a biphasic wave that predicted the magnitude of the behavioral adjustment. These results disclose a phylogenetically preserved corticomotor mechanism supporting adaptive behavior in response to unexpected events.

Assessing shoulder muscle stretch reflexes following breast cancer treatment and postmastectomy breast reconstruction

Muscle stiffness is altered following postmastectomy breast reconstruction and breast cancer treatment. The exact mechanisms underlying these alterations are unknown; however, muscle stretch reflexes may play a role. This work examined short- (SLR) and long-latency (LLR) shoulder muscle stretch reflexes in breast cancer survivors. Forty-nine patients who had undergone postmastectomy breast reconstruction, 17 who had undergone chemoradiation, and 18 healthy, age-matched controls were enrolled. Muscle activity was recorded from the clavicular and sternocostal regions of the pectoralis major and anterior, middle, and posterior deltoids during vertical ab/adduction or horizontal flex/extension perturbations while participants maintained minimal torques. SLR and LLR were quantified for each muscle. Our major finding was that following postmastectomy breast reconstruction, SLR and LLR are impaired in the clavicular region of the pectoralis major. Individuals who had chemoradiation had impaired stretch reflexes in the clavicular and sternocostal region of the pectoralis major, anterior, middle, and posterior deltoid. These findings indicate that breast cancer treatments alter the regulation of shoulder muscle stretch reflexes and may be associated with surgical or nonsurgical damage to the pectoral fascia, muscle spindles, and/or sensory Ia afferents.NEW & NOTEWORTHY Shoulder muscle stretch reflexes may be impacted following postmastectomy breast reconstruction and chemoradiation. Here, we examined short- and long-latency shoulder muscle stretch reflexes in two experiments following common breast reconstruction procedures and chemoradiation. We show impairments in pectoralis major stretch reflexes following postmastectomy breast reconstruction and pectoralis major and deltoid muscle stretch reflexes following chemoradiation. These findings indicate that breast cancer treatments alter the regulation of shoulder muscle stretch reflexes.

Proprioceptive and Visual Feedback Responses in Macaques Exploit Goal Redundancy

A common problem in motor control concerns how to generate patterns of muscle activity when there are redundant solutions to attain a behavioral goal. Optimal feedback control is a theory that has guided many behavioral studies exploring how the motor system incorporates task redundancy. This theory predicts that kinematic errors that deviate the limb should not be corrected if one can still attain the behavioral goal. Studies in humans demonstrate that the motor system can flexibly integrate visual and proprioceptive feedback of the limb with goal redundancy within 90 ms and 70 ms, respectively. Here, we show monkeys (Macaca mulatta) demonstrate similar abilities to exploit goal redundancy. We trained four male monkeys to reach for a goal that was either a narrow square or a wide, spatially redundant rectangle. Monkeys exhibited greater trial-by-trial variability when reaching to the wide goal consistent with exploiting goal redundancy. On random trials we jumped the visual feedback of the hand and found monkeys corrected for the jump when reaching to the narrow goal and largely ignored the jump when reaching for the wide goal. In a separate set of experiments, we applied mechanical loads to the arm of the monkey and found similar corrective responses based on goal shape. Muscle activity reflecting these different corrective responses were detected for the visual and mechanical perturbations starting at ∼90 and ∼70 ms, respectively. Thus, rapid motor responses in macaques can exploit goal redundancy similar to humans, creating a paradigm to study the neural basis of goal-directed motor action and motor redundancy.SIGNIFICANCE STATEMENT Moving in the world requires selecting from an infinite set of possible motor commands. Theories predict that motor commands are selected that exploit redundancies. Corrective responses in humans to either visual or proprioceptive disturbances of the limb can rapidly exploit redundant trajectories to a goal in <100 ms after a disturbance. However, uncovering the neural correlates generating these rapid motor corrections has been hampered by the absence of an animal model. We developed a behavioral paradigm in monkeys that incorporates redundancy in the form of the shape of the goal. Critically, monkeys exhibit corrective responses and timings similar to humans performing the same task. Our paradigm provides a model for investigating the neural correlates of sophisticated rapid motor corrections.

After-effects of thixotropic conditionings on operational chest wall and compartmental volumes of patients with Parkinson's disease

Individuals with Parkinson's disease (PD) present respiratory dysfunctions, mainly due to decreased chest wall expansion, which worsens with the course of the disease. These findings contribute to the restrictive respiratory pattern and the reduction in chest wall volume. According to literature, inspiratory muscle thixotropic conditioning maneuvers may improve lung volumes in these patients. The study aimed to determine the after-effects of respiratory muscle thixotropic maneuvers on breathing patterns and chest wall volumes of PD. A crossover study was performed with twelve patients with PD (8 males; mean age 63.9±8.8 years, FVC%pred 89.7±13.9, FEV1%pred 91.2±15, FEV1/FVC%pred 83.7±5.7). Chest wall volumes were assessed using OEP during thixotropic maneuvers. Increases in EIVCW (mean of 126mL, p = 0.01) and EEVCW (mean of 150mL, p = 0.005) were observed after DITLC (deep inspiration from total lung capacity) due to increases in pulmonary (RCp) and abdominal (RCa) ribcage compartments. Changes in ICoTLC (inspiratory contraction from TLC) led to significant EIVCW (mean of 224mL, p = 0.001) and EEVCW (mean of 229mL, p = 0.02) increases that were mainly observed in the RCp. No significant changes were found when performing DERV (deep expiration from residual volume) and ICoRV (Inspiratory contraction from RV). Positive correlations were also observed between the degree of inspiratory contraction during ICoTLC and EEVRCp (rho = 0.613, p = 0.03) and EIVRCp (rho = 0.697, p = 0.01) changes. Thixotropy conditioning of inspiratory muscles at an inflated chest wall volume increases EIVCW and EEVCW in the ten subsequent breaths in PD patients. These maneuvers are easy to perform, free of equipment, low-cost, and may help patients improve chest wall volumes during rehabilitation.

Clinical neurophysiology of Parkinson's disease and parkinsonism

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This review is part of the series on the clinical neurophysiology of movement disorders and focuses on Parkinson’s disease and parkinsonism.

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The pathophysiology of cardinal parkinsonian motor symptoms and myoclonus are reviewed.

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The recordings from microelectrode and deep brain stimulation electrodes are reported in detail.

This review is part of the series on the clinical neurophysiology of movement disorders. It focuses on Parkinson’s disease and parkinsonism. The topics covered include the pathophysiology of tremor, rigidity and bradykinesia, balance and gait disturbance and myoclonus in Parkinson’s disease. The use of electroencephalography, electromyography, long latency reflexes, cutaneous silent period, studies of cortical excitability with single and paired transcranial magnetic stimulation, studies of plasticity, intraoperative microelectrode recordings and recording of local field potentials from deep brain stimulation, and electrocorticography are also reviewed. In addition to advancing knowledge of pathophysiology, neurophysiological studies can be useful in refining the diagnosis, localization of surgical targets, and help to develop novel therapies for Parkinson’s disease.

Modulations of corticospinal excitability following rapid ankle dorsiflexion in skill- and endurance-trained athletes

Purpose

Long-term sports training, such as skill and endurance training, leads to specific neuroplasticity. However, it remains unclear if muscle stretch-induced proprioceptive feedback influences corticospinal facilitation/inhibition differently between skill- and endurance-trained athletes. This study investigated modulation of corticospinal excitability following rapid ankle dorsiflexion between well-trained skill and endurance athletes.

Methods

Ten skill- and ten endurance-trained athletes participated in the study. Corticospinal excitability was tested by single- and paired-pulse transcranial magnetic stimulations (TMS) at three different latencies following passive rapid ankle dorsiflexion. Motor evoked potential (MEP), short-latency intracortical inhibition (SICI), intracortical facilitation (ICF), and long-latency intracortical inhibition (LICI) were recorded by surface electromyography from the soleus muscle.

