The difference in cortical activation pattern for complex motor skills: A functional near- infrared spectroscopy study

Lateralization of acquisition and consolidation in direction but not amplitude of a motor skill task

Previous research suggests that the neural processes underlying specification of movement direction and amplitude are independently represented in the nervous system. However, our understanding of acquisition and consolidation processes in the direction and distance learning remains limited. We designed a virtual air hockey task, in which the puck direction is determined by the hand direction at impact, while the puck distance is determined by the amplitude of the velocity. In two versions of this task, participants were required to either specify the direction or the distance of the puck, while the alternate variable did not contribute to task success. Separate groups of right-handed participants were recruited for each task. Each participant was randomly assigned to one of two groups with a counter-balanced arm practice sequence (right to left, or left to right). We examined acquisition and, after 24 h, we examined two aspects of consolidation: 1) same hand performance to test the durability and 2) the opposite hand to test the effector-independent consolidation (interlimb transfer) of learning. The distance task showed symmetry between hands in the extent of acquisition as well as in both aspects of consolidation. In contrast, the direction task showed asymmetry in both acquisition and consolidation: the dominant right arm showed faster and greater acquisition and greater transfer from the opposite arm training. The asymmetric acquisition and consolidation processes shown in the direction task might be explained by lateralized control and mapping of direction, an interpretation consistent with previous findings on motor adaptation paradigms.

Connectivity defines the distinctive anatomy and function of the hand-knob area

Control of the hand muscles during fine digit movements requires a high level of sensorimotor integration, which relies on a complex network of cortical and subcortical hubs. The components of this network have been extensively studied in human and non-human primates, but discrepancies in the findings obtained from different mapping approaches are difficult to interpret. In this study, we defined the cortical and connectional components of the hand motor network in the same cohort of 20 healthy adults and 3 neurosurgical patients. We used multimodal structural magnetic resonance imaging (including T1-weighted imaging and diffusion tractography), as well as functional magnetic resonance imaging and navigated transcranial magnetic stimulation (nTMS). The motor map obtained from nTMS compared favourably with the one obtained from functional magnetic resonance imaging, both of which overlapped well within the 'hand-knob' region of the precentral gyrus and in an adjacent region of the postcentral gyrus. nTMS stimulation of the precentral and postcentral gyri led to motor-evoked potentials in the hand muscles in all participants, with more responses recorded from precentral stimulations. We also observed that precentral stimulations tended to produce motor-evoked potentials with shorter latencies and higher amplitudes than postcentral stimulations. Tractography showed that the region of maximum overlap between terminations of precentral-postcentral U-shaped association fibres and somatosensory projection tracts colocalizes with the functional motor maps. The relationships between the functional maps, and between them and the tract terminations, were replicated in the patient cohort. Three main conclusions can be drawn from our study. First, the hand-knob region is a reliable anatomical landmark for the functional localization of fine digit movements. Second, its distinctive shape is determined by the convergence of highly myelinated long projection fibres and short U-fibres. Third, the unique role of the hand-knob area is explained by its direct action on the spinal motoneurons and the access to high-order somatosensory information for the online control of fine movements. This network is more developed in the hand region compared to other body parts of the homunculus motor strip, and it may represent an important target for enhancing motor learning during early development.

Applications of Functional Near-Infrared Spectroscopy (fNIRS) Neuroimaging During Rehabilitation Following Stroke: A Review

Stroke is a cerebrovascular disease that impairs blood supply to localized brain tissue regions due to various causes. This leads to ischemic and hypoxic lesions, necrosis of the brain tissue, and a variety of functional disorders. Abnormal cortical activation and functional connectivity occur in the brain after a stroke, but the activation patterns and functional reorganization are not well understood. Rehabilitation interventions can enhance functional recovery in stroke patients. However, clinicians require objective measures to support their practice, as outcome measures for functional recovery are based on scale scores. Furthermore, the most effective rehabilitation measures for treating patients are yet to be investigated. Functional near-infrared spectroscopy (fNIRS) is a non-invasive neuroimaging method that detects changes in cerebral hemodynamics during task performance. It is widely used in neurological research and clinical practice due to its safety, portability, high motion tolerance, and low cost. This paper briefly introduces the imaging principle and the advantages and disadvantages of fNIRS to summarize the application of fNIRS in post-stroke rehabilitation.

Use of functional magnetic resonance imaging to identify cortical loci for lower limb movements and their efficacy for individuals after stroke

BACKGROUND

Identification of cortical loci for lower limb movements for stroke rehabilitation is crucial for better rehabilitation outcomes via noninvasive brain stimulation by targeting the fine-grained cortical loci of the movements. However, identification of the cortical loci for lower limb movements using functional MRI (fMRI) is challenging due to head motion and difficulty in isolating different types of movement. Therefore, we developed a custom-made MR-compatible footplate and leg cushion to identify the cortical loci for lower limb movements and conducted multivariate analysis on the fMRI data. We evaluated the validity of the identified loci using both fMRI and behavioral data, obtained from healthy participants as well as individuals after stroke.

METHODS

We recruited 33 healthy participants who performed four different lower limb movements (ankle dorsiflexion, ankle rotation, knee extension, and toe flexion) using our custom-built equipment while fMRI data were acquired. A subgroup of these participants (Dataset 1; n = 21) was used to identify the cortical loci associated with each lower limb movement in the paracentral lobule (PCL) using multivoxel pattern analysis and representational similarity analysis. The identified cortical loci were then evaluated using the remaining healthy participants (Dataset 2; n = 11), for whom the laterality index (LI) was calculated for each lower limb movement using the cortical loci identified for the left and right lower limbs. In addition, we acquired a dataset from 15 individuals with chronic stroke for regression analysis using the LI and the Fugl-Meyer Assessment (FMA) scale.