Results

Compared to immediately before ankle dorsiflexion (Onset), TMS induced significantly greater MEPs during the supraspinal reaction period (~ 120 ms after short-latency reflex, SLR) in the skill group only (from 1.7 ± 1.0 to 2.7 ± 1.8%M-max, P = 0.005) despite both conditions being passive. ICF was significantly greater over all latencies in skill than endurance athletes (F_{(3, 45)} = 4.64, P = 0.007), although no between-group differences for stimulations at specific latencies (e.g., at SLR) were observed.

Conclusion

The skill group showed higher corticospinal excitability during the supraspinal reaction phase, which may indicate a “priming” of corticospinal excitability following rapid ankle dorsiflexion for a supraspinal reaction post-stretch, which appears absent in endurance-trained athletes.

Secondary endings of muscle spindles: Structure, reflex action, role in motor control and proprioception

NEW FINDINGS

What is the topic of this review? We describe the structure and function of secondary sensory endings of muscle spindles, their reflex action and role in motor control and proprioception. What advances does it highlight? In most mammalian skeletal muscles, secondary endings of spindles are more or much more numerous than primary endings but are much less well studied. By focusing on secondary endings in this review, we aim to redress the balance, draw attention to what is not known and stimulate future research.

ABSTRACT

Kinaesthesia and the control of bodily movement rely heavily on the sensory input from muscle spindles. Hundreds of these sensory structures are embedded in mammalian muscles. Each spindle has one or more sensory endings and its own complement of small muscle fibres that are activated by the CNS via fusimotor neurons, providing efferent control of sensory responses. Exactly how the CNS wields this influence remains the subject of much fascination and debate. There are two types of sensory endings, primary and secondary, with differing development, morphology, distribution and responsiveness. Spindle primary endings have received more attention than secondaries, although the latter usually outnumber them. This review focuses on the secondary endings. Their location within the spindle, their response properties, the projection of their afferents within the CNS and their reflex actions all suggest that secondaries have certain separate roles from the primaries in proprioception and motor control. Specifically, spindle secondaries seem more adapted than primaries to signalling slow and maintained changes in the relative position of bodily segments, thereby contributing to position sense, postural control and static limb positioning. By highlighting, in this way, the roles of secondary endings, a final aim of the review is to broaden understanding of muscle spindles more generally and of the important contributions they make to both sensory and motor mechanisms.

Towards a unified neural mechanism for reactive adaptive behaviour

Surviving in natural environments requires animals to sense sudden events and swiftly adapt behaviour accordingly. The study of such Reactive Adaptive Behaviour (RAB) has been central to a number of research streams, all orbiting around movement science but progressing in parallel, with little cross-field fertilization. We first provide a concise review of these research streams, independently describing four types of RAB: (1) cortico-muscular resonance, (2) stimulus locked response, (3) online motor correction and (4) action stopping. We then highlight remarkable similarities across these four RABs, suggesting that they might be subserved by the same neural mechanism, and propose directions for future research on this topic.

Rapid Feedback Responses Parallel the Urgency of Voluntary Reaching Movements

Optimal feedback control is a prominent theory used to interpret human motor behaviour. The theory posits that skilled actions emerge from control policies that link voluntary motor control (feedforward) with flexible feedback corrections (feedback control). It is clear the nervous system can generate flexible motor corrections (reflexes) when performing actions with different goals. We know little, however, about shared features of voluntary actions and feedback control in human movement. Here we reveal a link between the timing demands of voluntary actions and flexible responses to mechanical perturbations. In two experiments, 40 human participants (21 females) made reaching movements with different timing demands. We disturbed the arm with mechanical perturbations at movement onset (Experiment 1) and at locations ranging from movement onset to completion (Experiment 2). We used the resulting muscle responses and limb displacements as a proxy for the control policies that support voluntary reaching movements. We observed an increase in the sensitivity of elbow and shoulder muscle responses and a reduction in limb motion when the task imposed greater urgency to respond to the same perturbations. The results reveal a relationship between voluntary actions and feedback control as the limb was displaced less when moving faster in perturbation trials. Muscle responses scaled with changes in the displacement of the limb in perturbation trials within each timing condition. Across both experiments, human behaviour was captured by simulations based on stochastic optimal feedback control. Taken together, the results highlight flexible control that links sensory processing with features of human reaching movements.

Effects of Perturbation Velocity, Direction, Background Muscle Activation, and Task Instruction on Long-Latency Responses Measured From Forearm Muscles

The central nervous system uses feedback processes that occur at multiple time scales to control interactions with the environment. The long-latency response (LLR) is the fastest process that directly involves cortical areas, with a motoneuron response measurable 50 ms following an imposed limb displacement. Several behavioral factors concerning perturbation mechanics and the active role of muscles prior or during the perturbation can modulate the long-latency response amplitude (LLRa) in the upper limbs, but the interactions among many of these factors had not been systematically studied before. We conducted a behavioral study on thirteen healthy individuals to determine the effect and interaction of four behavioral factors – background muscle torque, perturbation direction, perturbation velocity, and task instruction – on the LLRa evoked from the flexor carpi radialis (FCR) and extensor carpi ulnaris (ECU) muscles after velocity-controlled wrist displacements. The effects of the four factors were quantified using both a 0D statistical analysis on the average perturbation-evoked EMG signal in the period corresponding to an LLR, and using a timeseries analysis of EMG signals. All factors significantly modulated LLRa, and their combination nonlinearly contributed to modulating the LLRa. Specifically, all the three-way interaction terms that could be computed without including the interaction between instruction and velocity significantly modulated the LLR. Analysis of the three-way interaction terms of the 0D model indicated that for the ECU muscle, the LLRa evoked when subjects are asked to maintain their muscle activation in response to the perturbations was greater than the one observed when subjects yielded to the perturbations (p < 0.001), but this effect was not measured for muscles undergoing shortening or in absence of background muscle activation. Moreover, higher perturbation velocity increased the LLRa evoked from the stretched muscle in presence of a background torque (p < 0.001), but no effects of velocity were measured in absence of background torque. Also, our analysis identified significant modulations of LLRa in muscles shortened by the perturbation, including an interaction between torque and velocity, and an effect of both torque and velocity. The time-series analysis indicated the significance of additional transient effects in the LLR region for muscles undergoing shortening.

COMPARISON OF THEORIES OF REST TREMOR MECHANISM IN PARKINSON’S DISEASE: CENTRAL OSCILLATOR (SOURCE-TRIGGERED OSCILLATIONS) AND FEEDBACK-INDUCED INSTABILITY IN THE SENSORIMOTOR LOOP (SELF-SUSTAINED OSCILLATIONS)

Rest tremor is one of the most common and disabling symptoms of Parkinson’s disease (PD). The exact neural origin of rest tremor is still not clearly understood. Understanding the origin of rest tremor is important as it may aid in optimizing existing treatment strategies such as Deep Brain Stimulation or in developing new treatment strategies for rest tremor reduction. There are broadly two theories that are gaining prominence for rest tremor generation in PD. The first theory is the central oscillator theory that states that the rest tremor is triggered by an oscillatory source in the brain. The second theory is the feedback-induced instability theory that states that the rest tremor arises out of a feedback-induced instability in the sensorimotor loop. This paper analyzes validity of the two theories based on established clinical observations of Parkinsonian rest tremor by using representative simulation examples. Finally, based on our analysis, we propose two test-worthy experiments for further validation.

Rapid crossed responses in an intrinsic hand muscle during perturbed bimanual movements

Mechanical perturbations in one upper limb often elicit corrective responses in both the perturbed as well as its contralateral and unperturbed counterpart. These crossed corrective responses have been shown to be sensitive to the bimanual requirements of the perturbation, but crossed responses (CRs) in hand muscles are far less well studied. Here, we investigate corrective CRs in an intrinsic hand muscle, the first dorsal interosseous (1DI), to clockwise and anticlockwise mechanical perturbations to the contralateral index finger while participants performed a bimanual finger abduction task. We found that the CRs in the unperturbed 1DI were sensitive to the direction of the perturbation of the contralateral index finger. However, the size of the CRs was not sensitive to the amplitude of the contralateral perturbation nor its context within the bimanual task. The onset latency of the CRs was too fast to be purely transcortical (<70 ms) in 12/12 participants. This confirms that during isolated bimanual finger movements, sensory feedback from one hand can influence the other, but the pathways mediating the earliest components of this interaction are likely to involve subcortical systems such as the brainstem or spinal cord, which may afford less flexibility to the task demands.NEW & NOTEWORTHY An intrinsic hand muscle shows a crossed response to a perturbation of the contralateral index finger. The crossed response is dependent on the direction of the contralateral perturbation but not on the amplitude or the bimanual requirements of the movement, suggesting a far less flexible control policy than those governing crossed responses in more proximal muscles. The crossed response is too fast to be purely mediated by transcortical pathways, suggesting subcortical contributions.

Influence of kinesthetic motor imagery and effector specificity on the long-latency stretch response

The long-latency "reflexive" response (LLR) following an upper limb mechanical perturbation is generated by neural circuitry shared with voluntary control. This feedback response supports many task-dependent behaviors and permits the expression of goal-directed corrections at latencies shorter than voluntary reaction time. An extensive body of literature has demonstrated that the LLR shows flexibility akin to voluntary control, but it has not yet been tested whether instruction-dependent LLR changes can also occur in the absence of an overt voluntary response. The present study used kinesthetic motor imagery (experiment 1) and instructed participants to execute movement with the unperturbed contralateral limb (experiment 2) to explore the relationship between the overt production of a voluntary response and LLR facilitation. Activity in stretched right wrist flexors were compared with standard "do not-intervene" and "compensate" conditions. Our findings revealed that on ~40% of imagery and ~50% of contralateral trials, a response occurred during the voluntary epoch in the stretched right wrist flexors. On these "leaked" trials, the early portion of the LLR (R2) was facilitated and displayed a similar increase to compensate trials. The latter half of the LLR (R3) showed further modulation, mirroring the patterns of voluntary epoch activity. By contrast, the LLR on "non-leaked" imagery and contralateral trials did not modulate. We suggest that even though a hastened voluntary response cannot account for all instruction-dependent LLR modulation, the overt execution of a response during the voluntary epoch in the same muscle(s) as the LLR is a prerequisite for instruction-dependent facilitation of this feedback response.NEW & NOTEWORTHY Using motor imagery and contralateral responses, we provide novel evidence that facilitation of the long-latency reflex (LLR) requires the execution of a response during the voluntary epoch. A high proportion of overt response "leaks" were found where the mentally simulated or mirrored response appeared in stretched muscle. The first half of the LLR was categorically sensitive to the appearance of leaks, whereas the latter half displayed characteristics closely resembling activity in the ensuing voluntary period.

Muscle Responses to Passive Joint Movements in Infants During the First Year of Life

Muscle tone represents one of the important concepts for characterizing changes in the state of the developing nervous system. It can be manifested in the level of activity of flexors and extensors and in muscle reactions to its passive stretching (StR) or shortening (ShR). Here we investigated such reactions in a cohort of healthy infants aged from 2 weeks to 12 months. We examined the presence and the characteristics of StR and ShR during slow passive cyclic flexion/extension movements (T~3 s) in the hip, knee, ankle, and elbow joints while awake infants were in the supine position. The results showed that most infants demonstrated prominent ShRs in response to passive joint rotations, although the StR was observed more frequently, suggesting that the ShR is an important component of adaptive motor behavior already at an early developmental stage. Interestingly, the occurrence of both StR and ShR in most muscles significantly decreased throughout the first year of life. Passive cyclic flexion/extension movements could also evoke rhythmic muscle responses in other joints or in the contralateral limb, however, such responses were predominantly observed in younger infants (<6 months). A noticeable manifestation of muscle reactions at an early developmental stage, along with spontaneous motor activity in this period of life, may reflect the processes underlying a formation of appropriate muscle tone and the self-organization of neural circuits. A substantial reduction of ipsilateral and contralateral muscle responses to passive movements with age is consistent with the idea of a functional reorganization of the motor circuitry during early development.

Anticipation of drop height affects neuromuscular control and muscle-tendon mechanics

This study examined the effect of drop height on neuromechanical control of the plantarflexors in drop jumps (DJs) before and during ground contact (GC). The effect of anticipation on muscle mechanical configurations was investigated in 22 subjects in three conditions (20, 30, and 40 cm): (i) known, (ii) unknown, or (iii) cheat falling heights (announced 40 cm, but actual drop height was 20 cm). Electromyographic (EMG) activity of the m. gastrocnemius medialis (GM) and other shank muscles was recorded and analyzed before GC and during GC separately for the short-, medium-, and long-latency responses (SLR, MLR, and LLR). Changes in GM fascicle length (L_M ) were determined via B-mode ultrasound, and muscle-tendon unit length (L_MTU ) was estimated. Peak force (P < .001), rate of force development (RFD) (P = .001) and GM EMG activity prior to (P = .003) and during GC (P = .007) was reduced in the unknown compared with the known conditions (P < .05). The amount of shortening in L_MTU during GC in unknown and cheat was less compared with the known conditions (P = .005; P = .049). Changes in L_MTU lengthening negatively correlated with changes in GM activity around SLR and MLR (P = .006; P = .02) in known and unknown conditions. Taken together, it seems that the central nervous system applies a protective strategy in the unknown condition by reducing muscle activity to result in a lower muscular stiffness and increased tendinous lengthening prior to and during GC. This might be a mechanism to absorb greater elastic energy in the tendon and reduce the magnitude and rate of muscle lengthening and subsequent stretch-induced muscle damage.

The relationship between leg stiffness, forces and neural control of the leg musculature during the stretch-shortening cycle is dependent on the anticipation of drop height

PURPOSE

This study aimed at investigating how prior knowledge of drop heights affects proactive and reactive motor control in drop jumps (DJ).

METHODS

In 22 subjects, the effect of knowledge of three different drop heights (20, 30, 40 cm) during DJs was evaluated in seven conditions: three different drop heights were either known, unknown or cheated (announced 40 cm, but actual drop height was 20 cm). Peak ground reaction force (F_max) to body weight (BW) ratio (F_max/BW) and electromyographic (EMG) activities of three shank and five thigh muscles were assessed 150 ms before and during ground contact (GC). Ankle, knee and hip joint kinematics were recorded in the sagittal plane.

RESULTS

Leg stiffness, proactive and reactive EMG activity of the leg muscles diminished in unknown and cheat conditions for all drop heights (7-33% and 2-26%, respectively). Antagonistic co-activation increased in unknown (3-37%). At touchdown, increased flexion in knee (~ 5.3° ± 1.9°) and hip extension (~ 2° ± 0.6°) were observed in unknown, followed by an increased angular excursion in hip (~ 2.3° ± 0.2°) and knee joints (~ 5.6° ± 0.2°) during GC (p < 0.05). Correlations between changes in activation intensities, joint kinematics, leg stiffness and F_max/BW (p < 0.05) indicate that anticipation changes the neuromechanical coupling of DJs. No dropouts were recorded.

CONCLUSION

These findings underline that anticipation influences timing and adjustment of motor responses. It is argued that proactive and reactive modulations associated with diminished activation intensities in leg extensors are functionally relevant in explaining changes in leg stiffness and subsequent decline in performance.