RESULTS

The cortical loci associated with the lower limb movements were hierarchically organized in the medial wall of the PCL following the cortical homunculus. The LI was clearer using the identified cortical loci than using the PCL. The healthy participants (mean ± standard deviation: 0.12 ± 0.30; range: - 0.63 to 0.91) exhibited a higher contralateral LI than the individuals after stroke (0.07 ± 0.47; - 0.83 to 0.97). The corresponding LI scores for individuals after stroke showed a significant positive correlation with the FMA scale for paretic side movement in ankle dorsiflexion (R2 = 0.33, p = 0.025) and toe flexion (R2 = 0.37, p = 0.016).

CONCLUSIONS

The cortical loci associated with lower limb movements in the PCL identified in healthy participants were validated using independent groups of healthy participants and individuals after stroke. Our findings suggest that these cortical loci may be beneficial for the neurorehabilitation of lower limb movement in individuals after stroke, such as in developing effective rehabilitation interventions guided by the LI scores obtained for neuronal activations calculated from the identified cortical loci across the paretic and non-paretic sides of the brain.

A table tennis serve versus rally hit elicits differential hemispheric electrocortical power fluctuations

Human visuomotor control requires coordinated interhemispheric interactions to exploit the brain's functional lateralization. In right-handed individuals, the left hemisphere (right arm) is better for dynamic control and the right hemisphere (left arm) is better for impedance control. Table tennis is a game that requires precise movements of the paddle, whole body coordination, and cognitive engagement, providing an ecologically valid way to study visuomotor integration. The sport has many different types of strokes (e.g., serve, return, and rally shots), which should provide unique cortical dynamics given differences in the sensorimotor demands. The goal of this study was to determine the hemispheric specialization of table tennis serving - a sequential, self-paced, bimanual maneuver. We used time-frequency analysis, event-related potentials, and functional connectivity measures of source-localized electrocortical clusters and compared serves with other types of shots, which varied in the types of movement required, attentional focus, and other task demands. We found greater alpha (8-12 Hz) and beta (13-30 Hz) power in the right sensorimotor cortex than in the left sensorimotor cortex, and we found a greater magnitude of spectral power fluctuations in the right sensorimotor cortex for serve hits than return or rally hits, in all right-handed participants. Surprisingly, we did not find a difference in interhemispheric functional connectivity between a table tennis serve and return or rally hits, even though a serve could arguably be a more complex maneuver. Studying real-world brain dynamics of table tennis provides insight into bilateral sensorimotor integration.NEW & NOTEWORTHY We found different spectral power fluctuations in the left and right sensorimotor cortices during table tennis serves, returns, and rallies. Our findings contribute to the basic science understanding of hemispheric specialization in a real-world context.

Increased hip flexion gait as an exercise modality for individuals with obesity

PURPOSE

Exercise is a critical element for the management of body weight and improvement of quality of life of individuals with obesity. Due to its convenience and accessibility, running is a commonly used exercise modality to meet exercise guidelines. However, the weight-bearing component during high impacts of this exercise modality might limit the participation in exercise and reduce the effectiveness of running-based exercise interventions in individuals with obesity. The hip flexion feedback system (HFFS) assists participants in meeting specific exercise intensities by giving the participant specific increased hip flexion targets while walking on a treadmill. The resulting activity involves walking with increased hip flexion which removes the high impacts of running. The purpose of this study was to compare physiological and biomechanical parameters during an HFFS session and an independent treadmill walking/running session (IND).

METHODS

Heart rate, oxygen consumption (VO2), heart rate error, and tibia peak positive accelerations (PPA) were investigated for each condition at 40% and 60% of heart rate reserve exercise intensities.

RESULTS

VO2 was higher for IND despite no differences in heart rate. Tibia PPAs were reduced during the HFFS session. Heart rate error was reduced for HFFS during non-steady state exercise.

CONCLUSION

While demanding lower energy consumption compared to running, HFFS exercise results in lower tibia PPAs and more accurate monitoring of exercise intensity. HFFS might be a valid exercise alternative for individuals with obesity or individuals that require low-impact forces at the lower limbs.

AI in Surgical Curriculum Design and Unintended Outcomes for Technical Competencies in Simulation Training

Importance

To better elucidate the role of artificial intelligence (AI) in surgical skills training requires investigations in the potential existence of a hidden curriculum.

Objective

To assess the pedagogical value of AI-selected technical competencies and their extended effects in surgical simulation training.

Design, Setting, and Participants

This cohort study was a follow-up of a randomized clinical trial conducted at the Neurosurgical Simulation and Artificial Intelligence Learning Centre at the Montreal Neurological Institute, McGill University, Montreal, Canada. Surgical performance metrics of medical students exposed to an AI-enhanced training curriculum were compared with a control group of participants who received no feedback and with expert benchmarks. Cross-sectional data were collected from January to April 2021 from medical students and from March 2015 to May 2016 from experts. This follow-up secondary analysis was conducted from June to September 2022. Participants included medical students (undergraduate year 0-2) in the intervention cohorts and neurosurgeons to establish expertise benchmarks.

Exposure

Performance assessment and personalized feedback by an intelligent tutor on 4 AI-selected learning objectives during simulation training.

Main Outcomes and Measures

Outcomes of interest were unintended performance outcomes, measured by significant within-participant difference from baseline in 270 performance metrics in the intervention cohort that was not observed in the control cohort.