Stumbling reactions in hypo and hyper gravity - muscle synergies are robust across different perturbations of human stance during parabolic flights

The control of bipedal stance and the capacity to regain postural equilibrium after its deterioration in variable gravities are crucial prerequisites for manned space missions. With an emphasize on natural orthograde posture, computational techniques synthesize muscle activation patterns of high complexity to a simple synergy organization. We used nonnegative matrix factorization to identify muscle synergies during postural recovery responses in human and to examine the functional significance of such synergies for hyper-gravity (1.75 g) and hypo-gravity (0.25 g). Electromyographic data were recorded from leg, trunk and arm muscles of five human exposed to five modes of anterior and posterior support surface translations during parabolic flights including transitional g-levels of 0.25, 1 and 1.75 g. Results showed that in 1 g four synergies accounted for 99% of the automatic postural response across all muscles and perturbation directions. Each synergy in 1 g was correlated to the corresponding one in 0.25 and 1.75 g. This study therefore emphasizes the similarity of the synergy organization of postural recovery responses in Earth, hypo- and hyper-gravity conditions, indicating that the muscle synergies and segmental strategies acquired under terrestrial habits are robust and persistent across variable and acute changes in gravity levels.

Stumbling Reactions in Partial Gravity - Neuromechanics of Compensatory Postural Responses and Inter-Limb Coordination During Perturbation of Human Stance

Spontaneous changes in gravity play a significant role in interplanetary space missions. To preserve the astronauts’ capability to execute mission-critical tasks and reduce the risk of injury in transit and on planetary surfaces, a comprehensive understanding of the neuromuscular control of postural responses after balance deterioration in hypo- or hyper-gravity conditions is essential. Therefore, this study aimed to evaluate the effect of acute gravitational variation on postural adjustments in response to perturbations. Gravitational changes were induced using parabolic flight. Postural set was manipulated by randomly providing unilateral left, bilateral or split perturbations which require balance corrections to restore postural stability. In six subjects, postural reactions were recorded after anterior and posterior surface perturbations for progressively increased gravitational conditions spanning from 0.25 to 1.75 g. Ankle and knee joint kinematics and electromyograms (EMG) of eight leg muscles were recorded prior (PRE) and after perturbation onset. Muscle activation onset latencies and amplitudes in the short-, medium-, and long-latency responses (SLR, MLR, LLR) were assessed. Results demonstrate an increased muscle activity (p < 0.05) and co-contraction in the lower extremities (p < 0.05) prior to perturbation in hypo- and hyper-gravity. After perturbation, reduced muscle onset latencies (p < 0.05) and increased muscle activations in the MLR and LLR (p < 0.05), concomitant with an increased co-contraction in the SLR, were manifested with a progressive rise in gravity. Ankle and knee joint deflections remained unaffected, whereas angular velocities increased (p < 0.05) with increasing gravitation. Effects were more pronounced in bi- compared to unilateral or split perturbations (p < 0.05). Neuro-mechanical adaptations to gravity were more distinct and muscle onset latencies were shorter in the displaced compared to the non-displaced leg. In conclusion, the timing and magnitude of postural reflexes involved in stabilization of bipedal stance are gravity-dependent. The approximately linear relationship between gravity and impulse-directed EMG amplitudes or muscle onset latencies after perturbation indicates that the central nervous system correctly predicts the level of gravity. Moreover, it accurately governs contractions in the antigravity musculature to counterbalance the gravitational pull and to regain upright posture after its disturbance. Importantly, unilateral perturbations evoked fast reflex responses in the synergistic muscles of the non-displaced contralateral leg suggesting a synchronized inter-limb coordination mediated by spinal circuitries.

Anticipation modulates neuromechanics of drop jumps in known or unknown ground stiffness

With an emphasis on ballistic movements, an accurately anticipated neural control is an essential prerequisite to deliver a motor response coincidentally with the event of ground contact. This study investigated how previous knowledge of the ground condition affects proactive and reactive motor control in drop jumps (DJ). Thereby, human anticipatory capacity of muscle activation was investigated regarding neuromuscular activation, joint kinematics and peak forces associated with DJ performance. In 18 subjects, the effect of knowledge of two different surface conditions during DJs was evaluated. Peak force, ground-contact-time (GCT), rate of force development (RFD) and jump height were assessed. Electromyographic (EMG) activities of the m. soleus (SOL) and gastrocnemius medialis (GM) were assessed for 150ms before (PRE) and during ground contact (GC) for the short-, medium-, and long-latency responses. Ankle and knee joint kinematics were recorded in the sagittal plane.In the unknown conditions peak force, RFD and jump height declined, GCT was prolonged, proactive EMG activity (PRE) in SOL and GM was diminished (P<0.05). During GC, a decline in EMG activity in the unknown condition was manifested for SOL and GM for the SLR, MLR and LLR (P<0.05). Ankle and knee joint deflections during GC were increased in the unknown vs. known condition (P<0.05). Peak force, RFD and jump height were positively correlated to GM-EMG in PRE, SLR, MLR and LLR (P<0.05). Results revealed that proactive and reactive modulations in muscle activity prior and during GC are interrelated to the force-time characteristics and height of the jumps. The unknown condition revealed a comparable neuromuscular activity during pre-activation for both conditions, followed by an inhibition in the subsequent phase after touch down. These findings underline that anticipation is a determining factor influencing timing and adjustment of motor responses to accomplish ballistic movements regarding precision and performance.

Reflex response to airway occlusion in human inspiratory muscles when recruited for breathing and posture

Briefly occluding the airway during inspiration produces a short-latency reflex inhibition in human inspiratory muscles. This occlusion reflex seems specific to respiratory muscles; however, it is not known whether the reflex inhibition has a uniform effect across a motoneuron pool when a muscle is recruited concurrently for breathing and posture. In this study, participants were seated and breathed through a mouthpiece that occluded inspiratory airflow for 250 ms at a volume threshold of 0.2 liters. The reflex response was measured in the scalene and sternocleidomastoid muscles during 1) a control condition with the head supported in space and the muscles recruited for breathing only, 2) a postural condition with the head unsupported and the neck flexors recruited for both breathing and to maintain head posture, and 3) a large-breath condition with the head supported and the volume threshold raised to between 0.8 and 1.0 liters to increase inspiratory muscle activity. When normalized to its preocclusion mean, the reflex response in the scalene muscles was not significantly different between the large-breath and control conditions, whereas concomitant recruitment of these muscles for posture control reduced the reflex response by half compared with the control condition. A reflex response occurred in sternocleidomastoid when it contracted phasically as an accessory muscle for inspiration during the large-breath condition. These results indicate that the occlusion reflex does not produce a uniform effect across the motoneuron pool and that afferent inputs for this reflex most likely act via intersegmental networks of premotoneurons rather than at a motoneuronal level.

NEW & NOTEWORTHY In this study, we investigated the effect of nonrespiratory activity on the reflex response to brief sudden airway occlusions in human inspiratory muscles. We show that the reflex inhibition in the scalene muscles was not uniform across the motoneuron pool when the muscle was recruited concurrently for breathing and postural control. The reflex had a larger effect on respiratory-driven motoneurons than those recruited to maintain head posture.

Acquisition, Maintenance, and Therapeutic Use of a Simple Motor Skill

Operant conditioning of the spinal stretch reflex (SSR) or its electrical analog, the H-reflex, is a valuable experimental paradigm for studying the acquisition and maintenance of a simple motor skill. The CNS substrate of this skill consists of brain and spinal cord plasticity that operates as a hierarchy-the learning experience induces plasticity in the brain that guides and maintains plasticity in the spinal cord. This is apparent in the two components of the skill acquisition: task-dependent adaptation, reflecting brain plasticity; and long-term change, reflecting gradual development of spinal plasticity. The inferior olive, cerebellum, sensorimotor cortex, and corticospinal tract (CST) are essential components of this hierarchy. The neuronal and synaptic mechanisms of the spinal plasticity are under study. Because acquisition of this skill changes the spinal cord, it can affect other skills, such as locomotion. Thus, it enables investigation of how the highly plastic spinal cord supports the acquisition and maintenance of a broad repertoire of motor skills throughout life. These studies have resulted in the negotiated equilibrium model of spinal cord function, which reconciles the spinal cord's long-recognized reliability as the final common pathway for behaviors with its recently recognized ongoing plasticity. In accord with this model, appropriate H-reflex conditioning in a person with spasticity due to an incomplete spinal cord injury can trigger wider beneficial plasticity that markedly improves walking. H-reflex operant conditioning appears to provide a valuable new method for enhancing functional recovery in people with spinal cord injury and possibly other disorders as well.

Mechanical perturbations can elicit triggered reactions in the absence of a startle response

Perturbations delivered to the upper limbs elicit reflexive responses in stretched muscle at short- (M1: 25-50 ms) and long- (M2: 50-100 ms) latencies. When presented in a simple reaction time (RT) task, the perturbation can also elicit a preprogrammed voluntary response at a latency (< 100 ms) that overlaps the M2 response. This early appearance of the voluntary response following a proprioceptive stimulus causing muscle stretch is called a triggered reaction. Recent work has demonstrated that a perturbation also elicits activity in sternocleidomastoid (SCM) over a time-course consistent with the startle response and it was, therefore, proposed that the StartReact effect underlies triggered reactions (Ravichandran et al., Exp Brain Res 230:59-69, 2013). The present work investigated whether perturbation-evoked SCM activity results from startle or postural control and whether triggered reactions can also occur in the absence of startle. In Experiment 1, participants "compensated" against a wrist extension perturbation. A prepulse inhibition (PPI) stimulus (known to attenuate startle) was randomly presented before the perturbation. Rather than attenuating SCM activity, the responses in SCM were advanced by the PPI stimulus. In Experiment 2, participants "assisted" a wrist extension perturbation. The perturbation did not reliably elicit startle but despite this, two-thirds of trials had RTs of less than 100 ms and the earliest responses began at ~ 70 ms. These findings suggest that SCM activity following a perturbation is the result of postural control and is not related to startle. Moreover, an overt startle response is not a prerequisite for the elicitation of a triggered reaction.

Force encoding in muscle spindles during stretch of passive muscle

Muscle spindle proprioceptive receptors play a primary role in encoding the effects of external mechanical perturbations to the body. During externally-imposed stretches of passive, i.e. electrically-quiescent, muscles, the instantaneous firing rates (IFRs) of muscle spindles are associated with characteristics of stretch such as length and velocity. However, even in passive muscle, there are history-dependent transients of muscle spindle firing that are not uniquely related to muscle length and velocity, nor reproduced by current muscle spindle models. These include acceleration-dependent initial bursts, increased dynamic response to stretch velocity if a muscle has been isometric, and rate relaxation, i.e., a decrease in tonic IFR when a muscle is held at a constant length after being stretched. We collected muscle spindle spike trains across a variety of muscle stretch kinematic conditions, including systematic changes in peak length, velocity, and acceleration. We demonstrate that muscle spindle primary afferents in passive muscle fire in direct relationship to muscle force-related variables, rather than length-related variables. Linear combinations of whole muscle-tendon force and the first time derivative of force (dF/dt) predict the entire time course of transient IFRs in muscle spindle Ia afferents during stretch (i.e., lengthening) of passive muscle, including the initial burst, the dynamic response to lengthening, and rate relaxation following lengthening. Similar to acceleration scaling found previously in postural responses to perturbations, initial burst amplitude scaled equally well to initial stretch acceleration or dF/dt, though later transients were only described by dF/dt. The transient increase in dF/dt at the onset of lengthening reflects muscle short-range stiffness due to cross-bridge dynamics. Our work demonstrates a critical role of muscle cross-bridge dynamics in history-dependent muscle spindle IFRs in passive muscle lengthening conditions relevant to the detection and sensorimotor response to mechanical perturbations to the body, and to previously-described history-dependence in perception of limb position.

The Use of Velocity Information in Movement Reproduction

Background: Previous studies suggested that movement velocity influence space perception.

Aim and Objectives: We examined whether healthy participants used velocity information when they were asked to reproduce a previously performed movement. Two experiments were carried out.

Methods: In Experiment 1, blindfolded participants actively performed an arm movement (criterion movement, CM) at a natural velocity, or quickly, or slowly. After a brief delay, participants were asked to reproduce (reproduction movement, RM) CM-amplitude. No velocity constraints were imposed in making RM. In Experiment 2, CM was performed quickly or slowly. After a brief delay, the participants were asked to reproduce not only CM-amplitude but also CM-velocity.

Results: Experiment 1: in Natural condition, RM-velocity did not differ from CM-velocity and the participants accurately reproduced CM-amplitude. Conversely, in Fast and Slow condition, RM-velocities differed from CM-velocities and in Slow condition RM-amplitude was greater than CM-amplitude. Experiment 2: both RM-amplitude and -velocity did not differ from CM-amplitude and -velocity.

Conclusion: The present study confirms the view that movement velocity influences selectively space perception and suggests that this influence is stronger for slow than fast movements. Furthermore, although velocity information is crucial in accurately reproducing CM-amplitude, it was not used spontaneously when movements were performed at unnatural velocities.

The stretch reflex and the contributions of C David Marsden

The stretch reflex or myotatic reflex refers to the contraction of a muscle in response to its passive stretching by increasing its contractility as long as the stretch is within physiological limits. For ages, it was thought that the stretch reflex was of short latency and it was synonymous with the tendon reflex, subserving the same spinal reflex arc. However, disparities in the status of the two reflexes in certain clinical situations led Marsden and his collaborators to carry out a series of experiments that helped to establish that the two reflexes had different pathways. That the two reflexes are dissociated has been proved by the fact that the stretch reflex and the tendon reflex, elicited by stimulation of the same muscle, have different latencies, that of the stretch reflex being considerably longer. They hypothesized that the stretch reflex had a transcortical course before it reached the spinal motor neurons for final firing. Additionally, the phenomenon of stimulus-sensitive cortical myoclonus lent further evidence to the presence of the transcortical loop where the EEG correlate preceded the EMG discharge. This concept has been worked out by later neurologists in great detail, and the general consensus is that indeed, the stretch reflex is endowed with a conspicuous transcortical component.

Bouncing on Mars and the Moon—the role of gravity on neuromuscular control: correlation of muscle activity and rate of force development

On our astronomical neighbors Mars and the Moon, bouncing movements are the preferred locomotor techniques. During bouncing, the stretch-shortening cycle describes the muscular activation pattern. This study aimed to identify gravity-dependent changes in kinematic and neuromuscular characteristics in the stretch-shortening cycle. Hence, neuromuscular control of limb muscles as well as correlations between the muscles’ pre-activation, reflex components, and force output were assessed in lunar, Martian, and Earth gravity. During parabolic flights, peak force (Fmax), ground-contact-time, rate of force development (RFD), height, and impulse were measured. Electromyographic (EMG) activities in the m. soleus (SOL) and gastrocnemius medialis (GM) were assessed before (PRE) and during bounces for the reflex phases short-, medium-, and long-latency response (SLR, MLR, LLR). With gradually decreasing gravitation, Fmax, RFD, and impulse were reduced, whereas ground-contact time and height increased. Concomitantly, EMG_GM decreased for PRE, SLR, MLR, and LLR, and in EMG_SOL in SLR, MLR, and LLR. For SLR and MLR, Fmax and RFD were positively correlated to EMG_SOL. For PRE and LLR, RFD and Fmax were positively correlated to EMG_GM. Findings emphasize that biomechanically relevant kinematic adaptations in response to gravity variation were accompanied by muscle- and phase-specific modulations in neural control. Gravitational variation is anticipated and compensated for by gravity-adjusted muscle activities. Importantly, the pre-activation and reflex phases were differently affected: in SLR and MLR, SOL is assumed to contribute to the decline in force output with a decreasing load, and, complementary in PRE and LLR, GM seems to be of major importance for force generation.