Results

A total of 46 medical students (median [range] age, 22 [18-27] years; 27 [59%] women) and 14 surgeons (median [range] age, 45 [35-59] years; 14 [100%] men) were included in this study, and no participant was lost to follow-up. Feedback on 4 AI-selected technical competencies was associated with additional performance change in 32 metrics over the entire procedure and 20 metrics during tumor removal that was not observed in the control group. Participants exposed to the AI-enhanced curriculum demonstrated significant improvement in safety metrics, such as reducing the rate of healthy tissue removal (mean difference, -7.05 × 10-5 [95% CI, -1.09 × 10-4 to -3.14 × 10-5] mm3 per 20 ms; P < .001) and maintaining a focused bimanual control of the operative field (mean difference in maximum instrument divergence, -4.99 [95% CI, -8.48 to -1.49] mm, P = .006) compared with the control group. However, negative unintended effects were also observed. These included a significantly lower velocity and acceleration in the dominant hand (velocity: mean difference, -0.13 [95% CI, -0.17 to -0.09] mm per 20 ms; P < .001; acceleration: mean difference, -2.25 × 10-2 [95% CI, -3.20 × 10-2 to -1.31 × 10-2] mm per 20 ms2; P < .001) and a significant reduction in the rate of tumor removal (mean difference, -4.85 × 10-5 [95% CI, -7.22 × 10-5 to -2.48 × 10-5] mm3 per 20 ms; P < .001) compared with control. These unintended outcomes diverged students' movement and efficiency performance metrics away from the expertise benchmarks.

Conclusions and Relevance

In this cohort study of medical students, an AI-enhanced curriculum for bimanual surgical skills resulted in unintended changes that improved performance in safety but negatively affected some efficiency metrics. Incorporating AI in course design requires ongoing assessment to maintain transparency and foster evidence-based learning objectives.

The assessment of interhemispheric imbalance using functional near-infrared spectroscopic and transcranial magnetic stimulation for predicting motor outcome after stroke

Objective

To investigate changes in interhemispheric imbalance of cortical excitability during motor recovery after stroke and to clarify the relationship between motor function recovery and alterations in interhemispheric imbalance, with the aim to establish more effective neuromodulation strategies.

Methods

Thirty-one patients underwent assessments of resting motor threshold (RMT) using transcranial magnetic stimulation (TMS); the cortical activity of the primary motor cortex (M1), premotor cortex (PMC), and supplementary motor area (SMA) using functional near-infrared spectroscopy (fNIRS); as well as motor function using upper extremity Fugl-Meyer (FMA-UE). The laterality index (LI) of RMT and fNIRS were also calculated. All indicators were measured at baseline(T1) and 1 month later(T2). Correlations between motor function outcome and TMS and fNIRS metrics at baseline were analyzed using bivariate correlation.

Results

All the motor function (FMA-UE1, FMA-UE2, FMA-d2) and LI-RMT (LI-RMT1 and LI-RMT2) had a moderate negative correlation. The higher the corticospinal excitability of the affected hemisphere, the better the motor outcome of the upper extremity, especially in the distal upper extremity (r = -0.366, p = 0.043; r = -0.393, p = 0.029). The greater the activation of the SMA of the unaffected hemisphere, the better the motor outcome, especially in the distal upper extremity (r = -0.356, p = 0.049; r = -0.367, p = 0.042). There was a significant moderate positive correlation observed between LI-RMT2 and LI-SMA1 (r = 0.422, p = 0.018). The improvement in motor function was most significant when both LI-RMT1 and LI-SMA1 were lower. Besides, in patients dominated by unaffected hemisphere corticospinal excitability during motor recovery, LI-(M1 + SMA + PMC)2 exhibited a significant moderate positive association with the proximal upper extremity function 1 month later (r = 0.642, p = 0.007).

Conclusion

The combination of both TMS and fNIRS can infer the prognosis of motor function to some extent. Which can infer the role of both hemispheres in recovery and may contribute to the development of effective individualized neuromodulation strategies.

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).

The interaction between changes of muscle activation and cortical network dynamics during isometric elbow contraction: a sEMG and fNIRS study

Objective: The relationship between muscle activation during motor tasks and cerebral cortical activity remains poorly understood. The aim of this study was to investigate the correlation between brain network connectivity and the non-linear characteristics of muscle activation changes during different levels of isometric contractions. Methods: Twenty-one healthy subjects were recruited and were asked to perform isometric elbow contractions in both dominant and non-dominant sides. Blood oxygen concentrations in brain from functional Near-infrared Spectroscopy (fNIRS) and surface electromyography (sEMG) signals in the biceps brachii (BIC) and triceps brachii (TRI) muscles were recorded simultaneously and compared during 80% and 20% of maximum voluntary contraction (MVC). Functional connectivity, effective connectivity, and graph theory indicators were used to measure information interaction in brain activity during motor tasks. The non-linear characteristics of sEMG signals, fuzzy approximate entropy (fApEn), were used to evaluate the signal complexity changes in motor tasks. Pearson correlation analysis was used to examine the correlation between brain network characteristic values and sEMG parameters under different task conditions. Results: The effective connectivity between brain regions in motor tasks in dominant side was significantly higher than that in non-dominant side under different contractions (p < 0.05). The results of graph theory analysis showed that the clustering coefficient and node-local efficiency of the contralateral motor cortex were significantly varied under different contractions (p < 0.01). fApEn and co-contraction index (CCI) of sEMG under 80% MVC condition were significantly higher than that under 20% MVC condition (p < 0.05). There was a significant positive correlation between the fApEn and the blood oxygen value in the contralateral brain regions in both dominant or non-dominant sides (p < 0.001). The node-local efficiency of the contralateral motor cortex in the dominant side was positively correlated with the fApEn of the EMG signals (p < 0.05). Conclusion: In this study, the mapping relationship between brain network related indicators and non-linear characteristic of sEMG in different motor tasks was verified. These findings provide evidence for further exploration of the interaction between the brain activity and the execution of motor tasks, and the parameters might be useful in evaluation of rehabilitation intervention.

The Development of Left Hemisphere Lateralization for Sentence-Level Prosodic Processing

PURPOSE

The fine-tuning of linguistic prosody in later childhood is poorly understood, and its neurological processing is even less well studied. In particular, it is unknown if grammatical processing of prosody is left- or right-lateralized in childhood versus adulthood and how phonological working memory might modulate such lateralization. Furthermore, it is virtually unknown how prosody develops neurologically among children with cochlear implants (CIs).