Perturbation Predictability Can Influence the Long-Latency Stretch Response

Perturbations applied to the upper limbs elicit short (M1: 25–50 ms) and long-latency (M2: 50–100 ms) responses in the stretched muscle. M1 is produced by a spinal reflex loop, and M2 receives contribution from multiple spinal and supra-spinal pathways. While M1 is relatively immutable to voluntary intention, the remarkable feature of M2 is that its size can change based on intention or goal of the participant (e.g., increasing when resisting the perturbation and decreasing when asked to let-go or relax following the perturbation). While many studies have examined modulation of M2 between passive and various active conditions, through the use of constant foreperiods (interval between warning signal and a perturbation), it has also been shown that the magnitude of the M2 response in a passive condition can change based on factors such as habituation and anticipation of perturbation delivery. To prevent anticipation of a perturbation, most studies have used variable foreperiods; however, the range of possible foreperiod duration differs between experiments. The present study examined the influence of different variable foreperiods on modulation of the M2 response. Fifteen participants performed active and passive responses to a perturbation that stretched wrist flexors. Each block of trials had either a short (2.5–3.5 seconds; high predictability) or long (2.5–10.5 seconds; low predictability) variable foreperiod. As expected, no differences were found between any conditions for M1, while M2 was larger in the active rather than passive conditions. Interestingly, within the two passive conditions, the long variable foreperiods resulted in greater activity at the end of the M2 response than the trials with short foreperiods. These results suggest that perturbation predictability, even when using a variable foreperiod, can influence circuitry contributing to the long-latency stretch response.

Quantification of neural reflex and muscular intrinsic contributions to parkinsonian rigidity

Parkinson's disease (PD) is a progressive neurodegenerative disease characterized by rigidity, bradykinesia, resting tremor, and postural instability. Rigidity, defined as an increased resistance to passive movement of a joint, progresses faster than other motor signs in PD. Rigidity is attributable to both exaggerated neural reflex and altered muscle mechanical properties. However, little is known about the contributions of individual components to rigidity. Further, there is no evidence regarding the effects of dopaminergic medication on individual components. Objectives of this study were to quantify the contributions of neural reflexes and intrinsic muscle properties to rigidity and investigate the effects of medication on each contributing component. Joint torque and muscle activities of the wrist in 14 patients and 14 controls were measured during externally induced movements. Each subject with PD was tested in Off- and On-medication states. A system identification technique was applied to differentiate and quantify the neural reflex and intrinsic mechanical components. A mixed model of ANOVA was performed to compare the differences between the two components of rigidity for both groups, and to compare between the Off- and On-medication states for patients. The results showed that reflex and intrinsic components are comparable (p > 0.05), and both are enhanced in subjects with PD than in the controls (p < 0.05). Medication decreased the reflex component of rigidity (p < 0.01). It is concluded that both reflex and intrinsic factors are responsible for rigidity. Present findings are clinically significant as they may provide guidance in development of effective therapeutic interventions.

Temporal, but not Directional, Prior Knowledge Shortens Muscle Reflex Latency in Response to Sudden Transition of Support Surface During Walking

The central nervous system takes advantage of prior knowledge about potential upcoming perturbations for modulating postural reflexes. There are two distinct aspects of prior knowledge: spatial and temporal. This study investigated how each of spatial and temporal prior knowledge contributes to the shortening of muscle response latency. Eleven participants walked on a split-belt treadmill and perturbed by sudden acceleration or deceleration of the right belt at right foot contact. Spatial prior knowledge was given by instruction of possible direction (e.g., only acceleration) of upcoming perturbation at the beginning of an experimental session. Temporal prior knowledge was given to subjects by warning tones at foot contact during three consecutive strides before the perturbation. In response to acceleration perturbation, reflexive muscle activity was observed in soleus (SOL) and gastrocnemius (GAS) muscles. Onset latency of the GAS response was shorter (72 ms vs. 58 ms) when subjects knew the timing of the upcoming perturbation, whereas the latency was independent of directional prior knowledge. SOL onset latency (44 ms) was not influenced by directional nor temporal prior knowledge. Although spinal neural circuit that mediates short-latency reflex was not influenced by the prior knowledge, excitability in supra-spinal neural circuit that mediates medium- and long-latency reflex might be enhanced by knowing the timing of the upcoming perturbation.

Parkinsonian Rigidity Depends on the Velocity of Passive Joint Movement

Background. It has been long believed that Parkinsonian rigidity is not velocity-dependent based on the neurological examination. However, this has not been verified scientifically. Methods. The elbow joints of 20 Parkinson's disease patients were passively flexed and extended, and two characteristic values, the elastic coefficient (elasticity) and the difference in bias (difference in torque measurements for extension and flexion), were identified from a plot of the angle and torque characteristics. Flexion and extension were done at two different velocities, 60°/s and 120°/s, and a statistical analysis was performed to determine whether the changes in these characteristic values were velocity-dependent. Results. The elastic coefficient was not velocity-dependent, but the difference in bias increased in a velocity-dependent manner (P = 0.0017). Conclusions. The features of rigidity may differ from the conventional definition, which states that they are not dependent on the velocity of joint movement.

Interlimb communication following unexpected changes in treadmill velocity during human walking

Interlimb reflexes play an important role in human walking, particularly when dynamic stability is threatened by external perturbations or changes in the walking surface. Interlimb reflexes have recently been demonstrated in the contralateral biceps femoris (cBF) following knee joint rotations applied to the ipsilateral leg (iKnee) during the late stance phase of human gait (Stevenson AJ, Geertsen SS, Andersen JB, Sinkjær T, Nielsen JB, Mrachacz-Kersting N. J Physiol 591: 4921-4935, 2013). This interlimb reflex likely acts to slow the forward progression of the body to maintain dynamic stability following the perturbations. We examined this hypothesis by unexpectedly increasing or decreasing the velocity of the treadmill before (-100 and -50 ms), at the same time, or following (+50 ms) the onset of iKnee perturbations in 12 healthy volunteers. We quantified the cBF reflex amplitude when the iKnee perturbation was delivered alone, the treadmill velocity change was delivered alone, or when the two perturbations were combined. When the treadmill velocity was suddenly increased (or decreased) 100 or 50 ms before the iKnee perturbations, the combined cBF reflex was significantly larger (or smaller) than the algebraic sum of the two perturbations delivered separately. Furthermore, unexpected changes in treadmill velocity increased the incidence of reflexes in other contralateral leg muscles when the iKnee perturbations were elicited alone. These results suggest a context dependency for interlimb reflexes. They also show that the cBF reflex changed in a predictable manner to slow the forward progression of the body and maintaining dynamic stability during walking, thus signifying a functional role for interlimb reflexes.

Impaired corrective responses to postural perturbations of the arm in individuals with subacute stroke

Background

Stroke is known to alter muscle stretch responses following a perturbation, but little is known about the behavioural consequences of these altered feedback responses. Characterizing impairments in people with stroke in their interactions with the external environment may lead to better long term outcomes. This information can inform therapists about rehabilitation targets and help subjects with stroke avoid injury when moving in the world.

Methods

In this study, we developed a postural perturbation task to quantity upper limb function of subjects with subacute stroke (n = 38) and non-disabled controls (n = 74) to make rapid corrective responses with the arm. Subjects were instructed to maintain their hand at a target before and after a mechanical load was applied to the limb. Visual feedback of the hand was removed for half of the trials at perturbation onset. A number of parameters quantified subject performance, and impairment in performance was defined as outside the 95th percentile performance of control subjects.

Results

Individual subjects with stroke showed increased postural instability (44%), delayed motor responses (79%), delayed returns towards the spatial target (79%), and greater endpoint errors (74%). Several subjects also showed impairments in the temporal coordination of the elbow and shoulder joints when responding to the perturbation (47%). Interestingly, impairments in task parameters were often found for both arms of individual subjects with stroke (up to 58% for return time). Visual feedback did not improve performance on task parameters except for decreasing endpoint error for all subjects. Significant correlations between task performance and clinical measures were dependent on the arm assessed.

Conclusions

This study used a simple postural perturbation task to highlight that subjects with stroke commonly have difficulties responding to mechanical disturbances that may have important implications for their ability to perform daily activities.

Perturbation-evoked responses in primary motor cortex are modulated by behavioral context

Corrective responses to external perturbations are sensitive to the behavioral task being performed. It is believed that primary motor cortex (M1) forms part of a transcortical pathway that contributes to this sensitivity. Previous work has identified two distinct phases in the perturbation response of M1 neurons, an initial response starting ∼20 ms after perturbation onset that does not depend on the intended motor action and a task-dependent response that begins ∼40 ms after perturbation onset. However, this invariant initial response may reflect ongoing postural control or a task-independent response to the perturbation. The present study tested these two possibilities by examining if being engaged in an ongoing postural task before perturbation onset modulated the initial perturbation response in M1. Specifically, mechanical perturbations were applied to the shoulder and/or elbow while the monkey maintained its hand at a central target or when it was watching a movie and not required to respond to the perturbation. As expected, corrective movements, muscle stretch responses, and M1 population activity in the late perturbation epoch were all significantly diminished in the movie task. Strikingly, initial perturbation responses (<40 ms postperturbation) remained the same across tasks, suggesting that the initial phase of M1 activity constitutes a task-independent response that is sensitive to the properties of the mechanical perturbation but not the goal of the ongoing motor task.

Habituation behavior of the medium-latency reflex over the anterior tibial muscle after electrical stimulation of the sural nerve

Over human leg muscles, three motor responses (MR) can commonly be elicited, namely short-latency reflex (SLR), medium-latency reflex (MLR), and long-latency reflex (LLR). The MLR is less well understood than SLR and LLR. As the response to subsequent stimuli may be used to characterize central influences of an MR, we were interested, whether the MLR differs from SLR and LLR with respect to its habituation and facilitation behavior. MR were examined over the anterior tibial (TA) muscle at different contraction levels after electrical single or train stimuli (time intervals of 3 ms) over the ipsilateral sural nerve. Furthermore, MR were selectively averaged after each of four subsequent stimuli (1Hz, 0.4 Hz, trains-of-3). After single stimuli, the peak latency values were 46.2±2.3 ms, 88.0±5.8 ms (MLR), and 131.7±22.2 ms (LLR). All three MR gained similarly strong and significantly in amplitude when up to 10 kg of weight was loaded compared with no weight load. After train stimuli, the LLR but not SLR and MLR gained significantly in amplitude as compared with single stimuli. Different to SLR and LLR, the MLR showed significant habituation behavior at a stimulus repetition rate of 1Hz but not of 0.4 Hz. Thus, inhibitory interneurons seem to be involved in the MLR pathway.

Beyond muscles stiffness: importance of state-estimation to account for very fast motor corrections

Feedback delays are a major challenge for any controlled process, and yet we are able to easily control limb movements with speed and grace. A popular hypothesis suggests that the brain largely mitigates the impact of feedback delays (∼50 ms) by regulating the limb intrinsic visco-elastic properties (or impedance) with muscle co-contraction, which generates forces proportional to changes in joint angle and velocity with zero delay. Although attractive, this hypothesis is often based on estimates of limb impedance that include neural feedback, and therefore describe the entire motor system. In addition, this approach does not systematically take into account that muscles exhibit high intrinsic impedance only for small perturbations (short-range impedance). As a consequence, it remains unclear how the nervous system handles large perturbations, as well as disturbances encountered during movement when short-range impedance cannot contribute. We address this issue by comparing feedback responses to load pulses applied to the elbow of human subjects with theoretical simulations. After validating the model parameters, we show that the ability of humans to generate fast and accurate corrective movements is compatible with a control strategy based on state estimation. We also highlight the merits of delay-uncompensated robust control, which can mitigate the impact of internal model errors, but at the cost of slowing feedback corrections. We speculate that the puzzling observation of presynaptic inhibition of peripheral afferents in the spinal cord at movement onset helps to counter the destabilizing transition from high muscle impedance during posture to low muscle impedance during movement.

Context-dependent inhibition of unloaded muscles during the long-latency epoch

A number of studies have highlighted the sophistication of corrective responses in lengthened muscles during the long-latency epoch. However, in various contexts, unloading can occur, which requires corrective actions from a shortened muscle. Here, we investigate the sophistication of inhibitory responses in shortened muscles due to unloading. Our first experiment quantified the inhibitory responses following an unloading torque that displaced the hand either into or away from a peripheral target. We observed larger long-latency inhibitory responses when perturbed into the peripheral target compared with away from the target. In our second experiment, we characterized the degree of inhibition following unloading with respect to different levels of preperturbation muscle activity. We initially observed that the inhibitory activity during the short-latency epoch scaled with increased levels of preperturbation muscle activity. However, this scaling peaked early in the R2 epoch (∼ 50 ms) but then quickly diminished through the rest of the long-latency epoch. Finally, in experiment 3, we investigated whether inhibitory perturbation responses consider intersegmental dynamics of the limb. We quantified unloading responses for either pure shoulder or pure elbow torques that evoked similar motion at the shoulder but different elbow motion. The long-latency inhibitory response in the shoulder, unlike the short-latency, was greater for the shoulder torque compared with the response following an elbow torque, as previously observed for a loading response. Taken together, these results illustrate that the long-latency unloading response is capable of a similar level of complexity as observed when loads are applied to the limb.

Effectiveness of Anma massage therapy in alleviating physical symptoms in outpatients with Parkinson's disease: a before-after study

We aimed to confirm the physical effects of a single Anma massage session and continuous Anma massage therapy for outpatients with Parkinson's disease (PD). Twenty-one PD outpatients (mean age, 64.43 ± 8.39 [SD] years; Hoehn and Yahr stage I-IV) received a single 40-min Anma massage session involving upper and lower limb exercises and some subsequently received seven weekly Anma massage sessions. After a single session, visual analogue scale scores were significantly lower for muscle stiffness, movement difficulties, pain, and fatigue; gait speed and pegboard test time were significantly shortened; stride length was significantly lengthened; and shoulder flexion and abduction were significantly improved. No significant changes occurred in controls. After continuous sessions, we found general improvements in the same outcomes. In conclusion, Anma massage might effectively alleviate various physical PD symptoms; furthermore, because it is given through clothing, Anma massage is accessible for PD patients with movement difficulties.

Airway somatosensory deficits and dysphagia in Parkinson's disease

BACKGROUND

Individuals with Parkinson's disease (PD) often experience substantial impairment of swallow control, and are typically unaware of the presence or severity of their impairments suggesting that these individuals may also experience airway sensory deficits. However, the degree to which impaired swallow function in PD may relate to airway sensory deficits has yet to be formally tested.

OBJECTIVE

The purpose of this study was to examine whether airway sensory function is associated with swallow impairment in PD.