METHOD

Normal-hearing (NH) children ages 6-12 years and NH adults ages 18-28 years completed a functional near-infrared spectroscopy neuroimaging task, during which they heard sentence pairs and judged whether the sentences did or did not differ in their overall prosody (declarative, question, with or without narrow focus). Children also completed standard measures of expressive and receptive language.

RESULTS

Age group differences emerged; children exhibited stronger bilateral temporoparietal activity but reduced left frontal activation. Furthermore, children's performance on a nonword repetition test was significantly associated with activation in the left inferior frontal gyrus-an area that was generally more activated in adults than in children.

CONCLUSIONS

The prosody-related findings are generally consistent with prior neurodevelopmental works on sentence comprehension, especially those involving syntax and semantics, which have also noted a developmental shift from bilateral temporal to left inferior frontal regions typically associated with increased sensitivity to sentence structure. The findings thus inform theoretical perspectives on brain and language development and have implications for studying the effects of CIs on neurodevelopmental processes for sentence prosody.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22255996.

Molecular Hydrogen: an Emerging Therapeutic Medical Gas for Brain Disorders

Oxidative stress and neuroinflammation are the main physiopathological changes involved in the initiation and progression of various neurodegenerative disorders or brain injuries. Since the landmark finding reported in 2007 found that hydrogen reduced the levels of peroxynitrite anions and hydroxyl free radicals in ischemic stroke, molecular hydrogen's antioxidative and anti-inflammatory effects have aroused widespread interest. Due to its excellent antioxidant and anti-inflammatory properties, hydrogen therapy via different routes of administration exhibits great therapeutic potential for a wide range of brain disorders, including Alzheimer's disease, neonatal hypoxic-ischemic encephalopathy, depression, anxiety, traumatic brain injury, ischemic stroke, Parkinson's disease, and multiple sclerosis. This paper reviews the routes for hydrogen administration, the effects of hydrogen on the previously mentioned brain disorders, and the primary mechanism underlying hydrogen's neuroprotection. Finally, we discuss hydrogen therapy's remaining issues and challenges in brain disorders. We conclude that understanding the exact molecular target, finding novel routes, and determining the optimal dosage for hydrogen administration is critical for future studies and applications.

Neuroplasticity Following Stroke from a Functional Laterality Perspective: A fNIRS Study

To explore alterations of resting-state functional connectivity (rsFC) in sensorimotor cortex following strokes with left or right hemiplegia considering the lateralization and neuroplasticity. Seventy-three resting-state functional near-infrared spectroscopy (fNIRS) files were selected, including 26 from left hemiplegia (LH), 21 from right hemiplegia (RH) and 26 from normal controls (NC) group. Whole-brain analyses matching the Pearson correlation were used for rsFC calculations. For right-handed normal controls, rsFC of motor components (M1 and M2) in the left hemisphere displayed a prominent intensity in comparison with the right hemisphere (p < 0.05), while for stroke groups, this asymmetry has disappeared. Additionally, RH rather than LH showed stronger rsFC between left S1 and left M1 in contrast to normal controls (p < 0.05), which correlated inversely with motor function (r = - 0.53, p < 0.05). Regarding M1, rsFC within ipsi-lesioned M1 has a negative correlation with motor function of the affected limb (r = - 0.60 for the RH group and - 0.43 for the LH group, p < 0.05). The rsFC within contra-lesioned M1 that innervates the normal side was weakened compared with that of normal controls (p < 0.05). Stronger rsFC of motor components in left hemisphere was confirmed by rs-fNIRS as the "secret of dominance" for the first time, while post-stroke hemiplegia broke this cortical asymmetry. Meanwhile, a statistically strengthened rsFC between left S1 and M1 only in right-hemiplegia group may act as a compensation for the impairment of the dominant side. This research has implications for brain-computer interfaces synchronizing sensory feedback with motor performance and transcranial magnetic regulation for cortical excitability to induce cortical plasticity.

Fronto-parietal cortex activation during walking in patients with Parkinson's disease adopting different postural strategies

Background

Cortical activation patterns in patients with Parkinson's disease (PD) may be influenced by postural strategies, but the underlying neural mechanisms remain unclear. Our aim is to examine the role of the fronto-parietal lobes in patients with PD adopting different postural strategies and the effect of dual task (DT) on fronto-parietal activation.

Methods

Two groups of patients with PD adopting either the posture first strategy (PD-PF) or the posture second strategy (PD-PS) were examined respectively when in the “OFF” state while single-walking task (SW) and DT. Frontal and parietal lobe activity was assessed by functional near infrared spectroscopy (fNIRS) and measuring gait parameters. Linear mixed models were used for analyses.

Results

Patients with PD who adopted PS had greater cortical activation than those who adopted PF, and there was no difference between PF and PS in the behavioral parameters. For oxyhemoglobin levels, the task condition (SW vs. DT) had a main effect in fronto-parietal lobes. Postural strategy (PD-PF vs. PD-PS) a main effect in the left prefrontal cortex (LPFC), left parietal lobe (LPL), and right parietal lobe (RPL) regions. In the task of walking with and without the cognitive task, patients with PD adopting PS had higher activation in the LPL than those adopting PF. In DT, only PD patients who adopted PS had elevated oxyhemoglobin levels in the LPFC, right prefrontal cortex (RPFC), and LPL compared with the SW, whereas patients with PD who adopted PF showed no differences in any region.

Conclusion

Different patterns of fronto-parietal activation exist between PD-PF and PD-PS. This may be because PD-PS require greater cortical functional compensation than those adopting PF.