METHODS

Eighteen PD participants and 18 healthy controls participated in this study and underwent endoscopic assessment of airway somatosensory function, endoscopic assessment of swallow function, and clinical ratings of swallow and disease severity.

RESULTS

PD participants exhibited abnormal airway somatosensory function and greater swallow impairment compared with healthy controls. Swallow and sensory deficits in PD were correlated with disease severity. Moreover, PD participants reported similar self-rated swallow function as healthy controls, and swallow deficits were correlated with sensory function suggesting an association between impaired sensory function and poor self-awareness of swallow deficits in PD.

CONCLUSIONS

These results suggest that control of swallow is influenced by airway somatosensory function, that swallow-related deficits in PD are related to abnormal somatosensation, and that swallow and airway sensory function may degrade as a function of disease severity. Therefore, the basal ganglia and related neural networks may play an important role to integrate airway sensory input for swallow-related motor control. Furthermore, the airway deficits observed in PD suggest a disintegration of swallow-related sensory and motor control.

Rapid online selection between multiple motor plans

Recent theories of voluntary control predict that multiple motor strategies can be precomputed and expressed throughout movement. We examined online decisional processing in humans by asking them to make reaching movements with obstacles located just to the sides of a direct path between start and end targets. On random trials, the limb was perturbed with one of four mechanical loads that varied in direction and amplitude. Notably, we observed two different strategies when we applied a perturbation (left medium-sized) that deviated the participants' hand directly toward an obstacle. In some trials, subjects directed their hand between the obstacles and in other trials to the left of the obstacles. Importantly, changes in the muscle stretch response between these two strategies were observed in <60 ms after perturbation, during the R2 long-latency epoch (~45-75 ms). As predicted, the selected strategy depended on the estimated position of the limb when it was perturbed. In our second experiment, we presented either one or three potential goal targets. Movements initially directed to the closest target could be quickly redirected to other potential targets after a perturbation. Differences in muscle stretch responses for redirected movements were observed ~75 ms after perturbation during the R3 long-latency epoch (~75-105 ms). The results show that decisional processes are rapidly implemented during movement execution. In addition, our data suggest a hierarchical process with corrective responses on "how" to attain a behavioral goal expressed during the R2 epoch and responses on "what" goal to attain during the R3 epoch.

Operant conditioning of spinal reflexes: from basic science to clinical therapy

New appreciation of the adaptive capabilities of the nervous system, recent recognition that most spinal cord injuries are incomplete, and progress in enabling regeneration are generating growing interest in novel rehabilitation therapies. Here we review the 35-year evolution of one promising new approach, operant conditioning of spinal reflexes. This work began in the late 1970’s as basic science; its purpose was to develop and exploit a uniquely accessible model for studying the acquisition and maintenance of a simple behavior in the mammalian central nervous system (CNS). The model was developed first in monkeys and then in rats, mice, and humans. Studies with it showed that the ostensibly simple behavior (i.e., a larger or smaller reflex) rests on a complex hierarchy of brain and spinal cord plasticity; and current investigations are delineating this plasticity and its interactions with the plasticity that supports other behaviors. In the last decade, the possible therapeutic uses of reflex conditioning have come under study, first in rats and then in humans. The initial results are very exciting, and they are spurring further studies. At the same time, the original basic science purpose and the new clinical purpose are enabling and illuminating each other in unexpected ways. The long course and current state of this work illustrate the practical importance of basic research and the valuable synergy that can develop between basic science questions and clinical needs.

Primary motor cortex of the parkinsonian monkey: altered neuronal responses to muscle stretch

Exaggeration of the long-latency stretch reflex (LLSR) is a characteristic neurophysiologic feature of Parkinson's disease (PD) that contributes to parkinsonian rigidity. To explore one frequently-hypothesized mechanism, we studied the effects of fast muscle stretches on neuronal activity in the macaque primary motor cortex (M1) before and after the induction of parkinsonism by unilateral administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). We compared results from the general population of M1 neurons and two antidromically-identified subpopulations: distant-projecting pyramidal-tract type neurons (PTNs) and intra-telecenphalic-type corticostriatal neurons (CSNs). Rapid rotations of elbow or wrist joints evoked short-latency responses in 62% of arm-related M1 neurons. As in PD, the late electromyographic responses that constitute the LLSR were enhanced following MPTP. This was accompanied by a shortening of M1 neuronal response latencies and a degradation of directional selectivity, but surprisingly, no increase in single unit response magnitudes. The results suggest that parkinsonism alters the timing and specificity of M1 responses to muscle stretch. Observation of an exaggerated LLSR with no change in the magnitude of proprioceptive responses in M1 is consistent with the idea that the increase in LLSR gain that contributes to parkinsonian rigidity is localized to the spinal cord.

Corticomuscular transmission of tremor signals by propriospinal neurons in Parkinson's disease

Cortical oscillatory signals of single and double tremor frequencies act together to cause tremor in the peripheral limbs of patients with Parkinson's disease (PD). But the corticospinal pathway that transmits the tremor signals has not been clarified, and how alternating bursts of antagonistic muscle activations are generated from the cortical oscillatory signals is not well understood. This paper investigates the plausible role of propriospinal neurons (PN) in C3–C4 in transmitting the cortical oscillatory signals to peripheral muscles. Kinematics data and surface electromyogram (EMG) of tremor in forearm were collected from PD patients. A PN network model was constructed based on known neurophysiological connections of PN. The cortical efferent signal of double tremor frequencies were integrated at the PN network, whose outputs drove the muscles of a virtual arm (VA) model to simulate tremor behaviors. The cortical efferent signal of single tremor frequency actuated muscle spindles. By comparing tremor data of PD patients and the results of model simulation, we examined two hypotheses regarding the corticospinal transmission of oscillatory signals in Parkinsonian tremor. Hypothesis I stated that the oscillatory cortical signals were transmitted via the mono-synaptic corticospinal pathways bypassing the PN network. The alternative hypothesis II stated that they were transmitted by way of PN multi-synaptic corticospinal pathway. Simulations indicated that without the PN network, the alternating burst patterns of antagonistic muscle EMGs could not be reliably generated, rejecting the first hypothesis. However, with the PN network, the alternating burst patterns of antagonist EMGs were naturally reproduced under all conditions of cortical oscillations. The results suggest that cortical commands of single and double tremor frequencies are further processed at PN to compute the alternating burst patterns in flexor and extensor muscles, and the neuromuscular dynamics demonstrated a frequency dependent damping on tremor, which may prevent tremor above 8 Hz to occur.

Bilateral impairments in task-dependent modulation of the long-latency stretch reflex following stroke

OBJECTIVE

Modulation of the long-latency reflex (LLR) is important for sensorimotor control during interaction with different mechanical loads. Transcortical pathways usually contribute to LLR modulation, but the integrity of pathways projecting to the paretic and non-paretic arms of stroke survivors is compromised. We hypothesize that disruption of transcortical reflex pathways reduces the capacity for stroke survivors to appropriately regulate the LLR bilaterally.

METHODS

Elbow perturbations were applied to the paretic and non-paretic arms of persons with stroke, and the dominant arm of age-matched controls as subjects interacted with Stiff or Compliant environments rendered by a linear actuator. Reflexes were quantified using surface electromyograms, recorded from biceps.

RESULTS

LLR amplitude was significantly larger during interaction with the Compliant load compared to the Stiff load in controls. However, there was no significant change in LLR amplitude for the paretic or non-paretic arm of stroke survivors.

CONCLUSION

Modulation of the LLR is altered in the paretic and non-paretic arms after stroke.

SIGNIFICANCE

Our results are indicative of bilateral sensorimotor impairments following stroke. The inability to regulate the LLR may contribute to bilateral deficits in tasks that require precise control of limb mechanics and stability.