Effects of different exercise intensities of race-walking on brain functional connectivity as assessed by functional near-infrared spectroscopy

Introduction

Race-walking is a sport that mimics normal walking and running. Previous studies on sports science mainly focused on the cardiovascular and musculoskeletal systems. However, there is still a lack of research on the central nervous system, especially the real-time changes in brain network characteristics during race-walking exercise. This study aimed to use a network perspective to investigate the effects of different exercise intensities on brain functional connectivity.

Materials and methods

A total of 16 right-handed healthy young athletes were recruited as participants in this study. The cerebral cortex concentration of oxyhemoglobin was measured by functional near-infrared spectroscopy in the bilateral prefrontal cortex (PFC), the motor cortex (MC) and occipital cortex (OC) during resting and race-walking states. Three specific periods as time windows corresponding to different exercise intensities were divided from the race-walking time of participants, including initial, intermediate and sprint stages. The brain activation and functional connectivity (FC) were calculated to describe the 0.01-0.1 Hz frequency-specific cortical activities.

Results

Compared to the resting state, FC changes mainly exist between MC and OC in the initial stage, while PFC was involved in FC changes in the intermediate stage, and FC changes in the sprint stage were widely present in PFC, MC and OC. In addition, from the initial-development to the sprint stage, the significant changes in FC were displayed in PFC and MC.

Conclusion

This brain functional connectivity-based study confirmed that hemodynamic changes at different exercise intensities reflected different brain network-specific characteristics. During race-walking exercise, more extensive brain activation might increase information processing speed. Increased exercise intensity could facilitate the integration of neural signals such as proprioception, motor control and motor planning, which may be an important factor for athletes to maintain sustained motor coordination and activity control at high intensity. This study was beneficial to understanding the neural mechanisms of brain networks under different exercise intensities.

A study of dynamic hand orthosis combined with unilateral task-oriented training in subacute stroke: A functional near-infrared spectroscopy case series

Background

Motor dysfunction in the upper extremities after stroke prohibits people with stroke from being independent in daily living. The application of fNIRS to explore brain activity under rehabilitation intervention is a research focus on neurorehabilitation.

Objective

The purpose of this study was to explore, using a grip-release ring motor task, the activated changes of regions of interest and changes in motor function utilizing fNIRS technology and test scales on persons with stroke who received unilateral task-oriented therapy with a hand orthosis in the early subacute stroke period before and after intervention. The study aimed to find a sensitive motor task and region of interest first, then to evaluate the feasibility and mechanism of this rehabilitation method by utilizing fNIRS technology in the next randomized controlled trial.

Methods

In this case series, eight right-handed, right hemiplegia subacute stroke persons (6 males,2 females from age 47 to 72) were enrolled. They received 30 min of unilateral task-oriented therapy without orthosis and 30 min of unilateral task-oriented therapy with orthosis (5 days/week) for 4 weeks. Activated channel numbers and beta values based on oxygenated hemoglobin concentration change using a grip-release ring motor task were estimated with fNIRS. Clinical outcome measures, including grip strength evaluation, action research arm test, and Fugl-Meyer assessment of the arm, were evaluated at the same time.

Results

Individual activation analysis showed that, after intervention, Subjects 1, 2, 6, 7, and 8 had the maximum mean beta value located in the left premotor cortex, while Subjects 4 and 5 had the maximum mean beta value located in the left sensorimotor cortex. The activation analysis of Subject 3 showed the maximum mean beta value located in the right premotor cortex. Deactivations of left sensorimotor cortex, left premotor cortex, and bilateral prefrontal cortex were observed after intervention which were different from other cases. Group activation analysis showed that bilateral cerebral hemispheres were activated in all eight participants, with right hemisphere and right supplementary motor cortex activated dominantly. After the intervention, the activation of bilateral hemispheres decreased but in different brain regions; there was a trend that the activation intensity of left sensorimotor cortex, right premotor cortex, and right prefrontal cortex decreased while activation intensity of left premotor cortex and left prefrontal cortex increased. Each participant demonstrated improvements in all the clinical test scales after intervention.

Conclusions

Left premotor cortex, left sensorimotor cortex, and right supplementary motor cortex may be the primary regions of interest. Grasp-release ring task was not appropriate to achieve our fNIRS research objective and a more sensitive motor task or more sensitive evaluating indicator should be used in further studies.

fNIRS-based adaptive visuomotor task improves sensorimotor cortical activation

OBJECTIVE

Investigating how to promote the functional activation of the central sensorimotor system is an important goal in the neurorehabilitation research domain. We aim to validate the effectiveness of facilitating cortical excitability using a closed-loop visuomotor task, in which the task difficulty is adaptively adjusted based on an individual's sensorimotor cortical activation.

APPROACH

We developed a novel visuomotor task, in which subjects moved a handle of a haptic device along a specific path while exerting a constant force against a virtual surface under visual feedback. The difficulty levels of the task were adapted with the aim of increasing the activation of sensorimotor areas, measured non-invasively by functional near-infrared spectroscopy. The changes in brain activation of the bilateral prefrontal cortex, sensorimotor cortex, and the occipital cortex obtained during the adaptive visuomotor task (adaptive group), were compared to the brain activation pattern elicited by the same duration of task with random difficulties in a control group.

MAIN RESULTS

During one intervention session, the adaptive group showed significantly increased activation in the bilateral sensorimotor cortex, also enhanced effective connectivity between the prefrontal and sensorimotor areas compared to the control group.

SIGNIFICANCE

Our findings demonstrated that the fNIRS-based adaptive visuomotor task with high ecological validity can facilitate the neural activity in sensorimotor areas and thus has the potential to improve hand motor functions.

Nondominant Hand Skills Spatial and Psychomotor Analysis During a Complex Virtual Reality Neurosurgical Task-A Case Series Study

BACKGROUND

Virtual reality surgical simulators provide detailed psychomotor performance data, allowing qualitative and quantitative assessment of hand function. The nondominant hand plays an essential role in neurosurgery in exposing the operative area, assisting the dominant hand to optimize task execution, and hemostasis. Outlining expert-level nondominant hand skills may be critical to understand surgical expertise and aid learner training.

OBJECTIVE

To (1) provide validity for the simulated bimanual subpial tumor resection task and (2) to use this simulation in qualitative and quantitative evaluation of nondominant hand skills for bipolar forceps utilization.

METHODS

In this case series study, 45 right-handed participants performed a simulated subpial tumor resection using simulated bipolar forceps in the nondominant hand for assisting the surgery and hemostasis. A 10-item questionnaire was used to assess task validity. The nondominant hand skills across 4 expertise levels (neurosurgeons, senior trainees, junior trainees, and medical students) were analyzed by 2 visual models and performance metrics.

RESULTS

Neurosurgeon median (range) overall satisfaction with the simulated scenario was 4.0/5.0 (2.0-5.0). The visual models demonstrated a decrease in high force application areas on pial surface with increased expertise level. Bipolar-pia mater interactions were more focused around the tumoral region for neurosurgeons and senior trainees. These groups spent more time using the bipolar while interacting with pia. All groups spent significantly higher time in the left upper pial quadrant than other quadrants.

CONCLUSION

This work introduces new approaches for the evaluation of nondominant hand skills which may help surgical trainees by providing both qualitative and quantitative feedback.

Searching for the Mechanism of Action of Extremely Low Frequency Electromagnetic Field-The Pilot fNIRS Research

There is an ongoing debate on the benefits of magnetic stimulation in neurological disorders. Objectives: We aimed to evaluate the influence of magnetic stimulation on blood oxygenation of the motor cortex using functional near-infrared spectroscopy (fNIRS). Methods: A total of 16 healthy volunteer participants were subjected to four protocols. In the first two protocols, the participants remained at rest without (and then with) magnetic stimulation. In the next two protocols, motor cortex stimulation was achieved using a finger-tapping task, with and without magnetic stimulation. Changes in blood oxygenation levels within the motor cortex were recorded and analysed. Results: No characteristic changes in the blood oxygenation level-dependent responses were observed in resting participants after magnetic stimulation. No statistically significant difference was observed in the amplitude of the fNIRS signal before and after magnetic stimulation. We observed characteristic blood oxygenation level-dependent responses after the finger-tapping task in the second protocol, but not after magnetic stimulation. Conclusions: Although we did not observe any measurable effect of the magnetic field on the haemodynamic response of the motor cortex, understanding the mechanism(s) of magnetic stimulation may be important. Additional, detailed studies are needed to prove or negate the potential of this medical procedure.

Age-Related Changes in Functional Connectivity during the Sensorimotor Integration Detected by Artificial Neural Network

Large-scale functional connectivity is an important indicator of the brain’s normal functioning. The abnormalities in the connectivity pattern can be used as a diagnostic tool to detect various neurological disorders. The present paper describes the functional connectivity assessment based on artificial intelligence to reveal age-related changes in neural response in a simple motor execution task. Twenty subjects of two age groups performed repetitive motor tasks on command, while the whole-scalp EEG was recorded. We applied the model based on the feed-forward multilayer perceptron to detect functional relationships between five groups of sensors located over the frontal, parietal, left, right, and middle motor cortex. Functional dependence was evaluated with the predicted and original time series coefficient of determination. Then, we applied statistical analysis to highlight the significant features of the functional connectivity network assessed by our model. Our findings revealed the connectivity pattern is consistent with modern ideas of the healthy aging effect on neural activation. Elderly adults demonstrate a pronounced activation of the whole-brain theta-band network and decreased activation of frontal–parietal and motor areas of the mu-band. Between-subject analysis revealed a strengthening of inter-areal task-relevant links in elderly adults. These findings can be interpreted as an increased cognitive demand in elderly adults to perform simple motor tasks with the dominant hand, induced by age-related working memory decline.

fMRI-based validation of continuous-wave fNIRS of supplementary motor area activation during motor execution and motor imagery

Compared to functional magnetic resonance imaging (fMRI), functional near infrared spectroscopy (fNIRS) has several advantages that make it particularly interesting for neurofeedback (NFB). A pre-requisite for NFB applications is that with fNIRS, signals from the brain region of interest can be measured. This study focused on the supplementary motor area (SMA). Healthy older participants (N = 16) completed separate continuous-wave (CW-) fNIRS and (f)MRI sessions. Data were collected for executed and imagined hand movements (motor imagery, MI), and for MI of whole body movements. Individual anatomical data were used to (i) define the regions of interest for fMRI analysis, to (ii) extract the fMRI BOLD response from the cortical regions corresponding to the fNIRS channels, and (iii) to select fNIRS channels. Concentration changes in oxygenated ([Formula: see text]) and deoxygenated ([Formula: see text]) hemoglobin were considered in the analyses. Results revealed subtle differences between the different MI tasks, indicating that for whole body MI movements as well as for MI of hand movements [Formula: see text] is the more specific signal. Selection of the fNIRS channel set based on individual anatomy did not improve the results. Overall, the study indicates that in terms of spatial specificity and task sensitivity SMA activation can be reliably measured with CW-fNIRS.

What does hand motor function tell us about our aging brain in association with WMH?

Background

White matter hyperintensities (WMH) are a common cerebral finding in older people. WMH are usually asymptomatic, but excessive WMH are associated with cognitive decline and dementia. WMH are also among the neurological findings most consistently associated with declining motor performance in healthy ageing.

Aims

To determine if WMH load is associated with simple and complex motor movements in dominant and non-dominant hands in cognitively intact older subjects.

Methods

Hand motor performance was assessed with the Purdue Pegboard and Finger-tapping tests on 44 healthy right-handed participants, mean age 70.9 years (range 59–84 years). Participants also underwent magnetic resonance (MR) imaging, which were used to quantify WMH volume. The effect of WMH on the motor parameters was assessed via mediation analyses.

Results

WMH load increased significantly with age, while the motor scores decreased significantly with age. WMH load mediated only the relationship between age and left-hand pegboard scores.

Discussion

WMH mediated only the more complex Purdue Pegboard task for the non-dominant hand. This is likely because complex movements in the non-dominant hand recruit a larger cerebral network, which is more vulnerable to WMH.

Conclusions

Complex hand movements in the non-dominant hand are mediated by WMH. Subtle loss of motor movements of non-dominant hand might predict future excessive white matter atrophy.

Effect of force accuracy on hemodynamic response: an fNIRS study using fine visuomotor task

Objective. Despite converging neuroimaging studies investigating how neural activity is modulated by various motor related factors, such as movement velocity and force magnitude, little has been devoted to identifying the effect of force accuracy. This study thus aimed to investigate the effect of task difficulty on cortical neural responses when participants performed a visuomotor task with varying demands on force accuracy.Approach. Fourteen healthy adults performed a set of force generation operations with six levels of force accuracy. The participants held a pen-shaped tool and moved the tool along a planar ring path, meanwhile producing a constant force against the plane under visual guidance. The required force accuracy was modulated by allowable tolerance of the force during the task execution. We employed functional near-infrared spectroscopy to record signals from bilateral prefrontal, sensorimotor and occipital areas, used the hemoglobin concentration as indicators of cortical activation, then calculated the effective connectivity across these regions by Granger causality.Main results.We observed overall stronger activation (oxy-hemoglobin concentration,p= 0.015) and connectivity (p< 0.05) associated with the initial increase in force accuracy, and the diminished trend in activation and connectivity when participants were exposed to excessive demands on accurate force generation. These findings suggested that the increasing task difficulty would be only beneficial for the mental investment up to a certain point, and above that point neural responses would show patterns of lower activation and connections, revealing mental overload at excessive task demands.Significance.Our results provide the first evidence for the inverted U-shaped effect of force accuracy on hemodynamic responses during fine visuomotor tasks. The insights obtained through this study also highlight the essential role of inter-region connectivity alterations for coping with task difficulty, enhance our understanding of the underlying motor neural processes, and provide the groundwork for developing adaptive neurorehabilitation strategies.

Cortical hemodynamic mapping of subthalamic nucleus deep brain stimulation in Parkinsonian patients, using high-density functional near-infrared spectroscopy

Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for idiopathic Parkinson's disease. Despite recent progress, the mechanisms responsible for the technique's effectiveness have yet to be fully elucidated. The purpose of the present study was to gain new insights into the interactions between STN-DBS and cortical network activity. We therefore combined high-resolution functional near-infrared spectroscopy with low-resolution electroencephalography in seven Parkinsonian patients on STN-DBS, and measured cortical haemodynamic changes at rest and during hand movement in the presence and absence of stimulation (the ON-stim and OFF-stim conditions, respectively) in the off-drug condition. The relative changes in oxyhaemoglobin [HbO], deoxyhaemoglobin [HbR], and total haemoglobin [HbT] levels were analyzed continuously. At rest, the [HbO], [HbR], and [HbT] over the bilateral sensorimotor (SM), premotor (PM) and dorsolateral prefrontal (DLPF) cortices decreased steadily throughout the duration of stimulation, relative to the OFF-stim condition. During hand movement in the OFF-stim condition, [HbO] increased and [HbR] decreased concomitantly over the contralateral SM cortex (as a result of neurovascular coupling), and [HbO], [HbR], and [HbT] increased concomitantly in the dorsolateral prefrontal cortex (DLPFC)-suggesting an increase in blood volume in this brain area. During hand movement with STN-DBS, the increase in [HbO] was over the contralateral SM and PM cortices was significantly lower than in the OFF-stim condition, as was the decrease in [HbO] and [HbT] in the DLPFC. Our results indicate that STN-DBS is associated with a reduction in blood volume over the SM, PM and DLPF cortices, regardless of whether or not the patient is performing a task. This particular effect on cortical networks might explain not only STN-DBS's clinical effectiveness but also some of the associated adverse effects.

Chopstick operation training with the left non-dominant hand

Background

Training a non-dominant hand is important for rehabilitating people who are required to change handedness. However, improving the dexterity in using chopsticks with a non-dominant hand through training remains unclear. This study is aimed to measure whether chopstick training improves non-dominant hand chopstick operation skills and leads to acquisition of skill levels similar to those of the dominant hand.

Methods

This single-blinded randomized controlled trial enrolled 34 healthy young right-handed subjects who scored >70 points on the Edinburgh Handedness Questionnaire Inventory. They were randomly allocated to training or control groups. The training group participated in a 6-week chopstick training program with the non-dominant left hand, while the control group did not. Asymmetry of chopstick operation skill, perceived psychological stress, and oxygen-hemoglobin concentration as a brain activity measure in each hemisphere were measured before and after training.

Results

Participants in the training group had significantly lower asymmetry than those in the control group during the post-training assessment (F[1,30] ≥ 5.54, p ≤ 0.03, partial η² ≥ 0.156). Only perceived psychological stress had a significantly higher asymmetry during the post-training assessment (t[15] = 3.81, p < 0.01).

Conclusion

Six weeks of chopstick training improved non-dominant chopstick operation skills, and a performance level similar to that of the dominant hand was acquired.

What is the significance of the traditional pinching mode of holding chopsticks?

Background

The purpose of this study was to clarify the influence of manipulation mode of chopsticks on the learning process, using assessment of task performance and electromyography, and to understand the significance of the traditional manipulation mode from the viewpoint of physiological anthropology. Previous studies have described two modes of manipulating chopsticks, the traditional pincers-pinching mode and the scissors-pinching mode.

Methods

We conducted experiments with two conditions of holding chopsticks: scissors mode and pincers mode. Eight subjects participated and were assigned to these modes, and they learned handling tasks in their assigned mode for 5 days with the non-dominant hand. We measured task execution times and conducted electromyography of the following muscles: first dorsalis interosseus, flexor pollicis brevis, flexor digiti minimi brevis, flexor digitorum superficialis, and extensor digitorum.

Results

The training effects were found in each mode. The pincers mode showed significantly shorter task performance times than did scissors mode. On electromyography, significant increases in activity of flexor digiti minimi brevis and tended an increase in flexor digitorum superficialis and a decrease in extensor digitorum occurred in pincers mode but not in scissors mode.

Conclusions

The traditional mode of holding chopsticks was associated with not only high task performance but also an advantage in terms of learning motor control.

Characterizing hemodynamic response alterations during basketball dribbling

Knowledge on neural processing during complex non-stationary motion sequences of sport-specific movements still remains elusive. Hence, we aimed at investigating hemodynamic response alterations during a basketball slalom dribbling task (BSDT) using multi-distance functional near-infrared spectroscopy (fNIRS) in 23 participants (12 females). Additionally, we quantified how the brain adapts its processing as a function of altered hand use (dominant right hand (DH) vs. non-dominant left hand (NDH) vs. alternating hands (AH)) and pace of execution (slow vs. fast) in BSDT. We found that BSDT activated bilateral premotor cortex (PMC), supplementary motor cortex (SMA), primary motor cortex (M1) as well as inferior parietal cortex and somatosensory association cortex. Slow dominant hand dribbling (DH_slow) evoked lower contralateral hemodynamic responses in sensorimotor regions compared to fast dribbling (DH_fast). Furthermore, during DH_slow dribbling, we found lower hemodynamic responses in ipsilateral M1 as compared to dribbling with alternating hands (AH_slow). Hence, altered task complexity during BSDT induced differential hemodynamic response patterns. Furthermore, a correlation analysis revealed that lower levels of perceived task complexity are associated with lower hemodynamic responses in ipsilateral PMC-SMA, which is an indicator for neuronal efficiency in participants with better basketball dribbling skills. The present study extends previous findings by showing that varying levels of task complexity are reflected by specific hemodynamic response alterations even during sports-relevant motor behavior. Taken together, we suggest that quantifying brain activation during complex movements is a prerequisite for assessing brain-behavior relations and optimizing motor performance.

Identifying Resting-State Functional Connectivity Changes in the Motor Cortex Using fNIRS During Recovery from Stroke

Resting-state functional imaging has been used to study the functional reorganization of the brain. The application of functional near-infrared spectroscopy (fNIRS) to assess resting-state functional connectivity (rsFC) has already been demonstrated in recent years. The present study aimed to identify the difference in rsFC patterns during the recovery from the upper-limb deficit due to stroke. Twenty patients with mild stroke having an onset of four to eight weeks were recruited from the stroke clinic of our institute and an equal number of healthy volunteers were included in the study after ethical committee approval. The fNIRS signals were recorded bilaterally over the premotor area and supplementary motor area and over the primary motor cortex. Pearson Correlation is the method used to compute rsFC for the healthy group and patient group. For the healthy group, both intra-hemispheric and inter-hemispheric connections were stronger. RSFC analysis demonstrated changes from the healthy pattern for the patient group with an upper-limb deficit. The left hemisphere affected group showed disrupted ipsilesional and an increased contra-lesional connectivity. The longitudinal data analysis of rsFC showed improvement in the connections in the ipsilesional hemisphere between the primary motor area, somatosensory area, and premotor areas. In the future, the rsFC changes during the recovery could be used to predict the extent of recovery from stroke motor deficits.

Brain-Based Binary Communication Using Spatiotemporal Features of fNIRS Responses

“Locked-in” patients lose their ability to communicate naturally due to motor system dysfunction. Brain-computer interfacing offers a solution for their inability to communicate by enabling motor-independent communication. Straightforward and convenient in-session communication is essential in clinical environments. The present study introduces a functional near-infrared spectroscopy (fNIRS)-based binary communication paradigm that requires limited preparation time and merely nine optodes. Eighteen healthy participants performed two mental imagery tasks, mental drawing and spatial navigation, to answer yes/no questions during one of two auditorily cued time windows. Each of the six questions was answered five times, resulting in five trials per answer. This communication paradigm thus combines both spatial (two different mental imagery tasks, here mental drawing for “yes” and spatial navigation for “no”) and temporal (distinct time windows for encoding a “yes” and “no” answer) fNIRS signal features for information encoding. Participants’ answers were decoded in simulated real-time using general linear model analysis. Joint analysis of all five encoding trials resulted in an average accuracy of 66.67 and 58.33% using the oxygenated (HbO) and deoxygenated (HbR) hemoglobin signal respectively. For half of the participants, an accuracy of 83.33% or higher was reached using either the HbO signal or the HbR signal. For four participants, effective communication with 100% accuracy was achieved using either the HbO or HbR signal. An explorative analysis investigated the differentiability of the two mental tasks based solely on spatial fNIRS signal features. Using multivariate pattern analysis (MVPA) group single-trial accuracies of 58.33% (using 20 training trials per task) and 60.56% (using 40 training trials per task) could be obtained. Combining the five trials per run using a majority voting approach heightened these MVPA accuracies to 62.04 and 75%. Additionally, an fNIRS suitability questionnaire capturing participants’ physical features was administered to explore its predictive value for evaluating general data quality. Obtained questionnaire scores correlated significantly (r = -0.499) with the signal-to-noise of the raw light intensities. While more work is needed to further increase decoding accuracy, this study shows the potential of answer encoding using spatiotemporal fNIRS signal features or spatial fNIRS signal features only.